COVID Questionnaire - Social/Behavioral
NameDescriptionQuestion text
W10_covid_63Social distancing frequency in publicSocial distancing is staying at least 6 feet away from other people. In the past two weeks, how often have you practiced social distancing?
W10_covid_64aEssential food itemsEssential food items
W10_covid_64bAlcoholAlcohol
W10_covid_64cCigarettes, vapes or other nicotine productsCigarettes, vapes, or other nicotine products
W10_covid_64dMarijuanaMarijuana
W10_covid_64eOther drugsOther drugs in order to get high
W10_covid_64fPrescriptionsPrescriptions
W10_covid_64gFood itemsFood items
W10_covid_64hAlcoholAlcohol
W10_covid_64iCigarettes, vapes or other nicotine productsCigarettes, vapes, or other nicotine products
W10_covid_64jMarijuanaMarijuana
W10_covid_64kPrescriptionsPrescriptions
W10_covid_64lWent to outdoor recreational public placesGone to outdoor recreational public places (e.g., parks, beach, hiking trails)
W10_covid_64mWent to indoor recreational public placesGone to indoor recreational public places (e.g., mall)
W10_covid_64nWalked near houseGone for a walk near your house
W10_covid_64oUsed public transportationUsed public transportation
W10_covid_64pAttended gathering/party with 10+ peopleAttended a gathering or party with more than 10 people
W10_covid_64qHosted gathering/party with 10+ peopleHosted a gathering or party at your house with more than 10 people
W10_covid_64rAttended gathering/party with 2-9 peopleAttended or hosted a gathering of 2-9 people
W10_covid_64tWent to restaurant/bar/clubGone out to a restaurant, bar, club, or other place where people gather
W10_covid_64uWent to friend/neighbor/relative's houseGone to a friend, neighbor, or relative's house (that is not your own)
W10_covid_64vWent to faith-based gatheringGone to a faith-based gathering such as a church, synagogue, temple, or mosque
W10_covid_65Hand washing frequencyIn the past two weeks, how often did you usually wash your hands?
W10_covid_66Doorknob cleaning frequencyIn the past two weeks, how often did you clean the doorknobs in your house?
W10_covid_67Sanitizing packages/take-out frequencyIn the past two weeks, when you ordered take-out or received packages, how often did you sanitize these items (e.g., wipe them down or spray with disinfectant)?
W10_covid_68Rating of coping during COVID-19 coronavirus pandemicHow well are you handling the COVID-19 coronavirus pandemic?
W10_covid_69aTaking breaks from news/mediaTo 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.)
W10_covid_69bStretching or meditationTo 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.)
W10_covid_69cEngaging in healthy behaviors (i.e. eating healthy, exercising, no drugs)To 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.)
W10_covid_69dRelaxingTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Making time to relax.)
W10_covid_69eConnecting with othersTo 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.)
W10_covid_69fContacting healthcare providerTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Contacting a healthcare provider.)
W10_covid_69gSmoking/vaping more frequentlyTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Smoking more cigarettes or vaping more.)
W10_covid_69hDrinking alcoholTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Drinking alcohol.)
W10_covid_69iUsing 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.).)
W10_covid_69jUsing 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.)
W10_covid_69kUsing marijuana/cannabisTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Using cannabis or marijuana.)
W10_covid_69lEating high fat or sugary foodsTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Eating high fat or sugary foods.)
W10_covid_69mCutting or self-injuryTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Cutting or self-injury.)
W10_covid_69nOver-exerciseTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Over exercise.)
W10_covid_69oEating more than usualTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Eating more food than usual.)
W10_covid_69pEating less than usualTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=Eating less food than usual.)
W10_covid_69qNone of the aboveTo cope with social distancing and isolation, are you doing any of the following? Select all that apply. (choice=None of the above.)
W10_covid_70Self-rating of general healthIn general, would you say your health is...
W10_covid_71Typical number of colds/flus per yearAbout how many times per year do you usually get sick with cold or flu-like symptoms (for example, a cough, sore throat or fever)
W10_covid_72aOften gets colds/flusIn general, I very often get colds, flu and other infectious diseases.
W10_covid_72bIs unlikely to catch cold/fluI am unlikely to catch a cold, flu or other illness, even if it is 'going around'.
W10_covid_72cIs likely to catch circulating illnessesIf an illness is 'going around', I will get it.
W10_covid_72dImmune system protects them from most illnessesMy immune system protects me from most illnesses that other people get.
W10_covid_72eMore likely than others to catch colds/fluI am more likely than the people around me to catch colds, flu, and other infectious diseases
W10_covid_72fPast experiences of getting sick less frequently than friends/familyMy past experiences make me believe I am not likely to get sick even when my friends or family are sick.
W10_covid_72gPast experiences of frequently catching colds/fluIn the past, I have often caught colds, flu, and other infectious diseases
W10_covid_72hPrefers to wash hands soon after shaking handsI prefer to wash my hands pretty soon after shaking someone's hand.
W10_covid_72iAvoids touching surfaces in public restroomsI try to avoid touching counters and door handles of public restrooms because of the risk that I may catch something.
W10_covid_72jDoes not like writing with chewed pencilsI do not like to write with a pencil someone else has obviously chewed on.
W10_covid_72kDislikes wearing used clothingI dislike wearing used clothes because I do not know what the last person who wore it was like.
W10_covid_72lComfortable sharing bottled drinks with friendsI am comfortable sharing a water bottle or other drinks with a friend.
W10_covid_72mUncovered sneezes bother themIt really bothers me when people sneeze without covering their mouths.
W10_covid_72nIs not anxious around sick peopleIt does not make me anxious to be around sick people.
W10_covid_72oHands don't feel dirty after touching moneyMy hands do not feel dirty after touching money.
W10_covid_73Likeliness to catch COVID-19 coronavirusHow likely do you think it is that you will contract COVID-19 coronavirus?
W10_covid_74Likeliness of average person their age to catch COVID-19 coronavirusHow likely do you think it is that the average person your age will contract COVID-19 coronavirus?
W10_covid_75Have any symptomsHave any symptoms at all
W10_covid_76Have severe/painful symptomsHave really severe/painful symptoms
W10_covid_77Have to be hospitalizedHave to stay overnight in a hospital
W10_covid_78Have permanent health problems from virus complicationsHave permanent health problems resulting from the virus
W10_covid_79DieDie
W10_covid_80Projected overall severity of COVID-19 symptoms if contractedHow severe do you think your symptoms will be if you get sick with COVID-19 coronavirus?
W10_covid_81aAfraid of COVID-19 coronavirusI am afraid of COVID-19 coronavirus
W10_covid_81bUncomfortable thinking about COVID-19 coronavirusIt makes me uncomfortable to think about COVID-19 coronavirus
W10_covid_81cWorries a lot about COVID-19 coronavirusI worry a lot about COVID-19 coronavirus
W10_covid_81dHands become clammy when thinking about COVID-19 coronavirusMy hands become clammy when I think about COVID-19 coronavirus
W10_covid_81eIs afraid of dying from COVID-19 coronavirusI am afraid of dying from COVID-19 coronavirus
W10_covid_81fIs afraid that friends/family will die from COVID-19 coronavirusI am afraid that my friends or family will die from COVID-19 coronavirus
W10_covid_81gBecomes nervous/anxious when reading or watching news about COVID-19 coronavirusWhen watching news and reading stories about COVID-19 coronavirus, I become nervous or anxious
W10_covid_81hCan't sleep because worried about catching COVID-19 coronavirusI cannot sleep because I am worried about getting COVID-19 coronavirus
W10_covid_81iCan't sleep because worry about friends/family catching COVID-19 coronavirusI cannot sleep because I am worried about my friends or family getting COVID-19 coronavirus
W10_covid_81jHeart races or palpitates when thinking about catching COVID-19 coronavirusMy heart races or palpitates when I think about getting COVID-19 coronavirus
W10_covid_81kHeart races or palpitates when thinking about friends/family catching COVID-19 coronavirusMy heart races or palpitates when I think about my friends or family getting COVID-19 coronavirus
W10_covid_83aHaving trouble paying for foodI am worried about or already having trouble paying for food to eat
W10_covid_83bNot having enough to feed familyI am worried about not having enough to eat or to feed my family
W10_covid_83cNot able to find food/essential itemsI am worried about or cannot find key foods or other essential items (e.g., toilet paper) anywhere
W10_covid_83dSpending more than usual on foodI am worried about or already spending more than I usually do on food
W10_covid_83eEating much more/less than usualI am worried about or already eat much more or much less than I usually do
W10_covid_84aWorried about being evicted or becoming homelessI am worried about being evicted or losing my home, or not having a place to live
W10_covid_84bHas been evicted/lost homeI have been evicted or lost my home.
W10_covid_85aLosing job/having hours or pay reducedI am worried about losing my job or having my hours and pay reduced
W10_covid_85dStressed about pandemic's effect on economyI am stressed about how the pandemic is affecting / is going to affect the economy
W10_covid_85eWorried about employment opportunities 6 months from nowI am worried about employment opportunities 6 months from now
W10_covid_85fNot having enough money to liveI am worried about not having enough money to live
W10_covid_85gFriends/family not having enough money to liveI am worried about my friends or family not having enough money to live
W10_covid_85hEducation being affectedI am worried about how my education will be affected, or about how it has already been affected
W10_covid_85iHas lost job or hours/pay have been reducedI have lost my job or my hours and pay have been reduced
W10_covid_85jWorking more hours than usualI am working more hours than usual
W10_covid_85kHaving serious financial problemsI am having serious financial problems
W10_covid_86aIs getting enough exerciseI am getting enough exercise right now
W10_covid_86bIs exercising less than usualI am getting less exercise than usual
W10_covid_86cIs exercising more than usualI am exercising more than usual
W10_covid_87aHaving trouble making doctor's appointmentsI am having trouble making doctor's appointments
W10_covid_87bHaving trouble filling prescriptions on timeI am having a hard time getting my prescriptions filled on time
W10_covid_87cWorried about going to doctor's appt/picking up prescriptionsI am worried about going to doctors' appointments or to the pharmacy to pick up my prescriptions because of COVID-19 coronavirus
W10_covid_87dBeing able to afford medical careI am worried about affording medical care
W10_covid_children_ynHas children living in homeDo you have children living at home with you?
W10_covid_88aHad difficulty arranging childcareI have had difficulty arranging childcare
W10_covid_88bHad increased costs for childcareI have incurred increased costs for childcare
W10_covid_88cChildcare has become more difficultChildcare has become significantly more difficult
W10_covid_88dSees family/friends less than usualI see my family/friends much less than I used to
W10_covid_88eHave had video calls with family/friendsI have had video calls with my family/friends
W10_covid_88fHave organized or participated in online gatherings with family/friendsI have organized or participated in online gatherings with family or friends
W10_covid_88gFeels isolated from family/friends or feels lonelyI am feeling very isolated from family/friends or feel very lonely
W10_covid_88hSocializes with family/friends less than usualI am socializing with family/friends much less than I used to
W10_covid_89aPeople are overreacting to the pandemic fearsI think people are overreacting to the pandemic fears
W10_covid_89bSpends a lot of time thinking about handwashing or sanitizing itemsI spend a lot of time thinking about whether I have washed my hands enough or sanitized items in my home enough
W10_covid_89cSpends a lot of time on social media to learn about COVID-19 coronavirusI spend a lot of time on social media to learn about COVID-19
W10_covid_89dSpends a lot of time reading or watching news about COVID-19 coronavirusI spend a lot of time reading or watching the news about COVID-19
W10_covid_89eThinks COVID-19 coronavirus is a serious worldwide health problemThe COVID-19 coronavirus is a serious worldwide health problem
W10_covid_89fIs worried about riots/disorder in communityI am worried about riots/disorder in my community
W10_covid_89gHas been avoided/insulted due to race/ethnicity during pandemicSince the pandemic began, people have avoided me or insulted me more often because of my race/ethnicity
W10_covid_89hIs worried about others not following state or local city ordersI am worried about other people not following state or local city orders (e.g., to stay indoors and not leave the house)