Cdn.ymaws.com



PRAMS marijuana questionsFrom PRAMS Phase 6: . Did you use any of these drugs in the month before you got pregnant? For each item, circle Y (Yes) if you used it or circle N (No) if you did not.Prescription drugs N Y If yes, what kinds? Please tell us [BOX]Marijuana (pot, bud) or hashish (hash) N YAmphetamines (uppers, ice, speed, crystal meth, crank) N YCocaine (rock, coke, crack) or heroin (smack, horse) N YTranquilizers (downers, ludes) or hallucinogens (LSD/acid, PCP/angel dust, ecstasy) N YSniffing gasoline, glue, hairspray, or other aerosols N YHI77. Did you use any of these drugs when you were pregnant? For each item, circle Y (Yes) if you used it or circle N (No) if you did not.Prescription drugs N Y If yes, what kinds? Please tell us [BOX]Marijuana (pot, bud) or hashish (hash) N YAmphetamines (uppers, ice, speed, crystal meth, crank) N YCocaine (rock, coke, crack) or heroin (smack, horse) N YTranquilizers (downers, ludes) or hallucinogens (LSD/acid, PCP/angel dust, ecstasy) N YSniffing gasoline, glue, hairspray, or other aerosols N YAK70. During any of the following time periods, did you smoke marijuana or hash? For each time period, circle Y (Yes) if you smoked then or N (No) if you did not smoke then.a. During the 12 months before I got pregnant N Yb. During my most recent pregnancy N Yc. Since my new baby was born N YVT74. During any of the following time periods, did you smoke marijuana or hash? For each time period, circle Y (Yes) if you smoked then or N (No) if you did not smoke then.During the 12 months before I got pregnant N YDuring my most recent pregnancyN YSince my new baby was born N YR5. During any of your prenatal care visits, did a doctor, nurse, or other health care worker ask you—a. How much alcohol you were drinking .....................................................N Yb. If someone was hurting you emotionally or physically ............................N Yc. If you were using illegal drugs (marijuana or hash, cocaine, crack, etc.) N Yd. If you wanted to be tested for HIV (the virus that causes AIDS) .............N Ye. If you planned to use birth control after your baby was born...................N YUsed by: LA25, MO25, WV24WA22 (combined R5 with other questions and added state-developed option): During any of your prenatal care visits, did a doctor, nurse, or other health care worker do any of the things listed below? For each item circle Y (Yes) if someone asked or talked with you about it or circle N (No) if no one asked or talked with you about it.a. Ask if you were smoking cigarettesb. Ask how much alcohol you were drinkingc. Ask if someone was hurting you emotionally or physicallyd. Ask if you were using illegal drugs (marijuana or hash, cocaine, crack, etc.)e. Ask if you planned to use birth control after your baby was bornf. Talk with you about how eating fish containing high levels of mercury could affect your babyg. Talk with you about the bacteria group B Strep (or beta Strep)h. Talk with you about how much weight you should gain during your pregnancyi. Talk with you about diseases or birth defects that could run in your family or your partner’s familyj. Talk with you about ‘Baby blues’ or postpartum depressionk. Ask if you wanted to be tested for HIV (the virus that causes AIDS)While you were pregnant (before you were pregnant, since your baby was born)During the past 30 days, how did you use marijuana? For each of the following methods please say yes if it does apply or no if it does not apply. (1 Yes; 2 No; 7 Don't know/Not sure; 9 Refused)A Was it Vaporized? (e-cigarette-like vaporizer)B Was it smoked? (in a joint, bong, pipe, blunt)C Was it eaten in food? (in brownies, cakes, cookies, candy) D Was it consumed in a beverage? (tea, cola, alcohol) E Was it dabbed? F Was it used in some other way? Other ____________ (specify) ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download