NEW BLOCK

HeTimI @

Time at start of ADL section (set by HeAvoid)

TIME

HeAvoid

When you go on a trip away from your home like a trip to the shop,

restaurant, or visits to friends, how often do you purposely limit

the amount of walking you have to do? Is it ...READ OUT...

1 never,

2 rarely,

3 sometimes,

4 often,

5 or, always?

6 SPONTANEOUS Never takes trip away from home

HeADLa @

SHOW CARD L

We need to understand difficulties people may have with various

activities because of a health or physical problem. Please tell me

whether you have any difficulty doing each of the everyday activities

on this card. Exclude any difficulties that you expect to last less

than three months.

Because of a health problem, do you have difficulty doing any of the

activities on this card?

PROBE : What others? CODE ALL THAT APPLY

1 Walking 100 yards

2 Sitting for about two hours

3 Getting up from a chair after sitting for long periods

4 Climbing several flights of stairs without resting

5 Climbing one flight of stairs without resting

6 Stooping, kneeling, or crouching

7 Reaching or extending your arms above shoulder level

8 Pulling or pushing large objects like a living room chair

9 Lifting or carrying weights over 10 pounds, like a heavy bag of

groceries

10 Picking up a 5p coin from a table