Appendix B
Harris Interactive Omnibus Survey Questions

BASE: 12- TO 18-YEAR-OLDS

The next few questions are about health care. Health care includes services provided by a doctor, nurse or other health care provider. It includes checkups, “well” visits, school physicals, or medical care when you are sick or injured.


Q1. Which of the following best describes what you do to get health care from a doctor or other health care provider?

  1. I always have my parent or guardian help me get health care services.

  2. I usually have my parent or guardian help me get health care services.

  3. I rarely have my parent or guardian help me get health care services—only in special situations.

  4. I usually have my friends help me get health care services.

  5. I always get health care services by myself—I don’t get help from family or friends.

  6. None of these.



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Appendix B Harris Interactive Omnibus Survey Questions BASE: 12- TO 18-YEAR-OLDS The next few questions are about health care. Health care includes services provided by a doctor, nurse or other health care provider. It includes check- ups, “well” visits, school physicals, or medical care when you are sick or injured. Q1. Which of the following best describes what you do to get health care from a doctor or other health care provider? 1 I always have my parent or guardian help me get health care services. 2 I usually have my parent or guardian help me get health care services. 3 I rarely have my parent or guardian help me get health care services—only in special situations. 4 I usually have my friends help me get health care services. 5 I always get health care services by myself—I don’t get help from family or friends. 6 None of these. 

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5 APPENDIX B BASE: 12- TO 18-YEAR-OLDS Q2. What does your parent or guardian usually do to help you get health care from a doctor or other health care provider? Please check all that apply. 1 Pays for all or part of the health care. 2 Helps in scheduling appointments. 3 Helps find the right doctor or health care provider. 4 Drives me or takes me to the doctor’s office, hospital or other health care office. 5 Gives me advice on when I should see a doctor or other health care provider. 6 None of these. BASE: 12- TO 18-YEAR-OLDS Q3. Which of the following ever prevent you from getting health care? Please check all that apply. 1 It costs too much. 2 I have no health insurance. 3 It is too hard to get to appointments that fit my schedule. 4 I have no way to get to appointments. 5 I am not sure the visits are private or confidential. 6 The medical staff does not understand my ethnic or cultural background. 7 The medical staff is not interested in listening to my concerns. 8 I will not be treated with respect. 9 I am worried that my parents will find out information I don’t want them to know. 10 Something else. 11 Nothing prevents me from getting health care. BASE: SELECTED MORE THAN ONE RESPONSE IN Q3 Q4. What is the main thing that prevents you from getting health care? [DISPLAY ONLY RESPONSES SELECTED IN Q3] 1 It costs too much. 2 I have no health insurance. 3 It is too hard to get to appointments that fit my schedule. 4 I have no way to get to appointments.

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 ADOLESCENT HEALTH SERVICES 5 I am not sure the visits are private or confidential. 6 The medical staff does not understand my ethnic or cultural background. 7 The medical staff is not interested in listening to my concerns. 8 I will not be treated with respect. 9 I am worried that my parents will find out information I don’t want them to know. 10 Something else. BASE: 12- TO 18-YEAR-OLDS Q5. How interested are you in using email, text messaging or other tech- nology to get health information, be reminded of medical appointments, or speak with a health care provider? 1 Not at all interested. 2 Somewhat interested. 3 Fairly interested. 4 Very interested. 5 Extremely interested. BASE: 12- TO 18-YEAR-OLDS Q6. What would you most like to change about your health care to make it more helpful to you? Please include medical, dental, or mental health care services.