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Sponsored by the Robert Wood Johnson Foundation, the Active for Life (AFL) initiative investigated how two physical activity programs for adults aged 50 and older, Active Choices (AC) and Active Living Every Day (ALED), worked in community settings. Created by researchers at Stanford University, Active Choices used lifestyle counseling and personalized telephone support to encourage older adults to be physically active. In AFL, this was a 6-month program delivered through one face-to-face meeting followed by up to eight one-on-one telephone counseling calls. Active Living Every Day, which was created by the Cooper Institute and Human Kinetics Inc., also provided lifestyle counseling to promote physical activity, but in a classroom and workbook format. During the first three years of the four-year AFL initiative, ALED was delivered as a 20-week program where participants attended weekly small group meetings, but in the last year it was shortened to 12 weekly meetings. Nine organizations received AFL grants to implement the programs during 2003-2006. Four grantees implemented the one-on-one AC model, while five implemented the group-based ALED model.

Data were collected from the AC and ALED sites for both a process and outcomes evaluation. The primary aims of the process evaluation were to (1) monitor the extent to which the grantees demonstrated fidelity to the AC and ALED models in their program implementation, (2) assess staff experiences implementing the programs, and (3) assess participants' impressions of the programs. A quasi-experimental, pre-post study design was used to assess outcomes. Primary aims of the outcomes evaluation were to evaluate the impact of AC and ALED on self-reported physical activity, and to evaluate the impact of the programs on self-reported stress, depressive symptoms, and satisfaction with body function and appearance. Secondary aims of the outcome evaluation were to (1) evaluate the impact of the programs on measures of functional fitness, (2) examine whether changes in self-reported physical activity and functional fitness were moderated by participant characteristics, including age, gender, race, baseline physical activity self-efficacy, and baseline physical activity social support, and (3) examine whether changes in self-reported physical activity were consistent with a mediation model for physical activity self-efficacy and physical activity social support.

The collection has 14 data files (datasets). Datasets 1-7 constitute the process evaluation data, and Datasets 8-14 the outcomes evaluation data:

Dataset 1 (AC Initial Face-to-Face Sessions Data) contains information about the initial face-to-face AC session: the format, date, and length of the session, whether the 8 steps required in the face-to-face session were completed, what was discussed between the health educator and the participant related to physical activity plans, interests, benefits, and barriers, and the health educator's progress notes. The file contains one record for each AC participant.

Dataset 2 (AC Completed Calls Data) comprises information about the completed AC calls, but does not cover the topics discussed on the calls. Recorded information about each call includes the date and length of the call, the health educator's progress notes, and whether the participant was assessed for injury, light activity, moderate activity, exercise goals, or exercise intentions. Each call is represented by a separate record in the data file and, typically, there are multiple records per participant.

Dataset 3 (AC Topics Discussed on Completed Calls ) contains information about the topics discussed on each completed AC call, e.g., exercise barriers/benefits, previous exercise experiences, goal setting, long term goals, injury prevention, rewards/reinforcement, social support, progress tracking, and relapse prevention. Each record in the file represents one topic and there are often multiple records per call for each participant.

Dataset 4 (AC Aggregate Call Data) aggregates the call data across calls for each AC participant. For example, for a given participant, this dataset shows the total number of calls completed, the number of calls where injury/health problems were assessed, etc. The file contains one record per participant.

Dataset 5 (ALED Sessions Data) contains information about each class session for every ALED group, including the session date, start time, and end time, learning activities covered in the session, participant evaluations of the session and the facilitator, facilitator progress notes, the number of participants who were in various stages of readiness for moderate exercise, and the number of participants who tracked physical activity and thoughts about physical activity. This file has one record for each session of every ALED group.

Dataset 6 (ALED Attendance and Tracking Data (Years 2-4)) consists of participant-level attendance and tracking data for every ALED session during the second to fourth years of the evaluation, including the participant's attendance at the session, whether the participant's stage of readiness was assessed, and whether the participant tracked thoughts about physical activity or actual physical activity. There is no participant-level ALED data for the first year. Each participant has a separate record for each session. Thus, the file contains 20 records per participant in the years 2-3, and 12 records per participant in year 4.

Dataset 7 (ALED Aggregate Attendance and Tracking Data (Years 2-4)) contains ALED attendance and tracking data for each participant in years 2-4, aggregated across the sessions. The data file has one record for each participant.

Dataset 8 (Demographics) comprises program information (e.g., program status, start date, end date, site, etc.), demographic information (e.g., age, gender, race, Hispanic origin, employment status, income, and the participant's state and ZIP code of residence), and responses to the Physical Activity Readiness Questionnaire (PAR-Q), a screening tool that was used to assess possible risks of exercising based on answers to specific health history questions. The file contains one record for each AFL participant, except for those with a status of "nonstarter" or "repeater."

Datasets 9 (Pretest Survey Data) and 10 (Posttest Survey Data) contain data from the Pretest and Posttest Surveys. The Pretest Survey was administered at the beginning of the AC and ALED programs, while the Posttest Survey was administered at their end. Topics covered by the surveys include social and recreational activities, activities undertaken for exercise, perceived stress, depressive symptoms, satisfaction with body appearance and function, social support for physical activity, self-efficacy for physical activity, neighborhood environment, health conditions, health-related quality of life, caregiving, and self-reported height and weight. Both surveys included items from the Community Health Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS), the Center for Epidemiological Studies Depression Questionnaire (CES-D), the Behavioral Risk Factor Surveillance System Questionnaires (BRFSS), and the International Physical Activity Prevalence Study Environmental Module. These data files each have one record for each participant who submitted a questionnaire.

Dataset 11 (ALED Week 12 Survey Data (Year 4)) contains responses to the ALED Week 12 Posttest Survey, which was used to evaluate the 12-week adaptation of ALED in Year 4. (In Year 4, ALED participants completed both a 12- and 20-week posttest survey). There is one record for each participant who returned this survey.

Dataset 12 (Six-Month Posttest Follow-Up Survey Data (Years 3-4)) comprises data from a special 6-month follow-up survey which was administered in years 3-4 in six of the ALED sites and one of the AC sites. Participants were questioned about their current physical activities, weight, health-related quality of life, satisfaction with bodily function, and other topics. As with Datasets 9-11, the data file contains one record for each participant who returned a questionnaire.

Dataset 13 (Functional Fitness Tests Data) contains the results of pretest and posttest functional fitness tests which were administered by one ALED grantee. Four tests were adminstered: (1) the 30-Foot Walk Test, (2) the 30-Second Chair Stand, (3) 8-Foot Up and Go, and (4) the Chair Sit and Reach Test. This participant-level data file also includes pretest height measurements plus pretest and posttest weight measurements.

Dataset 14 (Participants' Impressions of the Programs (Years 1, 3, and 4)) contains data collected by the last sections of the Posttest Survey, ALED Week 12 survey, and 6-Month Follow-up Survey. The topics it covers include the participants' impressions of the programs, participation in physical activities, and changes (compared to before they started the AFL program) in motivation to be physically active, actual level of physical activity, medical and health conditions, overall pain, flexibility/limberness, level of stress, happiness, and enjoyment of life. The file has a separate record for each survey completed by the participants. Thus, there are 1-3 records per participant.

The American Health Values Survey (AHVS) was conducted by the National Opinion Research Center (NORC) at the University of Chicago in order to develop a typology of Americans based on their health values and beliefs. The survey, of more than 10,000 adults from five individual communities, examined values and beliefs related to health at both the individual as well as societal levels. The community surveys sought to compare differences between the local typologies, but also to investigate any similarities with national typology groups. The survey assessed the importance of health in:

• day-to-day personal life (i.e. the amount of effort spent on disease prevention as well as appropriate seeking of medical care);
• equity, the value placed on the opportunity to succeed generally in life as well as on health equity;
• social solidarity, the importance of taking into account the needs of others as well as personal needs;
• health care disparities, views about how easy/hard it is for African Americans, Latinos and low-income Americans to get quality health care;
• and, the importance of the social determinants of health.

In addition, the survey also explored views about how active government should be in health; collective efficacy, the ease of affecting positive community change by working with others; and health-related civic engagement e.g. the support of health charities and organizations working on health issues.

There are public-use and restricted-use versions of the data provided for each of the five sentinel communities participating in this study. Although each site differs on the number of respondents as listed below, each data file contains the same 143 variables for each site and version of the data. The only difference between the public-use versus restricted-use versions of the data is the variable ZIP, which was MASKED in the public-use version.

• DS1 and DS2 - Baltimore, Maryland: 2,139
• DS3 and DS4 - Maricopa County, Arizona: 2,247
• DS5 and DS6 - Stockton, California: 2,127
• DS7 and DS8 - Mobile, Alabama: 1,821
• DS9 and DS10 - North Central counties in Nebraska: 2,846

The Robert Wood Johnson Foundation (RWJF) has a vision to build a Culture of Health (CoH) by making health a shared national priority, one valued and advanced by multiple stakeholders across all sectors of society. This vision embraces a very broadly integrated and comprehensive approach to health, one where well-being lies at the center of every aspect of American life. In 2014, the RWJF commissioned NORC at the University of Chicago to plan and conduct the first American Health Values Survey (AHVS) to understand the extent to which United States adults held views consistent with this vision. The idea was to explore which types of United States adults were more supportive and less supportive of the goal and what the differences were between the more and less supportive groups. To aid in the understanding of these differences, NORC developed a typology of United States adults based on their values and beliefs related to the CoH vision.

Using a large-scale national survey fielded in late 2015 and early 2016, NORC identified six major segments of the population of adults in the United States based on their differing health values and beliefs and developed detailed profiles of each segment that described their pattern of values and beliefs as well as their demographic, political and other characteristics. NORC subsequently replicated the typology development work in five RWJF Sentinel Communities across the nation and also developed a typology of rural America. The same segments, or similar ones, were common across various geographic areas of the United States. Four years have since passed, in which changes occurred in the country. RWJF in 2019 commissioned NORC to conduct a second national, cross-sectional survey (AHVS II) in late 2019 and early 2020.

In the context of COVID-19, RAND and the Robert Wood Johnson Foundation have partnered to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low-to moderate-income backgrounds.

Questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents' views and priorities regarding health actions and investments are changing (including the roles of government and the private sector), and how general values about such issues as freedom and racism may be related to pandemic views and response expectations.

This study includes the results for Wave 1 for the general population.

Demographic information includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

In the context of COVID-19, RAND and the Robert Wood Johnson Foundation have partnered to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low-to moderate-income backgrounds.

In the context of COVID-19, RAND and the Robert Wood Johnson Foundation partnered again to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low- to moderate-income backgrounds.

The study is a longitudinal study, collecting data in four waves. The study also included 2 populations: A sample of populations at greater risk, and a general population sample. This study includes the results for Wave 2 for populations at greater risk.

One previous wave and two future waves were conducted. The questions in the surveys were largely similar across all four waves. All respondents who participated in Wave 1 were invited to participate in the future waves.

Demographic info includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

In the context of COVID-19, RAND and RWJF partnered again to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low to moderate-income backgrounds.

The questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents' views and priorities regarding health actions and investments are changing (including the roles of government and the private sector), and how general values about such issues as freedom and racism may be related to pandemic views and response expectations. The study is a longitudinal study, which collected data in four waves. The study also included 2 populations: A sample of populations at greater risk, and a general population sample. This study included the results for Wave 2 for populations at greater risk. The questions in the surveys were largely similar across all four waves.

Demographic info includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

In the context of COVID-19, RAND and the Robert Wood Johnson Foundation partnered again to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how these health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low- to moderate-income backgrounds.

The questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents' views and priorities regarding health actions and investments are changing (including the roles of government and the private sector), and how general values about such issues as freedom and racism may be related to pandemic views and response expectations.

This study includes the results for Wave 4 for the general population.

Demographic information includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

In the context of COVID-19, RAND and the Robert Wood Johnson Foundation (RWJF) partnered again to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low to moderate-income backgrounds.

The questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents' views and priorities regarding health actions and investments are changing (including the roles of government and the private sector), and how general values about such issues as freedom and racism may be related to pandemic views and response expectations. Some questions used in the NSHA are fielded in this COVID-19 survey while others are newly used from other COVID-19 surveys or newly developed for this effort. The study is a longitudinal study, collecting data in four waves. The study also included 2 populations: A sample of populations at greater risk, and a general population sample. This study includes the results for Wave 4 for populations at greater risk. The questions in the surveys were largely similar across all four waves.

Demographic info includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

This study was one of three modules in a larger study designed to define, identify, and disseminate information about best practice physical activity programming in community-based organizations. The National Council on the Aging (NCOA), together with the Robert Wood Johnson Foundation (RWJF), conducted Module 1, a national competition for NCOA Awards for Excellence in Physical Activity Programming. The purpose of the competition was to bring national attention to best practice in physical activity programming operated by local public or non-profit organizations that serve older adults. NCOA was assisted in this endeavor by the University of Illinois at Chicago (UIC), the Healthy Aging Research Network of the Centers for Disease Control and Prevention's Prevention Research Centers, and a variety of nationally known physical activity experts. Module 2 was a census of physical activity programs for older adults that was conducted in seven locations by Healthy Aging Research Network. Module 3 was this National Impact Study, a study of best practice programming at three community-based organizations serving older adults. It was designed to answer the research question, "Do best practice physical activity programs provided by community-based organizations have a measurable impact on the health and well being of participants?" The three studied organizations were among the ten winners of the best practice competition.

Data were collected from previously sedentary, volunteer participants from each of the three organizations. The goal was to enroll 250 older adults at each site for a total of 750 subjects across the three programs. At each site, one half of all subjects (n = 125) were to be assigned to the treatment group and the other half to a control group. Subjects in the treatment group participated in the best practice program classes while the control group could enroll in other exercise classes but not the best practice program classes. The subjects were to be interviewed three times: baseline, three months, and nine months. Each interview contained two parts: (1) the administration of health and exercise related questions and (2) the administration of four physical fitness tests that assessed the respondent's strength, flexibility and aerobic endurance. Background information collected by the survey includes age, education, employment status, marital status, income, race, and Hispanic origin.

The National Survey of America's Families (NSAF) is a household survey that provides a comprehensive look at quantitative measures of the well-being of children, adults, and their families. While the focus of the survey is at the state level, the scope is national -- with a primary emphasis on low-income families. NSAF information was gathered from interviews conducted with the Most Knowledgeable Adult (MKA), the person in the household who was most knowledgeable about the questions being asked about the respondent, their spouse/partner (if applicable) and the focal child (or children). Data were collected from more than 40,000 families in two stages. First, a screener interview was administered to determine whether a household was eligible to complete the second, extended interview.

Two types of extended interviews were administered. Option A interviews were used in households with children under age 18. Option B interviews were used in childless adult households and also with emancipated minors. The extended interview was divided into several sections and is labeled A through P below:

• A. Student Status. This section contained two questions that asked whether the respondent was a student and whether that household was the respondent's usual residence.

• B. Health Status and Satisfaction. These questions asked about the respondent's satisfaction with health care, access to health care, the health status of the focal children, and the health status of the respondent.

• C. Parent/Child/Family Interaction and Education. This series of questions asked about education for focal children. Questions addressed the focal child's current grade (or the last grade completed) and the child's attitudes toward school and schoolwork, skipping school, suspensions, and changing schools. Questions were also asked about children over 11 years old working for pay and attending summer school.

• D. Household Roster. In this section, the name, age, and sex of all persons living in the household were recorded, and relationships between all household members were investigated.

• E. Health Care Coverage. Information was gathered about current health insurance coverage for the respondent, the respondent's spouse/partner, and the focal children. Questions were also asked about characteristics of that coverage and of periods in which family members had no insurance coverage.

• F. Health Care Use and Access. This section gathered information about health status, health care services received, and necessary health care services that were postponed during the preceding 12 months. Questions on routine care, overnight stays in hospitals, dental care, mental health care, women's health care, well-child care, and prescription medicines were also included.

• G. Child Care. In this section, respondents were queried as to child care arrangements including Head Start, child care centers, before- or after-school care, and babysitters. Questions were asked about the total number of hours per week in each care situation, the typical number of children cared for, the typical number of adult child care providers, and child care costs.

• H. Nonresidential Parent/Father. These questions determined whether a focal child had a nonresident parent, how often the child saw his/her nonresident parent, whether the nonresident parent provided financial support, and whether nonresident parents were required by child support orders to provide financial support.

• I. Employment and Earnings. This section contained a series of questions about the employment and earnings of the respondent and the spouse/partnerfor the current and preceding year. Topics included employment status, occupation, industry, employer-provided health insurance, hours worked, and earnings. Some questions were also asked about the earnings of other family members.

• J. Family Income. Family income also was identified from a wide variety of sources other than earnings from employment. These sources included public assistance (e.g., Aid to Families with Dependent Children [AFDC], General Assistance, Emergency Assistance, or vouchers), Food Stamps, child support, foster care payments, financial assistance from friends or relatives, unemployment compensation, workers' compensation or veterans' payments, Supplemental Security Income, Social Security, pension or annuity income, interest or dividend income, income from rental property, or any other income source.

• K. Welfare Program Participation. This section gathered detailed information about AFDC and Food Stamp benefits that the respondent might have received within the preceding two years. For both types of assistance, periods in which the respondent's benefits were reduced or eliminated were identified, as were strategies for coping during such times. Current AFDC or Food Stamp recipients were asked about any requirements they had to fulfill (e.g., job search, training, etc.) in order to receive these benefits. Recipients were also asked questions about awareness of time limits and experiences with diversion. For respondents with children, questions were asked about benefits received in the previous year through the supplemental food program for Women, Infants, and Children (WIC) and free or reduced-cost school breakfast and lunch programs.

• L. Education and Training. This series of questions inquired about the highest grade completed, highest degree earned, participation in job training programs during the previous year, and classes taken for credit during the previous year.

• M. Housing and Economic Hardship. Questions covered the respondent's living arrangements, the name(s) of the lease- or mortgage- holder(s) in the household, and the amount of rent or mortgage paid monthly. Information was collected about financial contributions by the respondent or his/her spouse or partner to children under 18 years old living outside the household. The effect of economic hardship on the family's food consumption and ability to pay for housing costs was also assessed.

• N. Issues, Problems, and Social Services. Questions in this section covered the respondent's state of mind, feelings about his or her child (or children), constructive activities the child (or children) might have been involved with, the availability of social services in their community, problems the child (or children) might have had in the preceding year and efforts to obtain help for those problems, and the respondent's involvement in volunteer and religious activities.

• O. Race, Ethnicity, and Nativity. Race and ethnicity were asked for the respondent, the spouse/partner, and the focal child (or children). For household members who were born outside the United States, country of origin and citizenship questions were asked.

• P. Closing. At the end of the survey, respondents were asked their opinions about welfare and working and about raising children. Closing questions asked for the respondent's ZIP code and, in households with foreign-born individuals, tracing information for use in a follow-up survey.

The 1997 NSAF data are available in nine parts and are organized into hierarchical, flat household-, family-, person-, adult-, and child-level files. A description of each is provided below:

1. Focal Child Data. This dataset contains data elements from the extended interview that are specific to focal children (FC1 and FC2). Select data items that were asked only of MKAs are also included. Information in this dataset is primarily from sections N (Issues, Problems, and Social Services) and P (Closing) of the extended interview. The dataset contains one record for each focal child.

2. Adult Pair Data. Included in this dataset is information collected from the extended interview about both the respondent and the respondent's spouse/partner. There is one observation per respondent and one per spouse (where applicable). Information in this dataset is primarily from sections I (Employment and Earnings) and L (Education and Training) of the extended interview.

3. Random Adult Data. Information in this person-level dataset is specific to a randomly selected adult, either the respondent or the spouse/partner. This situation occurs only in sections E (Health Insurance Coverage) and F (Health Care Access and Utilization) of the extended interview.

4. Childless Adult Data. This dataset contains data elements from the extended interview that are asked only of the respondent in Option B interviews. Variables in this dataset come mainly from section N (Issue, Problems, and Social Services) and P (Closing). There is one record per Option B interview in the dataset.

5. Family-Respondent Data. Information in this dataset centers around information about the family's use of health care and social services. This family-level dataset contains one observation per respondent. Because there could be more than one respondent per family, family-respondent level variables may have different values within a single family.

6. Household Data. This household-level dataset contains general information about the household such as the demographic characteristics of its members. Also contained in this dataset are administrative and process data such as housing subsidies, public housing, the number of bedrooms in the house, whether the home was owned or rented, and information pertaining to screeners and the completion of interviews.

7. Person Data. This dataset contains one observation for each person living in the household. Included in this dataset is demographic information as well as information on current health insurance status and income.

8. Social Family Data. Included in this dataset are items asked about the social family and variables aggregated at the social family level. The social family includes not only married partners and their children, but also unmarried partners, all of their children, and members of the extended family (anyone related by blood to the MKA, the spouse/partner, or their children). Among the survey items included are those variables indicating whether anyone in the social family had a particular type of income and health insurance. Also included are variables summarizing information across all members of a social family, such as the number of family members. There is one record for each social family.

9. CPS Family Data. Since the social family definition was used in fielding the NSAF, this dataset includes only variables created using the Current Population Survey (CPS) definition of family. A CPS family includes the householder, spouse of family householder, children in the family, and other relatives of the family household respondent. There is one record for each CPS family in this dataset.

The National Survey of America's Families (NSAF) is a household survey that provides a comprehensive look at quantitative measures of the well-being of children, adults, and their families. While the focus of the survey is at the state level, the scope is national -- with a primary emphasis on low-income families. NSAF information was gathered from interviews conducted with the Most Knowledgeable Adult (MKA), the person in the household who was most knowledgeable about the questions being asked about the respondent, their spouse/partner (if applicable) and the focal child (or children). Data were collected from more than 40,000 families in two stages. First, a screener interview was administered to determine whether a household was eligible to complete the second, extended interview.

Two types of extended interviews were administered. Option A interviews were used in households with children under age 18. Option B interviews were used in childless adult households and also with emancipated minors. The extended interview was divided into several sections and is labeled A through P below:

• A. Student Status. This section contained two questions that asked whether the respondent was a student and whether that household was the respondent's usual residence.

• B. Health Status and Satisfaction. These questions asked about the respondent's satisfaction with health care, access to health care, the health status of the focal children, and the health status of the respondent. It also covered questions about the respondent's awareness of specific insurance programs such as Medicaid, and those associated with the Children's Health Insurance Program (CHIP).

• C. Parent/Child/Family Interaction and Education. This series of questions asked about education for focal children. Questions addressed the focal child's current grade (or the last grade completed) and the child's attitudes toward school and schoolwork, skipping school, suspensions, and changing schools. Questions were also asked about children over 11 years old working for pay and attending summer school.

• D. Household Roster. In this section, the name, age, and sex of all persons living in the household were recorded, and relationships between all household members were investigated.

• E. Health Care Coverage. Information was gathered about current health insurance coverage for the respondent, the respondent's spouse/partner, and the focal children. Questions were also asked about characteristics of that coverage and of periods in which family members had no insurance coverage.

• F. Health Care Use and Access. This section gathered information about health status, health care services received, and necessary health care services that were postponed during the preceding 12 months. Questions on routine care, overnight stays in hospitals, dental care, mental health care, women's health care, well-child care, and prescription medicines were also included.

• G. Child Care. In this section, respondents were queried as to child care arrangements including Head Start, child care centers, before- or after-school care, and babysitters. Questions were asked about the total number of hours per week in each care situation, the typical number of children cared for, the typical number of adult child care providers, and child care costs.

• H. Nonresidential Parent/Father. These questions determined whether a focal child had a nonresident parent, how often the child saw his/her nonresident parent, whether the nonresident parent provided financial support, and whether nonresident parents were required by child support orders to provide financial support.

• I. Employment and Earnings. This section contained a series of questions about the employment and earnings of the respondent and the spouse/partner for the current and preceding year. Topics included employment status, occupation, industry, employer-provided health insurance, hours worked, and earnings. Some questions were also asked about the earnings of other family members.

• J. Family Income. Family income also was identified from a wide variety of sources other than earnings from employment. These sources included public assistance (e.g., Temporary Assistance for Needy Families [TANF], General Assistance, Emergency Assistance, vouchers), Food Stamps, child support, foster care payments, financial assistance from friends or relatives, unemployment compensation, workers' compensation or veterans' payments, Supplemental Security Income, Social Security, pension or annuity income, interest or dividend income, income from rental property, or any other income source.

• K. Welfare Program Participation. This section gathered detailed information about TANF and Food Stamp benefits that the respondent might have received within the preceding two years. For both types of assistance, periods in which the respondent's benefits were reduced or eliminated were identified, as were strategies for coping during such times. Current TANF or Food Stamp recipients were asked about any requirements they had to fulfill (e.g., job search, training, etc.) in order to receive these benefits. Recipients were also asked questions about awareness of time limits and experiences with diversion. For respondents with children, questions were asked about benefits received in the previous year through the supplemental food program for Women, Infants, and Children (WIC) and free or reduced-cost school breakfast and lunch programs. Additional questions were asked about respondent experiences in obtaining government assistance for child care and health insurance through Medicaid and CHIP, and receipt and/or the use of the Earned Income Tax Credit (EITC) in 1998.

• L. Education and Training. This series of questions inquired about the highest grade completed, highest degree earned, participation in job training programs during the previous year, and classes taken for credit during the previous year.

• M. Housing and Economic Hardship. Questions covered the respondent's living arrangements, the name(s) of the lease- or mortgage- holder(s) in the household, and the amount of rent or mortgage paid monthly. Information was collected about financial contributions by the respondent or his/her spouse or partner to children under 18 years old living outside the household. The effect of economic hardship on the family's food consumption and ability to pay for housing costs was also assessed.

• N. Issues, Problems, and Social Services. Questions in this section covered the respondent's state of mind, feelings about his or her child (or children), constructive activities the child (or children) might have been involved with, the availability of social services in their community, problems the child (or children) might have had in the preceding year and efforts to obtain help for those problems, and the respondent's involvement in volunteer and religious activities.

• O. Race, Ethnicity, and Nativity. Race and ethnicity were asked for the respondent, the spouse/partner, and the focal children. For household members who were born outside the United States, country of origin and citizenship questions were asked.

• P. Closing. At the end of the survey, respondent's were asked their opinions about welfare and working and about raising children.The respondent's ZIP code and address were requested and tracing information was asked of households with families receiving welfare at any time since January 1997, for possible use in a follow-up survey.

The 1999 NSAF data are available in nine parts and are organized into hierarchical, flat household-, family-, person-, adult-, and child-level files. A description of each is provided below:

1. Focal Child Data. This dataset contains data elements from the extended interview that are specific to focal children (FC1 and FC2). Select data items that were asked only of MKAs are also included. Information in this dataset is primarily from sections N (Issues, Problems, and Social Services) and P (Closing) of the extended interview. The dataset contains one record for each focal child.

2. Adult Pair Data. Included in this dataset is information collected from the extended interview about both the respondent and the respondent's spouse/partner. There is one observation per respondent and one per spouse (where applicable). Information in this dataset is primarily from sections I (Employment and Earnings) and L (Education and Training) of the extended interview.

3. Random Adult Data. Information in this person-level dataset is specific to a randomly selected adult, either the respondent or the spouse/partner. This situation occurs only in sections E (Health Insurance Coverage) and F (Health Care Access and Utilization) of the extended interview.

4. Childless Adult Data. This dataset contains data elements from the extended interview that are asked only of the respondent in Option B interviews. Variables in this dataset come mainly from section N (Issue, Problems, and Social Services) and P (Closing). There is one record per Option B interview in the dataset.

5. Family-Respondent Data. Information in this dataset centers around information about the family's use of health care and social services. This family-level dataset contains one observation per respondent. Because there could be more than one respondent per family, family-respondent level variables may have different values within a single family.

6. Household Data. This household-level dataset contains general information about the household such as the demographic characteristics of its members. Also contained in this dataset is administrative and process data such as housing subsidies, public housing, the number of bedrooms in the house, if the home was owned or rented, and information pertaining to screeners and the completion of interviews.

7. Person Data. This dataset contains one observation for each person living in the household. Included in this dataset is demographic information as well as information on current health insurance status and income.

8. Social Family Data. Included in this dataset are items asked about the social family and variables aggregated at the social family level. The social family includes not only married partners and their children, but also unmarried partners, all of their children, and members of the extended family (anyone related by blood to the MKA, the spouse/partner, or their children). Among the survey items included are those variables indicating whether anyone in the social family had a particular type of income and health insurance. Also included are variables summarizing information across all members of a social family, such as the number of family members. There is one record for each social family.

9. CPS Family Data. Since the social family definition was used in fielding the NSAF, this dataset includes only variables created using the Current Population Survey (CPS) definition of family. A CPS family includes the householder, spouse of family householder,children in the family, and other relatives of the family household respondent. There is one record for each CPS family in this dataset.

The National Survey of America's Families (NSAF) is a household survey that provides a comprehensive look at quantitative measures of the well-being of children, adults, and their families. While the focus of the survey is at the state level, the scope is national -- with a primary emphasis on low-income families. NSAF information was gathered from interviews conducted with the Most Knowledgeable Adult (MKA), the person in the household who was most knowledgeable about the questions being asked about the respondent, their spouse/partner (if applicable) and the focal child (or children). Data were collected from more than 40,000 families in two stages. First, a screener interview was administered to determine whether a household was eligible to complete the second, extended interview.

Two types of extended interviews were administered. Option A interviews were used in households with children under age 18. Option B interviews were used in childless adult households and also with emancipated minors. The extended interview was divided into several sections and is labeled A through P below:

• A. Student Status. This section contained two questions that asked whether the respondent was a student and whether that household was the respondent's usual residence.

• B. Health Status and Satisfaction. These questions asked about the respondent's satisfaction with health care, access to health care, the health status of the focal children, and the health status of the respondent. It also covered questions about the respondent's awareness of specific insurance programs such as Medicaid, and those associated with the Children's Health Insurance Program (CHIP).

• C. Parent/Child/Family Interaction and Education. This series of questions asked about education for focal children. Questions addressed the focal child's current grade (or the last grade completed) and the child's attitudes toward school and schoolwork, skipping school, suspensions, and changing schools. Questions were also asked about children over 11 years old working for pay and attending summer school.

• D. Household Roster. In this section, the name, age, and sex of all persons living in the household were recorded, and relationships between all household members were investigated.

• E. Health Care Coverage. Information was gathered about current health insurance coverage for the respondent, the respondent's spouse/partner, and the focal children. Questions were also asked about characteristics of that coverage and of periods in which family members had no insurance coverage.

• F. Health Care Use and Access. This section gathered information about health status, health care services received, and necessary health care services that were postponed during the preceding 12 months. Questions on routine care, overnight stays in hospitals, dental care, mental health care, women's health care, well-child care, and prescription medicines were also included.

• G. Child Care. In this section, respondents were queried as to child care arrangements including Head Start, child care centers, before- or after-school care, and babysitters. Questions were asked about the total number of hours per week in each care situation, the typical number of children cared for, the typical number of adult child care providers, and child care costs.

• H. Nonresidential Parent/Father. These questions determined whether a focal child had a nonresident parent, how often the child saw his/her nonresident parent, whether the nonresident parent provided financial support, and whether nonresident parents were required by child support orders to provide financial support.

• I. Employment and Earnings. This section contained a series of questions about the employment and earnings of the respondent and the spouse/partner for the current and preceding year. Topics included employment status, occupation, industry, employer-provided health insurance, hours worked, and earnings. Some questions were also asked about the earnings of other family members.

• J. Family Income. Family income was also identified from a wide variety of sources other than earnings from employment. These sources included public assistance (e.g., Temporary Assistance for Needy Families [TANF], General Assistance, Emergency Assistance, or vouchers), Food Stamps, child support, foster care payments, financial assistance from friends or relatives, unemployment compensation, workers' compensation or veterans' payments, Supplemental Security Income, Social Security, pension or annuity income, interest or dividend income, income from rental property, or any other income source.

• K. Welfare Program Participation. This section gathered detailed information about TANF and Food Stamp benefits that the respondent might have received within the preceding two years. For both types of assistance, periods in which the respondent's benefits were reduced or eliminated were identified, as were strategies for coping during such times. Current TANF or Food Stamp recipients were asked about any requirements they had to fulfill (e.g., job search, training, etc.) in order to receive these benefits. Recipients were also asked questions about awareness of time limits and experiences with diversion. For respondents with children, questions were asked about benefits received in the previous year through the supplemental food program for Women, Infants, and Children (WIC) and free or reduced-cost school breakfast and lunch programs. Additional questions were asked about respondent experiences in obtaining government assistance for child care and health insurance through Medicaid and CHIP, and receipt and/or the use of the Earned Income Tax Credit (EITC) in any year between 1999 and 2002.

• L. Education and Training. This series of questions inquired about the highest grade completed, highest degree earned, participation in job training programs during the previous year, and classes taken for credit during the previous year.

• M. Housing and Economic Hardship. Questions covered the respondent's living arrangements, the name(s) of the lease- or mortgage- holder(s) in the household, and the amount of rent or mortgage paid monthly. Information was collected about financial contributions by the respondent or his/her spouse or partner to children under 18 years old living outside the household. The effect of economic hardship on the family's food consumption and ability to pay for housing costs was also assessed.

• N. Issues, Problems, and Social Services. Questions in this section covered the respondent's state of mind, feelings about his or her child (or children), constructive activities the child (or children) might have been involved with, the availability of social services in their community, problems the child (or children) might have had in the preceding year and efforts to obtain help for those problems, and the respondent's involvement in volunteer and religious activities.

• O. Race, Ethnicity, and Nativity. Race and ethnicity were asked for the respondent, the spouse/partner, and the focal child (or children). For household members who were born outside the United States, country of origin and citizenship questions were asked.

• P. Closing. At the end of the survey, respondents were asked their opinions about welfare and working and about raising children. Respondents' ZIP code and address were also requested.

• The 2002 NSAF data are available in nine parts and are organized into hierarchical, flat household-, family-, person-, adult-, and child-level files. A description of each is provided below:

  1. Focal Child Data. This dataset contains data elements from the extended interview that are specific to focal children (FC1 and FC2). Select data items that were asked only of MKAs are also included. Information in this dataset is primarily from sections N (Issues, Problems, and Social Services) and P (Closing) of the extended interview. The dataset contains one record for each focal child.

  2. Adult Pair Data. Included in this dataset is information collected from the extended interview about both the respondent and the respondent's spouse/partner. There is one observation per respondent and one per spouse (where applicable). Information in this dataset is primarily from sections I (Employment and Earnings) and L (Education and Training) of the extended interview.

  3. Random Adult Data. Information in this person-level dataset is specific to a randomly selected adult, either the respondent or the spouse/partner. This situation occurs only in sections E (Health Insurance Coverage) and F (Health Care Access and Utilization) of the extended interview.

  4. Childless Adult Data. This dataset contains data elements from the extended interview that are asked only of the respondent in Option B interviews. Variables in this dataset come mainly from section N (Issue, Problems, and Social Services) and P (Closing). There is one record per Option B interview in the dataset.

  5. Family-Respondent Data. Information in this dataset centers around information about the family's use of health care and social services. This family-level dataset contains one observation per respondent. Because there could be more than one respondent per family, family-respondent level variables may have different values within a single family.

  6. Household Data. This household-level dataset contains general information about the household such as the demographic characteristics of its members. Also contained in this dataset are administrative and process data such as housing subsidies, public housing, the number of bedrooms in the house, whether the home is owned or rented, and information pertaining to screeners and the completion of interviews.

  7. Person Data. This dataset contains one observation for each person living in the household. Included in this dataset is demographic information as well as information on current health insurance status and income.

  8. Social Family Data. Included in this dataset are items asked about the social family and variables aggregated at the social family level. The social family includes not only married partners and their children, but also unmarried partners, all of their children, and members of the extended family (anyone related by blood to the MKA, the spouse/partner, or their children). Among the survey items included are those variables indicating whether anyone in the social family had a particular type of income and health insurance. Also included are variables summarizing information across all members of a social family, such as the number of family members. There is one record for each social family.

  9. CPS Family Data. Since the social family definition was used in fielding the NSAF, this dataset includes only variables created using the Current Population Survey (CPS) definition of family. A CPS family includes the householder, spouse of family householder, children in the family, and other relatives of the family household respondent. There is one record for each CPS family in this dataset.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

This study includes the results from the 2018 RWJF National Survey of Health Attitudes. This 2018 survey is considered the second wave, the first wave of the survey was conducted in 2015 (ICPSR 37405). In 2018, the study team fielded an updated version that included many of the same questions but added some new constructs that were of interest as part of the larger Culture of Health effort. This study complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016).

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes (NSHA) is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

This study includes the results from the 2023 RWJF National Survey of Health Attitudes. The 2023 survey is the third wave of the NSHA. The first wave was conducted in 2015 (ICPSR 37405) and the second wave in 2018 (ICPSR 37633). The 2023 report complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016), and its subsequent topline 2018 Survey of National Health Attitudes: Description and Top-Line Summary (Carman et al., 2019) and is organized similarly for consistency. A companion set of longitudinal surveys during the COVID-19 pandemic was fielded between 2020 and 2021 and is further described in four top-line reports, COVID-19 and the Experiences of Populations at Greater Risk (Carman et al., 2020-2021).

The questions in the 2023 survey uniquely capture aspects of American mindset about health, health equity, structural racism, and wellbeing in ways that are not present in other surveys. This version of the NSHA can be viewed in three main sections: (1) individual health experiences, perspectives, and knowledge (making health a shared value); (2) health equity perspectives; and (3) community wellbeing, including climate views and barriers to community engagement. Insights from the surveys referenced above, including this one, have established a baseline and set of cross-sectional pulse checks on where the American public is regarding their recognition of social determinants of health, their understanding of health inequities including structural racism, their willingness to address those inequities and their indication of who in society should be responsible for solving health inequities.