ACBS Data Submission Layout - adult

Attachment 5g. Data Submission Layout BRFSS Asthma Survey – Adult Questionnaire “2020”

Field Size	Columns	Description of Field and SAS Variable Name	Comments and Values
2	1-2	State FIPS Code (_STATE)	As supplied by GENESYS on sample record.
6	3-8	Replicate Number (REPNUM)
2	9-10	File Month (FMONTH_f)
8	11-18	Interview Date (IDATE) MMDDYYYY	Date of original BRFSS interview.
2	19-20	Interview Month (IMONTH_f)	Month of follow-up
2	21-22	Interview Day (IDAY_f)	Day of follow-up
4	23-26	Interview Year (IYEAR_f)	Year of follow-up
5	27-31	Interviewer Id (INTVID_f)	Interviewer Id of follow-up
4	32-35	Final Disposition(DISPCODE_f)	Disposition code of follow-up
10	36-45	Annual Sequence Number (SEQNO)	As supplied by GENESYS on sample record. Value should be unique for a state within a year.
2	46-47	Number of Attempts (NATTMPTS_f)	Number of attempts of follow-up.

CDC estimates the average public reporting burden for this collection of information as 155 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (No. 0920-1204, Exp. Date 11/30/2020).

Form Approved

OMB Control No. 0920-1204

Exp. Date 11/30/2020

Section 1. Introduction
1	48		Q1.1 Are you {sample person’s first name or initials}? (Samp_name)		1 = Yes 2 = No
SKIP Q1.2, if Section 01, Q1.1 is coded 1
1	49		Q1.2 May I speak with {sample person first name or initials}? (Samp_pers)		1 = Yes 2 = No
			Q1.3 Enter time/date for return call
Section 2. Informed Consent
1	50	Q2.0 Check if correct person from core survey is on phone. Ask “is this {sample person’s name} and are you {sample person’s age} years old. If yes, continue. If not the correct respondent, ask to speak to that person, and start over at section 1. Keep a disposition code for this, (Repeat) I would like to repeat the questions from the previous survey now to make sure you qualify for this study.			1 = Yes , Correct 2 = No, Not the Correct Person
1	51	Q2.1 Have you ever been told by a doctor or other health professional that you have asthma? (EVER_ASTH)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	52	Q2.2 Do you still have asthma? (CUR_ASTH)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	53	Q2.3 May we combine your answers to this survey with your answers from the survey you did a few weeks ago? (PERMISS)			1 = Yes (Skip to Question 3) 2 = No (Go to Terminate) 7 = Don’t know/Not sure (Go to Terminate) 9 = Refused (Go to Terminate)
Section 3. Recent History
3	54-56	Q3.1 How old were you when you were first told by a doctor or other health professional that you had asthma? (AGEDX)			___ Enter Age in Years [Range check: 001-115, 777, 888, 999] 888 = Under one year old 777 = Don’t know 999 = Refused
1	57	Q3.2 How long ago was that? Was it ..” READ CATEGORIES (INCIDNT)			1 = Within the past 12 months 2 = 1-5 years ago 3 = more than 5 yrs ago 7 = Don’t know 9 = Refused .ac.uk
2	58-59	Q3.3 How long has it been since you last talked to a doctor or other health professional about your asthma? This could have been in your doctor’s office, the hospital, an emergency room or urgent care center. (LAST_MD)			88 = Never 04 = Within the past year 05 = 1yr to less than 3 yrs ago 06 = 3 yrs to 5 yrs ago 07 = More than 5 yrs ago 77 = Don’t know 99 = Refused
2	60-61	Q3.4 How long has it been since you last took asthma medication? (LAST_MED)			88 = Never 01 = Less than 1 day ago 02 = 1-6 days ago 03 = 1 week to less than 3 months ago 04 = 3 months to less than 1 year ago 05 = 1 year to less than 3 years ago 06 = 3 years to 5 years ago 07 = More than 5 yrs ago 77 = Don’t know 99 = Refused
2	62-63	Q3.5 How long has it been since you last had any symptoms of asthma? (LASTSYMP)			88 = Never 01 = Less than 1 day ago 02 = 1-6 days ago 03 = 1 week to less than 3 months ago 04 = 3 months to less than 1 year ago 05 = 1 year to less than 3 years ago 06 = 3 years to 5 years ago 07 = More than 5 yrs ago 77 = Don’t know 99 = Refused
Section 4. History of Asthma (Symptoms & Episodes in past year)
2	64-65	Q4.1 During the past 30 days, on how many days did you have any symptoms of asthma? (SYMP_30D)			__ Days [Range Check: (01-30, 77, 88, 99)] 88 = No symptoms in the past 30 days 30 = Everyday 77 = Don’t know 99 = Refused
1	66	Q4.2 Do you have symptoms all the time? "All the time” means symptoms that continue throughout the day. It does not mean symptoms for a little while each day. (DUR_30D)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
2	67-68	Q4.3 During the past 30 days, on how many days did symptoms of asthma make it difficult for you to stay asleep? (ASLEEP30)			__ Days/Nights [Range check: (01-30, 77, 88, 99)] 88 = None 30 = Everyday 77 = Don’t know 99 = Refused
2	69-70	If LASTSYMP = 88 (never) or = 04, 05, 06, or 07 (more than 3 months ago) then have CATI code SYMPFREE = 14 If SYMP_30D = 88 (no symptoms in the past 30 days) then have CATI code SYMPFREE = 14 Q4.4 During the past two weeks, on how many days were you completely symptom-free, that is no coughing, wheezing, or other symptoms of asthma? (SYMPFREE)			__ Days/Nights [Range check: (01-14, 77, 88, 99)] 88 = None 77 = Don’t know 99 = Refused
1	71	If last symptoms was 3 months to 1 year ago (LASTSYMP = 4) pick up here, symptoms within the past 3 months continue here as well READ: Asthma attacks, sometimes called episodes, refer to periods of worsening asthma symptoms that make you limit your activity more than you usually do, or make you seek medical care. Q4.5 During the past 12 months, have you had an episode of asthma or an asthma attack? (EPIS_12M)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
3	72-74	Q4.6 During the past three months, how many asthma episodes or attacks have you had? (EPIS_TP) [cati cHECK: iF RESPONSE = 77, 88, 99 VERIFY THAT 777, 888 AND 999 WERE NOT THE INTENT]			___ [Range check : (001- 100, 777, 888, 999)] 888 = None 777 = Don’t know 999 = Refused
3	75-77	Q4.7 How long did your most recent asthma episode or attack last? (DUR_ASTH)			1_ _ Minutes 2_ _ Hours 3_ _ Days 4_ _ Weeks 555 Never 777 Don’t know / Not sure 999 Refused
1	78	Q4.8 Compared with other episodes or attacks, was this most recent attack shorter, longer, or about the same? (COMPASTH)			1 = Shorter 2 = Longer 3 = About the same 4 = The Most recent attack was actually the first attack 7 = Don’t know 9 = Refused
		Section 5 Health Care Utilization
1	79	Q5.01 Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare or Medicaid? (INS1)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	80	Q5.02 During the past 12 months was there any time that you did not have any health insurance or coverage? (INS2)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
3	81-83	Q5.1 During the past 12 months how many times did you see a doctor or other health professional for a routine checkup for your asthma? (NER_TIME) [cati cHECK: iF RESPONSE = 77, 88, 99 VERIFY THAT 777, 888 or 999 WERE NOT THE INTENT]			__ [Range check : (001-365, 777, 888, 999)] 888 = None 777 = Don’t know 999 = Refused
1	84	Q5.2 An urgent care center treats people with illnesses or injuries that must be addressed immediately and cannot wait for a regular medical appointment. During the past 12 months, have you had to visit an emergency room or urgent care center because of your asthma? (ER_VISIT)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
3	85-87	Q5.3 During the past 12 months, how many times did you visit an emergency room or urgent care center because of your asthma? (ER_TIMES) [cati cHECK: iF RESPONSE = 77, 88, 99 VERIFY THAT 777, 888 or 999 WERE NOT THE INTENT			___ Enter Number [Range check : (001-365, 777, 888, 999)] 888 = None 777 = Don’t know 999 = Refused
3	88-90	[IF ONE OR MORE ER VISITS (ER_TIMES (5.3)) INSERT “Besides those emergency room or urgent care center visits,”] Q5.4 During the past 12 months, how many times did you see a doctor or other health professional for urgent treatment of worsening asthma symptoms or for an asthma episode or attack? (URG_TIME) [cati cHECK: iF RESPONSE = 77, 88, 99 VERIFY THAT 777, 888 or 999 WERE NOT THE INTENT]			___ Enter Number [Range check : (001-365, 777, 888, 999)] 888 = None 777 = Don’t know 999 = Refused
1	91	Q5.5 During the past 12 months, that is since [1 YEAR AGO TODAY], have you had to stay overnight in a hospital because of your asthma? Do not include an overnight stay in the emergency room. (HOSP_VST)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
3	92-94	Q5.6A During the past 12 months, how many different times did you stay in any hospital overnight or longer because of your asthma? (HOSPTIME) [cati cHECK: iF RESPONSE = 77, 99 VERIFY THAT 777 or 999 WERE NOT THE INTENT			___ Times [Range check : (001-365, 777, 999)] 777 = Don’t know 999 = Refused
1	95	Q5.7 The last time you left the hospital, did a health professional talk with you about how to prevent serious attacks in the future? (HOSPPLAN)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
3	96-98	Q5.8A During the past 12 months, how many days were you unable to work or carry out your usual activities because of your asthma? (MISS_DAY) [cati cHECK: iF RESPONSE = 77, 88, 99 VERIFY THAT 777, 888 or 999 WERE NOT THE INTENT			___ Enter Days [Range check : (001-365, 777, 888, 999)] 888 = Zero 777 = Don’t know 999 = Refused
1	99	Q5.9 During just the past 30 days would you say you limited your usual activities due to asthma not at all, a little, a moderate amount, or a lot? Change 1/2012 (ACT_DAYS30)			1 = Not at All 2 = A Little 3 = A Moderate Amount 4 = A Lot 7 = Don’t know 9 = Refused
Section 6. Knowledge of Asthma/Management Plan
1	100	Has a doctor or other health professional ever taught you ... Q6.1a How to recognize early signs or symptoms of an asthma episode? (TCH_SIGN)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	101	Has a doctor or other health professional ever taught you ... Q6.2b What to do during an asthma episode or attack? (TCH_RESP)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	102	A peak flow meter is a hand held device that measures how quickly you can blow air out of your lungs. Has a doctor or other health professional ever taught you … Q6.3c How to use a peak flow meter to adjust your daily medications? (TCH_MON)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	103	An asthma action plan, or asthma management plan, is a form with instructions about when to change the amount or type of medicine, when to call the doctor for advice, and when to go to the emergency room. Q6.4 Has a doctor or other health professional EVER given you an asthma action plan? (MGT_PLAN)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	104	Q6.5 Have you ever taken a course or class on how to manage your asthma? (MGT_CLAS)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
Section 7. Modifications to Environment
1	105	An air cleaner or air purifier can filter out pollutants like dust, mold and chemicals. It can be attached to the furnace or free standing. It is not, however, the same as a normal furnace filter. Q7.1 Is an air cleaner or purifier regularly used inside your home? (AIRCLEANER)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	106	Q7.2 Is a dehumidifier regularly used to reduce moisture inside your home? (DEHUMID)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	107	Q7.3 Is an exhaust fan that vents to the outside used regularly when cooking in your kitchen? (KITC_FAN)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	108	Q7.4 Is gas used for cooking? (COOK_GAS)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	109	Q7.5 In the past 30 days, has anyone seen or smelled mold or a musty odor inside your home? Do not include mold on food. (ENV_MOLD)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	110	Q7.6 Does your household have pets such as dogs, cats, hamsters, birds or other feathered or furry pets that spend time indoors? (ENV_PETS)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	111	Q7.7 Are pets allowed in your bedroom? (PETBEDRM)			1 = Yes 2 = No 3 = Some are/Some aren’t 7 = Don’t know/Not sure 9 = Refused
1	112	Q7.8 In the past 30 days, has anyone seen a cockroach inside your home? (C_ROACH)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	113	Q7.9 In the past 30 days, has anyone seen mice or rats inside your home? Do not include mice or rats kept as pets. (C_RODENT)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	114	Q7.10 Is a wood burning fireplace or wood burning stove used in your home? (WOOD_STOVE)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	115	Q7.11 Are unvented gas logs, unvented gas fireplace, or unvented gas stove used in your home? (GAS_STOVE)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	116	Q7.12 In the past week, has anyone smoked inside your home? (S_INSIDE)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	117	Q7.13 Has a health professional ever advised you to change things in your home, school, or work to improve your asthma? (MOD_ENV)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	118	Q7.14 Do you use a mattress cover that is made especially for controlling dust mites? (MATTRESS)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	119	Q7.15 Do you use a pillow cover that is made especially for controlling dust mites? (E_PILLOW)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	120	Q7.16 Do you have carpeting or rugs in your bedroom? This does not include throw rugs small enough to be laundered. (CARPET)			1 = Yes 2 = No 7 = Don’t know/Not sure 9 = Refused
1	121	Q7.17 Are your sheets and pillowcases washed in cold, warm, or hot water? (HOTWATER)			1 = Cold 2 = Warm 3 = Hot 4 = Varies 7 = Don’t know/Not sure 9 = Refused
1	122	Q7.18 In your bathroom, do you regularly use an exhaust fan that vents to the outside? (BATH_FAN)			1 = Yes 2 = No or “No Fan” 7 = Don’t know/Not sure 9 = Refused
Section 8. Medications
1	123	The next set of questions is about medications for asthma. The first few questions are very general, but later questions are very specific to your medication use. Q8.1 Over-the-counter medication can be bought without a doctor’s order. Have you ever used over-the-counter medication for your asthma? (OTC)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	124	Q8.2 Have you ever used a prescription inhaler? (INHALERE)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	125	Q8.3 Did a doctor or other health professional show you how to use the inhaler? (INHALERH)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	126	Q8.4 Did a doctor or other health professional watch you use the inhaler? (INHALERW)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	127	[IF LAST_MED = 88, 4, 5, 6, 7, 77, or 99, SKIP TO SECTION 9] Now I am going to ask questions about specific prescription medications you may have taken for asthma in the past 3 months. I will be asking for the names, amount, and how often you take each medicine. I will ask separately about medication taken in various forms: pill or syrup, inhaler, and Nebulizer. Q8.5 It will help to get your medicines so you can read the labels. (SCR_MED1)			1 = Yes 2 = No 3 = Respondent knows the Meds 7 = Don’t know 9 = Refused
1	128	Q8.7 Do you have all the medications? (SCR_MED3)			1 = Yes, I have all the medications 2 = Yes, I have some of the medications but not all 3 = No 7 = Don’t know 9 = Refused
1	129	Q8.8 In the past 3 months have you taken prescription asthma medicine using an inhaler? (INH_SCR)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
16	130-145	Q8.9 In the past 3 months, what prescription asthma medications did you take by inhaler? [MARK ALL THAT APPLY. PROBE: Any other prescription asthma inhaler medications?] (INH_MEDS) (Limit=8 Inhaler Meds.)
		SPELL THE NAME OF THE MEDICATION.] Note: the yellow numbered items below are new medications added in 2008. Also, CATI programmers, note that the top ten items (in bold below) should be highlighted in the CATI system if possible so they can be found more easily.
	Medication			Pronunciation
01	Advair (+ A. Diskus)			ăd-vâr (or add-vair)
02	Aerobid			â-rō'bĭd (or air-row-bid)
03	Albuterol ( + A. sulfate or salbutamol)			ăl'-bu'ter-ōl (or al-BYOO-ter-ole) săl-byū'tə-môl'
04	Alupent			al-u-pent
43	Alvesco (+ Ciclesonide)			al-ves-co
40	Asmanex (twisthaler)			as-muh-neks twist-hey-ler
05	Atrovent			At-ro-vent
06	Azmacort			az-ma-cort
07	Beclomethasone dipropionate			bek"lo-meth'ah-son dī' pro’pe-o-nāt (or be-kloe-meth-a-sone)
08	Beclovent			be' klo-vent" (or be-klo-vent)
09	Bitolterol			bi-tōl'ter-ōl (or bye-tole-ter-ole)
10	Brethaire Discontinued - Delete			breth-air
11	Budesonide			byoo-des-oh-nide
12	Combivent			com-bi-vent
13	Cromolyn			kro'mŏ-lin (or KROE-moe-lin)
44	Dulera			do-lair-a
14	Flovent			flow-vent
15	Flovent Rotadisk			flow-vent row-ta-disk
16	Flunisolide			floo-nis'o-līd (or floo-NISS-oh-lide)
17	Fluticasone			flue-TICK-uh-zone
34	Foradil			FOUR-a-dil
35	Formoterol			for moh' te rol
18	Intal Discontinued - Delete			in-tel
19	Ipratropium Bromide			ĭp-rah-tro'pe-um bro'mīd (or ip-ra-TROE-pee-um)
37	Levalbuterol tartrate			lev-al-BYOU-ter-ohl
20	Maxair			măk-sâr
21	Metaproteronol			met"ah-pro-ter'ĕ-nōl (or met-a-proe-TER-e-nole)
39	Mometasone furoate			moe-MET-a-sone
22	Nedocromil			ne-DOK-roe-mil
23	Pirbuterol			pēr-bu'ter-ōl (or peer-BYOO-ter-ole)
41	Pro-Air HFA			proh-air HFA
24	Proventil			pro"ven-til' (or pro-vent-il)
25	Pulmicort Flexhaler			pul-ma-cort flex-hail-er
36	QVAR			q -vâr (or q-vair)
03	Salbutamol (or Albuterol)			săl-byū'tə-môl'
26	Salmeterol			sal-ME-te-role
27	Serevent			Sair-a-vent
42	Symbicort			sim-buh-kohrt
28	Terbutaline (+ T. sulfate)			ter-bu'tah-lēn (or ter-BYOO-ta-leen)
29	Tilade Discontinued - Delete			tie-laid
30	Tornalate			tor-na-late
31	Triamcinolone acetonide			tri"am-sin'o-lōn as"ĕ-tō-nīd' (or trye-am-SIN-oh-lone)
32	Vanceril			van-sir-il
33	Ventolin			vent-o-lin
38	Xopenex HFA			ZOH-pen-ecks
66	Other, Please Specify			[SKIP TO OTH_I1]
77	Don’t know
88	No Inhalers
99	Refused

100	146-245	Q8.10 ENTER OTHER MEDICATION FROM (8.9) IN TEXT FIELD IF MORE THAN ONE MEDICATION IS GIVEN, ENTER ALL MEDICATIONS ON ONE LINE. [LOOP BACK TO ILP01 AS NECESSARY TO ADMINSTER QUESTIONS ILP01 THRU ILP10 FOR EACH MEDICINE REPORTED IN INH_MEDS OTH_11 [FOR FILL [MEDICINE FROM INH_MEDS SERIES] FOR QUESTIONS ILP01 THROUGH ILP10] [IF {MEDICINE FROM INH_MEDS SERIES} IS 03, 04, 21, 24, OR 33 ASK ILP01 ELSE SKIP TO ILP02	Text field – up to 100 characters
		Section Repeated for Medication entry. (Limit=8) Questions 8.11–8.19 will be repeated for each medication up to 8 times and saved in blocks of 15 columns (Two columns for the Med. Code and 13 columns for the 9 questions.) Columns 246-260 will hold the first series, columns and the eighth series in columns 351-365.

2	246-247	1st Inhaler value from “INH_MEDS” field ILP_A (First Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66
13	248-260	Questions 8.11 through 8.19 for FIRST medication

1	248	Q8.11 Question has been removed, 2012. Please leave this column blank. 1st Medication
1	249	Q8.12 Question has been removed, 2012. Please leave this column blank. 1st Medication
1	250	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_A) 1st Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused
1	251	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_A) 1st Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	252	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_A) 1st Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	253	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_A) 1st Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	254-255	Q8.17 Question has been removed, 2012. Please leave these columns blank. 1st Medication
3	256-258	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_A) 1st Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	259-260	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_A) 1st Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused

2

261-262

2nd Inhaler value from “INH_MEDS” field ILP_B (Second Inhaler Medication Value)

Valid Inhaler Meds: 01 – 44, 66

13	263-275	Questions 8.11 through 8.19 for SECOND medication
1	263	Q8.11 Question has been removed, 2012. Please leave this column blank. 2nd Medication

1	264	Q8.12 Question has been removed, 2012. Please leave this column blank. (ILP02_B) 2nd Medication
1	265	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_B) 2nd Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused

1	266	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_B) 2nd Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	267	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_B) 2nd Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	268	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_B) 2nd Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	269-270	Q8.17 Question has been removed, 2012. Please leave these columns blank. 2nd Medication
3	271-273	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_B) 2nd Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	274-275	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_B) 2nd Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused
2	276-277	3rd Inhaler value from “INH_MEDS” field ILP_C (Third Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66

13

278-290

Questions 8.11 through 8.19 for THIRD medication

1	278	Q8.11 Question has been removed, 2012. Please leave this column blank. 3rd Medication
1	279	Q8.12 Question has been removed, 2012. Please leave this column blank. 3rd Medication
1	280	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_C) 3rd Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused
1	281	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_C) 3rd Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	282	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_C) 3rd Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	283	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_C) 3rd Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	284-285	Q8.17 Question has been removed, 2012. Please leave these columns blank. 3rd Medication
3	286-288	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_C) 3rd Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	289-290	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_C) 3rd Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused
2	291-292	4th Inhaler value from “INH_MEDS” field ILP_D (Fourth Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66

13

293-305

Questions 8.11 through 8.19 for FOURTH medication

1	293	Q8.11 Question has been removed, 2012. Please leave this column blank. 4th Medication
1	294	Q8.12 Question has been removed, 2012. Please leave this column blank. 4th Medication
1	295	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_D) 4th Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused
1	296	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_D) 4th Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	297	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_D) 4th Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	298	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_D) 4th Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	299-300	Q8.17 Question has been removed, 2012. Please leave this column blank. 4th Medication
3	301-303	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_D) 4th Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	304-305	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_D) 4th Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused
2	306-307	5th Inhaler value from “INH_MEDS” field ILP_E (Fifth Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66

13

308-320

Questions 8.11 through 8.19 for FIFTH medication

1	308	Q8.11 Question has been removed, 2012. Please leave this column blank. 5th Medication
1	309	Q8.12 Question has been removed, 2012. Please leave this column blank. 5th Medication
1	310	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_E) 5th Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused
1	311	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_E) 5th Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	312	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_E) 5th Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	313	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_E) 5th Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	314-315	Q8.17 Question has been removed, 2012. Please leave these columns blank. 5th Medication
3	316-318	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_E) 5th Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	319-320	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_E) 5th Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused
2	321-322	6th Inhaler value from “INH_MEDS” field ILP_F (Sixth Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66

13

323-335

Questions 8.11 through 8.19 for SIXTH medication

1	323	Q8.11 Question has been removed, 2012. Please leave this column blank. 6th Medication
1	324	Q8.12 Question has been removed, 2012. Please leave this column blank. 6th Medication
1	325	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_F) 6th Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused
1	326	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_F) 6th Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	327	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_F) 6th Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	328	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_F) 6th Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	329-330	Q8.17 Question has been removed, 2012. Please leave these columns blank. 6th Medication
3	331-333	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_F) 6th Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	334-335	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_F) 6th Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused
2	336-337	7th Inhaler value from “INH_MEDS” field ILP_G (Seventh Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66
13	338-350	Questions 8.11 through 8.19 for SEVENTH medication
1	338	Q8.11 Question has been removed, 2012. Please leave this column blank. 7th Medication
1	339	Q8.12 Question has been removed, 2012. Please leave this column blank. 7th Medication
1	340	Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_G) 7th Medication	1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused
1	341	Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_G) 7th Medication	1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused
1	342	Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_G) 7th Medication	1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused
1	343	Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_G) 7th Medication	1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	344-345	Q8.17 Question has been removed, 2012. Please leave these columns blank. 7th Medication
3	346-348	Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_G) 7th Medication	301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused
2	349-350	Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_G) 7th Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]	__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused
2	351-352	8th Inhaler value from “INH_MEDS” field ILP_H (Eighth Inhaler Medication Value)	Valid Inhaler Meds: 01 – 44, 66
13	353-365	Questions 8.11 through 8.19 for EIGHTH medication
1	353	Q8.11 Question has been removed, 2012. Please leave this column blank. 8th Medication

1

354

Q8.12 Question has been removed, 2012. Please leave this column blank. 8th Medication

1

355

Q8.13 A spacer is a small attachment for an inhaler that makes it easier to use. Do you use a spacer with [MEDICINE FROM INH_MEDS SERIES]? (ILP03_H) 8th Medication

1 = Yes 2 = No 3 = Medication is a dry powder inhaler or disk inhaler not a canister inhaler 4 = Medication has a built-in spacer/ does not need a spacer 7 = Don’t know 9 = Refused

1

356

Q8.14 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] when you had an asthma episode or attack? (ILP04_H) 8th Medication

1 = Yes 2 = No 3 = No attack in past 3 months 7 = Don’t know 9 = Refused

1

357

Q8.15 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] before exercising? (ILP05_H) 8th Medication

1 = Yes 2 = No 3 = Didn’t exercise in past 3 months 7 = Don’t know 9 = Refused

1

358

Q8.16 In the past 3 months, did you take [MEDICINE FROM INH_MEDS SERIES] on a regular schedule everyday? (ILP06_H) 8th Medication

1 = Yes 2 = No 7 = Don’t know 9 = Refused

2

359-360

Q8.17 Question has been removed, 2012. Please leave these columns blank. 8th Medication

3

361-363

Q8.18 How many times per day or per week do you use [MEDICINE FROM INH_MEDS SERIES]? (ILP08_H) 8th Medication

301-399 = Days 401-499 = Weeks 555 = Never 666 = Less often than once a week 777 = Don’ know 999 = Refused

2

364-365

Q8.19 How many canisters of this inhaler have you used in the past 3 months? (ILP10_H) 8th Medication [INTERVIEWER: IF RESPONDENT USED LESS THAN ONE FULL CANISTER IN THE PAST THREE MONTHS, CODE IT AS ‘88’]

__ = 01-76 Canisters 88 = None/Less than 1 full canister 77 = Don’ know 99 = Refused

2	366-367	Intentionally left blank2
1	368	Q8.20 In the past 3 months, have you taken any prescription medicine in pill form for your asthma? (PILLS)	1 = Yes 2 = No 7 = Don’t know 9 = Refused
10	369-378	Q8.21 What prescription medications do you take in pill form? [MARK ALL THAT APPLY. PROBE: Any other prescription asthma pills?] (PILLS_MD) These values will also be re-entered in columns below: 479-480 PILL_MD_A (First Pills Medication value) 482-483 PILL_MD_B (Second Pills Medication value) 485-486 PILL_MD_C (Third Pills Medication value) 488-489 PILL_MD_D (Fourth Pills Medication value) 491-492 PILL_MD_E (Fifth Pills Medication value)	88 = No Pills 77 = Don’t know 99 = Refused

				[INTERVIEWER: IF NECESSARY, ASK THE RESPONDENT TO SPELL THE NAME OF THE MEDICATION.] Note: the yellow numbered items below are new medications added in 2008. Also, CATI programmers, note that the top ten items (in bold below) should be highlighted in the CATI system if possible so they can be found more easily.
	Medication					Pronunciation
01	Accolate					ac-o-late
02	Aerolate					air-o-late
03	Albuterol					ăl'-bu'ter-ōl (or al-BYOO-ter-all)
04	Alupent					al-u-pent
05	Choledyl (oxtriphylline)					ko-led-il
07	Deltasone					del-ta-sone
08	Elixophyllin					e-licks-o-fil-in
11	Medrol					Med-rol
12	Metaprel					Met-a-prell
13	Metaproteronol					met"ah-pro-ter'ĕ-nōl (or met-a-proe-TER-e-nole)
14	Methylpredinisolone					meth-ill-pred-niss-oh-lone (or meth-il-pred-NIS-oh-lone)
15	Montelukast					mont-e-lu-cast
17	Pediapred					Pee-dee-a-pred
18	Prednisolone					pred-NISS-oh-lone
19	Prednisone					PRED-ni-sone
21	Proventil					pro-ven-til
23	Respid					res-pid
24	Singulair					sing-u-lair
25	Slo-phyllin					slow- fil-in
26	Slo-bid					slow-bid
48	Terbutaline (+ T. sulfate)					ter byoo' ta leen
28	Theo-24					thee-o-24
30	Theochron					thee -o-kron
31	Theoclear					thee-o-clear
32	Theodur					thee-o-dur
33	Theo-Dur					thee-o-dur
35	Theophylline					thee-OFF-i-lin
37	Theospan					thee-o-span
40	T-Phyl					t-fil
42	Uniphyl					u-ni-fil
43	Ventolin					vent-o-lin
44	Volmax					vole-max
45	Zafirlukast					za-FIR-loo-kast
46	Zileuton					zye-loo-ton
47	Zyflo Filmtab					zye-flow film tab
66	Other, please specify					[SKIP TO OTH_P1]
77	Don’t know
88	No Pills
99	Refused
100			379-478		(OTH_P1) IF MORE THAN ONE MEDICATION IS GIVEN, ENTER ALL MEDICATIONS ON ONE LINE.			Text field – up to 100 characters
					Question 8.22 Repeated for Medication entry. (Limit=5) Question 8.22 will be repeated for each medication up to 5 times. Column 577 will hold the first response, columns 578 the response to the second cycle, and the sixth cycle will be in column 582.			Valid Meds in Pill form: 01 – 48, 66
2			479-480		1st Pill value from “PILLS_MD_A” field PILL01_A (First Pill Medication value)			Valid Meds in Pill form: 01 – 48, 66
1			481		Q8.22 In the past 3 months, did you take [MEDICATION LISTED IN PILLS_MD] on a regular schedule every day? (PILL01) 1st Pill			1 = Yes 2 = No 7 = Don’t know 9 = Refused
2			482-483		2nd Pill value from “PILLS_MD_B” field PILL01_B (Second Pill Medication value)			Valid Meds in Pill form: 01 – 48, 66
1			484		Q8.22 In the past 3 months, did you take [MEDICATION LISTED IN PILLS_MD] on a regular schedule every day? (PILL02) 2nd Pill			1 = Yes 2 = No 7 = Don’t know 9 = Refused

2

485-486

3rd Pill value from “PILLS_MD_C” field PILL01_C (Third Pill Medication value)

Valid Meds in Pill form: 01 – 48, 66

1

487

Q8.22 In the past 3 months, did you take [MEDICATION LISTED IN PILLS_MD] on a regular schedule every day? (PILL03) 3rd Pill

1 = Yes 2 = No 7 = Don’t know 9 = Refused

2

488-489

4th Pill value from “PILLS_MD_D” field PILL01_D (Fourth Pill Medication value)

Valid Meds in Pill form: 01 – 48, 66

1

490

Q8.22 In the past 3 months, did you take [MEDICATION LISTED IN PILLS_MD] on a regular schedule every day? (PILL04) 4th Pill

1 = Yes 2 = No 7 = Don’t know 9 = Refused

2

491-492

5th Pill value from “PILLS_MD_E” field PILL01_E (Fifth Pill Medication value)

Valid Meds in Pill form: 01 – 48, 66

1	493		Q8.22 In the past 3 months, did you take [MEDICATION LISTED IN PILLS_MD] on a regular schedule every day? (PILL05) 5th Pill				1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	494		Q8.23 In the past 3 months, have you taken any prescription asthma medication in syrup form? (SYRUP)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
8	495-502		Q8.24 What prescriptions asthma medications have you taken as a syrup? [MARK ALL THAT APPLY. PROBE: Any other prescription syrup medications for asthma?]] (SYRUP_ID) (Limit = 4 Syrup Meds.)				Medication 01 = Aerolate (09) 02 = Albuterol 03 = Alupent (04) 04 = Metaproteronol 05 = Prednisolone 06 = Prelone (05) 07 = Proventil (02) 08 = Slo-Phyllin (09) 09 = Theophyllin 10 = Ventolin (02) 66 = Other, Please Specify: 88 = None 77 = Don’t know 99 = Refused
			[INTERVIEWER: IF NECESSARY, ASK THE RESPONDENT TO SPELL THE NAME OF THE MEDICATION.]
	Medication			Pronunciation
01	Aerolate			air-o-late
02	Albuterol			ăl'-bu'ter-ōl (or al-BYOO-ter-ole)
03	Alupent			al-u-pent
04	Metaproteronol			met"ah-pro-ter'ĕ-nōl (or met-a-proe-TER-e-nole)
05	Prednisolone			pred-NISS-oh-lone
06	Prelone			pre-loan
07	Proventil			Pro-ven-til
08	Slo-Phyllin			slow-fil-in
09	Theophyllin			thee-OFF-i-lin
10	Ventolin			vent-o-lin
66	Other, Please Specify:
77	Don’t know
88	No Syrups
99	Refused
2	495-496		1st Syrup value from “SYRUP_ID” field SYRUP_A (First Syrup Medication value)				Valid Meds in Syrup form: 01 – 10, 66
2	497-498		2nd Syrup value from “SYRUP_ID” field SYRUP_B (Second Syrup Medication value)				Valid Meds in Syrup form: 01 – 10, 66
2	499-500		3rd Syrup value from “SYRUP_ID” field SYRUP_C (Third Syrup Medication value)				Valid Meds in Syrup form: 01 – 10, 66
2	501-502		4th Syrup value from “SYRUP_ID” field SYRUP_D (Fourth Syrup Medication value)				Valid Meds in Syrup form: 01 – 10, 66
1	503		Intentionally left blank3
100	504-603		(OTH_S1) IF MORE THAN ONE MEDICATION IS GIVEN, ENTER ALL MEDICATIONS ON ONE LINE.				Text field – up to 100 characters
1	604		Q8.25 Read: A nebulizer is a small machine with a tube and facemask or mouthpiece that you breathe through continuously. In the past 3 months, were any of your asthma medicines used with a nebulizer? (NEB_SCR)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	605		Q8.26a I am going to read a list of places where you might have used a nebulizer. Please answer yes if you have used a nebulizer in the place I mention, otherwise answer no. In the past 3 months did you use a nebulizer … At Home ? (NEB_PLCa)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	606		Q8.26b In the past 3 months did you use a nebulizer … At a Doctor’s Office ? (NEB_PLCb)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	607		Q8.26c In the past 3 months did you use a nebulizer … In an Emergency room? (NEB_PLCc)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	608		Q8.26d .In the past 3 months did you use a nebulizer … At work (or a school)? (NEB_PLCd)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	609		Q8.26e In the past 3 months did you use a nebulizer … At any other place? (NEB_PLCe)				1 = Yes 2 = No 7 = Don’t know 9 = Refused
10	610-619		Q8.27 In the past 3 months, what prescriptions medications have you taken using a nebulizer? (NEB_ID) (Limit = 5 Nebulizers Meds.) These values will also be re-entered in columns below: 620-621 NEB_ID_A (First Nebulizer Medication value) 627-628 NEB_ID_B (Second Nebulizer Medication value) 634-635 NEB_ID_C (Third Nebulizer Medication value) 641-642 NEB_ID_D (Fourth Nebulizer Medication value) 648-649 NEB_ID_E (Fifth Nebulizer Medication value)				Medication 01 = Albuterol 02 = Alupent (11) 03 = Atrovent (09) 04 = Bitolterol 05 = Budesonide 06 = Cromolyn 07 = Duoneb (01 + 09) 08 = Intal (06) 09 = Ipratroprium bromide 10 = Levalbuterol 11 = Metaproteronol 12 = Proventil (01) 13 = Pulmicort (05) 14 = Tornalate (04) 15 = Ventolin (01) 16 = Xopenex (10) 17= Combivent Inhalation solution 18= Perforomist (Formoterol) 66 = Other, Please Specify: 88 = None 77 = Don’t know 99 = Refused
			[INTERVIEWER: IF NECESSARY, ASK THE RESPONDENT TO SPELL THE NAME OF THE MEDICATION.]
		Medication			Pronunciation
01		Albuterol			ăl'-bu'ter-ōl (or al-BYOO-ter-ole)
02		Alupent			al-u-pent
03		Atrovent			At-ro-vent
04		Bitolterol			bi-tōl'ter-ōl (or bye-tole-ter-ole)
05		Budesonide			byoo-des-oh-nide
17		Combivent Inhalation solution			com-bi-vent
06		Cromolyn			kro'mŏ-lin (or KROE-moe-lin)
07		DuoNeb			DUE-ow-neb
08		Intal			in-tel
09		Ipratroprium bromide			ĭp-rah-tro'pe-um bro'mīd (or ip-ra-TROE-pee-um)
10		Levalbuterol			lev al byoo' ter ol
11		Metaproteronol			met"ah-pro-ter'ĕ-nōl (or met-a-proe-TER-e-nole)
18		Perforomist (Formoterol)			per-form-ist
12		Proventil			Pro-ven-til
13		Pulmicort			pul-ma-cort
14		Tornalate			tor-na-late
15		Ventolin			vent-o-lin
16		Xopenex			ZOH-pen-ecks
66		Other, Please Specify:			[SKIP TO OTH_N1]
77		Don’t know
88		No Nebulizer
99		Refused
2	620-621		1st Nebulizer value from “NEB_ID” field NEB_ID_A (First Nebulizer Medication value)				Valid Meds in Nebulizer form: 01 – 18, 66
1	622		Q8.28 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] when you had an asthma episode or attack? (NEB01_A) 1st Nebulizer				1 = Yes 2 = No 3 = No attack in past 3 months 7= Don’t know 9 = Refused
1	623		Q8.29 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] on a regular schedule everyday? (NEB02_A) 1st Nebulizer				1 = Yes 2 = No 7= Don’t know 9 = Refused
3	624-626		Q8.30 How many times per day or per week do you use [MEDICINE FROM NEB_ID SERIES]? (NEB03_A) 1st Nebulizer				3_ _DAYS 4_ _WEEKS 555 = NEVER 666 = LESS OFTEN THAN ONCE A WEEK 777 = Don’t know 999 = Refused
2	627-628		2nd Nebulizer value from “NEB_ID” field NEB_ID_B (Second Nebulizer Medication value)				Valid Meds in Nebulizer form: 01 – 18, 66
1	629		Q8.28 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] when you had an asthma episode or attack? (NEB01_B) 2nd Nebulizer				1 = Yes 2 = No 3 = No attack in past 3 months 7= Don’t know 9 = Refused
1	630		Q8.29 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] on a regular schedule everyday? (NEB02_B) 2nd Nebulizer				1 = Yes 2 = No 7= Don’t know 9 = Refused
3	631-633		Q8.30 How many times per day or per week do you use [MEDICINE FROM NEB_ID SERIES]? (NEB03_B) 2nd Nebulizer				3_ _DAYS 4_ _WEEKS 555 = NEVER 666 = LESS OFTEN THAN ONCE A WEEK 777 = Don’t know 999 = Refused
2	634-635		3rd Nebulizer value from “NEB_ID” field NEB_ID_C (Third Nebulizer Medication value)				Valid Meds in Nebulizer form: 01 – 18, 66
1	636		Q8.28 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] when you had an asthma episode or attack? (NEB01_C) 3rd Nebulizer				1 = Yes 2 = No 3 = No attack in past 3 months 7= Don’t know 9 = Refused
1	637		Q8.29 In the past 3 months, did you take [MEDICINE FROM NEB_IDS SERIES] on a regular schedule everyday? (NEB02_C) 3rd Nebulizer				1 = Yes 2 = No 7= Don’t know 9 = Refused
3	638-640		Q8.30 How many times per day or per week do you use [MEDICINE FROM NEB_ID SERIES]? (NEB03_C) 3rd Nebulizer				3_ _DAYS 4_ _WEEKS 555 = NEVER 666 = LESS OFTEN THAN ONCE A WEEK 777 = Don’t know 999 = Refused
2	641-642		4th Nebulizer value from “NEB_ID” field NEB_ID_D (Fourth Nebulizer Medication value)				Valid Meds in Nebulizer form: 01 – 18, 66
1	643		Q8.28 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] when you had an asthma episode or attack? (NEB01_D) 4th Nebulizer				1 = Yes 2 = No 3 = No attack in past 3 months 7= Don’t know 9 = Refused
1	644		Q8.29 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] on a regular schedule everyday? (NEB02_D) 4th Nebulizer				1 = Yes 2 = No 7= Don’t know 9 = Refused
3	645-647		Q8.30 How many times per day or per week do you use [MEDICINE FROM NEB_ID SERIES]? (NEB03_D) 4th Nebulizer				3_ _DAYS 4_ _WEEKS 555 = NEVER 666 = LESS OFTEN THAN ONCE A WEEK 777 = Don’t know 999 = Refused
2	648-649		5th Nebulizer value from “NEB_ID” field NEB_ID_E (First Nebulizer Medication value)				Valid Meds in Nebulizer form: 01 – 18, 66
1	650		Q8.28 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] when you had an asthma episode or attack? (NEB01_E) 5th Nebulizer				1 = Yes 2 = No 3 = No attack in past 3 months 7= Don’t know 9 = Refused
1	651		Q8.29 In the past 3 months, did you take [MEDICINE FROM NEB_ID SERIES] on a regular schedule everyday? (NEB02_E) 5th Nebulizer				1 = Yes 2 = No 7= Don’t know 9 = Refused
3	652-654		Q8.30 How many times per day or per week do you use [MEDICINE FROM NEB_ID SERIES]? (NEB03_E) 5th Nebulizer				3_ _DAYS 4_ _WEEKS 555 = NEVER 666 = LESS OFTEN THAN ONCE A WEEK 777 = Don’t know 999 = Refused
100	655-754		OTH_N1 IF MORE THAN ONE MEDICATION IS GIVEN, ENTER ALL MEDICATIONS ON ONE LINE.			Text field – up to 100 characters
			Section 9. Cost of Care
1	755		Q9.1 Was there a time in the past 12 months when you needed to see your primary care doctor for your asthma but could not because of the cost? (ASMDCOST)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	756		Q9.2 Was there a time in the past 12 months when you were referred to a specialist for asthma care but could not go because of the cost? (ASSPCOST)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	757		Q9.3 Was there a time in the past 12 months when you need to buy medication for your asthma, but could not because of the cost? (ASRXCOST)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
			Section 10. Work related Asthma
1	758		Q10.1 Next, we are interested in things that affect asthma in the workplace. However, first I’d like to ask how you would describe your current employment status? Would you say … (EMP_STAT)			1 = Employed full-time 2 = Employed part-time 3 = Not Employed 7 = Don’t know 9 = Refused
2	759-760		Q10.2 What is the main reason you are not now employed? (UNEMP_R)			01 = Keeping house 02 = Going to school 03 = Retired 04 = Disabled 05 = Unable to work for other health reasons 06 = Looking for work 07 = Laid off 08 = Other 77 = Don’t know 99 = Refused
1	761		Q10.3 Have you ever been employed? (EMP_EVER1)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	762		Q10.4 Are your asthma symptoms MADE WORSE by things like chemicals, smoke, dust or mold in your CURRENT job? (WORKENV5)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	763		Q10.5 Was your asthma first CAUSED by things like chemicals, smoke, dust or mold in your CURRENT job? (WORKENV6)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	764		Q10.6 Were your asthma symptoms MADE WORSE by things like chemicals, smoke, dust or mold in any previous job you ever had? (WORKENV7)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	765		Q10.7 Was your asthma first CAUSED by things like chemicals, smoke, dust or mold in any PREVIOUS job you ever had? (WORKENV8)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	766		Q10.8 Did you ever lose or quit a job because things in the workplace, like chemicals, smoke, dust or mold, caused your asthma or made your asthma symptoms worse? (WORKQUIT1)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	767		Q10.9 Did you and a doctor or other health professional ever DISCUSS whether your asthma could have been caused by, or your symptoms made worse by, any job you ever had? (WORKTALK)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	768		Q10.10 Have you ever been TOLD BY a doctor or other health professional that your asthma was caused by, or your symptoms made worse by, any job you ever had? (WORKSEN3)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	769		Q10.11 Have you ever TOLD a doctor or other health professional that your asthma was caused by, or your symptoms made worse by, any job you ever had? (WORKSEN4)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
			Section 11. Comorbid Conditions
1	770		Q11.1 Have you ever been told by a doctor or health professional that you have chronic obstructive pulmonary disease also known as COPD? (COPD)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	771		Q11.2 Have you ever been told by a doctor or other health professional that you have emphysema? (EMPHY)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	772		Q11.3 Have you ever been told by a doctor or other health Professional that you have Chronic Bronchitis? (BRONCH)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	773		Q11.4 Have you ever been told by a doctor or other health professional that you were depressed? (DEPRESS)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
SECTION 12. Complimentary and Alternative Therapy
1	774		Sometimes people use methods other than prescription medications to help treat or control their asthma. These methods are called non-traditional, complementary, or alternative health care. I am going to read a list of these alternative methods. For each one I mention, please answer “yes” if you have used it to control your own asthma in the past 12 months. Answer “no” if you have not used it in the past 12 months. Q12.1 In the past 12 months, have you used (herbs) to control your asthma? (CAM_HERB)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	775		Q12.2 In the past 12 months, have you used (vitamins) to control your asthma? (CAM_VITA)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	776		Q12.3 In the past 12 months, have you used (acupuncture) to control your asthma? (CAM_PUNC)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	777		Q12.4 In the past 12 months, have you used (acupressure) to control your asthma? (CAM_PRES)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	778		Q12.5 In the past 12 months, have you used (aromatherapy) to control your asthma? (CAM_AROM)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	779		Q12.6 In the past 12 months, have you used (homeopathy) to control your asthma? (CAM_HOME)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	780		Q12.7 In the past 12 months, have you used (reflexology) to control your asthma? (CAM_REFL)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	781		Q12.8 In the past 12 months, have you used (yoga) to control your asthma? (CAM_YOGA)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	782		Q12.9 In the past 12 months, have you used (breathing techniques) to control your asthma? (CAM_BR)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	783		Q12.10 In the past 12 months, have you used (naturopathy) to control your asthma? (CAM_NATR)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	784		Q12.11 Besides the types I have just asked about, have you used any other type of alternative care for your asthma in the past 12 months? (CAM_OTHR)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
100	785-884		Q12.12 What else have you used? (CAM_TEXT) [100 ALPHANUMERIC CHARACTER LIMIT] ENTER OTHER ALTERNATIVE MEDICINE IN TEXT FIELD IF MORE THAN ONE IS GIVEN, ENTER ALL MEDICATIONS ON ONE LINE.
80	885-964		Disposition codes for call attempts 1 through 20 with the first disposition code in columns 885-887, etc... (CATTMPTS_F)			4-digit disposition code for each of the first 20 call attempts
10	965-974		Intentionally left blank…
2	975-976		Questionnaire Versions Identifier. Import value from BRFSS Columns 613-614 (QSTVER_F)			10 = Landline (No additional version) 11 = Landline (One additional version) 12 = Landline (Two additional versions) 13 = Landline (Three additional versions) 20 = Cell Phone (No additional version) 21 = Cell Phone (One additional version) 22 = Cell Phone (Two additional versions) 23 = Cell Phone (Three additional versions)
2	977-978		Language identifier: Language in which the interview was conducted. Import value from BRFSS Columns 615-616 (QSTLANG_F)			1 = English 2 = Spanish 3-99 = Other
1	979		Asthma Callback Script Import value from BRFSS Column 609 (CALLBACK_F)			1 = Yes 2 = No
1	980		Which person in the household was selected as the focus of the call-back? Import value from BRFSS Column 610 (ADLTCHLD_F)			1 = Adult 2 = Child
1	981		Have you ever been told by a doctor, nurse or other health professional that you had asthma? Import value from BRFSS Core Section 6 Question 4, Column 118 (ASTHMA3_F)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	982		Do you still have asthma? Import value from BRFSS Core Section 6 Question 5, Column 119 (ASTHNOW_F)			1 = Yes 2 = No 7 = Don’t know 9 = Refused
1	983		Asthma Callback Script Test (CALLBACK_Ver)			1 = Callback using Protocol (2 weeks) 2 = Callback conducted “Immediately”
1	984		Are you a resident of [STATE]? Import value from BRFSS Column 085 (CSTATE_F) Only for cellphones			1 = Yes 2 = No 7 = Don’t know 9 = Refused
2	985-986		State of Origin of the Call Import value from BRFSS Column 000-000 (O_STATE_F)			2 digit state FIPSCODE
2	987-988		In what state do you live? Import value from BRFSS Columns 86-87 (RSPSTATE_F) Only for cellphones			2 digit state FIPSCODE
6	989-994		RESPDNUM			RESPONDENT NUMBER
25	995-1019		Intentionally left blank…
1	1020		End of File Marker…			PLEASE PLACE A “1” IN THIS FIELD

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