Version 2.78

99635-5 Which of the following are the main symptoms people infected with the coronavirus experience?

Observation ID in Form

1

Fully-Specified Name

Component
Main symptoms experienced by people infected with condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6157-3

Answer Code Score Answer ID
Fever or chills LA33094-6
Runny or stuffy nose LA33095-3
Chest congestion LA33096-1
Skin rash LA33097-9
Cough LA16122-6
Sore throat LA30867-8
Sneezing Copyright http://snomed.info/sct ID:76067001 Sneezing (finding) LA33098-7
Muscle or body aches LA33099-5
Headaches LA33100-1
Fatigue or tiredness LA33101-9
Shortness of breath LA17001-1
Abdominal discomfort LA33102-7
Vomiting LA15099-7
Hair loss LA33104-3
Dry skin LA33105-0
Body temperature higher than 100.4 F or 38.0 C LA33106-8
Diarrhea Copyright http://snomed.info/sct ID:62315008 Diarrhea (finding) LA15424-7
Lost sense of smell LA33107-6

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99636-3 In the last seven days, have you done the following:

Observation ID in Form

2

Fully-Specified Name

Component
Activity related to possible exposure to condition of interest
Property
Find
Time
7D
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6159-9

Answer Code Score Answer ID
Gone out to a bar, club, or other place where people gather LA33108-4
Gone to the grocery store or pharmacy LA33109-2
Gone to a friend, neighbor, or relative's residence (that isn't your own) LA33110-0
Had visitors such as friends, neighbors, or relatives at your residence LA33111-8
Attended a gathering with more than 10 people, such as a reunion, wedding, funeral, birthday party, concert, or religious service LA33112-6
Sought care from a hospital or health care facility LA33113-4
Been placed in isolation or quarantine LA33114-2
Remained in your residence at all times, except for essential activities or exercise LA33115-9
Shared items like towels or utensils with other people LA33116-7
Had close contact (within 6 feet) with people who live with you LA33117-5
Had close contact (within 6 feet) with people who don't live with you LA33118-3
Gone outside to walk, hike, or exercise LA33119-1

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99637-1 Which of the following have you done in the last seven days to keep yourself safe from coronavirus? Only consider actions that you took or decisions that you made personally.

Observation ID in Form

3

Fully-Specified Name

Component
Measures taken to keep safe from condition of interest
Property
Find
Time
RptPeriod
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6160-7

Answer Code Score Answer ID
Washed your hands with soap or used hand sanitizer several times per day LA33120-9
Canceled or postponed air travel for work LA33121-7
Canceled or postponed air travel for pleasure LA33122-5
Canceled or postponed work or school activities LA33123-3
Canceled or postponed personal or social activities LA33124-1
Visited a doctor LA33125-8
Canceled a doctor's appointment LA33126-6
Stockpiled food or water LA33127-4
Avoided contact with people who could be high-risk LA33128-2
Avoided public spaces, gatherings or crowds LA33129-0
Prayed LA33130-8
Avoided eating at restaurants LA33131-6
Stockpiled hand sanitizer or disinfectant wipes LA33132-4
Worked or studied at home LA33133-2
Worn a mask or other face covering LA33134-0
Stockpiled medication LA33135-7

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99638-9 Have federal, state, or local governments encouraged you to limit non-essential travel?

Observation ID in Form

4

Fully-Specified Name

Component
Federal, state, or local governments encouraged limiting non-essential travel
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6161-5

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 2 LA32-8
Unsure 3 LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99634-8 Have federal, state, or local governments required you to limit non-essential travel?

Observation ID in Form

5

Fully-Specified Name

Component
Federal, state, or local governments required limiting non-essential travel
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6161-5

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 2 LA32-8
Unsure 3 LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99639-7 How effective are the following actions for keeping you safe from coronavirus? Wearing a facemask such as the one shown here.

Observation ID in Form

6

Image

N95 Style Facemask

N95 Style Facemask

Source: RTI International

Fully-Specified Name

Component
Effectiveness of wearing a face mask to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99640-5 How effective are the following actions for keeping you safe from coronavirus? Praying

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of praying to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99641-3 How effective are the following actions for keeping you safe from coronavirus? Washing your hands with soap or using hand sanitizer frequently

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of washing your hands with soap or using hand sanitizer frequently to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99642-1 How effective are the following actions for keeping you safe from coronavirus? Seeing a doctor if you feel sick

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of seeing a doctor if you feel sick to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99643-9 How effective are the following actions for keeping you safe from coronavirus? Seeing a doctor if you feel healthy but worry that you were exposed

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of seeing a doctor if you feel healthy but worry that you were exposed to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99644-7 How effective are the following actions for keeping you safe from coronavirus? Avoiding public spaces, gatherings, and crowds

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of avoiding public spaces, gatherings, and crowds to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99645-4 How effective are the following actions for keeping you safe from coronavirus? Avoiding contact with people who could be high-risk.

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of avoiding contact with people who could be high-risk to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99646-2 How effective are the following actions for keeping you safe from coronavirus? Avoiding hospitals and clinics

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of avoiding hospitals and clinics to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99647-0 How effective are the following actions for keeping you safe from coronavirus? Avoiding restaurants

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of avoiding restaurants to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99648-8 How effective are the following actions for keeping you safe from coronavirus? Avoiding airplanes

Observation ID in Form

6

Fully-Specified Name

Component
Effectiveness of avoiding airplanes to keep safe from condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6162-3

Answer Code Score Answer ID
Extremely ineffective LA33136-5
Somewhat ineffective LA33137-3
Somewhat effective LA33138-1
Extremely effective LA33139-9
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99649-6 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Grocery shopping

Observation ID in Form

7

Fully-Specified Name

Component
Safety of grocery shopping for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99650-4 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Attending gatherings of more than 100 people

Observation ID in Form

7

Fully-Specified Name

Component
Safety of attending gatherings of more than 100 people for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99651-2 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Going to the hospital

Observation ID in Form

7

Fully-Specified Name

Component
Safety of going to the hospital for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99652-0 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Dining in at restaurants

Observation ID in Form

7

Fully-Specified Name

Component
Safety of dining in at restaurants for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99653-8 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Eating "take-out" meals from restaurants

Observation ID in Form

7

Fully-Specified Name

Component
Safety of eating take-out meals from restaurants for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99654-6 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Visiting with relatives or friends in their home

Observation ID in Form

7

Fully-Specified Name

Component
Safety of visiting with relatives or friends in their home for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99655-3 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Handling packages that have been delivered

Observation ID in Form

7

Fully-Specified Name

Component
Safety of handling packages that have been delivered for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99656-1 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Playing on playground equipment

Observation ID in Form

7

Fully-Specified Name

Component
Safety of playing on playground equipment for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99657-9 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Touching door knobs, countertops, and other surfaces in your home

Observation ID in Form

7

Fully-Specified Name

Component
Safety of touching door knobs, countertops, and other surfaces in your home for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99658-7 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Interacting closely with other members of your household

Observation ID in Form

7

Fully-Specified Name

Component
Safety of interacting closely with other members of your household for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99659-5 How safe or unsafe are the following actions for avoiding exposure to coronavirus? Going outside to walk, hike, or exercise

Observation ID in Form

7

Fully-Specified Name

Component
Safety of going outside to walk, hike, or exercise for avoiding exposure to condition of interest
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6163-1

Answer Code Score Answer ID
Extremely safe LA33140-7
Somewhat safe LA33141-5
Somewhat unsafe LA33142-3
Extremely unsafe LA33143-1
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99660-3 We'd like to ask about your family, as well as your close friends. How many family or close friends do you have? Only include people who are still alive, regardless of where they live

Observation ID in Form

8

Form Context

Input number: 0-999: Soft check "Do you really have [NUMBER] family and close friends?"

Source: RTI International

Fully-Specified Name

Component
Number of family members or close friends
Property
Num
Time
Pt
System
^Patient
Scale
Qn
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.73
Change Reason
Release 2.73: EXAMPLE_UCUM_UNITS: # by itself is not a valid UCUM unit. Added curly braces to make it legal.;
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

Example Units

Unit Source
{#} Example UCUM Units

99661-1 Of these people, how many do you think have been infected with the coronavirus?

Observation ID in Form

9

Form Context

Soft check: "Do you really know [NUMBER] people who have been infected?"

Source: RTI International

Form Context

Input number: 0-999, must be <= to total contacts

Source: RTI International

Fully-Specified Name

Component
Number of family members or close friends that have been infected with condition of interest
Property
Num
Time
Pt
System
^Patient
Scale
Qn
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.74
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

Example Units

Unit Source
{#} Example UCUM Units

99662-9 On a scale of 0 to 100 percent, what is the chance that you will get the coronavirus in the next three months? If you're not sure, please give your best guess.

Observation ID in Form

10

Fully-Specified Name

Component
Percent chance of contracting condition of interest in next 3Mo
Property
NFr
Time
Pt
System
^Patient
Scale
Qn
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

Example Units

Unit Source
% Example UCUM Units

99663-7 If you do get the coronavirus, what is the percent chance you will die from it? If you're not sure, please give your best guess.

Observation ID in Form

11

Fully-Specified Name

Component
Percent chance of death from condition of interest if infected
Property
NFr
Time
Pt
System
^Patient
Scale
Qn
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

Example Units

Unit Source
% Example UCUM Units

99664-5 The childhood vaccines, such as those for measles and chickenpox: Have many known harmful side effects

Observation ID in Form

12a1

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: childhood vaccines have many known harmful side effects
Property
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Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99665-2 The childhood vaccines, such as those for measles and chickenpox: Provide important benefits to society

Observation ID in Form

12a2

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: childhood vaccines provide important benefits to society
Property
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Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99666-0 The childhood vaccines, such as those for measles and chickenpox: May lead to illness and death

Observation ID in Form

12a3

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: childhood vaccines may lead to illness and death
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99667-8 The childhood vaccines, such as those for measles and chickenpox: Are useful and effective

Observation ID in Form

12a4

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: childhood vaccines are useful and effective
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99668-6 How likely are you to get vaccinated for coronavirus once a vaccination is available to the public?

Observation ID in Form

13

Fully-Specified Name

Component
Likelihood of getting vaccinated for condition of interest when available
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6164-9

Answer Code Score Answer ID
Very unlikely LA15589-7
Somewhat unlikely LA33144-9
Somewhat likely LA33145-6
Very likely LA15586-3
Unsure LA14072-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99669-4 Most people believe that people with coronavirus are dangerous

Observation ID in Form

14a

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: most people believe that people with condition of interest are dangerous
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99670-2 Most people believe that people who used to have coronavirus are dangerous

Observation ID in Form

14b

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: most people believe that people who used to have condition of interest are dangerous
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99671-0 Most people believe that having coronavirus is a sign of personal weakness or failure

Observation ID in Form

14c

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: most people believe that having condition of interest is a sign of personal weakness or failure
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel

99672-8 If I caught the coronavirus, I would consider it a sign of my personal weakness or failure

Observation ID in Form

14d

Form Context

Do you agree or disagree with the following statements?

Source: RTI International

Fully-Specified Name

Component
Agreement with statement: if I caught condition of interest, I would consider it a sign of my personal weakness or failure
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL1626-2

Answer Code Score Answer ID
Strongly agree LA15237-3
Agree LA15774-5
Disagree LA15773-7
Strongly disagree LA15236-5

Member of these Panels

LOINC Long Common Name
99673-6 COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel