What do you think is the most effective ONE thing you can do to prevent getting sick from the flu?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

What do you think is the most effective ONE thing you can do to prevent getting sick from the flu?

• Avoiding touching your eyes, nose or mouth as much as possible during the flu season.
• Avoiding close contact with others who may have the flu.
• Getting the flu vaccination.
• Taking anti-viral medication, like Tamiflu, on the first or second day that you have symptoms of the flu.

Asked only in January - February 2009.

What do you think is the most effective thing to do to prevent spreading the flu to people when you are sick?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

What do you think is the most effective thing to do to prevent spreading the flu to people when you are sick?

• Frequent hand washing.
• Covering your mouth and nose when coughing or sneezing.
• Staying home when you are sick with the flu.
• Getting the flu vaccination.
• Something else.

Asked only in January - February 2009.

How many flu vaccinations, including FluMist, have you had in the past 5 years, that is, since January 2003?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

Since September 2007, have you seen a doctor or other health professional about your own health?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

Since September 2007, has a doctor or other health professional told you to get a flu vaccination?

INTERVIEWER NOTE: Flu vaccination includes the flu shot and flu mist which is sprayed into the nose.

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

Do you think the flu vaccination is very effective, somewhat effective, or not at all effective in preventing the flu?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If you do not get the flu vaccination this fall or winter, what do you think are your chances of getting the flu?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

There are many reasons why people don't get flu vaccinations. What is the ONE main reason you did not get a flu vaccination last flu season?

INTERVIEWER INSTRUCTION: If more than one reason is given, ask "What is the one MAIN reason you did not get the flu vaccination last flu season?"

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If you were to get the flu vaccination, how worried would you be about getting sick from it?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

Do you know what the term "pandemic flu" means?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

"Pandemic Influenza" or "Pan Flu" is a global outbreak of a new type of serious influenza that almost everyone is susceptible to and it spreads quickly from person to person. Currently, there is not a pandemic flu outbreak occurring.

Are you very concerned, somewhat concerned or not at all concerned about a pandemic flu outbreak?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If there is a pandemic flu outbreak and you do not get the pandemic flu vaccination, what do you think your chances are of getting sick with the pandemic flu?

Interviewer Note: Please read both the subjective label and the percentage range.

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If there is a pandemic flu outbreak and you do not get the pandemic flu vaccination, what do you think your chances are of getting sick with the pandemic flu?

Interviewer Note: Please read both the subjective label and the percentage range.

• Very High (90%-100%)
• High (70%-89%)
• Average (50%-69%)
• Low (20%-49%)
• Very Low (less than or equal to 19%)

Asked only in January - February 2009.

If there was a pandemic flu outbreak, how likely are you to get a pandemic flu vaccination if it was available to you?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If there was a pandemic flu outbreak, how likely are you to get a pandemic flu vaccination if it was available to you?

• Definetely get one
• Probably get one
• Probably not get one
• Definitely not get a pandemic flu vaccination

Asked only in January - February 2009.

If public health officials recommended that everyone go to a particular public place such as a local school, fire station, or sports stadium to get vaccinated to prevent the spread of pandemic flu, would you…

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If public health officials recommended that everyone go to a particular public place such as a local school, fire station, or sports stadium to get vaccinated to prevent the spread of pandemic flu, would you…

• Definetely go
• Probably go
• Probably not go
• Definitely not go to a particular place to get vaccinated

Asked only in January - February 2009.

Imagine an outbreak of pandemic flu in the U.S. in the next year. What would be the most important ONE thing you would want to know?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

Imagine an outbreak of pandemic flu in the U.S. in the next year. What would be the most important ONE thing you would want to know?

• How to prevent getting the flu
• How to prevent spreading the flu
• Symptoms of the flu
• How to treat the flu
• Cities where cases of the flu have been identified
• Information about the flu vaccine
• Something else

Asked only in January - February 2009.

During a pandemic flu outbreak in the U.S., what would be your ONE most preferred source for getting information about the pandemic flu? Please tell me your one most preferred source.

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

During a pandemic flu outbreak in the U.S., what would be your ONE most preferred source for getting information about the pandemic flu? Please tell me you one most perferred source?

• Newspapers
• Television
• Radio
• Internet Websites
• Your doctor
• The CDC (Centers for Disease Control and Prevention)
• State or local public health departments
• Other government agencies
• Family or friends
• Religious leaders
• Some other source

Asked only in January - February 2009.

Excluding vaccination, what is the ONE most likely thing you would do if a pandemic flu outbreak were reported IN YOUR STATE? Please choose one from the following list?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

Excluding vaccination, what is the ONE most likely thing you would do if a pandemic flu outbreak were reported IN YOUR STATE? Please choose one from the following list.

• Consult a website
• Avoid crowds and public events
• Consult your doctor
• Try to get a prescription for an anti-viral drug such as Tamiflu
• Reduce or avoid travel
• Wash hands frequently
• Wear a face mask
• Keep household members at home while the outbreak lasts
• Stock up on medicines and food to hlep with flu symptoms
• Something else

Asked only in January - February 2009.

If public health officials recommended that everyone stay at home for a month because of a serious outbreak of pandemic flu in your community, are you very likely, somewhat likely, somewhat unlikely, or very unlikely to stay home for a month?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

If public health officials recommended that everyone stay at home for a month becuase of a serious outbreak of pandemic flu in your community, are you very likely, somewhat likely, somewhat unlikely, or very unlikely to stay home for a month?

Asked only in January - February 2009.

During a severe outbreak of pandemic flu in your community, would you participate in a telephone interview like this one about pandemic flu? Would you definitely participate, probably participate, probably not participate, or definitely not participate in an interview?

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

I'm going to read you a list of job types. Please tell me if you currently work in any of these fields.

• Emergency medical services, law enforcement, fire services, or in the manufacture of pandemic vaccines or anti-virals.
• Public health, healthcare provider, home health, or in a nursing home.
• Homeland or national security as one who would be deployed during a flu pandemic.

Pilot Question - Asked only in December 2008 at request of BSB/CDC.

I'm going to read you a list of job types. Please tell me if you currently work in any of these fields.

• a. Emergency medical services, law enforcement, fire services, or in the manufacture of pandemic vaccines or anti-virals
• b. Public health, healthcare provider, home health, or in a nursing home.
• c. Homeland or national security as one who would be deployed during a flu pandemic.

Asked only in January - February 2009.

About how many hours did the [age] year old child watch television yesterday?

About how many hours per week does the [age] year old child spend in a day care center, day care home, or pre-school?

Are there family rules about:
a. What time the [age] year old child goes to bed on a school night?
b. T he amount of time the [age] year old child is allowed to watch television?
c. Which television programs and movies the [age] year old child is allowed to watch?
d. Which computer or video games the [age] year old child is allowed to play?

Are you a parent or a guardian of this child?

Is the [age] year old child’s time divided between parents or guardians who live in separate households?

On how many days out of the past seven days was the [age] year old child supervised by an adult after school?

To the following questions please answer how many days during the past seven days you have done the following activities with the [age] year old child.
A. Played a sport, physical game, or exercised with the [age] year old child?
b. Played a non-physical game with the [age] year old child?
c. Watched television with the [age] year old child?
d. Read to the [age] year old child?

To the following questions please answer how many days out of the past seven days you did the following activities with the [age] year old child?
a. Played a sport, physical game, or exercised together with the [age] year old child?
b. Played a non-physical game with the [age] year old child?
c. Watched television with the [age] year old child?
d. Spent at least 20 minutes talking with the [age] year old child?
e. Helped the [age] year old child with school activities or homework?
f. Made the [age] year old child responsible for completing a household chore?
g. Attended a game or event the [age] year old child participated in?

What is the age of the oldest child in your household under the age of 18?

Where does the [age] year old child go most often when school lets out?

Would you say you are the parent or guardian who spends the most time caring for the [age] year old child?

About how much do you think you weighed when you were 21 years old?

And when you took part in this activity, for how many minutes or hours did you usually keep at it? (ACTIVTY 1)

And when you took part in this activity, for how many minutes or hours did you usually keep at it? (ACTIVTY 2)

During the past month, how many times per week or per month did you do physical activities or exercises to STRENGTHEN your muscles? Do NOT count aerobic activities like walking, running, or bicycling. Count activities using your own body weight like yoga, sit-ups or push-ups and those using weight machines, free weights, or elastic bands.

During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?

During the past seven days, how many days did you do any activities that increase muscle strength or tone, such as lifting weights, pull-ups, push-ups, or sit-ups?

During the past seven days, how many days did you do moderate activities for at least ten minutes, such as brisk walking, bicycling, gardening, or anything else that caused some increase in breathing or heart rate?

During the past seven days, how many days did you do vigorous activities for at least ten minutes, such as running, aerobics, heavy yard work, or anything else that caused large increases in breathing or heart rate?

During the past seven days, how many hours did you spend using a computer during your leisure-time?

During the past seven days, how many hours did you spend watching television while sitting or lying down?

During the past seven days, how many days did you walk continuously for at least ten minutes for recreation, exercise, or to get to and from places?

Has a doctor or other health professional ever talked to you about physical activity or exercise?

How many days per week do you do these moderate activities for at least 10 minutes at a time?

How many days per week do you do these vigorous activities for at least 10 minutes at a time?

How many hours per week do you work at a job or business?

How many times per week or per month did you take part in this activity during the past month? (ACTIVTY 1)

How many times per week or per month did you take part in this activity during the past month? (ACTIVTY 2)

Now, thinking about the moderate physical activities you do [fill in (when you are not working) if "employed" or "self-employed"] in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate?

Now thinking about the vigorous physical activities you do [fill in (when you are not working) if "employed" or "self-employed" to core Q12.8 or Q13.8] in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?

On days when you did moderate activities, how much total time did you spend doing these activities?

On days when you did vigorous activities, how much total time did you spend doing these activities?

On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?

On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?

How much has your weight changed over the past five years?

On days when you walked, how much total time did you spend walking?

What kind of business or industry is this? (What was made, sold, or service provided)

What kind of work do you do now?

What type of physical activity or exercise did you spend the most time doing during the past month? [See Coding List A] (ACTIVTY 1)

INTERVIEWER INSTRUCTION: If the respondent's activity is not included in the Coding List A, choose the option listed as "Other ".

INTERVIEWER NOTE: Housework may be included as a physical activity or exercise spent and can be coded as "Other".

What type of physical activity or exercise did you spend the most time doing during the past month? [See Coding List A] (ACTIVTY 2)

INTERVIEWER INSTRUCTION: If the respondent's activity is not included in the Coding List A, choose the option listed as "Other ".

INTERVIEWER NOTE: Housework may be included as a physical activity or exercise spent and can be coded as "Other".

When you are at work, which of the following best describes what you do?
Would you say:

• Mostly sitting or standing
• Mostly walking
• Mostly heavy labor or physically demanding work

When you are at work, which of the following best describes what you do? [NOTE: If respondent has multiple jobs, include all jobs.]
Would you say:

• Mostly sitting or standing
• Mostly walking
• Mostly heavy labor or physically demanding work

Which of the following best describes your future plans regarding physical activity?

The next two questions are about physical activity that you may do as part of your daily transportation to your job, the store, or other places that you go. Please include physical activity that you may have included in your previous answers.

During the past month, did you ride a bicycle for transportation, like to go to or from work, to run errands, or to go somewhere else that you wanted or needed to go?

The next two questions are about physical activity that you may do as part of your daily transportation to your job, the store, or other places that you go. Please include physical activity that you may have included in your previous answers.

During the past month, did you walk for transportation, like to go to or from work, to run errands, or to go somewhere else that you wanted or needed to go?

About how long has this doctor been caring for you?

About how old do you think your doctor is?

Are you able to see the same doctor every time or nearly every time you have a routine check-up or care for a medical condition?

During the past two years, was there a time that you thought you needed to see a specialist but were unable to get a referral?

How would you rate your doctor’s medical skill?

Other than vitamins or antibiotics, do you take any medication that is prescribed by your doctor on a daily basis for control of a medical problem?

What is the medical specialty of your doctor?

What is the sex of your doctor?

Who decides when you need your next appointment?

During the past ten years have you received a tetanus shot?

Is there one particular doctor or health professional who you usually go to when you need routine medical care?

Have you been pregnant in the last 5 years?

To your knowledge, are you now pregnant?

(Has a doctor or other health professional) ever advised you to quit smoking?

(Has a doctor or other health professional ever talked with you) about alcohol use?

(Has a doctor or other health professional ever talked with you) about drug abuse?

Has a doctor or other health professional ever talked with you about getting a mammogram?

(Has a doctor or other health professional ever talked with you) about injury prevention, such as safety belt use, helmet use, or smoke detectors?

Has a doctor or other health professional ever talked with you about physical activity or exercise?

(Has a doctor or other health professional) ever talked with you about your sexual practices, including family planning, sexually transmitted diseases, AIDS, or the use of condoms?

Has a doctor or other health professional ever talked with you about your diet or eating habits?

A digital rectal exam is an exam in which a doctor, nurse, or other health professional places a gloved finger into the rectum to feel the size, shape, and hardness of the prostate gland. Have you ever had a digital rectal exam?

A Prostate-Specific Antigen test, also called a PSA test, is a blood test used to check men for prostate cancer. Have you ever had a PSA test?

Has your father, brother, son, or grandfather ever been told by a doctor, nurse, or health professional that he had prostate cancer?

Have you ever been told by a doctor, nurse, or other health professional that you had prostate cancer?

How long has it been since you had your last PSA test?

How long has it been since your last digital rectal exam?

Previously, I asked you some questions about tests for prostate cancer you may have had. Has you physician ever discussed with you both the advantages and disadvantages of being screened for prostate cancer?

When did you have your last digital rectal exam?

When did you have your last PSA test?

How do you feel about laws that require drivers and front seat passengers to wear seat belts? Do you favor these laws a lot, do you favor them some or do you favor these laws not at all?

Do you think that seat belt laws should also apply to back seat adult passengers?

In your opinion, SHOULD police be allowed to stop a vehicle if they observe a seat belt violation when no other traffic laws are being broken?

In some schools, students have their heights and weights measured to determine their level of growth and development, and to identify children who may be overweight or underweight for their age. Do you favor this practice in Kansas schools?