col1 col2 col3 col4 col5 col6 col7 col8 col9 col10 col11 col12 col13 col14 col15 col16 col17 col18 col19 col20 Class/Chapter Type Image Audio English Reference thisFrame thisSpot/LessonCode toSpot toMovie Table Field Entry CharlesCol DataName Special NumRule Min Max toOnZero ST-PatInfo Title PatInfo-1 Strider Registration and Information: Journey to Your Inner Self Welcome & introduction ST-PatInfo Subhead SHEAD_13 PatInfo-2 The 12 Week Journey to Better Health Welcome & introduction Introduction ST-PatInfo Body Guide PatInfo-3 I’ll be your STRIDES GUIDE for this 12 week journey to better health. Welcome & introduction ST-PatInfo Body SHEAD_6 Rev-1 Each day you come, I will guide you through a half-hour of discussion of how far you have gone in the past week and what you learned on earlier trips. Welcome & introduction ST-PatInfo Body MAN_GUIDE PatInfo-5 Then the Strides Staff will lead the trip in a half-hour discussion of where we're going today. Welcome & introduction ST-PatInfo Body Guide Rev-2 After that, I will guide you through a half-hour of activities, help you set goals for the coming week and review what was taught today. Welcome & introduction ST-PatInfo Body Guide PatInfo-8 OK. Let’s begin. Pick Passport number ST-PatInfo Body SHEAD_8 PatInfo-9 To become a STRIDER, you need to sign up. Pick Passport number ST-PatInfo Subhead SHEAD_2 PatInfo-10 Passport Pick Passport number Passport ST-PatInfo Body SHEAD_2 PatInfo-11 First you will need a Passport. Pick Passport number ST-PatInfo Question Passport Rev-3 We will give you a special Passport Number. Enter it and then Touch OK. Pick Passport number numpad PassNum INFO IDnum digits 4 ST-PatInfo Body SHEAD_2 Rev-4 Write your number down or remember it. You will need it every time you visit. Pick Passport number ST-PatInfo Answer PatInfo-16 Let’s Go Pick Passport number col16 ST-PatInfo Body Guide PatInfo-18 In the next 45 minutes, I’ll ask you a lot of questions the Staff will need to be able to help you on this journey. Just answer by touching the screen. Question Instructions ST-PatInfo Body Guide PatInfo-19 If you have to stop or do not finish, I’ll remember where you were so you can finish later. Question Instructions ST-PatInfo Subhead SHEAD_3 PatInfo-20 How to Contact You Contact Information ContactInfo ST-PatInfo Question Blank Rev-6 Please Enter your First Name and then touch OK. Contact Information keyboard INFO FirstName ST-PatInfo Question Blank Rev-7 Please Enter your Last Name and then touch OK. Contact Information keyboard INFO LastName ST-PatInfo Question Address PatInfo-22 Enter your Street Address and then touch OK Contact Information keyboard INFO Street ST-PatInfo Question Address Rev-8 Enter your city and then touch OK. Contact Information keyboard INFO City ST-PatInfo Question Address Rev-8a Enter your state and then touch OK. Contact Information keyboard INFO City ST-PatInfo Question Address Rev-9 Enter your zip code and then touch OK. Contact Information numpad INFO City zipcode ST-PatInfo Question SHEAD_3 Rev-10 Enter your area code and phone number and then touch OK. Contact Information numpad INFO Phone phone ST-PatInfo Question Blank PatInfo-25 Please enter your Email Address, if you have one, and then touch OK. Contact Information keyboard INFO Email ST-PatInfo Question Blank PatInfo-26 Please enter the name of someone close to you who we may contact if we need to reach you. Contact Information keyboard INFO ContactName ST-PatInfo Question SHEAD_3 Rev-11 Now, enter their area code and phone number and then touch OK. Contact Information numpad INFO ContactPhone phone ST-PatInfo Subhead SHEAD_4 PatInfo-28 Tell us about You Demographic information AboutYou INFO ST-PatInfo Body SHEAD_9 PatInfo-29 We would like to learn a lot about you and your life. Demographic information INFO ST-PatInfo Body Guide PatInfo-30 This will help us make practical suggestions that can help you on this journey. Demographic information INFO ST-PatInfo Question SHEAD_8 PatInfo-31 What is your age? Demographic information numpad INFO Age 1 range 10 100 ST-PatInfo Question SHEAD_4 PatInfo-34 What is your sex? Demographic information single INFO sex 2 ST-PatInfo Answer PatInfo-35 Male Demographic information INFO Gender ST-PatInfo Answer PatInfo-36 Female Demographic information INFO Gender ST-PatInfo Question race Rev-12 Which of the following ethnic groups do you most identify with? Demographic information single INFO Groups 3 ST-PatInfo Answer PatInfo-38 White Demographic information Quit INFO Race ST-PatInfo Answer PatInfo-39 African-American Demographic information INFO Race ST-PatInfo Answer PatInfo-40 Hispanic Demographic information INFO Race ST-PatInfo Answer PatInfo-41 Asian Demographic information INFO Race ST-PatInfo Answer other Other Demographic information INFO Race ST-PatInfo Subhead SHEAD_5 PatInfo-43 Tell us about your work. Activity Information Work INFO ST-PatInfo Question PatInfo-44 Do you work outside your home? Activity Information single INFO Work 4 ST-PatInfo Answer yes Yes Activity Information WorkProblem INFO Work ST-PatInfo Answer no No Activity Information WorkWeight INFO Work ST-PatInfo Question SHEAD_12 Rev-13 Does your weight prevent you from working outside the home? Activity Information single WorkWeight INFO WorkWeight 5 ST-PatInfo Answer yes Yes Activity Information School INFO WorkWeight ST-PatInfo Answer no No Activity Information School INFO WorkWeight ST-PatInfo Question SHEAD_12 Rev-14 Has your weight ever kept you from performing job duties? Activity Information single WorkProblem INFO WorkProblem 6 ST-PatInfo Answer yes Yes Activity Information INFO WorkProblem ST-PatInfo Answer no No Activity Information INFO WorkProblem ST-PatInfo Question SHEAD_15 PatInfo-49 Have you ever had a work related injury? Activity Information single INFO WorkInjury 7 ST-PatInfo Answer yes Yes Activity Information INFO WorkInjury ST-PatInfo Answer no No Activity Information INFO WorkInjury ST-PatInfo Question SHEAD_5 Rev-15 How many different jobs do you have right now? Activity Information numpad INFO JobNumber 8 range 0 10 School ST-PatInfo Question Blank PatInfo-51 Please type in your job title or description of your main job? Activity Information keyboard INFO JobTypes 9 ST-PatInfo Question SHEAD_5 Rev-16 If you work outside the home, how many days a week do you work? Activity Information numpad INFO WorkNumDays 10 daysinweek ST-PatInfo Question SHEAD_11 Rev-17 If you work outside the home, is your work schedule the same every week or does it vary? Activity Information single INFO 11 ST-PatInfo Answer PatInfo-54 Same every workday Activity Information INFO WorkSchedule ST-PatInfo Answer PatInfo-55 Varies a lot Activity Information INFO WorkSchedule ST-PatInfo Answer PatInfo-56 Varies a little Activity Information INFO WorkSchedule ST-PatInfo Question SHEAD_5 PatInfo-57 Touch each of the days you work in a typical week. Then touch OK. Activity Information multiple INFO WorkTypDays 12 ST-PatInfo Answer PatInfo-58 Monday Activity Information INFO WorkTypDays ST-PatInfo Answer PatInfo-59 Tuesday Activity Information INFO WorkTypDays ST-PatInfo Answer PatInfo-60 Wednesday Activity Information INFO WorkTypDays ST-PatInfo Answer PatInfo-61 Thursday Activity Information INFO WorkTypDays ST-PatInfo Answer PatInfo-62 Friday Activity Information INFO WorkTypDays ST-PatInfo Answer PatInfo-63 Saturday Activity Information INFO WorkTypDays ST-PatInfo Answer PatInfo-64 Sunday Activity Information INFO WorkTypDays ST-PatInfo Question SHEAD_11 Rev-18 If you work outside the home, do you work the same number of hours each day or does it vary? Activity Information single INFO WorkRegHours 13 ST-PatInfo Answer PatInfo-66 Same every workday Activity Information INFO WorkRegHours ST-PatInfo Answer PatInfo-67 Varies a lot Activity Information INFO WorkRegHours ST-PatInfo Answer PatInfo-68 Varies a little Activity Information INFO WorkRegHours ST-PatInfo Question PatInfo-69 How many hours do you work on a typical day? Activity Information numpad INFO WorkNumHours 14 hoursinday ST-PatInfo Question Sit PatInfo-70 In a typical day at work: how many hours do you sit? Activity Information numpad INFO WorkHoursSit 15 hoursActivityWork ST-PatInfo Answer PatInfo-71 In a typical day at work: how many hours do you stand? Activity Information numpad INFO WorkHoursStand hoursActivityWork ST-PatInfo Answer PatInfo-72 In a typical day at work: how many hours do you walk? Activity Information numpad INFO WorkHoursWalk hoursActivityWork ST-PatInfo Question PatInfo-73 Do you do any carrying, lifting or stair climbing at work? Activity Information single INFO WorkLifting 16 ST-PatInfo Answer yes Yes Activity Information INFO WorkLifting ST-PatInfo Answer no No Activity Information INFO WorkLifting ST-PatInfo Question Bus PatInfo-93a How do you get to work? Activity Information single INFO WorkHowTravel 17 ST-PatInfo Answer PatInfo-94 Car Activity Information INFO WorkHowTravel ST-PatInfo Answer PatInfo-95 Bus Activity Information INFO WorkHowTravel ST-PatInfo Answer PatInfo-96 Walk Activity Information INFO WorkHowTravel ST-PatInfo Answer PatInfo-97 Bike Activity Information INFO WorkHowTravel ST-PatInfo Answer other Other Activity Information INFO WorkHowTravel ST-PatInfo Question Bus Rev-19 How many minutes does it take you to get to work? Activity Information numpad School INFO WorkTravelMinutes 18 range 0 180 ST-PatInfo Subhead SHEAD_6 PatInfo-74 Tell us about school. Activity Information School INFO ST-PatInfo Question Education PatInfo-75 What level of school have you completed? Activity Information single INFO SchoolLevel 19 ST-PatInfo Answer PatInfo-76 Not High School Grad Activity Information INFO SchoolLevel ST-PatInfo Answer PatInfo-77 High School Grad Activity Information INFO SchoolLevel ST-PatInfo Answer PatInfo-78 Technical or Vocational Education Activity Information INFO SchoolLevel ST-PatInfo Answer PatInfo-79 Some College Activity Information INFO SchoolLevel ST-PatInfo Answer PatInfo-80 College Grad Activity Information INFO SchoolLevel ST-PatInfo Answer PatInfo-81 Post Graduate Education Activity Information INFO SchoolLevel ST-PatInfo Question Education PatInfo-82 Do you go to school now? Activity Information Single INFO SchoolNow 20 ST-PatInfo Answer yes Yes Activity Information INFO SchoolNow ST-PatInfo Answer no No Activity Information ChildrenHome INFO SchoolNow ST-PatInfo Question Calendar PatInfo-85 How many days a week do you go to school? Activity Information numpad INFO SchoolNumDays 21 daysinweek ST-PatInfo Question Calendar PatInfo-86 Is this the same every week? Activity Information single INFO SchoolRegDays 22 ST-PatInfo Answer yes Yes Activity Information INFO SchoolRegDays ST-PatInfo Answer no No Activity Information INFO SchoolRegDays ST-PatInfo Question Rev-20 About how many hours are you in school on a typical day? Activity Information numpad INFO SchoolNumHours 23 hoursinday ST-PatInfo Question Sit PatInfo-88 At school on a typical day, how many hours do you sit? Activity Information numpad INFO SchoolHoursSit 24 hoursActivitySchool ST-PatInfo Answer PatInfo-89 At school on a typical day, how many hours do you stand? Activity Information numpad INFO SchoolHoursStand hoursActivitySchool ST-PatInfo Answer PatInfo-90 At school on a typical day, how many hours do you walk? Activity Information numpad INFO SchoolHoursWalk hoursActivitySchool ST-PatInfo Question PatInfo-91 Do you do any carrying, lifting or stair climbing at school? Activity Information single INFO SchoolLifting 25 ST-PatInfo Answer yes Yes Activity Information INFO SchoolLifting ST-PatInfo Answer no No Activity Information INFO SchoolLifting ST-PatInfo Question Bus Rev-21 How do you get to school? Activity Information single INFO SchoolHowTravel 26 ST-PatInfo Answer PatInfo-94 Car Activity Information INFO SchoolHowTravel ST-PatInfo Answer PatInfo-95 Bus Activity Information INFO SchoolHowTravel ST-PatInfo Answer PatInfo-96 Walk Activity Information INFO SchoolHowTravel ST-PatInfo Answer PatInfo-97 Bike Activity Information INFO SchoolHowTravel ST-PatInfo Answer other Other Activity Information INFO SchoolHowTravel ST-PatInfo Question Bus Rev-22 How many minutes does it take you to get to school? Activity Information numpad INFO SchoolTravelMinutes 27 range 0 180 ST-PatInfo Question PatInfo-100 Do you own or have access to a car? Activity Information single INFO HaveCar 28 ST-PatInfo Answer PatInfo-101 Own a car Activity Information INFO HaveCar ST-PatInfo Answer PatInfo-102 Have access to car Activity Information INFO HaveCar ST-PatInfo Answer PatInfo-103 No car available Activity Information INFO HaveCar ST-PatInfo Subhead SHEAD_8 PatInfo-104 Tell us about Children in your home. Activity Information ChildrenHome INFO ST-PatInfo Question PatInfo-105 Do you have children living in your home? Activity Information single INFO ChildrenAtHome 29 ST-PatInfo Answer yes Yes Activity Information INFO ChildrenAtHome ST-PatInfo Answer no No Activity Information Home INFO ChildrenAtHome ST-PatInfo Question SHEAD_6 PatInfo-108 Do you get children ready for school Activity Information single INFO ChildrenReadySchool 30 ST-PatInfo Answer yes Yes Activity Information INFO ChildrenReadySchool ST-PatInfo Answer no No Activity Information INFO ChildrenReadySchool ST-PatInfo Question SHEAD_7 PatInfo-109 Do you take children to school Activity Information single INFO ChildrenTakeSchool 31 ST-PatInfo Answer yes Yes Activity Information INFO ChildrenTakeSchool ST-PatInfo Answer no No Activity Information INFO ChildrenTakeSchool ST-PatInfo Question PatInfo-110 How do you get to their school. Activity Information Single INFO ChildrenHowTravel 32 ST-PatInfo Answer PatInfo-111 Car Activity Information INFO ChildrenHowTravel ST-PatInfo Answer PatInfo-112 Bus Activity Information INFO ChildrenHowTravel ST-PatInfo Answer PatInfo-113 Walk Activity Information INFO ChildrenHowTravel ST-PatInfo Answer other Other Activity Information INFO ChildrenHowTravel ST-PatInfo Question PatInfo-115 Does anyone help with these activities Activity Information single INFO ChildrenHelp 33 ST-PatInfo Answer yes Yes Activity Information INFO ChildrenHelp ST-PatInfo Answer no No Activity Information INFO ChildrenHelp ST-PatInfo Subhead SHEAD_9 PatInfo-116 Tell us about your Home. Activity Information Home INFO ST-PatInfo Question PatInfo-117 Is your home an apartment, house, duplex or other? Activity Information single INFO HomeType 34 ST-PatInfo Answer PatInfo-118 House Activity Information INFO HomeType ST-PatInfo Answer PatInfo-119 Apartment Activity Information INFO HomeType ST-PatInfo Answer PatInfo-120 Duplex Activity Information INFO HomeType ST-PatInfo Answer other Other Activity Information INFO HomeType ST-PatInfo Question Steps PatInfo-122 How many floors are in your home? Activity Information numpad INFO HomeNumFloors 35 range 1 10 ST-PatInfo Question TV PatInfo-123 Do you have a TV that works? Activity Information single INFO HomeTV 36 ST-PatInfo Answer yes Yes Activity Information INFO HomeTV ST-PatInfo Answer no No Activity Information INFO HomeTV ST-PatInfo Question VCR PatInfo-124 Do you have a DVD or VCR player that works? Activity Information single INFO HomeDVD 37 ST-PatInfo Answer yes Yes Activity Information INFO HomeDVD ST-PatInfo Answer no No Activity Information HouseClean INFO HomeDVD ST-PatInfo Question VCR PatInfo-125 Do you use your DVD or VCR without help from someone? Activity Information single INFO HomeDVDuse 38 ST-PatInfo Answer yes Yes Activity Information INFO HomeDVDuse ST-PatInfo Answer no No Activity Information INFO HomeDVDuse ST-PatInfo Question House PatInfo-126 In your home, who does most of: House cleaning Activity Information single HouseClean INFO HomeCleaning 39 ST-PatInfo Answer PatInfo-127 Me Activity Information INFO HomeCleaning ST-PatInfo Answer PatInfo-128 Someone Else Activity Information INFO HomeCleaning ST-PatInfo Question Cooking PatInfo-129 In your home, who does most of: Cooking Activity Information single INFO HomeCooking 40 ST-PatInfo Answer PatInfo-130 Me Activity Information INFO HomeCooking ST-PatInfo Answer PatInfo-131 Someone Else Activity Information INFO HomeCooking ST-PatInfo Question coat PatInfo-132 In your home, who does most of: Shopping Activity Information single INFO HomeShopping 41 ST-PatInfo Answer PatInfo-133 Me Activity Information INFO HomeShopping ST-PatInfo Answer PatInfo-134 Someone Else Activity Information INFO HomeShopping ST-PatInfo Question Bus PatInfo-135 In your home, who does most of: Errands Activity Information single INFO HomeErrands 42 ST-PatInfo Answer PatInfo-136 Me Activity Information INFO HomeErrands ST-PatInfo Answer PatInfo-137 Someone Else Activity Information INFO HomeErrands ST-PatInfo Question Race PatInfo-138 If you do these things, do you have help? Activity Information single INFO HomeHelp 43 ST-PatInfo Answer PatInfo-139 No help Activity Information INFO HomeHelp ST-PatInfo Answer PatInfo-140 Some Help Activity Information INFO HomeHelp ST-PatInfo Answer PatInfo-141 A lot of Help Activity Information INFO HomeHelp ST-PatInfo Answer PatInfo-141a Do not do these Activity Information INFO HomeHelp ST-PatInfo Subhead SHEAD_10 PatInfo-142 Exercise Equipment and Places Activity Information ExerciseEquipment INFO ST-PatInfo Question exercise Rev-23 What type of exercise equipment do you have? Touch all that you have at home. Activity Information multiple INFO ExerEqType 44 ST-PatInfo Answer PatInfo-147 Weights Activity Information INFO ExerEqType ST-PatInfo Answer PatInfo-148 Treadmill Activity Information INFO ExerEqType ST-PatInfo Answer Rev-24 Exercise bike. Activity Information INFO ExerEqType ST-PatInfo Answer Rev-25 Elliptical or Stair climber Activity Information INFO ExerEqType ST-PatInfo Answer Rev-26 Stretch bands. Activity Information INFO ExerEqType ST-PatInfo Answer Rev-27 Working pedometer (step counter) Activity Information INFO ExerEqType ST-PatInfo Answer other Other Activity Information INFO ExerEqType ST-PatInfo Answer None None Activity Information Tapes INFO ExerEqType ST-PatInfo Question Rev-29 Which of the items you checked is the most comfortable for you to use? Activity Information single INFO 45 ST-PatInfo Answer PatInfo-147 Weights Activity Information INFO ExerEqComfort ST-PatInfo Answer PatInfo-148 Treadmill Activity Information INFO ExerEqComfort ST-PatInfo Answer Rev-24 Exercise bike. Activity Information INFO ExerEqComfort ST-PatInfo Answer Rev-25 Elliptical or Stair climber Activity Information INFO ExerEqComfort ST-PatInfo Answer Rev-26 Stretch bands. Activity Information INFO ExerEqComfort ST-PatInfo Answer Rev-27 Working pedometer (step counter) Activity Information INFO ExerEqComfort ST-PatInfo Answer other Other Activity Information INFO ExerEqComfort ST-PatInfo Question Rev-34 Which of these items are you using right now? ?Touch all you are using and then touch OK. Activity Information multiple INFO 46 ST-PatInfo Answer PatInfo-147 Weights Activity Information INFO ExerEqUseNow ST-PatInfo Answer PatInfo-148 Treadmill Activity Information INFO ExerEqUseNow ST-PatInfo Answer Rev-24 Exercise bike. Activity Information INFO ExerEqUseNow ST-PatInfo Answer Rev-25 Elliptical or Stair climber Activity Information INFO ExerEqUseNow ST-PatInfo Answer Rev-26 Stretch bands. Activity Information INFO ExerEqUseNow ST-PatInfo Answer Rev-27 Working pedometer (step counter) Activity Information INFO ExerEqUseNow ST-PatInfo Answer other Other Activity Information INFO ExerEqUseNow ST-PatInfo Question PatInfo-156 Do you have any exercise DVDs or videotapes? Activity Information single Tapes INFO ExerDVDhave 47 ST-PatInfo Answer yes Yes Activity Information INFO ExerDVDhave ST-PatInfo Answer no No Activity Information AvailRecCtr INFO ExerDVDhave ST-PatInfo Question exercise PatInfo-159 Are you comfortable using them? Activity Information single INFO ExerDVDUseIt 48 ST-PatInfo Answer yes Yes Activity Information INFO ExerDVDUseIt ST-PatInfo Answer no No Activity Information INFO ExerDVDUseIt ST-PatInfo Question PatInfo-160 Can they be used now the way your furniture is arranged? Activity Information single INFO ExerDVDPlaceOK 49 ST-PatInfo Answer yes Yes Activity Information INFO ExerDVDPlaceOK ST-PatInfo Answer no No Activity Information INFO ExerDVDPlaceOK ST-PatInfo Question Family PatInfo-161 Will family member object to having you use this area for exercise? Activity Information YesNo INFO ExerDVDFamilyOK 50 ST-PatInfo Question RecCtr PatInfo-165 Here is a list of recreational centers in this area. Touch ones that are convenient to you. If none convenient, touch None. Activity Information List AvailRecCtr INFO ExerCtrConvenient 51 RecCenters ST-PatInfo Question Bus PatInfo-164 How many minutes would it take to get to the closest one from your home? Activity Information numpad INFO ExerCtrMinutes 52 range 0 180 ST-PatInfo Question RecCtr PatInfo-166 Have you ever gone to any of these recreation centers? Activity Information single INFO ExerCtrVisit 53 ST-PatInfo Answer yes Yes Activity Information INFO ExerCtrVisit ST-PatInfo Answer no No Activity Information INFO ExerCtrVisit ST-PatInfo Question RecCtr PatInfo-167 Are you a member of a gym or recreation center? Activity Information single INFO ExerCtrMemberNow 54 ST-PatInfo Answer yes Yes Activity Information INFO ExerCtrMemberNow ST-PatInfo Answer no No Activity Information INFO ExerCtrMemberNow ST-PatInfo Question RecCtr PatInfo-170 Have you ever been a member of a gym or recreation center? Activity Information single INFO ExerCtrMemberEver 55 ST-PatInfo Answer yes Yes Activity Information INFO ExerCtrMemberEver ST-PatInfo Answer no No Activity Information INFO ExerCtrMemberEver ST-PatInfo Subhead SHEAD_11 PatInfo-171 TIME: How do you spend your day? Activity Information YourTime INFO ST-PatInfo Question Car Rev-39 What is your last activity outside the house on a typical day? Activity Information single INFO TimeLastAct 56 ST-PatInfo Answer PatInfo-173 Work Activity Information INFO TimeLastAct ST-PatInfo Answer PatInfo-174 School Activity Information INFO TimeLastAct ST-PatInfo Answer Rev-40 Picking up and driving others Activity Information INFO TimeLastAct ST-PatInfo Answer PatInfo-176 Errands Activity Information INFO TimeLastAct ST-PatInfo Question House Rev-41 What time do you get home from this last activity on a typical day? Enter the hour you get home and then touch OK. Activity Information numpad INFO TimeArrHome 57 time ST-PatInfo Subhead SHEAD_13 Rev-42 Weight History Weight Loss History Dieting INFO ST-PatInfo Question Scales PatInfo-179 What is the heaviest you have ever been? Weight Loss History numpad INFO WgtHeaviest 58 range 1 1200 ST-PatInfo Question Birthday PatInfo-180 At what age did you last have this weight? Weight Loss History numpad INFO WgtAgeHeaviest 59 age ST-PatInfo Question Scales PatInfo-181 What is the lowest weight that you have had as an adult? Weight Loss History numpad INFO WgtLowest 60 range 1 1200 ST-PatInfo Question Birthday PatInfo-182 At what age did you last have this weight? Weight Loss History numpad INFO WgtAgeLowest 61 age ST-PatInfo Question Scales Rev-43 What was your lowest weight when you were dieting? Enter your weight and then touch OK. Weight Loss History numpad INFO WgtDietLow 62 range 1 1200 ST-PatInfo Subhead SHEAD_13 PatInfo-208 Dieting Weight Loss History Dieting INFO ST-PatInfo Question Rev-44 How many times have you tried a diet for at least 3 weeks to lose weight? Weight Loss History numpad INFO DietTimes 63 range 0 500 WeightLossHistory ST-PatInfo Question RecCtr Rev-45 What kinds of diets have you tried in the past? Touch all that apply, then touch OK. Weight Loss History multiple INFO WgtTried 64 ST-PatInfo Answer Rev-55 counting calories Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-56 reducing portions Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-57 cutting back on high fat foods or sweets Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-49 Weight Watchers Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-50 Jenny Craig Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-51 South Beach Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-52 Atkins Weight Loss History INFO WgtTried ST-PatInfo Answer Rev-53 Slimfast Weight Loss History INFO WgtTried ST-PatInfo Answer other Other Weight Loss History INFO WgtTried ST-PatInfo Question apple Rev-54 On which diet did you lose the most weight? Weight Loss History multiple INFO WgtSuccess 65 ST-PatInfo Answer Rev-55 counting calories Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-56 reducing portions Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-57 cutting back on high fat foods or sweets Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-49 Weight Watchers Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-50 Jenny Craig Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-51 South Beach Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-52 Atkins Weight Loss History INFO WgtSuccess ST-PatInfo Answer Rev-53 Slimfast Weight Loss History INFO WgtSuccess ST-PatInfo Answer other Other Weight Loss History INFO WgtSuccess ST-PatInfo Question RecCtr PatInfo-196 Which did you like the best? Weight Loss History single INFO WgtLike 66 ST-PatInfo Answer Rev-55 counting calories Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-56 reducing portions Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-57 cutting back on high fat foods or sweets Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-49 Weight Watchers Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-50 Jenny Craig Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-51 South Beach Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-52 Atkins Weight Loss History INFO WgtLike ST-PatInfo Answer Rev-53 Slimfast Weight Loss History INFO WgtLike ST-PatInfo Answer other Other Weight Loss History INFO WgtLike ST-PatInfo Question Rev-71 Why did you stop following this diet? Touch each reason, then touch OK. Weight Loss History multiple INFO DietStop 67 ST-PatInfo Answer Rev-72 Still follow this diet Weight Loss History INFO DietStop ST-PatInfo Answer Rev-73 could not afford Weight Loss History INFO DietStop ST-PatInfo Answer Rev-74 took too much time Weight Loss History INFO DietStop ST-PatInfo Answer Rev-75 schedule changed Weight Loss History INFO DietStop ST-PatInfo Answer Rev-76 too hungry Weight Loss History INFO DietStop ST-PatInfo Answer Rev-151 lost motivation Weight Loss History INFO DietStop ST-PatInfo Answer Rev-151a got tired of food Weight Loss History INFO DietStop ST-PatInfo Answer other other Weight Loss History INFO DietStop ST-PatInfo Subhead SHEAD_12 Rev-78 Exercise Weight Loss History INFO DietStop ST-PatInfo Question RecCtr Rev-79 What kinds of exercise have you tried in the past? Touch all that apply, then touch OK. Weight Loss History multiple INFO ExerTried 68 ST-PatInfo Answer Rev-175 walking briskly outside or treadmill Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-176 bicycling or exercise bicycle Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-177 water aerobics Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-178 swimming Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-84 weight machines Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-85 dumbbells or weights Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-180 running or jogging Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-87 low impact aerobic class or tape Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-88 high impact aerobic class or tape Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-89 Pilates class or tape Weight Loss History INFO ExerTried ST-PatInfo Answer Rev-184 other exercise machine Weight Loss History INFO ExerTried ST-PatInfo Answer other other Weight Loss History INFO ExerTried ST-PatInfo Answer none none Weight Loss History WeightLossHistory INFO ExerTried ST-PatInfo Question Rev-91 Which exercises have been most successful for you? Touch all that apply, then touch OK. Weight Loss History multiple INFO ExerSuccess 69 ST-PatInfo Answer Rev-175 walking briskly outside or treadmill Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-176 bicycling or exercise bicycle Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-177 water aerobics Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-178 swimming Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-84 weight machines Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-85 dumbbells or weights Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-180 running or jogging Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-87 low impact aerobic class or tape Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-88 high impact aerobic class or tape Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-89 Pilates class or tape Weight Loss History INFO ExerSuccess ST-PatInfo Answer Rev-184 other exercise machine Weight Loss History INFO ExerSuccess ST-PatInfo Answer other other Weight Loss History INFO ExerSuccess ST-PatInfo Question RecCtr Rev-103 Which exercise did you like the best? Weight Loss History single INFO ExerLike 70 ST-PatInfo Answer Rev-175 walking briskly outside or treadmill Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-176 bicycling or exercise bicycle Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-177 water aerobics Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-178 swimming Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-84 weight machines Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-85 dumbbells or weights Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-180 running or jogging Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-87 low impact aerobic class or tape Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-88 high impact aerobic class or tape Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-89 Pilates class or tape Weight Loss History INFO ExerLike ST-PatInfo Answer Rev-184 other exercise machine Weight Loss History INFO ExerLike ST-PatInfo Answer other other Weight Loss History INFO ExerLike ST-PatInfo Question Sad Rev-115 Why did you stop your exercising? Touch all that apply. Weight Loss History multiple INFO WgtFailed 71 ST-PatInfo Answer Rev-116 too expensive Weight Loss History INFO ExerFailed ST-PatInfo Answer Rev-117 not enough time Weight Loss History INFO ExerFailed ST-PatInfo Answer Rev-118 did not like Weight Loss History INFO ExerFailed ST-PatInfo Answer Rev-119 pain Weight Loss History INFO ExerFailed ST-PatInfo Answer Rev-120 injury Weight Loss History INFO ExerFailed ST-PatInfo Answer Rev-121 Broken equipment Weight Loss History INFO ExerFailed ST-PatInfo Answer Rev-121a Lost motivation Weight Loss History INFO ExerFailed ST-PatInfo Answer other Other Weight Loss History INFO ExerFailed ST-PatInfo Subhead SHEAD_12 Rev-122 Weight Loss Medication & Appetite History Weight Loss History WeightLossHistory INFO ST-PatInfo Question Rev-123 Have you ever taken a prescription medication to lose weight? Weight Loss History single INFO WgtMed 72 ST-PatInfo Answer yes yes Weight Loss History WeightMeds INFO WgtMed ST-PatInfo Answer no no Weight Loss History WeightSuppl INFO WgtMed ST-PatInfo Question Rev-124 What prescriptions did you take? Touch all that apply and then press OK Weight Loss History multiple WeightMeds INFO WgtMed 73 ST-PatInfo Answer Rev-125 Phentermine (also called Adipex) Weight Loss History INFO WgtMed ST-PatInfo Answer Rev-126 FenFen Weight Loss History INFO WgtMed RecCenters ST-PatInfo Answer Rev-127 Orlistat (also called Xenical) Weight Loss History INFO WgtMed ST-PatInfo Answer Rev-128 Sibutramine (also called Meridia) Weight Loss History INFO WgtMed ST-PatInfo Answer Rev-129 Topiramate (also called Topamax) Weight Loss History INFO WgtMed ST-PatInfo Answer other other Weight Loss History INFO WgtMed ST-PatInfo Question Rev-130 Did the prescription help you lose and keep off weight? Weight Loss History single INFO WgtMedWork 74 ST-PatInfo Answer yes yes Weight Loss History INFO WgtMedWork ST-PatInfo Answer no no Weight Loss History INFO WgtMedWork ST-PatInfo Question Rev-131 Why did you stop taking the prescription? Touch all that apply and then touch OK Weight Loss History multiple INFO WgtMedWhyNot 75 ST-PatInfo Answer Rev-132 Could not afford medication Weight Loss History INFO WgtMedWhyNot ST-PatInfo Answer Rev-149 Side effects Weight Loss History INFO WgtMedWhyNot ST-PatInfo Answer Rev-150 could not afford doctor visits Weight Loss History INFO WgtMedWhyNot ST-PatInfo Answer Rev-151 lost motivation Weight Loss History INFO WgtMedWhyNot ST-PatInfo Answer Rev-152 did not work Weight Loss History INFO WgtMedWhyNot ST-PatInfo Answer other other Weight Loss History INFO WgtMedWhyNot ST-PatInfo Question Rev-137 Have you ever taken an over the counter supplement to lose weight? Weight Loss History single WeightSuppl INFO WgtSupTook 76 ST-PatInfo Answer yes yes Weight Loss History INFO WgtSupTook ST-PatInfo Answer no no Weight Loss History WeightDone INFO WgtSupTook ST-PatInfo Question Rev-138 Which supplements did you take? Touch all that apply and then press OK Weight Loss History multiple INFO WgtSupWhich 77 ST-PatInfo Answer Rev-139 Dexatrim Weight Loss History INFO WgtSupWhich ST-PatInfo Answer Rev-140 Alli Weight Loss History INFO WgtSupWhich ST-PatInfo Answer Rev-141 Trimspa Weight Loss History INFO WgtSupWhich ST-PatInfo Answer Rev-142 Ephedrine Weight Loss History INFO WgtSupWhich ST-PatInfo Answer Rev-143 Ma Huang Weight Loss History INFO WgtSupWhich ST-PatInfo Answer Rev-144 Bitter Orange Weight Loss History INFO WgtSupWhich ST-PatInfo Answer Rev-145 Hoodia Weight Loss History INFO WgtSupWhich ST-PatInfo Answer other other Weight Loss History INFO WgtSupWhich ST-PatInfo Question Rev-146 Did the supplement help you lose and keep off weight? Weight Loss History single INFO WgtSuppWork 78 ST-PatInfo Answer yes yes Weight Loss History INFO WgtSuppWork ST-PatInfo Answer no no Weight Loss History INFO WgtSuppWork ST-PatInfo Question Rev-147 Why did you stop taking the supplement? Touch all that apply and then touch OK Weight Loss History multiple INFO WgtSupQuit 79 ST-PatInfo Answer Rev-148 Could not afford medication Weight Loss History INFO WgtSupQuit ST-PatInfo Answer Rev-149 Side effects Weight Loss History INFO WgtSupQuit ST-PatInfo Answer Rev-151 lost motivation Weight Loss History INFO WgtSupQuit ST-PatInfo Answer Rev-152 did not work Weight Loss History INFO WgtSupQuit ST-PatInfo Answer other other Weight Loss History INFO WgtSupQuit ST-PatInfo Question Pills Rev-153 Which of these things have you ever done while trying to lose weight? Weight Loss History multiple WeightDone INFO DietMethods 80 ST-PatInfo Answer PatInfo-211 used water pills (also known as diuretics) Weight Loss History INFO DietMethods ST-PatInfo Answer PatInfo-212 used laxatives Weight Loss History INFO DietMethods ST-PatInfo Answer PatInfo-213 used purging or throwing up Weight Loss History INFO DietMethods ST-PatInfo Answer PatInfo-214 use starving or skipping eating Weight Loss History INFO DietMethods ST-PatInfo Answer Rev-154 binge eating until uncomfortably full Weight Loss History INFO DietMethods ST-PatInfo Answer none none Weight Loss History INFO DietMethods ST-PatInfo Answer other other Weight Loss History INFO DietMethods ST-PatInfo Subhead SHEAD_14 PatInfo-216 Appetite History Weight Loss History Appetite INFO ST-PatInfo Question IceCream PatInfo-217 Do you experience cravings for certain foods? Weight Loss History single INFO AptCravings 81 ST-PatInfo Answer yes Yes Weight Loss History INFO AptCravings ST-PatInfo Answer no No Weight Loss History INFO AptCravings ST-PatInfo Answer Sometimes Sometimes Weight Loss History INFO AptCravings ST-PatInfo Question Sad PatInfo-221 Do you eat in response to stress? Weight Loss History single INFO AptStress 82 ST-PatInfo Answer yes Yes Weight Loss History INFO AptStress ST-PatInfo Answer no No Weight Loss History INFO AptStress ST-PatInfo Answer Sometimes Sometimes Weight Loss History INFO AptStress ST-PatInfo Question Pizza PatInfo-225 Do you use food for comfort? Weight Loss History single INFO AptComfort 83 ST-PatInfo Answer yes Yes Weight Loss History INFO AptComfort ST-PatInfo Answer no No Weight Loss History INFO AptComfort ST-PatInfo Answer Sometimes Sometimes Weight Loss History INFO AptComfort ST-PatInfo Question Potato PatInfo-229 Do you eat from boredom? Weight Loss History single INFO AptBoredom 84 ST-PatInfo Answer yes Yes Weight Loss History INFO AptBoredom ST-PatInfo Answer no No Weight Loss History INFO AptBoredom ST-PatInfo Answer Sometimes Sometimes Weight Loss History INFO AptBoredom ST-PatInfo Question WomanB PatInfo-233 Do you eat when not hungry? Weight Loss History single INFO AptNotHungry 85 ST-PatInfo Answer yes Yes Weight Loss History INFO AptNotHungry ST-PatInfo Answer no No Weight Loss History INFO AptNotHungry ST-PatInfo Answer Sometimes Sometimes Weight Loss History INFO AptNotHungry ST-PatInfo Question WomanW PatInfo-237 Do you eat because you are always hungry? Weight Loss History single INFO AptAlwaysHungry 86 ST-PatInfo Answer yes Yes Weight Loss History INFO AptAlwaysHungry ST-PatInfo Answer no No Weight Loss History INFO AptAlwaysHungry ST-PatInfo Answer Sometimes Sometimes Weight Loss History INFO AptAlwaysHungry ST-PatInfo Subhead SHEAD_15 PatInfo-241 History of Abuse History of Abuse Abuse INFO ST-PatInfo Question Rev-155 Do you believe that you have ever been physically, emotionally or sexually abused by others? History of Abuse single INFO AbuseEver 87 ST-PatInfo Answer yes Yes Weight Loss History INFO AbuseEver ST-PatInfo Answer no No Weight Loss History INFO AbuseEver ST-PatInfo Question Rev-156 Do you believe that you are currently being physically, emotionally or sexually abused by others? History of Abuse Single INFO AbuseCurrent 88 ST-PatInfo Answer yes Yes History of Abuse INFO AbuseCurrent ST-PatInfo Answer no No History of Abuse Relationships INFO AbuseCurrent ST-PatInfo Question PatInfo-246 Have you every received help or therapy for abuse? History of Abuse single INFO AbuseHelp 89 ST-PatInfo Answer yes Yes History of Abuse INFO AbuseHelp ST-PatInfo Answer no No History of Abuse INFO AbuseHelp ST-PatInfo Subhead SHEAD_16 PatInfo-247 Your Relationships History of Abuse Relationships INFO ST-PatInfo Question PatInfo-248 Are you in a marriage or partnership with a ‘significant other’? History of Abuse single INFO RelHave 90 ST-PatInfo Answer yes Yes History of Abuse INFO RelHave ST-PatInfo Answer no No History of Abuse FoodChoices INFO RelHave ST-PatInfo Question PatInfo-249 Do you feel safe in this relationship? History of Abuse Single INFO RelSafe 91 ST-PatInfo Answer PatInfo-250 Very safe History of Abuse INFO RelSafe ST-PatInfo Answer PatInfo-251 Somewhat safe History of Abuse INFO RelSafe ST-PatInfo Answer PatInfo-252 Not very safe History of Abuse INFO RelSafe ST-PatInfo Question Rev-157 Do you believe your relationship problems have contributed to or caused your weight problem? History of Abuse single INFO RelIssues 92 ST-PatInfo Answer yes Yes History of Abuse INFO RelIssues ST-PatInfo Answer no No History of Abuse INFO RelIssues ST-PatInfo Question Rev-158 Do you believe your weight problem has contributed to or caused relationship problems ? History of Abuse single INFO WtIssues 93 ST-PatInfo Answer yes Yes History of Abuse INFO WtIssues ST-PatInfo Answer no No History of Abuse INFO WtIssues ST-PatInfo Question PatInfo-254 Does your spouse or ‘significant other’ have a weight problem? History of Abuse single INFO RelSpouseProb 94 ST-PatInfo Answer yes Yes History of Abuse INFO RelSpouseProb ST-PatInfo Answer no No History of Abuse INFO RelSpouseProb ST-PatInfo Subhead SHEAD_17 PatInfo-255 Typical Food Choices Typical Food Choices FoodChoices INFO ST-PatInfo Question Pizza PatInfo-262 Please indicate each of the fast food places you have been to in the past month? Check box multiple INFO FoodFastRest 95 ST-PatInfo Answer Rev-159 Fast Food Beef Check box INFO FoodFastRest ST-PatInfo Answer Rev-160 Fast Food Chicken Check box INFO FoodFastRest ST-PatInfo Answer Rev-161 Fast Food Sandwiches Check box INFO FoodFastRest ST-PatInfo Answer Rev-162 Fast Food Pizza Check box INFO FoodFastRest ST-PatInfo Answer PatInfo-265 Fast Food Chinese Check box INFO FoodFastRest ST-PatInfo Answer Rev-164 Fast Food Mexican Check box INFO FoodFastRest ST-PatInfo Answer Rev-165 Fast Food Breakfast Check box INFO FoodFastRest ST-PatInfo Answer Rev-166 Fast Food Donuts Check box INFO FoodFastRest ST-PatInfo Answer other Other Check box INFO FoodFastRest ST-PatInfo Question ST-blank Rev-167 How many meals have you cooked and eaten at home in the past week. Typical Food Choices numpad INFO FoodMealsHome 96 range 0 100 ST-PatInfo Question ST-blank Rev-168 How many meals (including drive-thru) have you eaten outside the home in the past week. Typical Food Choices numpad INFO FoodMealsOut 97 range 0 100 ST-PatInfo Subhead SHEAD_18 PatInfo-275 Current Activity Current Activity Activity INFO ST-PatInfo Question PatInfo-276 Which of these home or work activities have you done in the past month? Current Activity multiple INFO ActDone 98 ST-PatInfo Answer Rev-169 gardening Current Activity INFO ActDone ST-PatInfo Answer Rev-170 vacuuming Current Activity INFO ActDone ST-PatInfo Answer Rev-171 laundry Current Activity INFO ActDone ST-PatInfo Answer Rev-172 carrying 5 pounds 2 hours/day Current Activity INFO ActDone ST-PatInfo Answer Rev-173 carrying5-10 pounds 2 hours/day Current Activity INFO ActDone ST-PatInfo Answer Rev-174 mowing the lawn with a push mower Current Activity INFO ActDone ST-PatInfo Answer other other Current Activity INFO ActDone ST-PatInfo Question PatInfo-285 Which of these exercises have you done in the past month? Current Activity multiple INFO ExerDone 99 ST-PatInfo Answer Rev-175 walking briskly outside or treadmill Current Activity INFO ExerDone ST-PatInfo Answer Rev-176 bicycling or exercise bicycle Current Activity INFO ExerDone ST-PatInfo Answer Rev-177 water aerobics Current Activity INFO ExerDone ST-PatInfo Answer Rev-178 swimming Current Activity INFO ExerDone ST-PatInfo Answer Rev-179 weightlifting (machines, dumbells & weights) Current Activity INFO ST-PatInfo Answer Rev-180 running or jogging Current Activity INFO ExerDone ST-PatInfo Answer Rev-181 low impact aerobic class, tape/dvd Current Activity INFO ExerDone ST-PatInfo Answer Rev-182 high impact aerobic class, tape/dvd Current Activity INFO ExerDone ST-PatInfo Answer Rev-183 Pilates class, tape/dvd Current Activity INFO ST-PatInfo Answer Rev-184 other exercise machine Current Activity INFO ST-PatInfo Answer other other Current Activity INFO ST-PatInfo Answer none none Current Activity INFO ST-PatInfo Subhead SHEAD_22 PatInfo-354 Physical Activity PACE-readiness to change activity PhysicalActivity INFO ST-PatInfo Question Rev-185 Do you exercise now? PACE-readiness to change activity single ExerNow INFO 100 ST-PatInfo Answer yes Yes PACE-readiness to change activity HowOftenEx INFO ST-PatInfo Answer no No PACE-readiness to change activity ExerPlan INFO ST-PatInfo Question Rev-186 Do you plan to start exercising in the next 6 months? PACE-readiness to change activity single ExerPlan INFO 101 ST-PatInfo Answer yes Yes PACE-readiness to change activity ChestPain INFO ST-PatInfo Answer no No PACE-readiness to change activity ChestPain INFO ST-PatInfo Question Rev-187 How often do you exercise? PACE-readiness to change activity single HowOftenEx INFO 102 ST-PatInfo Answer Rev-188 I do not exercise regularly PACE-readiness to change activity INFO ST-PatInfo Answer Rev-189 I exercise every week: less than 4 times PACE-readiness to change activity INFO ST-PatInfo Answer Rev-190 I exercise every week: 5 or more times PACE-readiness to change activity INFO ST-PatInfo Question Rev-191 Has your doctor said you should only do certain exercises because you have a heart problem? PACE-readiness to change activity single INFO 103 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Question Rev-192 Do you feel pain in your chest when you exercise or do physical activity? PACE-readiness to change activity single ChestPain INFO 104 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Question Rev-193 In the past month, have you had chest pain when you were NOT exercising? PACE-readiness to change activity single INFO 105 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Question Rev-194 Do you lose your balance because of dizziness or do you ever pass out? PACE-readiness to change activity single INFO 106 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Question Rev-195 Do you have a bone or joint problems that could get worse if you change your exercise or physical activity? PACE-readiness to change activity single INFO 107 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Question Rev-196 Are you taking prescription medications for your blood pressure or a heart condition? PACE-readiness to change activity single INFO 108 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Question Rev-197 Is there any other reason you should not exercise? PACE-readiness to change activity single INFO 109 ST-PatInfo Answer yes Yes PACE-readiness to change activity INFO ST-PatInfo Answer no No PACE-readiness to change activity INFO ST-PatInfo Body Rev-198 I will ask you about personal exercise you do outside of your work. PACE-readiness to change activity INFO ST-PatInfo Body Rev-199 Examples of personal exercise include: walking, running, swimming, dancing, bike riding, aerobics and lifting weights. PACE-readiness to change activity INFO ST-PatInfo Question Rev-200 How much do you exercise, outside of your work. PACE-readiness to change activity single INFO 110 ST-PatInfo Answer Rev-201 Exercise 5 days a week for at least a month. PACE-readiness to change activity INFO ST-PatInfo Answer Rev-202 Have started but don't exercise regularly. PACE-readiness to change activity INFO ST-PatInfo Answer Rev-203 Don't exercise now but thinking of starting. PACE-readiness to change activity INFO ST-PatInfo Answer Rev-204 Don't exercise now and probably won't start in next 6 months. PACE-readiness to change activity INFO ST-PatInfo Subhead SHEAD_19 PatInfo-294 Your Health Your Health Health INFO ST-PatInfo Body Doctor PatInfo-301 During the past MONTH have you OFTEN been bothered by: Please answer YES or NO Pfizer- PRIME-MD INFO ST-PatInfo Question PatInfo-302 Stomach pain Pfizer- PRIME-MD YesNo INFO HealthStomach 111 ST-PatInfo Question PatInfo-303 Back pain Pfizer- PRIME-MD YesNo INFO HealthBack 112 ST-PatInfo Question PatInfo-304 Pain in your arms, legs or joints Pfizer- PRIME-MD YesNo INFO HealthJoint 113 ST-PatInfo Question PatInfo-305 (Female only) Menstrual pain or problems Pfizer- PRIME-MD YesNo INFO HealthMenstral 114 ST-PatInfo Question PatInfo-306 Pain or problems during sexual intercourse Pfizer- PRIME-MD YesNo INFO HealthSex 115 ST-PatInfo Question PatInfo-307 Headaches Pfizer- PRIME-MD YesNo INFO HealthHeadache 116 ST-PatInfo Question PatInfo-308 Chest pain Pfizer- PRIME-MD YesNo INFO HealthChest 117 ST-PatInfo Question PatInfo-309 Dizziness Pfizer- PRIME-MD YesNo INFO HealthDizzy 118 ST-PatInfo Question PatInfo-310 Fainting spells Pfizer- PRIME-MD YesNo INFO HealthFaint 119 ST-PatInfo Question PatInfo-311 Feeling your heart pound or race Pfizer- PRIME-MD YesNo INFO HealthHeart 120 ST-PatInfo Question PatInfo-312 Shortness of breath Pfizer- PRIME-MD YesNo INFO HealthBreath 121 ST-PatInfo Question PatInfo-313 Constipation, loose bowels or diarrhea Pfizer- PRIME-MD YesNo INFO HealthBowels 122 ST-PatInfo Question PatInfo-314 Nausea, gas or indigestion Pfizer- PRIME-MD YesNo INFO HealthNausea 123 ST-PatInfo Question PatInfo-315 Feeling tired or having low energy Pfizer- PRIME-MD YesNo INFO HealthTired 124 ST-PatInfo Question PatInfo-316 Trouble sleeping Pfizer- PRIME-MD YesNo INFO HealthSleeping 125 ST-PatInfo Question PatInfo-317 The thought that you have a serious undiagnosed disease Pfizer- PRIME-MD YesNo INFO HealthWorry 126 ST-PatInfo Question PatInfo-318 Your eating being out of control. Pfizer- PRIME-MD YesNo INFO Health 127 ST-PatInfo Question PatInfo-319 Little interest pleasure in doing things Pfizer- PRIME-MD YesNo INFO Health 128 ST-PatInfo Question PatInfo-320 Feeling down, depressed or hopeless Pfizer- PRIME-MD YesNo INFO Health 129 ST-PatInfo Question PatInfo-321 “Nerves” or feeling anxious or on edge Pfizer- PRIME-MD YesNo INFO Health 130 ST-PatInfo Question PatInfo-322 Worrying about a lot of different things Pfizer- PRIME-MD YesNo INFO Health 131 ST-PatInfo Question Rev-205 Have you had an anxiety attack (suddenly feeling fear or panic) Pfizer- PRIME-MD YesNo INFO Health 132 ST-PatInfo Question Rev-305 Have you thought you should cut down on your drinking of alcohol? Pfizer- PRIME-MD YesNo INFO Health 133 ST-PatInfo Question Rev-306 Has anyone complained about your drinking? Pfizer- PRIME-MD YesNo INFO Health 134 ST-PatInfo Question Rev-307 Have you felt guilty or upset about your drinking? Pfizer- PRIME-MD YesNo INFO Health 135 ST-PatInfo Question Rev-308 Was there ever a single day in which you had five or more drinks of beer, wine, or liquor? Pfizer- PRIME-MD YesNo INFO Health 136 ST-PatInfo Question Doctor PatInfo-295 Overall, would you say your health is: Pfizer- PRIME-MD single INFO HealthRate 110 ST-PatInfo Answer PatInfo-296 Excellent Pfizer- PRIME-MD INFO HealthRate ST-PatInfo Answer PatInfo-297 Very good Pfizer- PRIME-MD INFO HealthRate ST-PatInfo Answer PatInfo-298 Good Pfizer- PRIME-MD INFO HealthRate ST-PatInfo Answer PatInfo-299 Fair Pfizer- PRIME-MD INFO HealthRate ST-PatInfo Answer PatInfo-300 Poor Pfizer- PRIME-MD INFO HealthRate ST-PatInfo Subhead PatInfo-328 Allergies Your Health INFO HealthRate ST-PatInfo Question SHEAD_20 Rev-210 Do you have any allergies? Your Health single Allergies INFO AlgyHave 138 ST-PatInfo Answer yes Yes Your Health INFO AlgyHave ST-PatInfo Answer no No Your Health Medications INFO AlgyHave ST-PatInfo Answer PatInfo-332 Not Sure Your Health INFO AlgyHave ST-PatInfo Question PatInfo-333 Touch all the things that you are allergic to: Your Health multiple INFO AlgyHave 139 ST-PatInfo Answer PatInfo-334 Pets Your Health INFO AlgyWhat ST-PatInfo Answer PatInfo-335 Plants Your Health INFO AlgyWhat ST-PatInfo Answer PatInfo-336 Food Your Health INFO AlgyWhat ST-PatInfo Answer PatInfo-337 Medicine Your Health INFO AlgyWhat ST-PatInfo Answer Rev-211 Dust Your Health INFO AlgyWhat ST-PatInfo Answer PatInfo-338a Chemicals Your Health INFO AlgyWhat ST-PatInfo Answer other Other Your Health INFO AlgyWhat ST-PatInfo Subhead SHEAD_21 PatInfo-340 Medications Your Health Medications INFO ST-PatInfo Question Guide Rev-212 Did you review your medication list with the STRIDES staff? MetroHealthMeds single INFO MedTaken 140 ST-PatInfo Answer Guide yes Yes MetroHealthMeds INFO MedTaken ST-PatInfo Answer Guide no No MetroHealthMeds INFO MedTaken ST-PatInfo Question Rev-213 Are all of your medications prescribed by doctors at MetroHealth? MetroHealthMeds single Drugs INFO MetoMeds 141 ST-PatInfo Answer yes Yes MetroHealthMeds drugdays INFO MetoMeds ST-PatInfo Answer no No MetroHealthMeds drugdays INFO MetoMeds ST-PatInfo Answer Rev-228 I do not take prescription medications MetroHealthMeds EatingPlan INFO MetoMeds ST-PatInfo Question Rev-215 How many days did you miss taking your prescription medications in the past month? MetroHealthMeds single drugdays INFO DaysMissMeds 142 ST-PatInfo Answer None none MetroHealthMeds EatingPlan INFO DaysMissMeds ST-PatInfo Answer Rev-217 1-3 days MetroHealthMeds EatingPlan INFO DaysMissMeds ST-PatInfo Answer Rev-218 4-7 days MetroHealthMeds drugmissed INFO DaysMissMeds ST-PatInfo Answer Rev-219 more than 7 days MetroHealthMeds drugmissed INFO DaysMissMeds ST-PatInfo Answer Rev-228 I do not take prescription medications MetroHealthMeds EatingPlan INFO DaysMissMeds ST-PatInfo Question Rev-221 Touch all reasons you missed taking prescription medications. Then touch OK. MetroHealthMeds multiple drugmissed INFO ReasonMissMeds 143 ST-PatInfo Answer Rev-222 forgot MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer Rev-223 medication side effects MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer Rev-224 no money MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer Rev-225 lost MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer Rev-226 was ill or hospitalized MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer Rev-227 had no refills MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer Rev-228 I do not take prescription medications MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Answer other other MetroHealthMeds INFO ReasonMissMeds ST-PatInfo Question Rev-229 Touch the statement that best describes 'your eating plan'. MetroHealthEating single EatingPlan INFO EatPlan 144 ST-PatInfo Answer Rev-230 I am overweight (or gaining weight) and do not want to cut calories now MetroHealthEating INFO EatPlan ST-PatInfo Answer Rev-231 I am overweight (or gaining weight) but am thinking about cutting calories. MetroHealthEating INFO EatPlan ST-PatInfo Answer Rev-232 I am overweight and am trying hard to cut calories but don’t do it every day. MetroHealthEating INFO EatPlan ST-PatInfo Answer Rev-233 I am not overweight and have not been gaining weight. MetroHealthEating INFO EatPlan ST-PatInfo Question Rev-234 How often do you have someone (like a family member, friend, hospital worker) help you read hospital materials? MetroHealthEating single INFO FamReadForms 145 ST-PatInfo Answer Never Never MetroHealthEating INFO FamReadForms ST-PatInfo Answer Rev-237 Occasionally MetroHealthEating INFO FamReadForms ST-PatInfo Answer Sometimes Sometimes MetroHealthEating INFO FamReadForms ST-PatInfo Answer AllAlways Almost Always MetroHealthEating INFO FamReadForms ST-PatInfo Answer Always Always MetroHealthEating INFO FamReadForms ST-PatInfo Question Rev-236 How often do you have problems learning about your condition because you don’t understand written information? MetroHealthEating single INFO 146 ST-PatInfo Answer Never Never MetroHealthEating INFO ST-PatInfo Answer Rev-237 Occasionally MetroHealthEating INFO ST-PatInfo Answer Sometimes Sometimes MetroHealthEating INFO ST-PatInfo Answer AllAlways Almost Always MetroHealthEating INFO ST-PatInfo Answer Always Always MetroHealthEating INFO ST-PatInfo Question Rev-309 How confident are you filling out medical forms by yourself? MetroHealthEating single INFO 147 ST-PatInfo Answer Rev-238 Not At All Confident MetroHealthEating INFO ST-PatInfo Answer Rev-239 Not Very Confident MetroHealthEating INFO ST-PatInfo Answer Rev-240 Somewhat Confident MetroHealthEating INFO ST-PatInfo Answer Rev-241 Fairly Confident MetroHealthEating INFO ST-PatInfo Answer Rev-310 Very Confident MetroHealthEating INFO ST-PatInfo Subhead Your Diet Your Diet YourDiet INFO ST-PatInfo Body Rev-242 I would like to ask you about the fruits or vegetables you eat. Examples of a serving of fruit or vegetables: MetroHealthEating INFO ST-PatInfo Body Rev-243 Ľ cup dried fruit MetroHealthEating INFO ST-PatInfo Body Rev-244 ˝ cup of raw, cooked, frozen, or canned fruits or vegetables MetroHealthEating INFO ST-PatInfo Body Rev-245 1 cup raw leafy vegetables MetroHealthEating INFO ST-PatInfo Body Rev-246 1 medium sized whole fruit such as an apple, banana, orange, pear, or peach MetroHealthEating INFO ST-PatInfo Question Rev-247 How many servings of fruits and vegetables do you eat on most days? MetroHealthEating single INFO 148 ST-PatInfo Answer None None MetroHealthEating INFO ST-PatInfo Answer Rev-249 1 serving MetroHealthEating INFO ST-PatInfo Answer Rev-250 2 servings MetroHealthEating INFO ST-PatInfo Answer Rev-251 3 servings MetroHealthEating INFO ST-PatInfo Answer Rev-252 4 servings MetroHealthEating INFO ST-PatInfo Answer Rev-253 5+ servings MetroHealthEating INFO ST-PatInfo Body Rev-254 I will ask you if you eat a 'low fat diet'. Examples of a low fat diet include: MetroHealthEating INFO ST-PatInfo Body Rev-255 Taking the skin off chicken, trimming the fat off meat MetroHealthEating INFO ST-PatInfo Body Rev-256 Using 1% or skim milk MetroHealthEating INFO ST-PatInfo Body Rev-257 No fast foods or deep fried foods MetroHealthEating INFO ST-PatInfo Question Rev-258 Do you eat a low fat diet? MetroHealthEating single INFO 149 ST-PatInfo Answer Rev-259 Not at all MetroHealthEating INFO ST-PatInfo Answer Rev-260 Not now, but thinking about it MetroHealthEating INFO ST-PatInfo Answer Rev-261 Sometimes, but not all the time MetroHealthEating INFO ST-PatInfo Answer Rev-262 All the time MetroHealthEating INFO ST-PatInfo Subhead Label Food Labels Food Labels INFO ST-PatInfo Title Label Label-1 Reading a Food Label Reading a Food Label label LABEL ST-PatInfo Body IceCream Label-1 This information is on the back of a container of pint of ice cream. Reading a Food Label LABEL ST-PatInfo Question Label Label-2 If you eat the entire container, how many calories will you eat? Reading a Food Label single LABEL Calories 150 ST-PatInfo Answer Label Label-3 120 Reading a Food Label LABEL Calories ST-PatInfo Answer Label Label-4 250 Reading a Food Label LABEL Calories ST-PatInfo Answer-R Label Label-5 1000 Reading a Food Label LabelQ2 LABEL Calories ST-PatInfo Answer Label Label-6 1500 Reading a Food Label LABEL Calories ST-PatInfo Answer Label Label-7 2000 Reading a Food Label LABEL Calories ST-PatInfo Answer Label NotSure Not Sure Reading a Food Label LABEL Calories ST-PatInfo Body Guide LabelCorrect-1 The correct answer was: 1000. 4 servings times 250 calories per serving. Reading a Food Label LabelQ2 LABEL Carbs 151 ST-PatInfo Question Label Label-9 If you are allowed to eat 60g of carbohydrates as a snack, how much ice cream could you have? Reading a Food Label single LabelQ2 LABEL Carbs 151 ST-PatInfo Answer Label Label-10 1/2 cup Reading a Food Label LABEL Carbs ST-PatInfo Answer-R Label Label-11 1 cup Reading a Food Label LabelQ3 LABEL Carbs ST-PatInfo Answer Label Label-12 1-1/2 cups Reading a Food Label LABEL Carbs ST-PatInfo Answer Label Label-13 2 cups Reading a Food Label LABEL Carbs ST-PatInfo Answer Label Label-14 whole container Reading a Food Label LABEL Carbs ST-PatInfo Answer Label NotSure Not Sure Reading a Food Label LABEL Carbs ST-PatInfo Body Guide LabelCorrect-2a The correct answer was: 1 cup. There are 30 carbohydrate grams in a 1/2 cup serving so you could eat 1 cup. Reading a Food Label LABEL Carbs 151 ST-PatInfo Body Doctor Label-16 Your doctor advises you to reduce the amount of saturated fat in your diet. Reading a Food Label LabelQ3 ST-PatInfo Question Label Label-17 You usually have 42g of saturated fat each day, which includes 1 serving of ice cream. If you stop eating ice cream, how many grams of saturated fat would you be consuming each day? Reading a Food Label single LABEL Fat 152 ST-PatInfo Answer Label Label-18 9g Reading a Food Label LABEL Fat ST-PatInfo Answer Label Label-19 13g Reading a Food Label LABEL Fat ST-PatInfo Answer Label Label-20 28g Reading a Food Label LABEL Fat ST-PatInfo Answer-R Label Label-21 33g Reading a Food Label LabelQ4 LABEL Fat ST-PatInfo Answer Label Label-22 fairly Confident Reading a Food Label LABEL Fat ST-PatInfo Answer Label NotSure Not Sure Reading a Food Label LABEL Fat ST-PatInfo Body Guide LabelCorrect-3 The correct answer was: 33g. Subtract 9g of saturated fat from 42g = 33g. Reading a Food Label LABEL Carbs 151 ST-PatInfo Question Label Label-24 If you usually eat 2500 calories in a day, what percentage of your daily value of calories will you be eating if you eat one serving? Reading a Food Label single LabelQ4 LABEL Percent 153 ST-PatInfo Answer Label Label-25 2% Reading a Food Label LABEL Percent ST-PatInfo Answer Label Label-26 8% Reading a Food Label LABEL Percent ST-PatInfo Answer-R Label Label-27 10% Reading a Food Label LabelQ5 LABEL Percent ST-PatInfo Answer Label Label-28 12% Reading a Food Label LABEL Percent ST-PatInfo Answer Label Label-29 20% Reading a Food Label LABEL Percent ST-PatInfo Answer Label NotSure Not Sure Reading a Food Label LABEL Percent ST-PatInfo Body Guide LabelCorrect-4 The correct answer was: 10%. Ice cream has 250 calories per serving which is 10% of a 2500 calorie diet. Reading a Food Label LABEL Carbs 151 ST-PatInfo Question Label Rev-263 Pretend the you are allergic to the following substances: Penicillin, peanuts, latex gloves, and bee stings. Is safe for you to eat this ice cream? Reading a Food Label single LabelQ5 LABEL Allergy 154 ST-PatInfo Answer Label yes Yes Reading a Food Label LABEL Allergy ST-PatInfo Answer-R Label Label-33 No Reading a Food Label Peanut LABEL Allergy ST-PatInfo Answer Label NotSure Not Sure Reading a Food Label LABEL Allergy ST-PatInfo Body Guide LabelCorrect-5b The correct answer was: No. Reading a Food Label LABEL Carbs 151 ST-PatInfo Question Label Label-35 Why not? Reading a Food Label single Peanut LABEL AllergyWhy 155 ST-PatInfo Answer-R Label Label-36 Because it has peanut oil? Reading a Food Label literacy LABEL AllergyWhy ST-PatInfo Answer Label Label-37 Because it is fattening? Reading a Food Label LABEL AllergyWhy ST-PatInfo Answer Label Label-38 Because it has egg yokes? Reading a Food Label LABEL AllergyWhy ST-PatInfo Answer Label NotSure Not Sure Reading a Food Label LABEL AllergyWhy ST-PatInfo Body Guide LabelCorrect-6 The correct answer was: 'because it contains peanut oil'. Reading a Food Label ExplainCorrect LABEL Carbs 151 ST-PatInfo Subhead Lieracy Rev-264a Medical forms Medical forms INFO ST-PatInfo Question Lieracy Rev-264 How often do you have someone (like a family member, friend, or hospital worker) help you read hospital materials? Jancin-Health Lieracy scale5 literacy INFO 156 ST-PatInfo Answer Lieracy Never Never Jancin-Health Lieracy INFO ST-PatInfo Answer Lieracy VeryOften Very Often Jancin-Health Lieracy INFO ST-PatInfo Question Lieracy Rev-309 How confident are you filling out medical forms by yourself? Jancin-Health Lieracy scale5 INFO 157 ST-PatInfo Answer Lieracy HthLit-Q2A1 Not Confident Jancin-Health Lieracy INFO ST-PatInfo Answer Lieracy Rev-310 Very Confident Jancin-Health Lieracy INFO ST-PatInfo Question Lieracy HthLit-Q3 How often do you have problems learning about your medical condition because of difficulty understanding written information? Jancin-Health Lieracy scale5 INFO 158 ST-PatInfo Answer Lieracy Never Never Jancin-Health Lieracy INFO ST-PatInfo Answer Lieracy VeryOften Very Often Jancin-Health Lieracy INFO ST-PatInfo Subhead Sleepiness Sleepiness Sleepiness INFO ST-PatInfo Body Sleepiness Doze-1 Please indicate the likelihood of your dozing or sleeping while doing the following. Eplworth Sleepiness Scale dozing INFO ST-PatInfo Question Sleepiness Doze-Q1 Sitting and reading Eplworth Sleepiness Scale single INFO 159 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Doze-Q2 Watching television Eplworth Sleepiness Scale single INFO 160 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Doze-Q3 Sitting inactive in a public place- for example, a theater or meeting Eplworth Sleepiness Scale single INFO 161 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Rev-265 As a passenger in a car for an hour without a break Eplworth Sleepiness Scale single INFO 162 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Doze-Q5 Lying down to rest in the afternoon Eplworth Sleepiness Scale single INFO 163 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Doze-Q6 Sitting and talking to someone Eplworth Sleepiness Scale single INFO 164 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Doze-Q7 Sitting quietly after lunch (when you've had no alcohol) Eplworth Sleepiness Scale single INFO 165 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Question Sleepiness Doze-Q8 In a car, while stopped in traffic Eplworth Sleepiness Scale single INFO 166 ST-PatInfo Answer Sleepiness Doze-A1 high chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A2 moderate chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A3 slight chance of dozing Eplworth Sleepiness Scale INFO ST-PatInfo Answer Sleepiness Doze-A4 would never doze Eplworth Sleepiness Scale INFO ST-PatInfo Body Fatigue Fatg-1 These questions ask you to rate your level of fatigue. Krupp - Fatigue Severity Scale fatigue INFO ST-PatInfo Body Fatigue Rev-266 Please rate how much you agree or disagree with these statements on how accurately it reflects your condition during the past week. Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q1 My motivation is lower when I am fatigued. Krupp - Fatigue Severity Scale scale7 INFO 167 ST-PatInfo Answer Fatigue Rev-267 Disagree strongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q2 Exercise brings on my fatigue. Krupp - Fatigue Severity Scale scale7 INFO 168 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q3 I am easily fatigued. Krupp - Fatigue Severity Scale scale7 INFO 169 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q4 Fatigue interferes with my physical functioning. Krupp - Fatigue Severity Scale scale7 INFO 170 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q5 Fatigue causes frequent problems for me. Krupp - Fatigue Severity Scale scale7 INFO 171 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q6 My fatigue prevents sustained physical functioning. Krupp - Fatigue Severity Scale scale7 INFO 172 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q7 Fatigue interferes with carrying out certain duties and resposiblities. Krupp - Fatigue Severity Scale scale7 INFO 173 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q8 Fatigue is among my three most disabling symptoms. Krupp - Fatigue Severity Scale scale7 INFO 174 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Question Fatigue Fatg-Q9 Fatigue interferes with my work, family, or social life. Krupp - Fatigue Severity Scale scale7 INFO 175 ST-PatInfo Answer Fatigue Fatg-A1 Disagree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Answer Fatigue Fatg-A2 Agree stongly Krupp - Fatigue Severity Scale INFO ST-PatInfo Subhead Diabetes Diab-0 Diabetes Diabetes INFO ST-PatInfo Question Diabetes Dia-Q1 Do you have diabetes? Vincze - Diabetes Educator. single Diab INFO 179 ST-PatInfo Answer Diabetes yes Yes Vincze - Diabetes Educator. INFO ST-PatInfo Answer Diabetes no No Vincze - Diabetes Educator. SelfReg INFO ST-PatInfo Question Diabetes Diab-Q2 How many times have you participated in a diabetes support group or in a diabetes education program during the past year? Vincze - Diabetes Educator. Community resources numpad INFO 177 range 0 1000 ST-PatInfo Question Diabetes Diab-Q3 In general how often do your family and friends support in monitoring blood sugar (glucose)? Vincze - Diabetes Educator. Social Support. scale5 INFO 178 ST-PatInfo Answer Diabetes Never Never Vincze - Diabetes Educator. Social Support. INFO ST-PatInfo Answer Diabetes Diab-Q3A2 At least once a week Vincze - Diabetes Educator. Social Support. INFO ST-PatInfo Question Diabetes Rev-269 Does your insurance cover any of the following items?......medication, supplies, glucometer……… Vincze - Diabetes Educator. Insurance. single INFO 179 ST-PatInfo Answer Diabetes yes Yes Vincze - Diabetes Educator. Insurance. INFO ST-PatInfo Answer Diabetes no No Vincze - Diabetes Educator. Insurance. INFO ST-PatInfo Answer Diabetes Dontknow Don't Know Vincze - Diabetes Educator. Insurance. INFO ST-PatInfo Question Diabetes Dia-Q5 How certain are you that you could test your blood sugar (glucose) at least once a day? Vincze - Diabetes Educator. Self-Efficacy scale5 INFO 180 ST-PatInfo Answer Diabetes Dia-Q5A1 completely certain I could not do this Vincze - Diabetes Educator. Self-Efficacy INFO ST-PatInfo Answer Diabetes Dia-Q5A2 completely certain I could Vincze - Diabetes Educator. Self-Efficacy INFO ST-PatInfo Question Diabetes Dia-Q6 How often does finding a place interfere with testing your blood sugar (glucose)? Vincze - Diabetes Educator. Enviromental Barriars. scale5 INFO 181 ST-PatInfo Answer Diabetes Never Never Vincze - Diabetes Educator. Enviromental Barriars. INFO ST-PatInfo Answer Diabetes Always Always Vincze - Diabetes Educator. Enviromental Barriars. INFO ST-PatInfo Subhead SelfRegulation Decisions Decisions SelfReg INFO ST-PatInfo Question SelfRegulation SRC-Q1 I often have a problem making a decision. Schroder - Self-Regulation Competence scale5 INFO 182 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Question SelfRegulation SRC-Q2 Once I have decided on something, I do not question it any longer Schroder - Self-Regulation Competence scale5 INFO 183 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Question SelfRegulation SRC-Q3 My decisions get easily shaken by objections of other people Schroder - Self-Regulation Competence scale5 INFO 184 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Question SelfRegulation Rev-270 When problems arise, I am the one who takes the initiative. Schroder - Self-Regulation Competence scale5 INFO 185 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Question SelfRegulation SRC-Q5 I usually succeed in translating good intentions into actions. Schroder - Self-Regulation Competence scale5 INFO 186 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Question SelfRegulation SRC-Q6 I often find it very hard to bring myself to take an unpleasant action. Schroder - Self-Regulation Competence scale5 INFO 187 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Question SelfRegulation SRC-Q7 When I fail in a matter of some importance to me, I stick to my guns and try even harder that before. Schroder - Self-Regulation Competence scale5 INFO 188 ST-PatInfo Answer SelfRegulation SRC-A1 not often at all Schroder - Self-Regulation Competence INFO ST-PatInfo Answer SelfRegulation SRC-A2 very often Schroder - Self-Regulation Competence INFO ST-PatInfo Subhead Guide Attitudes Attitudes INFO ST-PatInfo Body Guide SDS-1 Are the following statements about you, true or false? Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q1 I never hesitate to go out of my way to help someone in trouble. Marlowe-Crowne Social Desireability Scale single INFO 189 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q2 I have never intensely disliked anyone. Marlowe-Crowne Social Desireability Scale single INFO 190 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q3 There have been times when I was quite jealous of the good fortune of others. Marlowe-Crowne Social Desireability Scale single INFO 191 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q4 I would never think of letting someone else be punished for my wrong doings. Marlowe-Crowne Social Desireability Scale single INFO 192 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q5 I sometimes feel resentful when I don’t get my way. Marlowe-Crowne Social Desireability Scale single INFO 193 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q6 There have been times when I felt like rebelling against people in authority even though I knew they were right. Marlowe-Crowne Social Desireability Scale single INFO 194 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q7 I am always courteous, even to people who are disagreeable. Marlowe-Crowne Social Desireability Scale single INFO 195 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q8 When I don’t know something I don’t at all mind admitting it. Marlowe-Crowne Social Desireability Scale single INFO 196 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q9 I can remember “playing sick” to get out of something. Marlowe-Crowne Social Desireability Scale single INFO 197 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Question SocialDesireability SDS-Q10 I am sometimes irritated by people who ask favors of me. Marlowe-Crowne Social Desireability Scale single INFO 198 ST-PatInfo Answer TRUE True Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Answer FALSE False Marlowe-Crowne Social Desireability Scale INFO ST-PatInfo Subhead Guide How You Feel How You Feel INFO ST-PatInfo Body Guide HSC-2 Please touch the answer that describes how you GENERALLY FEEL. Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Body Guide HSC-3 Remember there are no right or wrong answers. Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Body Guide HSC-4 Do not spend too much time on any one statement but give the answer which seems to BEST describe how you GENERALLY FEEL. Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q1 I am quick tempered. Schroder - Habitual self-control. Anger items. single INFO 199 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q2 I have a fiery temper. Schroder - Habitual self-control. Anger items. single INFO 200 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q3 I am a hotheaded person. Schroder - Habitual self-control. Anger items. single INFO 201 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q4 I get angry when I'm slowed down by others mistakes. Schroder - Habitual self-control. Anger items. single INFO 202 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q5 I feel annoyed when I am not given recognition for doing good work. Schroder - Habitual self-control. Anger items. single INFO 203 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q6 I fly off the handle. Schroder - Habitual self-control. Anger items. single INFO 204 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q7 When I get mad, I say nasty things. Schroder - Habitual self-control. Anger items. single INFO 205 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q8 It makes me furious when I am criticized in front of others. Schroder - Habitual self-control. Anger items. single INFO 206 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q9 When I am frustrated, I feel like hitting someone. Schroder - Habitual self-control. Anger items. single INFO 207 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question selfcontrol HSC-Q10 I feel infuriated when I do a good job and get a poor evaluation. Schroder - Habitual self-control. Anger items. single INFO 208 ST-PatInfo Answer selfcontrol HSC-A1 Almost Never Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Sometimes Sometimes Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol Often Often Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Answer selfcontrol AllAlways Almost Always Schroder - Habitual self-control. Anger items. INFO ST-PatInfo Question Rev-292 Touch on every experience you have had in the last 12 months. Then touch OK. Holmes-Rahe Life Stress Scale List stress INFO 209 HolmesStressList ST-PatInfo Subhead alcoholUse Alcohol Alcohol INFO ST-PatInfo Body alcoholUse AL-1 Now I will ask a few questions about your use of alcohol. CAGE-alcohol screening test alcohol INFO ST-PatInfo Body alcoholUse AL-2 Please answer honestly and accurately. CAGE-alcohol screening test INFO ST-PatInfo Question alcoholUse Rev-293 What types of alcohol do you drink? Touch all types that you drink and then touch OK. CAGE-alcohol screening test multiple INFO 252 ST-PatInfo Answer alcoholUse AL-Q1A1 Beer CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse AL-Q1A2 Wine CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse AL-Q1A3 Distilled spirits (liquor) CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Rev-294 Other types CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse AL-Q1A5 None. Do not drink alcohol. CAGE-alcohol screening test ThankYou INFO ST-PatInfo Question alcoholUse AL-Q2 Have you ever felt you should cut down on your drinking? CAGE-alcohol screening test single INFO 253 ST-PatInfo Answer alcoholUse Never Never CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Sometimes Sometimes CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Often Often CAGE-alcohol screening test INFO ST-PatInfo Question alcoholUse Rev-295 Have people annoyed you by criticizing your drinking? CAGE-alcohol screening test single INFO 254 ST-PatInfo Answer alcoholUse Never Never CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Sometimes Sometimes CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Often Often CAGE-alcohol screening test INFO ST-PatInfo Question alcoholUse AL-Q4 Have you ever felt bad or guilty about your drinking? CAGE-alcohol screening test single INFO 255 ST-PatInfo Answer alcoholUse Never Never CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Sometimes Sometimes CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Often Often CAGE-alcohol screening test INFO ST-PatInfo Question alcoholUse AL-Q5 Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)? CAGE-alcohol screening test single INFO 256 ST-PatInfo Answer alcoholUse Never Never CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Sometimes Sometimes CAGE-alcohol screening test INFO ST-PatInfo Answer alcoholUse Often Often CAGE-alcohol screening test INFO ST-PatInfo Question alcoholquantity AL-Q6 How many days in a typical week do you drink alcohol? Seeholzer - alcohol quantity single INFO 257 ST-PatInfo Answer alcoholquantity AL-Q6A1 One Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q6A2 Two Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q6A3 Three Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q6A4 Four Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q6A5 Five Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q6A6 Six Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q6A7 Every Day (7) Seeholzer - alcohol quantity INFO ST-PatInfo Question alcoholquantity AL-Q7 What is the size and type of one container of your typical drink? Seeholzer - alcohol quantity single INFO 258 ST-PatInfo Answer alcoholquantity Rev-296 Beer-12 oz. - regular Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity Rev-297 Beer - 20 oz. - medium Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity Rev-298 Beer - 40 oz.- large Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity Rev-299 Wine - regular 4 oz. Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q7A5 Wine - medium 6 oz. Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity AL-Q7A6 Wine - large 8+ oz. Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity Rev-300 Liquor - 1 oz.- regular Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity Rev-301 Liquor - 2 oz. - medium Seeholzer - alcohol quantity INFO ST-PatInfo Answer alcoholquantity Rev-302 Liquor - 3+ oz.- large Seeholzer - alcohol quantity INFO ST-PatInfo Question alcoholquantity Rev-303 What is the least number you drink in a day? Enter the number of these. Then touch OK. Seeholzer - alcohol quantity numpad INFO 259 ST-PatInfo Question alcoholquantity Rev-304 What is the highest number you drink in a day? Enter the number of these. Then touch OK. Seeholzer - alcohol quantity numpad INFO 260 ST-PatInfo Question alcoholquip Rev-305 Have you thought you should cut down on your drinking of alcohol? Pfizer- PRIME-MD YesNo INFO AlQuitThought 261 ST-PatInfo Question alcoholquip Rev-306 Has anyone complained about your drinking? Pfizer- PRIME-MD YesNo INFO AlComplain 262 ST-PatInfo Question alcoholquip Rev-307 Have you felt guilty or upset about your drinking? Pfizer- PRIME-MD YesNo INFO AlGluilty 263 ST-PatInfo Question alcoholquip Rev-308 Was there ever a single day in which you had five or more drinks of beer, wine, or liquor? Pfizer- PRIME-MD YesNo INFO AlFivePlus 264 ST-PatInfo Subhead Guide Thank You Thank You INFO ST-PatInfo Body Guide PatInfo-406 Thank You. This concludes the STRIDES Patient Information session. Thank you ChapterDone ThankYou