COVID Questionnaire - Social/Behavioral
NameDescriptionQuestion text
W12_covid_beh_14Others MaskIn the past two weeks, when you leave your home, are the other people around you wearing a mask?
W12_covid_beh_16Self MaskIn the past two weeks, when you went to places with other people around, how often did you wear a mask?
W12_covid_cope_1Cope isolation - breaksTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Taking breaks from watching, reading, or listening to news stories, including social media.)
W12_covid_cope_2Cope isolation - bodyTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Taking care of your body, such as taking deep breaths, stretching, or meditating.)
W12_covid_cope_3Cope isolation - healthyTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Engaging in healthy behaviors like trying to eat healthy, well-balanced meals, exercising regularly, getting plenty of sleep, or avoiding alcohol and drugs.)
W12_covid_cope_4Cope isolation - relaxTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Making time to relax.)
W12_covid_cope_5Cope isolation - connectingTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Connecting with others, including talking with people you trust about your concerns and how you are feeling.)
W12_covid_cope_6Cope isolation - healthcareTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Contacting a healthcare provider.)
W12_covid_cope_7Cope isolation - smokingTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Smoking more cigarettes or vaping more.)
W12_covid_cope_8Cope isolation - alcoholTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Drinking alcohol.)
W12_covid_cope_9Cope isolation - prescription drugsTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Using prescription drugs (like valium, etc.).)
W12_covid_cope_10Cope isolation - non-prescription drugsTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Using non-prescription drugs.)
W12_covid_cope_11Cope isolation - CannabisTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Using cannabis or marijuana.)
W12_covid_cope_12Cope isolation - SugarTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Eating high fat or sugary foods.)
W12_covid_cope_13Cope isolation - Self-injuryTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Cutting or self-injury.)
W12_covid_cope_14Cope isolation - Over ExcersizeTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Over exercise.)
W12_covid_cope_15Cope isolation - More FoodTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Eating more food than usual.)
W12_covid_cope_16Cope isolation - Less FoodTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=Eating less food than usual.)
W12_covid_cope_17Cope isolation - NoneTo cope with social distancing and isolation are you doing any of the following? (Select all that apply) (choice=None of the above)
W12_covid_83aCOVID Perception - Food CostPlease rate your level of agreement with the following: I am worried about having trouble paying for food to eat
W12_covid_83bCOVID Perception - Enough to EatI am worried about not having enough to eat or to feed my family
W12_covid_83dCOVID Perception - Spending More on FoodI am worried about spending more than I usually do on food
W12_covid_83eCOVID Perception - Eating MoreI am worried about eating much more or much less than I usually do
W12_covid_84aCOVID Perception - Evicted WorryI am worried about being evicted or losing my home, or not having a place to live
W12_covid_84bCOVID Perception - EvictedI have been evicted or lost my home.
W12_covid_85dCOVID Perception - Economy StressI am stressed about how the pandemic is affecting / is going to affect the economy
W12_covid_85eCOVID Perception - Employment WorryI am worried about employment opportunities 6 months from now
W12_covid_85fCOVID Perception - Money worryI am worried about not having enough money to live
W12_covid_85gCOVID Perception - Others money worryI am worried about my friends or family not having enough money to live
W12_covid_85hCOVID Perception - education worryI am worried about how my education will be affected, or about how it has already been affected
W12_covid_85iCOVID Perception - job lossI have lost my job or my hours and pay have been reduced
W12_covid_85jCOVID Perception - working moreI am working more hours than usual
W12_covid_85kCOVID Perception - financial problemsI am having serious financial problems
W12_covid_children_ynChildren in HouseholdDo you have children living at home with you?
W12_covid_88aCOVID Perception - childcareI have had difficulty arranging childcare
W12_covid_88bCOVID Perception - childcare costsI have incurred increased costs for childcare
W12_covid_88gCOVID Perception - isolatedI am feeling very isolated from family/friends or feel very lonely
W12_covid_88hCOVID Perception - less socalizationI am socializing with family/friends much less than I used to