| 98154-8 |
SARS-CoV-2-related socioeconomic questionnaire for adults |
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| Indent82589-3 |
What is the highest level of education that you have achieved to date? |
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| Indent45404-1 |
What is your current marital status? |
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| Indent86639-2 |
What is the total number of household members? |
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{#} |
| Indent98155-5 |
What is the number of household members below the age of 14? |
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{#} |
| Indent98156-3 |
I have experienced cancellations of routine doctor's visits and/or check-ups |
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| Indent98157-1 |
I have experienced postponements of routine doctor's visits and/or check-ups |
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| Indent98158-9 |
I have had problems accessing medication |
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| Indent98159-7 |
Treatment sessions were postponed by doctor or patient |
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| Indent98160-5 |
Treatment sessions were cancelled by doctor or patient |
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| Indent98174-6 |
I have experienced cancellations of routine doctor's visits and/or check-ups |
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| Indent98175-3 |
I have experienced postponements of routine doctor's visits and/or check-ups |
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| Indent98176-1 |
I have had problems accessing medication |
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| Indent98177-9 |
Treatment sessions were postponed by doctor or patient |
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| Indent98178-7 |
Treatment sessions were cancelled by doctor or patient |
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| Indent67875-5 |
Which one of the following best describes your current employment situation? |
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| Indent74161-1 |
How many total hours a week do you work on average? |
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h/wk |
| Indent98161-3 |
What is your current total monthly household net income (after taxes)? |
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/mo |
| Indent98162-1 |
Since the beginning of the pandemic (February/March 2020), have you had financial or liquidity problems (such as problems paying rent, school fees, mortgage, utility bills, etc.)? |
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| Indent98163-9 |
Since the beginning of the pandemic (February/March 2020), have you received any financial or material aid (e.g. public assistance, cash-transfers, items from food bank, etc.)? |
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| Indent98179-5 |
Over the last 12 months, have you had financial or liquidity problems (such as problems paying rent, school fees, mortgage, utility bills, etc.)? |
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| Indent98180-3 |
Over the last 12 months, have you recevied any financieal or material aid (e.g. public assistance, cash-transfers, items from food bank, etc.)? |
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| Indent98164-7 |
How often have you recently looked for information on COVID-19 on the internet, in newspapers, on television, radio, within social networks, and so on? |
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| Indent98165-4 |
On a theoretical scale from 0 to 10, what do you think is your current risk of infection/re-infection? |
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{score} |
| Indent98166-2 |
On a theoretical scale from 0 to 10, what do you think is your current risk that, in case of infection/re-infection, you will experience severe complications or even death? |
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{score} |
| Indent98167-0 |
How often do you wash your hands with hand-soap or hydro-alcoholic solutions? |
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| Indent98168-8 |
Do you keep a distance of at least 2 meters from others? |
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| Indent98169-6 |
Do you stay home to avoid social contacts or avoid gatherings with friends and relatives outside of your household/support bubble? |
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| Indent98170-4 |
Do you wear a face mask in public? |
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| Indent98171-2 |
Have you been offered a vaccine by the public health system? |
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| Indent98172-0 |
Have you accepted or will you accept to be vaccinated once you get offered a vaccine? |
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| Indent98173-8 |
Why did/would you not accept the vaccine? |
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