Form
Approved OMB
No. 0920-0727
Exp. Date xx/xx/20xx
APPENDIX
M – Yellowstone Study Questionnaire – Internet Version
YELLOWSTONE NATIONAL PARK
BACKCOUNTRY SURVEY
Thank you for taking the time to complete this survey. We would like to start by asking you about the dates you traveled in the backcountry at Yellowstone National Park (abbreviated as YELL) and the group of people you traveled with. We define the BACKCOUNTRY as those wilderness areas of the parks that (1) require a permit to enter, (2) are reached primarily by hiking, boating, or horseback, and (3) lack most facilities and services. You may refuse to answer any question at any time. Please but a mark in the box beside the correct answer or fill in the blanks (as appropriate). For this first series of questions, you may want to have a calendar available.
BACKCOUNTRY TRAVEL
Q1. On what date did you enter the backcountry at Yellowstone National Park (abbreviated as YELL)? (This is not necessarily the date you entered YELL itself). If you do not know the exact date, please enter the month.
|___|___|-|___|___|-2008
M M D D
Q2. Did you travel with another person or a group of people into the backcountry? (Note: your group is defined as all the people listed on your backcountry permit)
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.3)
NO (GO TO Q.5)
DON’T KNOW (GO TO Q.5)
Q3. How many people were in your group, NOT INCLUDING YOURSELF?
|___|___|___| persons DON’T KNOW
Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0727).
Q4. How many people were in each of the following categories, NOT INCLUDING YOURSELF?
Male Adults |___|___|___|
Female Adults |___|___|___|
Male Children (younger than 18 years) |___|___|___|
Female Children (younger than 18 years) |___|___|___|
DON’T KNOW
Q5. While you were in the backcountry, did you follow the itinerary as outlined on your backcountry permit? (PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
Q6. On what date did you leave the backcountry at YELL? (This is not necessarily the date you left YELL itself). If you do not know the exact date, please enter the month.
|___|___|-|___|___|-2008
M M D D
Next, we would now like to ask you questions about your activities and exposures WHILE YOU WERE IN THE BACKCOUNTRY at YELL. These questions are about drinking water, food and food preparation, sanitation and hygiene, recreational water activities, and contact with animals.
D RINKING WATER
Q7. What were your sources of drinking water while you were in the backcountry at Yellowstone National Park (abbreviated as YELL)?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Lake/pond (or other standing body of water) in the backcountry (GO TO Q.8)
Stream/river (or other flowing water, e.g., waterfalls) in the backcountry
(GO TO Q.8)
Spring in the backcountry (GO TO Q.8)
Commercially bottled water purchased before entering the backcountry
(GO TO Q.9)
Other water brought in from outside YELL (GO TO Q.9)
Water obtained from a faucet/tap inside YELL prior to entering the backcountry (GO TO Q.9)
Water obtained from a lake/pond (or other standing body of water) inside YELL prior to entering the backcountry (GO TO Q.8)
Water obtained from a stream/river (or other flowing body of water, e.g., waterfalls) inside YELL prior to entering the backcountry (GO TO Q.8)
Water obtained from a spring inside YELL prior to entering the backcountry
(GO TO Q.8)
Other (specify) ________________________________________ (GO TO Q.9)
Don’t Know (GO TO Q.9)
Q8. You indicated you drank water from the following source(s) while you were in the backcountry. What did the water at the source(s) look like? (FOR EACH NATURAL WATER SOURCE YOU LISTED IN Q7, PLEASE CHECK ONE ANSWER)
WATER SOURCE |
Flowing and clear |
Flowing but somewhat murky / cloudy / turbid |
Flowing but quite murky / cloudy / turbid |
Non-flowing and clear |
Non-flowing and somewhat murky / cloudy / turbid |
Non-flowing and quite murky / cloudy / turbid |
Other (specify in space below) |
Don’t know |
Lake / pond in backcountry |
|
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Stream / river in backcountry |
|
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Spring in backcountry |
|
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Lake / pond prior to entry into backcountry |
|
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Stream / river prior to entry into backcountry |
|
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Spring prior to entry into backcountry |
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Q9. Did you drink untreated water in the backcountry at YELL? By “untreated water” we mean water that was not treated using filtration, boiling, disinfection, or another treatment method before you drank it. Untreated water excludes bottled water and tap water. (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q10. Did you (or another member of your group) treat your water in YELL before you drank it? (Note: your group is defined as all the people listed on your backcountry permit) (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.11)
USUALLY (GO TO Q.11)
SOMETIMES (GO TO Q.11)
NEVER (GO TO Q.72)
DON’T KNOW (GO TO Q.72)
Q11. Was there a specific person (or persons) in your group who was (were) designated to treat the water for the group?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.12)
NO (GO TO Q.13)
DON’T KNOW (GO TO Q.13)
Q12. How many people in your group were designated to treat the water?
(PLEASE CHECK ONLY ONE ANSWER)
One
Two
Three
Four
Five
More than five
Don’t Know
Q13. What method(s) was (were) used to treat the water?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Filtration
Boiling
Disinfection drops/ tablets/ powder (e.g., chemicals like chlorine, iodine)
Ultraviolet (UV) light
Mixed oxidants / electrolysis
Clarification using a flocculating agent
Other (specify) ______________________________________________
Don’t Know
Q14. If MULTIPLE METHODS were selected in the previous question (Q.13), was one method alone used to treat the water before drinking it or were multiple methods sometimes used together to treat the water before drinking it?
(PLEASE CHECK ONLY ONE ANSWER)
Always only one method used (GO TO Q.16)
Always multiple methods used together (GO TO Q.15)
Sometimes one method used, sometimes multiple methods used together
(GO TO Q.15)
Other (specify) __________________________________ (GO TO Q.15)
Don’t Know (GO TO Q.16)
Q15. If MULTIPLE METHODS TOGETHER, which methods were used together? (PLEASE CHECK ALL THAT APPLY)
Filtration and boiling
Filtration and disinfection with chemicals
Filtration and ultraviolet (UV) light
Filtration and mixed oxidants / electrolysis
Filtration and clarification using a flocculating agent
Filtration and other method
Boiling and disinfection with chemicals
Boiling and ultraviolet (UV) light
Boiling and mixed oxidants / electrolysis
Boiling and clarification using a flocculating agent
Boiling and other method
Disinfection with chemicals and ultraviolet (UV) light
Disinfection with chemicals and mixed oxidants / electrolysis
Disinfection with chemicals & clarification using a flocculating agent
Disinfection with chemicals and other method
Ultraviolet (UV) light and mixed oxidants / electrolysis
Ultraviolet (UV) light and clarification using a flocculating agent
Ultraviolet (UV) light and other method
Mixed oxidants / electrolysis and clarification using a flocculating agent
Mixed oxidants / electrolysis and other method
Clarification using a flocculating agent and other method
Other combination (specify) _______________________________
Q16. If you FILTERED your water, please answer the following questions. If you did not filter your water, please go to Q.28:
Q17. You indicated that you drank filtered water while you were in the backcountry at YELL. Did you filter your drinking water or did someone else filter it for you?
(PLEASE CHECK ONLY ONE ANSWER)
I filtered my drinking water (GO TO Q.18)
Someone else filtered my drinking water (GO TO Q.19)
Sometimes I filtered, sometimes someone else filtered
(GO TO Q.18)
Other (specify) _____________________________ (GO TO Q.18)
Don’t Know (GO TO Q.22)
Q18. Did you ever filter water before this trip into the backcountry at YELL? (PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I DID NOT FILTER WATER ON THIS TRIP
Q19. Did the other people who filtered water on this trip ever filter water in the past? (PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I WAS THE ONLY PERSON WHO FILTERED WATER ON THIS TRIP
Q20. Did you wash your hands before filtering the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT FILTER WATER ON THIS TRIP
Q21. Did the other people who filtered water wash their hands before filtering the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I WAS THE ONLY PERSON WHO FILTERED WATER ON THIS TRIP
Q22. Regarding the filter(s) used on this trip, can you easily distinguish between (1) the filter hose that brings raw untreated water from the water source into the filter (intake hose), and (2) the hose that removes finished filtered water from the device (outflow hose)?
(PLEASE CHECK ONLY ONE ANSWER)
YES, the intake and outflow hoses look different on all the filters used
N O, the hoses look the same on all the filters used and are interchangeable
YES and NO, the hoses look different on one or more filters but look the same and are interchangeable on the other filter(s)
DON’T KNOW
Q23. After the water was filtered, was the intake hose emptied and dried? The intake hose is the one that brings raw unfiltered water from the water source into the filter.
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q24. How many individual filter devices did you/your group use while you were in the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
One
Two
Three
Four
Five
More than five
Don’t Know
Q25. Which filter(s) were used to filter water during your trip into the backcountry at YELL?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
I / WE USED THIS FILTER |
BRAND |
NAME |
|
Alpine |
Water Filter Bottle |
|
Aquamira |
Water Bottle and Filter |
|
Basic Designs |
Ceramic Filter Pump |
|
Basic Designs |
High-Flow Ceramic Water Filter |
|
Bota of Boulder |
Outback Water Filter |
|
Coghlan's |
Water Filter |
|
Eddie Bauer |
Outdoor Water Filtration Bottle |
|
First Need |
Base Camp Portable Water Purifier |
|
First Need |
Deluxe Water Purifier |
|
First Need |
Microlite Microfiltration Unit |
|
First Need |
Trav-L-Pure Water Purifier |
|
Fountain of Youth |
Water Filtration Bottle |
|
Frontier |
Ermergency Water Filter / Purification System |
|
Homeland Preparedness |
Emergency Water Filtration Bottle |
|
Katadyn |
Camp Microfilter with Gravity Siphon Filter System |
|
Katadyn |
Combi or Combi Plus Water Filter |
|
Katadyn |
Cyst Filter |
|
Katadyn |
Expedition Water Filter |
|
Katadyn |
Exstream Mackenzie Water Bottle Purifier |
|
Katadyn |
Exstream Orinoco Water Bottle Filter |
|
Katadyn |
Exstream Water Bottle Purifier |
|
Katadyn |
Exstream XR Water Purifier / Bottle |
|
Katadyn |
Gravidyn Drip Water Filter |
|
Katadyn |
Guide Water Filter / Microfilter |
|
Katadyn |
Hiker PRO Water Filter / Microfilter |
|
Katadyn |
Hiker Water Filter / Microfilter |
|
Katadyn |
Micro Filter Water Bottle |
|
Katadyn |
Mini Ceramic Filter / Microfilter |
|
Katadyn |
Pocket Filter / Microfilter |
|
Katadyn |
TRK Drip Water Filter with Ceradyn Element |
CONTINUED ON NEXT PAGE
I / WE USED THIS FILTER |
BRAND |
NAME |
|
MSR (Mountain Safety Research) |
MiniWorks EX Ceramic Water Filter |
|
MSR (Mountain Safety Research) |
SweetWater Microfilter / Purifier System |
|
MSR (Mountain Safety Research) |
WaterWorks EX Ceramic Water Filter |
|
NviroHealth |
Grip Hydrol Filter Bottle |
|
Platypus |
Gravity Filtration System |
|
ProForce |
Pocket Water Purifier |
|
ProForce |
Ranger Water Purifier |
|
ProForce |
Trekker Water Purifier |
|
Quake Kare |
Water Filtration Bottle |
|
Relags |
Adventure Filter |
|
Relags |
Travel Filter |
|
Sawyer Biological |
Water Filtration Bottle |
|
SweetWater |
Guardian Microfilter |
|
SweetWater |
Walkabout Filter |
|
Timberline |
Eagle Filtration Pump System |
|
Timberline |
Water Filter |
|
Timberline |
Basecamp Filter |
|
Other (specify) _____________________________________________ |
|
|
DON’T KNOW |
Q26. What was the pore size(s) of the filters that were used?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Smaller than 0.2 micron (m)
0.2 micron (m) absolute
0.2 micron (m) nominal or normal or average
Greater than 0.2 micron (m) but smaller than 1 micron
1 micron (m) absolute
1 micron (m) nominal or normal or average
Greater than 1 micron (m)
Other (specify) ______________________________________
Don’t Know
Q27. While you were in the backcountry at YELL, how often did you drink water that had been filtered?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q28. If you BOILED your water, please answer the following questions. If you did not boil your water, please go to Q.30:
Q29. You indicated that you drank boiled water while you were in the backcountry at YELL. How often did you drink water that had been boiled? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q30. If you DISINFECTED your water with chemicals, please answer the following questions. If you did not disinfect your water, please go to Q.41:
Q31. You indicated that you drank water that was disinfected with chemicals while you were in the backcountry at YELL. Did you disinfect your drinking water or did someone else disinfect it for you? (PLEASE CHECK ONLY ONE ANSWER)
I disinfected my drinking water (GO TO Q.32)
Someone else disinfected my drinking water (GO TO Q.33)
Sometimes I disinfected, sometimes someone else disinfected
(GO TO Q.32)
Other (specify) _____________________________ (GO TO Q.32)
Don’t Know (GO TO Q.36)
Q32. Did you ever disinfect water before this trip into the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I DID NOT DISINFECT WATER ON THIS TRIP
Q33. Did the other people who disinfected the water on this trip ever disinfect water in the past?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I WAS THE ONLY PERSON WHO DISINFECTED WATER ON THIS TRIP
Q34. Did you wash your hands before disinfecting the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT DISINFECT WATER ON THIS TRIP
Q35. Did the other people who disinfected the water wash their hands before disinfecting the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I WAS THE ONLY PERSON WHO DISINFECTED WATER ON THIS TRIP
Q36. Did the people disinfecting the water (including yourself, if applicable) use the recommended amount of chemicals (i.e., as recommended by the manufacturer)?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.38)
USUALLY (GO TO Q.37)
SOMETIMES (GO TO Q.37)
NEVER (GO TO Q.37)
DON’T KNOW (GO TO Q.38)
Q37. Why was more or less than the recommended amounts of chemicals used? (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Bad or unpleasant taste
Didn’t buy / bring enough
The recommended amount was more than was needed to kill all the germs
The recommended amount was less than was needed to kill all the germs
Concern about the health effects from too much of the chemical(s)
The water in this area did not pose a significant health risk
Had a difficult time estimating the volume of the water storage container
Other (specify) ______________________________
Don’t Know
Q38. Did you and / or others wait the recommended time after adding the chemicals before drinking the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q39. Which chemical(s) was (were) used to disinfect the water?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Chlorine tablets that come in a bottle
Chlorine tablets individually wrapped in foil
Chlorine drops/liquid
Chlorine powder/crystals
Chlorine dioxide tablets that come in a bottle
Chlorine dioxide tablets individually wrapped in foil
Chlorine dioxide drops/liquid
Chlorine dioxide powder
Iodine tablets
Iodine drops/liquid
Iodine powder/crystals
Silver ions
Other (specify) _________________________________________
Don’t Know
Q40. While you were in the backcountry, how often did you drink water that had been disinfected with chemicals?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q41. If you treated your water with ULTRAVIOLET (UV) LIGHT, please answer the following questions. If you did not treat your water this way, please go to Q.50:
Q42. You indicated that you drank water treated with UV light while you were in the backcountry at YELL. Did you treat your drinking water with UV light or did someone else treat it with UV light for you? (PLEASE CHECK ONLY ONE ANSWER)
I treated my drinking water with UV light (GO TO Q.43)
Someone else treated my drinking water with UV light
(GO TO Q.44)
Sometimes I treated, sometimes someone else treated
(GO TO Q.43)
Other (specify) ____________________________ (GO TO Q.43)
Don’t Know (GO TO Q.47)
Q43. Did you ever treat water with UV light before this trip into the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I DID NOT TREAT WATER WITH UV LIGHT ON THIS TRIP
Q44. Did the other people who treated water with UV light on this trip ever treat water with UV light in the past?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I WAS THE ONLY PERSON WHO TREATED WATER WITH ULTRAVIOLET (UV) LIGHT ON THIS TRIP
Q45. Did you wash your hands before treating the water with UV light? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT TREAT WATER WITH ULTRAVIOLET (UV) LIGHT ON THIS TRIP
Q46. Did the other people who treated the water with UV light wash their hands before treating the water this way?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I WAS THE ONLY PERSON WHO TREATED WATER WITH ULTRAVIOLET (UV) LIGHT ON THIS TRIP
Q47. Which device(s) was (were) used to treat water with UV light?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
SteriPEN Water Purifier
Other (specify) _______________________________________
Don’t Know
Q48. While you were in the backcountry at YELL, how often did you drink water that had been treated with UV light?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q49. How many individual UV light devices did you/your group use while you were in the backcountry at YELL
(PLEASE CHECK ONLY ONE ANSWER)
One
Two
Three
Four
Five
More than five
Don’t Know
Q50. If you treated your water with MIXED OXIDANTS or ELECTROLYSIS, please answer the following questions. If you did not treat your water this way, please go to Q.59:
Q51. You indicated that you drank water treated with mixed oxidants or electrolysis while you were in the backcountry at YELL. Did you treat your drinking water with mixed oxidants or electrolysis or did someone else treat it for you?
(PLEASE CHECK ONLY ONE ANSWER)
I treated my drinking water with mixed oxidants or electrolysis
(GO TO Q.52)
Someone else treated my drinking water with mixed oxidants or electrolysis (GO TO Q.53)
Sometimes I treated, sometimes someone else treated
(GO TO Q.52)
Other (specify) ____________________________ (GO TO Q.52)
Don’t Know (GO TO Q.56)
Q52. Did you ever treat water with mixed oxidants or electrolysis before this trip into the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I DID NOT TREAT WATER WITH MIXED OXIDANTS OR ELECTROLYSIS ON THIS TRIP
Q53. Did the other people who treated water with mixed oxidants or electrolysis ever treat water this way in the past?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I WAS THE ONLY PERSON WHO TREATED WATER WITH MIXED OXIDANTS OR ELECTROLYSIS ON THIS TRIP
Q54. Did you wash your hands before treating the water with mixed oxidants or electrolysis? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT TREAT WATER WITH MIXED OXIDANTS OR ELECTROLYSIS ON THIS TRIP
Q55. Did the other people who treated the water with mixed oxidants or electrolysis wash their hands before treating the water in this way? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I WAS THE ONLY PERSON WHO TREATED WATER WITH MIXED OXIDANTS OR ELECTROLYSIS ON THIS TRIP
Q56. Which device(s) was (were) used to treat water with mixed oxidants or electrolysis?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
MSR MIOX Water Purifier
Other (specify) _________________________________________
Don’t Know
Q57. While you were in the backcountry at YELL, how often did you drink water that had been treated with mixed oxidants or electrolysis?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q58. How many individual mixed oxidants / electrolysis devices did you/your group use while you were in the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
One
Two
Three
Four
Five
More than five
Don’t Know
Q59. If you treated your water with CLARIFICATION USING A FLOCCULATING AGENT, please answer the following questions. If you did not treat your water this way, please go to Q.70:
Q60. You indicated that you drank water clarified using a flocculating agent while you were in the backcountry at YELL. Did you clarify your drinking water or did someone else clarify it for you?
(PLEASE CHECK ONLY ONE ANSWER)
I clarified my drinking water (GO TO Q.61)
Someone else clarified my drinking water (GO TO Q.62)
Sometimes I clarified, sometimes someone else clarified
(GO TO Q.61)
Other (specify) _____________________________ (GO TO Q.61)
Don’t Know (GO TO Q.65)
Q61. Did you ever clarify water using a flocculating agent before this trip into the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I DID NOT CLARIFY WATER USING A FLOCCULATING AGENT ON THIS TRIP
Q62. Did the other people who clarified water using a flocculating agent ever treat water this way in the past?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
I WAS THE ONLY PERSON WHO CLARIFIED WATER USING A FLOCCULATING AGENT ON THIS TRIP
Q63. Did you wash your hands before clarifying the water using a flocculating agent? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT CLARIFY WATER USING A FLOCCULATING AGENT ON THIS TRIP
Q64. Did the other people who clarified the water using a flocculating agent wash their hands before treating the water in this way? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I WAS THE ONLY PERSON WHO TREATED WATER WITH MIXED OXIDANTS OR ELECTROLYSIS ON THIS TRIP
Q65. Did the people clarifying the water (including yourself, if applicable) use the recommended amount of flocculating agent (i.e., as recommended by the manufacturer)? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.67)
USUALLY (GO TO Q.66)
SOMETIMES (GO TO Q.66)
NEVER (GO TO Q.66)
DON’T KNOW (GO TO Q.67)
Q66. Why was more or less than the recommended amount of flocculating agent used? (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Bad or unpleasant taste
Didn’t buy/bring enough
The recommended amount was more than was needed to kill all the germs
T he recommended amount was less than was needed to kill all the germs
Concern about the health effects from too much of the chemicals
The water in this area did not pose a significant health risk
Had a difficult time estimating the volume of the water storage container
Other (specify) ______________________________
D on’t Know
Q67. Did you and / or others wait the recommended time after adding the flocculating agents before drinking the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q68. Which flocculating agents were used to disinfect the water?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
US Military Water Purification Tablets
Other (specify) _________________________________________
Don’t Know
Q69. While you were in the backcountry, how often did you drink water that had been clarified with a flocculating agent? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q70. If you treated your water with some OTHER METHOD, please answer the following questions. If you did not treat your water this way, please go to Q.72:
Q71. You indicated that you drank water that was treated by some other method. While you were in the backcountry at YELL, how often did you drink water that had been treated with this other method?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q72. Do you think it is safe to drink water from natural sources in any of the backcountry areas in YELL without first treating the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q73. Do you think it is safe to drink water from natural sources in any of the backcountry areas within the United States without first treating the water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q74. What were your sources of information about treating water in the backcountry? (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
The National Park Service
Manufacturers of treatment devices or chemicals
Staff at a camping / outdoor supplies / sports retail store
Backpacking / hiking magazine
B ackpacking / hiking website
B ackpacking / hiking book or guide book
W ilderness training course
Physician / healthcare provider
The Centers for Disease Control and Prevention
Friends / family / colleagues
Other (specify) ____________________________________________
Don’t Know
Q75. Did you share water bottles with other people in the backcountry?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
F OOD AND FOOD PREPARATION
Q76. Did you eat or taste any of the following foods while you were in the backcountry at Yellowstone National Park (abbreviated as YELL)?
(PLEASE CHECK ONLY ONE ANSWER FOR EACH FOOD ITEM)
FOOD |
YES |
NO |
DON’T KNOW |
Eggs carried raw into the backcountry? |
|
|
|
Ground beef carried raw into the backcountry? |
|
|
|
Beef carried raw into the backcountry (e.g., steak)? |
|
|
|
Chicken carried raw into the backcountry? |
|
|
|
Raw fruit? |
(GO TO Q.77) |
(GO TO Q.82) |
(GO TO Q.82) |
Raw vegetables? |
(GO TO Q.77) |
(GO TO Q.82) |
(GO TO Q.82) |
Wild berries found in the backcountry? |
(GO TO Q.77) |
(GO TO Q.82) |
(GO TO Q.82) |
Wild plants found in the backcountry? |
(GO TO Q.77) |
(GO TO Q.82) |
(GO TO Q.82) |
Q77. While you were in the backcountry, did you or a member of your group wash these raw foods before you ate them (i.e., raw fruit, raw vegetables, wild berries, wild plants)? (PLEASE CHECK ONLY ONE ANSWER) (Note: your group is defined as all the people listed on your backcountry permit)
ALWAYS (GO TO Q.78)
USUALLY (GO TO Q.78)
SOMETIMES (GO TO Q.78)
NEVER (GO TO Q.82)
DON’T KNOW (GO TO Q.82)
Q78. What type of water was used to wash these raw foods?
(PLEASE CHECK ONLY ONE ANSWER)
Untreated water only
Treated drinking water only (treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
Sometimes untreated water, sometimes treated drinking water
Other (specify) ________________________________________
Don’t Know
Q79. Who washed these raw foods while you were in the backcountry?
(PLEASE CHECK ONLY ONE ANSWER)
I washed the food
Another member(s) of my group washed the food
Sometimes I washed, sometimes another member(s) washed the food
Other (specify) ________________________________________
Don’t Know
Q80. Did you wash your hands before washing the raw foods?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT WASH RAW FOODS ON THIS TRIP
Q81. Did other people wash their hands before washing the raw foods? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I WAS THE ONLY PERSON WHO WASHED RAW FOODS ON THIS TRIP
Q82. Who prepared or cooked food for you while you were in the backcountry?
(PLEASE CHECK ONLY ONE ANSWER) (Note: your group is defined as all the people listed on your backcountry permit)
I prepared or cooked all the food I ate or tasted (GO TO Q.83)
Someone else in my group prepared or cooked all the food I ate or tasted
(GO TO Q.84)
Someone outside of my group prepared or cooked all the food I ate or tasted
(GO TO Q.84)
Sometimes I prepared or cooked the food, sometimes someone else in my group prepared or cooked the food (GO TO Q.83)
Sometimes I prepared or cooked the food, sometimes someone outside my group prepared or cooked the food (GO TO Q.83)
Sometimes someone else in my group prepared or cooked the food, sometimes someone outside my group prepared or cooked the food (GO TO Q.84)
Food was prepared or cooked by me, my group members, and people outside my group (GO TO Q.83)
Other (specify) ________________________________________ (GO TO Q.83)
Don’t Know (GO TO Q.85)
Q83. Did you wash your hands before preparing and cooking food in the backcountry? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
I DID NOT PREPARE OR COOK FOOD ON THIS TRIP
Q84. Did other people wash their hands before preparing and cooking food in the backcountry? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
D ON’T KNOW
I WAS THE ONLY PERSON ON THIS TRIP WHO PREPARED OR COOKED FOOD
Q85. Did you use cold or unheated water to rehydrate food you ate while you were in the backcountry? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.86)
NO (GO TO Q.89)
I DID NOT EAT FOOD THAT REQUIRED REHYDRATION (GO TO Q.89)
DON’T KNOW (GO TO Q.89)
Q86. Was the water boiled in the process of rehydrating the food?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q87. Was the water treated before it was used to rehydrate food? (Note: treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.88)
NO (GO TO Q.89)
DON’T KNOW (GO TO Q.89)
Q88. What method was used to treat the water before it was used to rehydrate food? (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Filtration
Boiling
Disinfection drops/ tablets/ powder (e.g., chemicals such as chlorine, iodine)
Ultraviolet (UV) light
Mixed oxidants/ electrolysis
Clarification using a flocculating agent
Bottled water purchased before entering the backcountry
Other (specify) ______________________________________
D on’t Know
Q89. Did you use water to cook any of the food you ate while you were in the backcountry? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.90)
NO (GO TO Q.93)
I DID NOT EAT FOOD THAT REQUIRED COOKING (GO TO Q.93)
DON’T KNOW (GO TO Q.93)
Q90. Was the water boiled in the process of cooking the food?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q91. Was the water treated before it was used for cooking? (Note: treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.92)
NO (GO TO Q.93)
DON’T KNOW (GO TO Q.93)
Q92. What method was used to treat the water before using it for cooking? (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Filtration
Boiling
D isinfection drops/ tablets/ powder (e.g., chemicals such as chlorine, iodine)
Ultraviolet (UV) light
Mixed oxidants/ electrolysis
Clarification using a flocculating agent
Bottled water purchased before entering the backcountry
Other (specify) ________________________________________
Don’t Know
Q93. Did you wash your hands before eating in the backcountry?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q94. Were cooking utensils, cutlery, and dishes washed and/or rinsed and/or soaked while you were in the backcountry (e.g., pots, pans, knives, forks, spoons, plates, bowls, glasses, cups, mugs)? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.95)
USUALLY (GO TO Q.95)
SOMETIMES (GO TO Q.95)
NEVER (i.e., never washed/rinsed/soaked but perhaps were wiped off or licked)
(GO TO Q.104)
DOES NOT APPLY – NO UTENSILS / CUTLERY / DISHES WERE USED
(GO TO Q. 104)
DON’T KNOW (GO TO Q. 104)
Q95. Was untreated water ever used to wash/rinse/soak the cooking utensils, cutlery, or dishes? (Note: untreated water is water that would not be used for drinking and was never filtered, boiled, disinfected with chemicals, treated with UV light, treated with mixed oxidants/electrolysis, clarified, or commercially bottled – e.g., water taken directly from a creek)
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.96)
NO (GO TO Q.99)
DON’T KNOW (GO TO Q.99)
Q96. Was soap used to wash/rinse/soak the cooking utensils, cutlery, or dishes in addition to the water? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q97. Was disinfectant (e.g., chlorine, iodine) added to the water just before the water was used to wash/rinse/soak the cooking utensils, cutlery, or dishes? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q98. What temperature was the water when it was used to wash/rinse/soak the cooking utensils, cutlery, or dishes?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
COLD
WARM
HOT BUT NEVER BOILING
BOILING (OR HOT WATER THAT HAD PREVIOUSLY BOILED)
DON’T KNOW
Q99. Was treated drinking water ever used to wash/rinse/soak the cooking utensils, cutlery, or dishes? (Note: treated drinking water is water that was filtered, boiled, disinfected with chemicals, treated with UV light, treated with mixed oxidants/electrolysis, clarified, or commercially bottled – e.g., water previously treated for drinking, hygiene, etc.)
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.100)
NO (GO TO Q.103)
DON’T KNOW (GO TO Q.103)
Q100. Was soap used to wash/rinse/soak the cooking utensils, cutlery, or dishes in addition to the water? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q101. Was additional disinfectant (e.g., chlorine, iodine) added to the water just before the water was used to wash/rinse/soak the cooking utensils, cutlery, or dishes? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q102. What temperature was the water when it was used to wash/rinse/soak the cooking utensils, cutlery, or dishes?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
COLD
WARM
HOT BUT NEVER BOILING
BOILING (OR HOT WATER THAT HAD PREVIOUSLY BOILED)
DON’T KNOW
Q103. How were these utensils/cutlery/dishes dried?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Air dried
Single-use disposable towel
Reusable towel used only to dry utensils / cutlery / dishes
Reusable towel used for multiple purposes (e.g., drying hands, drying dishes)
Clothes
Other (specify) ________________________________________
Don’t Know
Q104. Did you share cutlery and dishes with other people in the backcountry (e.g., knives, forks, spoons, plates, bowls, glasses, cups, mugs)?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q105. Did you share food or a meal out of a communal or shared container / plate where everyone put their utensils into the same food?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q106. Did you share food or a meal out of a communal or shared container / plate where everyone put their hands into the same food? Examples include but are not limited to food such as trail mix, dried fruit, nuts, fresh fruit or vegetables, jerky, chips, candy, cookies, and crackers. (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.107)
USUALLY (GO TO Q.107)
SOMETIMES (GO TO Q.107)
NEVER (GO TO Q.109)
DON’T KNOW (GO TO Q.109)
Q107. How often did you wash your hands before eating from a communal or shared container / plate? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q108. How often did others wash their hands before eating from a communal or shared container / plate? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
S ANITATION AND HYGIENE
Q109. Did you brush your teeth while you were in the backcountry at Yellowstone National Park (abbreviated as YELL)?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.110)
NO (GO TO Q.111)
DON’T KNOW (GO TO Q.111)
Q110. What water source did you use to brush your teeth with?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Untreated water
Treated drinking water (treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
Sometimes untreated water, sometimes treated drinking water
Other (specify) ______________________________________________
Don’t Know
Q111. Did you bathe or shower while you were in the backcountry?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.112)
NO (GO TO Q.119)
DON’T KNOW (GO TO Q.119)
Q112. What water source did you use for bathing or showering?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Lake/pond (or other standing body of water)
Stream/river (or other flowing water, e.g., waterfalls)
Spring
Hot spring
Other (specify) ______________________________________________
Don’t Know
Q113. Did you get water splashed in your face when you bathed or showered? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q114. Did you put your face or head in or under the water when you bathed or showered? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q115. Did you get any water in your mouth when you bathed or showered?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.116)
USUALLY (GO TO Q.116)
SOMETIMES (GO TO Q.116)
NEVER (GO TO Q.117)
DON’T KNOW (GO TO Q.117)
Q116. Did you swallow any of this water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q117. Did you dive or jump into any of the water you bathed in or showered with? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q118. Did you use soap when you bathed or showered while you were in the backcountry? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q119. While you were in the backcountry, did you ever wash your hands?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.120)
NO (GO TO Q.122)
DON’T KNOW (GO TO Q.122)
Q120. What did you use to wash your hands with?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Untreated water
Treated drinking water (treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
Soap and untreated water
S oap and treated drinking water (treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
Hand sanitizer that doesn’t require water
Other (specify) ______________________________________________
Don’t Know
Q121. What did you use to dry your hands with?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Nothing – air dried
Single-use disposable towel
Re-usable towel used only to dry hands and used only by you
Re-usable towel used only to dry hands and used by more than one person
Re-usable towel used for multiple purposes (e.g., drying hands, drying dishes) and used only by you
Re-usable towel used for multiple purposes (e.g., drying hands, drying dishes) and used by more than one person
Clothes
Other (specify) ______________________________________________
Don’t Know
Q122. While you were in the backcountry, did others you traveled with ever wash their hands? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.123)
NO (GO TO Q.125)
DON’T KNOW (GO TO Q.125)
I TRAVELED BY MYSELF (GO TO Q.125)
Q123. What did they use to wash their hands with?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Untreated water
Treated drinking water (treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
Soap and untreated water
S oap and treated drinking water (treatment includes filtering, boiling, disinfecting with chemicals, UV light, mixed oxidants/electrolysis, clarification, and commercially bottled water)
Hand sanitizer that doesn’t require water
Other (specify) ______________________________________________
Don’t Know
Q124. What did they use to dry their hands with?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Nothing – air dried
Single-use disposable towel
Re-usable towel used only to dry hands and used only by a single person
Re-usable towel used only to dry hands and used by more than one person
Re-usable towel used for multiple purposes (e.g., drying hands, drying dishes) and used only by a single person
Re-usable towel used for multiple purposes (e.g., drying hands, drying dishes) and used by more than one person
Clothes
Other (specify) ______________________________________________
Don’t Know
Q125. While you were in the backcountry, did you wash your hands after urination?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
I DID NOT URINATE WHILE I WAS IN THE BACKCOUNTRY
DON’T KNOW
Q126. While you were in the backcountry, did you wash your hands after bowel movements? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.127)
USUALLY (GO TO Q.127)
SOMETIMES (GO TO Q.127)
NEVER (GO TO Q.127)
I DID NOT HAVE A BOWEL MOVEMENT WHILE I WAS IN THE BACKCOUNTRY (GO TO Q.132)
DON’T KNOW (GO TO Q.127)
Q127. While you were in the backcountry, how did you dispose of your feces?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
I did not have a bowel movement while I was in the backcountry
(GO TO Q.132)
I used an outhouse / latrine / wooden box-style toilet (GO TO Q.130)
I buried my feces in a hole (GO TO Q.128)
I defecated directly on the ground and did not bury (GO TO Q.129)
O ther (specify) _________________________________ (GO TO Q.129)
Don’t Know (GO TO Q.129)
Q128. You indicated you buried your feces. On average, how deep were these holes? (PLEASE CHECK ONLY ONE ANSWER)
Less than 1 inch
1 to 2 inches
3 to 5 inches
6 to 8 inches
9 to 12 inches
Deeper than 12 inches
I did not bury my feces
Don’t Know
Q129. On average, how far away from a water source did you defecate (e.g., lake, pond, river, stream, waterfall, spring, hot spring)? For your a reference, a typical city transit bus is approximately 40 feet long, an Olympic-size swimming pool is 164 feet long, and an American football field is 360 feet long.
(PLEASE CHECK ONLY ONE ANSWER)
Less than 10 feet
10 to 29 feet
30 to 49 feet
50 to 74 feet
75 to 99 feet
100 to 124 feet
125 to 149 feet
150 to 200 feet
More than 200 feet
Don’t Know
Q130. While you were in the backcountry, did you use toilet paper? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.131)
USUALLY (GO TO Q.131)
SOMETIMES (GO TO Q.131)
NEVER (GO TO Q.132)
DON’T KNOW (GO TO Q.132)
Q131. Did the toilet paper last through the entire backcountry trip? (PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
R ECREATIONAL WATER ACTIVITIES
Q132. Did you canoe, kayak, or boat while you were in the backcountry at Yellowstone National Park (abbreviated as YELL)?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
Q133. Did you wade, soak your body, or swim in water while you were in the backcountry at YELL? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.134)
NO (GO TO Q.140)
DON’T KNOW (GO TO Q.140)
Q134. What water source(s) did you use to wade, soak, or swim in?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Lake/pond (or other standing body of water)
Stream/river (or other flowing water, e.g., waterfalls)
Spring
Hot spring
Other (specify) ______________________________________________
Don’t Know
Q135. Did you get water splashed in your face when you waded, soaked, or swam? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q136. Did you put your face or head in or under the water when you waded, soaked, or swam? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q137. Did you get any water in your mouth when you waded, soaked, or swam?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS (GO TO Q.138)
USUALLY (GO TO Q.138)
SOMETIMES (GO TO Q.138)
NEVER (GO TO Q.139)
DON’T KNOW (GO TO Q.139)
Q138. Did you swallow any of this water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q139. Did you dive or jump into any of this water?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
CONTACT WITH ANIMALS
Q140. Did you touch animal feces while you were in the backcountry at Yellowstone National Park (abbreviated as YELL) (e.g., while trying to remove feces from shoes or camping gear)? (PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
Q141. Did you see pack animals (e.g., horses, ponies, donkeys, mules remove llamas) while you were in the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.142)
NO (GO TO Q.143)
DON’T KNOW (GO TO Q.143)
Q142. Did you have physical contact with a pack animal while you were in the backcountry at YELL?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
We would now like to ask you questions about your health DURING AND AFTER the time you were traveling in the backcountry at YELL.
YOUR HEALTH
Q143. When you first entered the backcountry at Yellowstone National Park (abbreviated as YELL), were you having any of the following symptoms?
(PLEASE CHECK THE ONE CORRECT ANSWER FOR EACH SYMPTOM)
CONDITION |
YES |
NO |
DON’T KNOW |
Diarrhea? (defined as 3 or more loose bowel movements in 24 hours) |
|
|
|
Nausea? |
|
|
|
Vomiting? |
|
|
|
Abdominal pains or cramps? |
|
|
|
Q144. Since you entered the backcountry at YELL until now, did you develop or experience any of the following symptoms or conditions that you did not have when you first entered the backcountry? (PLEASE CHECK ALL THAT APPLY) Please also tell us on what date you first became ill or injured with this condition and whether this is the actual or estimated date.
CONDITION |
YES, I developed this symptom or condition |
DATE FIRST BECAME ILL OR INJURED (MM/DD/YYYY) |
A cold, nasal congestion, sinus infection, or sore throat? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Chest congestion? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Chest tightness? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Shortness of breath at rest? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Cough? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A lung infection (e.g., bronchitis, pneumonia)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
An asthma attack? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Wheezing? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Allergies (e.g., hayfever)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Eye irritation (e.g., itchy, painful, burning, watery)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Blurred vision? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
CONTINUED ON NEXT PAGE
CONDITION |
YES, I developed this symptom or condition |
DATE FIRST BECAME ILL OR INJURED (MM/DD/YYYY) |
Eye twitching? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
An eye infection? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
An ear infection or earache? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Headache? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Dizziness or light-headedness? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Balance problems, stumbling, or difficulty walking? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Weakness or decreased exercise performance? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Loss of appetite? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Diarrhea? (defined as 3 or more loose bowel movements in 24 hours) |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Blood in stools or bowel movements? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Nausea? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Vomiting? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Abdominal pains or cramps? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Constipation? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A urinary tract infection, pain or burning during urination, urinary discharge, or blood in the urine? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A tick bite(s)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Other insect bite(s)? (specify) _________________________________ |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A wound, cut, laceration, (delete “or” here) skin abrasion, or scrape? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
CONTINUED ON NEXT PAGE
CONDITION |
YES, I developed this symptom or condition |
DATE FIRST BECAME ILL OR INJURED (MM/DD/YYYY) |
A wound infection? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A rash or skin infection? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Blisters on your feet? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Burn (from fire or sparks, not sunburn)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Sunburn? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Joint pain or sprain? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Back pain or strain? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Other muscle cramps, strain, or pull? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A fracture or broken bone? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
A dislocated joint? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Another injury or wound? (specify) _____________________________ |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Another illness? (specify) ____________________________________ |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Psychological condition (e.g., loneliness, boredom, depression)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Excessive fatigue? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Insomnia or problems sleeping? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Poor concentration |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Social condition (e.g., problems with other backcountry users)? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Lack of physical conditioning? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Hypothermia? |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Other? (specify) ___________________________________________ |
|
_ _ / _ _ / _ _ _ _ actual estimated |
Q145. Did you cut short your time in the backcountry because of any illnesses, injuries, or other conditions you had while you were in the backcountry?
PLEASE CHECK ONLY ONE ANSWER
YES (GO TO Q.146)
NO (GO TO Q.147)
DON’T KNOW (GO TO Q.147)
Q146. Did you have to leave the backcountry sooner than you planned because of any of the following condition(s)? How many days did you lose from your backcountry trip? (IF YOU LOST LESS THAN ONE FULL DAY FROM YOUR PLANNED TRIP INTO THE BACKCOUNTRY, PLEASE WRITE THE NUMBER “0” [ZERO])
CONDITION |
I CUT SHORT MY TRIP BECAUSE OF THIS/ THESE CONDITION(S) (CHECK ALL THAT APPLY) |
NUMBER OF DAYS I LOST FROM MY PLANNED TRIP INTO THE BACKCOUNTRY |
A cold, nasal congestion, sinus infection, or sore throat? |
|
______ days |
Chest congestion? |
|
______ days |
Chest tightness? |
|
______ days |
Shortness of breath at rest? |
|
______ days |
Cough? |
|
______ days |
A lung infection (e.g., bronchitis, pneumonia)? |
|
______ days |
An asthma attack? |
|
______ days |
Wheezing? |
|
______ days |
Allergies (e.g., hayfever)? |
|
______ days |
Eye irritation (e.g., itchy, painful, burning, watery)? |
|
______ days |
Blurred vision? |
|
______ days |
Eye twitching? |
|
______ days |
An eye infection? |
|
______ days |
An ear infection or earache? |
|
______ days |
Headache? |
|
______ days |
Dizziness or light-headedness? |
|
______ days |
Balance problems, stumbling, or difficulty walking? |
|
______ days |
Weakness or decreased exercise performance? |
|
______ days |
CONTINUED ON NEXT PAGE
CONDITION |
I CUT SHORT MY TRIP BECAUSE OF THIS/ THESE CONDITION(S) (CHECK ALL THAT APPLY) |
NUMBER OF DAYS I LOST FROM MY PLANNED TRIP INTO THE BACKCOUNTRY |
Loss of appetite? |
|
______ days |
Diarrhea? (defined as 3 or more loose bowel movements in 24 hours) |
|
______ days |
Blood in stools or bowel movements? |
|
______ days |
Nausea? |
|
______ days |
Vomiting? |
|
______ days |
Abdominal pains or cramps? |
|
______ days |
Constipation? |
|
______ days |
A urinary tract infection, pain or burning during urination, urinary discharge, or blood in the urine? |
|
______ days |
A tick bite(s)? |
|
______ days |
Other insect bite(s)? (specify) _________________________________ |
|
______ days |
A wound, cut, laceration, (delete “or” here) skin abrasion, or scrape? |
|
______ days |
A wound infection? |
|
______ days |
A rash or skin infection? |
|
______ days |
Blisters on your feet? |
|
______ days |
Burn (from fire or sparks, not sunburn)? (When I choose this option, the sunburn date question also shows up – can you fix this?) |
|
______ days |
Sunburn? |
|
______ days |
Joint pain or sprain? |
|
______ days |
Back pain or strain? |
|
______ days |
Other muscle cramps, strain, or pull? |
|
______ days |
A fracture or broken bone? |
|
______ days |
A dislocated joint? |
|
______ days |
Another injury or wound? (specify) _____________________________ |
|
______ days |
Another illness? (specify) ____________________________________ |
|
______ days |
Psychological condition (e.g., loneliness, boredom, depression)? |
|
______ days |
Excessive fatigue? |
|
______ days |
Insomnia or problems sleeping? |
|
______ days |
CONTINUED ON NEXT PAGE
CONDITION |
I CUT SHORT MY TRIP BECAUSE OF THIS/ THESE CONDITION(S) (CHECK ALL THAT APPLY) |
NUMBER OF DAYS I LOST FROM MY PLANNED TRIP INTO THE BACKCOUNTRY |
Poor concentration |
|
______ days |
Social condition (e.g., problems with other backcountry users)? |
|
______ days |
Lack of physical conditioning? |
|
______ days |
Hypothermia? |
|
______ days |
Other? (specify) ___________________________________________ |
|
______ days |
Q147. If you had a tick bite, please specify the location(s). Otherwise, continue to the next question. (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q148. If you had some other insect bite(s), please specify the location(s). Otherwise, continue to the next question.
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q149. If you had a wound, cut, laceration, skin abrasion, or scrape, please specify the location(s). Otherwise, continue to the next question.
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q150. If you had a wound infection, please specify the location(s). Otherwise, continue to the next question. (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q151. If you had a rash or skin infection, please specify the location(s). Otherwise, continue to the next question.
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q152. If you had a burn, please specify the location(s). Otherwise, continue to the next question. (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q153. If you had a sunburn, please specify the location(s). Otherwise, continue to the next question. (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Back
Neck Abdomen
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) ______________________________________________
Don’t Know
Q154. If you had a joint pain(s) or sprain(s), please specify the location(s). Otherwise, continue to the next question.
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Shoulder Knee
Neck Ankle
Elbow Toe
Wrist
Finger or thumb
Hip
Other (specify) ______________________________________________
Don’t Know
Q155. If you had some other muscle cramp(s), strain(s), or pull(s), please specify the location(s). Otherwise, continue to the next question.
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Abdomen
Neck Groin
Shoulder Buttocks
Arm Leg
Hand Foot
Chest
Other (specify) _____________________________________________
Don’t Know
Q156. If you had a fracture or broken bone, please specify the location(s). Otherwise,
continue to the next question.
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Skull Rib
Neck Back
Clavicle Hip
Shoulder blade or shoulder Pelvis
Arm Leg
Elbow Knee
Wrist Ankle
Hand Foot
Finger or thumb Toe
Other (specify) ______________________________________________
Don’t Know
Q157. If you had a dislocated joint, please specify the location(s). Otherwise, continue to the next question. (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Shoulder Knee
Elbow Ankle
Wrist Toe
Finger or thumb
Hip
Other (specify) ______________________________________________
Don’t Know
Q158. If you had another injury or wound, specify the location(s). Otherwise, continue to the next question. (PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Head Abdomen
Neck Buttocks
Shoulder Groin
Arm Hip
Elbow Leg
Wrist Knee
Hand Ankle
Finger or thumb Foot
Chest Toe
Back
Other (specify) ______________________________________________
Don’t Know
Q159. We would now like to ask you more questions about the diarrhea or vomiting you developed SINCE YOU ENTERED the backcountry at Yellowstone National Park (abbreviated as YELL) UNTIL NOW. IF YOU HAVE NOT HAD DIARRHEA OR VOMITING SINCE YOU ENTERED THE BACKCOUNTRY UNTIL NOW, GO TO Q.169.
DIARRHEA OR VOMITING
Q160. You indicated that you developed diarrhea after you entered the backcountry. What was the maximum number of loose bowel movements you had in any 24-hour period during this illness?
NUMBER |___|___|___| maximum number of loose bowel movements in any
24-hour period
DON’T KNOW
I HAVE NOT HAD DIARRHEA SINCE I ENTERED THE BACKCOUNTRY (GO TO Q.163)
Q161. Do you currently have diarrhea? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.163)
NO (GO TO Q.162)
DON’T KNOW (GO TO Q.163)
Q162. How many days did your diarrhea (loose bowel movements) last? By this we mean from the first day of diarrhea up to and including the last day of diarrhea. If the diarrhea stopped and started in between, do not subtract the diarrhea-free days in between the day your diarrhea started and the day it ended completely. (IF THE NUMBER OF DAYS IS LESS THAN ONE FULL DAY, PLEASE WRITE/TYPE THE NUMBER “0” [ZERO])
NUMBER |___|___|___| days before diarrhea completely ended
[DO NOT SUBTRACT DAYS IN BETWEEN WITHOUT DIARRHEA]
If you do not know the number of days, on what date did the diarrhea completely end? (IF YOU DO NOT KNOW THE EXACT DATE PLEASE ESTIMATE)
|___|___|-|___|___|-2006
M M D D
Is this date the actual or estimated date?
(PLEASE CHECK ONLY ONE ANSWER)
ACTUAL ESTIMATED
Q163. You indicated that you developed vomiting after you entered the backcountry. What was the maximum number times you vomited in any 24-hour period during this illness?
NUMBER |___|___|___| maximum number of times vomited in any
24-hour period
DON’T KNOW
I HAVE NOT VOMITTED SINCE I ENTERED THE BACKCOUNTRY UNTIL NOW (GO TO Q.166)
Q164. Are you still ill with vomiting? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.166)
NO (GO TO Q.165)
DON’T KNOW (GO TO Q.166)
Q165. How many days did your vomiting last? By this we mean from the first day of vomiting up to and including the last day of vomiting. If the vomiting stopped and started in between, do not subtract the vomiting-free days in between the day your vomiting started and the day it ended completely. (IF THE NUMBER OF DAYS IS LESS THAN ONE FULL DAY, PLEASE WRITE/TYPE THE NUMBER “0” [ZERO])
NUMBER |___|___|___| days before vomiting completely ended
[DO NOT SUBTRACT DAYS IN BETWEEN WITHOUT VOMITING]
If you do not know the number of days, on what date did the vomiting completely end? (IF YOU DO NOT KNOW THE EXACT DATE, PLEASE ESTIMATE)
date: |___|___|-|___|___|-2006
M M D D
Is this date the actual or estimated date?
(PLEASE CHECK ONLY ONE ANSWER)
ACTUAL ESTIMATED
Q166. Did you lose any weight while you had diarrhea and / or vomiting?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.167)
NO (GO TO Q.169)
DON’T KNOW (GO TO Q. 169)
I DID NOT HAVE DIARRHEA OR VOMITING SINCE I ENTERED THE BACKCOUNTRY UNTIL NOW (GO TO Q. 169)
Q167. How much weight did you lose?
(PLEASE FILL OUT EITHER POUNDS OR KILOGRAMS)
NUMBER |___|___|___| pounds OR NUMBER |___|___|___| kilograms
DON’T KNOW
Q168. What is your usual weight?
(PLEASE FILL OUT EITHER POUNDS OR KILOGRAMS)
NUMBER |___|___|___| pounds OR NUMBER |___|___|___| kilograms
DON’T KNOW
Q169. We would now like to ask you questions about the diagnosis and treatment of any diarrhea or vomiting you developed SINCE YOU ENTERED the backcountry at YELL UNTIL NOW. IF YOU HAVE NOT HAD DIARRHEA OR VOMITING SINCE YOU ENTERED THE BACKCOUNTRY UNTIL NOW, GO TO
Q. 180.
DIAGNOSIS AND TREATMENT OF DIARRHEA OR VOMITING
Q170. After you left the backcountry at Yellowstone National Park (abbreviated as YELL), did you consult a healthcare provider about any diarrhea or vomiting? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.171)
NO (GO TO Q.180)
DON’T KNOW (GO TO Q. 180)
Q171. Did you consult a healthcare provider over the phone?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
Q172. Did you visit a healthcare provider?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.173)
NO (GO TO Q.174)
DON’T KNOW (GO TO Q.174)
Q173. How many times did you visit a healthcare provider (in total) for diarrhea or vomiting?
|___|___|___| times Don’t Know
Q174. Did you visit an Emergency Room because of diarrhea or vomiting?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.175)
NO (GO TO Q.176)
DON’T KNOW (GO TO Q.176)
Q175. How many times did you visit the Emergency Room (in total) for diarrhea or vomiting?
|___|___|___| times Don’t Know
Q176. Were you admitted to the hospital because of diarrhea or vomiting?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.177)
NO (GO TO Q.178)
DON’T KNOW (GO TO Q.178)
Q177. How many days (in total) were you hospitalized for diarrhea or vomiting? (IF YOU WERE HOSPITALIZED FOR LESS THAN ONE FULL DAY, PLEASE WRITE/TYPE THE NUMBER “0” [ZERO])
|___|___|___| days Don’t Know
Q178. At any time after you left the backcountry were you given intravenous fluids for diarrhea or vomiting? (PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
Q179. Once your diarrhea or vomiting began, how long were you ill before you first consulted a healthcare provider (either by phone or in person)?
(IF YOU DO NOT KNOW THE EXACT LENGTH OF TIME, PLEASE ESTIMATE)
|___|___|___| days / weeks / months (CIRCLE THE APPROPRIATE LENGTH OF TIME)
DON’T KNOW
Is this the actual or estimated length of time?
(PLEASE CHECK ONLY ONE ANSWER)
ACTUAL ESTIMATED
Q180. We would now like to ask you questions about any diarrhea or vomiting among the other members of the group you traveled with into the backcountry in YELL. Your group is defined as all the people listed on your backcountry permit. IF NONE OF YOUR GROUP MEMBERS HAD DIARRHEA OR VOMITING WHEN THEY ENTERED THE BACKCOUNTRY AND IF NONE HAVE HAD DIARRHEA OR VOMITING SINCE THEY ENTERED THE BACKCOUNTRY UNTIL NOW, GO TO Q.203.
DIARRHEA OR VOMITING IN GROUP MEMBERS
Q181. When you first entered the backcountry at Yellowstone National Park (abbreviated as YELL), did any member(s) of your group (NOT INCLUDING YOURSELF) have diarrhea or vomiting? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.182)
NO (GO TO Q. 185)
DON’T KNOW (GO TO Q. 185)
Q182. How many group members had diarrhea or vomiting when they first entered the backcountry, NOT INCLUDING YOURSELF?
|___|___|___| persons Don’t Know
Q183. Were any of these ill group members younger than 18 years of age?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.184)
NO (GO TO Q.185)
DON’T KNOW (GO TO Q. 185)
Q184. How many of these ill group members were younger than 18 years of age?
|___|___|___| persons Don’t Know
Q185. Since entering the backcountry at YELL until now, did any member of your group (NOT INCLUDING YOURSELF) develop diarrhea or vomiting that he/she did not have when he/she first entered the backcountry?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.186)
NO (GO TO Q.190)
DON’T KNOW (GO TO Q.190)
Q186. Since entering the backcountry until now, how many group members have had diarrhea or vomiting, NOT INCLUDING YOURSELF?
|___|___|___| persons Don’t Know
Q187. Were any of these ill group members younger than 18 years of age?
(PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.188)
NO (GO TO Q.189)
DON’T KNOW (GO TO Q.189)
Q188. How many of these ill group members were younger than 18 years of age?
|___|___|___| persons Don’t Know
Q189. If you were ill with diarrhea or vomiting when you entered the backcountry or if you became ill with diarrhea or vomiting since entering the backcountry until now, please answer the following question. If not, please go to Q203.
For each ill group member, please indicate whether these group members became ill before, at the same time, or after you became ill with vomiting or diarrhea.
GROUP MEMBER
|
BEFORE |
AT THE SAME TIME |
AFTER |
DON’T KNOW |
Group member #1 |
|
|
|
|
Group member #2 |
|
|
|
|
Group member #3 |
|
|
|
|
Group member #4 |
|
|
|
|
Group member #5 |
|
|
|
|
Group member #6 |
|
|
|
|
Group member #7 |
|
|
|
|
Group member #8 |
|
|
|
|
Group member #9 |
|
|
|
|
Group member #10 |
|
|
|
|
Q190. You indicated you had diarrhea or vomiting while you were in the backcountry at YELL. After you became ill, did you treat drinking water that others drank? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q191. After you became ill, did you wash, prepare, or cook food that others ate or tasted? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q192. After you became ill, did you wash or dry cooking utensils, cutlery, or dishes (e.g., pots, pans, knives, forks, spoons, plates, bowls, glasses, cups, mugs) that others ate or cooked with? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q193. After you became ill, did you share cutlery and dishes with other people in the backcountry (e.g., knives, forks, spoons, plates, bowls, glasses, cups, mugs)?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q194. After you became ill, did you share food or a meal out of the same container or off the same plate with other people in the backcountry where everyone put their utensils into the same food?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q195. After you became ill, did you share food or a meal out of the same container or off the same plate with other people in the backcountry where everyone put their hands into the same food?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q196. If A MEMBER OR members of your group were ill with diarrhea or vomiting when he / she / they entered the backcountry or if he / she / they became ill with diarrhea or vomiting since entering the backcountry until now, please answer the following question. If not, please go to Q203.
After he / she / they became ill, did he / she / they treat drinking water that others drank? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q197. After he / she / they became ill, did he / she / they treat drinking water that you drank? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q198. After he / she / they became ill, did he / she / they wash, prepare, or cook food that others ate or tasted (including yourself)?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q199. After he / she / they became ill, did he / she / they wash or dry cooking utensils, cutlery, or dishes (e.g., pots, pans, knives, forks, spoons, plates, bowls, glasses, cups, mugs) that others ate or cooked with (including yourself)? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q200. After he / she / they became ill, did he / she / they share cutlery and dishes with other people in the backcountry (including yourself) (e.g., knives, forks, spoons, plates, bowls, glasses, cups, mugs)?
(PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q201. After he / she / they became ill, did he / she / they share food or a meal out of the same container or off the same plate with other people in the backcountry (including yourself) where everyone put their utensils into the same food? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q202. After he / she / they became ill, did he / she / they share food or a meal out of the same container or off the same plate with other people in the backcountry (including yourself) where everyone put their hands into the same food? (PLEASE CHECK ONLY ONE ANSWER)
ALWAYS
USUALLY
SOMETIMES
NEVER
DON’T KNOW
Q203. Lastly, we would like to ask you some basic questions about yourself. Some of these questions are of a sensitive nature. You may refuse to answer any question at any time.
Q204. Have you ever been told by a physician that you have any of the following illnesses or have you ever had any of the following medical procedures?
(PLEASE CHECK ONE ANSWER FOR EVERY MEDICAL CONDITION)
CONDITION |
YES |
NO |
DON’T KNOW |
Chronic diarrhea? |
|
|
|
Crohn’s disease? |
|
|
|
Irritable bowel disease? |
|
|
|
Colitis or ulcerative colitis? |
|
|
|
Surgery to remove part of the stomach or intestine? |
|
|
|
Immunosuppression (e.g., cancer currently treated with chemotherapy or radiation, lupus or systemic lupus erythematosus, HIV or AIDS, organ transplant taking immunosuppressant drugs) |
|
|
|
Q205. What is your sex? (PLEASE CHECK ONLY ONE ANSWER)
MALE
FEMALE
Q206. What is your age? (PLEASE CHECK ONLY ONE ANSWER)
18 to 24 years of age
25 to 34 years of age
35 to 44 years of age
45 to 54 years of age
55 to 64 years of age
65 to 74 years of age
Older than 74 years of age
Don’t Know
Q207. Do you consider yourself to be Hispanic or Latino?
(PLEASE CHECK ONLY ONE ANSWER)
YES
NO
DON’T KNOW
Q208. What race or races do you consider yourself part of?
(PLEASE CHECK ALL THAT APPLY)
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or other Pacific Islander
Don’t Know
Q209. What is the highest level of formal schooling you have completed or the highest degree you have received? (PLEASE CHECK ONLY ONE ANSWER)
Less than 1st grade
1st through 8th grade
9th through 12th grade (No Diploma)
High school graduate: high school diploma or equivalent (GED)
Some college but no degree
Associate degree in college (AA, AS)
Bachelor’s degree (e.g., BA, BS) (delete “AB”)
Master’s degree (e.g., MA, MS, MEng, MSW, MBA)
Doctorate degree (e.g., MD, DVM, PhD, JD)
Technical degree
Other (specify) ___________________________________________________
Don’t Know
Q210. Which one of the following places best describes where you live for the majority of the year? (PLEASE CHECK ONLY ONE ANSWER)
City or urban area
Suburban area
Town or village
Rural area but not a farm
Farm
Other (specify) ___________________________________________________
Don’t Know
Q211. What category best describes your total household income before taxes?
(PLEASE CHECK ONLY ONE ANSWER)
Less than $10,000
$10,000 to less than $20,000
$20,000 to less than $40,000
$40,000 to less than $60,000
$60,000 to less than $80,000
$80,000 to less than 100,000
$100,000 to less than $150,000
$150,000 or more
Other (specify) ___________________________________________________
Don’t Know
Q212. What category best describes your primary employment type?
(PLEASE CHECK ONLY ONE ANSWER)
White collar (e.g., non-manual work generally performed at a desk, such as professionals [doctors, lawyers] and employees in administrative or clerical positions)
Blue collar (e.g., manual, unskilled or semiskilled labor, such as in a factory or maintenance trades)
Sales/Service
Farming
Student
Retired
Unemployed
Other (specify) ___________________________________________________
Don’t Know
Q213. Including this trip, how many times in your life have you been on a backcountry trip that required an overnight stay in the backcountry?
Number of Trips (PLEASE CHECK ONLY ONE ANSWER)
None
1 to 3 trips
4 to 6 trips
7 to 9 trips
10 to 19 trips
20 or more trips
Don’t Know
Q214. Including this trip, what are the durations of the overnight backcountry trips that you have experienced? (Mark – you have this question as a single answer – it should be a multiple answer question)
Trip Duration (PLEASE CHECK ALL THAT APPLY)
No overnight backpacking trips
Trips lasting less than 3 days
Trips lasting from 3 days to less than 1 week
Trips lasting 1-2 weeks
Trips lasing for more than 2 weeks
Don’t Know
Q215. Between May 1, 2006 and October 31, 2006, how many separate times have you obtained a permit and traveled into the backcountry at YELL?
|___|___|___| (enter a number between 1 and 180)
Q216. Have you or will you work or volunteer in YELL between May 1, 2006 and Oct. 31, 2006? (PLEASE CHECK ONLY ONE ANSWER)
YES (GO TO Q.217)
NO (GO TO Q.218)
DON’T KNOW (GO TO Q.218)
Q217. What was / is / will be your job description?
(PLEASE CHECK ALL THAT APPLY ON THE FOLLOWING LIST)
Volunteer
National Park Service employee
Concessionaire
Other (specify) ______________________________________________
Don’t Know
Q218. Under whose name was your backcountry permit issued?
First name: _________________________________________________
Last name: _________________________________________________
DON’T KNOW
Q219. On what date did you complete this questionnaire?
|___|___|-|___|___|-2008
M M D D
DON’T KNOW
This concludes our survey. The National Park Service and the Centers for Disease Control and Prevention would like to thank you very much for your time, patience, and cooperation in answering our questions.
Do you have any comments about the survey? Please let us know:
Further information about the study and about travel-related illness and injury is available on the following websites:
Centers for Disease Control and Prevention
Yellowstone National Park Backcountry Survey
https://www2a.ncid.cdc.gov/backcountry/backcontry.htm
National
Park Service
Sequoia
& Kings Canyon National Parks Backcountry Survey
http://www.nps.gov/public_health/inter/backcountry/seki_bc_survey.htm
If you have any questions about this study or your rights as a participant please call:
Centers for Disease Control and Prevention
Study questions: Please call Dr. Sharon Roy at 770-488-4412
Rights of participants: Please call CDC’s Deputy Associate Director for Science at 1-800-584-8814 and leave a message including your name and phone number. Say you are calling about the Division of Parasitic Diseases’ web-based survey of Yellowstone National Park Backcountry Users (protocol #4583). Someone will call you back as soon as possible.
National Park Service
Study questions: Please call Lieutenant Commander David Wong at
202-513-7160 or Captain Charles Higgins at 202-513-7217
Page
File Type | application/msword |
Author | str2 |
Last Modified By | str2 |
File Modified | 2007-06-07 |
File Created | 2007-06-07 |