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. 2024 Oct 18;16(10):e71784. doi: 10.7759/cureus.71784

Table 5. Study questionnaire.

Identification Details
District Name: Sitapur/Lucknow District Code: Sitapur-1, Lucknow-2
Area: Urban/Rural Setting Code: Urban-1, Rural-2
Block/Ward Name:   Block/Ward Code:  
Gram Panchayat/mohalla Name: Gram Panchayat/Enumeration block Code :
PSU Number:  
Respondent ID  
Date of Interview                Day       Month      Year
   Start Time                                                  Hour             Minute   
Result status of the questionnaire   Completed -1
Partly Completed -2
Not at Home 3
Refused-4
Postponed-5
Others (Specify)-99
Section-1 Identification of symptomatic individuals during March-June 2021
S.N. Questions Coding categories Codes Skip to
  Were you ever suffering from these new symptoms in the year 2021? INSTRUCTIONS: Multiple responses possible [Yes-1, No-2, Not sure-3] Please continue the interview only if the response to the first three coding categories is “Yes”. If the responses to the first three coding categories are “No”, please stop the interview and interview the next respondent.           New onset of fever or feeling feverish (such as chills, sweating) 1/2/3    
Cough 1/2/3
Mild or moderate difficulty in breathing (breathing slightly faster than normal, feeling like you can’t inhale or exhale, or wheezing, especially during exhaling or breathing out) 1/2/3
Sore throat 1/2/3
Running or stuffy nose 1/2/3
Muscle or body aches 1/2/3
Headaches 1/2/3
Unusual fatigue 1/2/3
Diarrhea 1/2/3
New loss of Taste and/or smell 1/2/3
Nausea or vomiting 1/2/3
  If yes, in which month did you suffer from these symptoms? INSTRUCTIONS: Multiple months are possible If the months do not include March, April, May or June or the respondent does not remember the name of the month, please stop the interview and interview the next respondent. Name of the month      
Do not know 98
Section 2: Socio-economic and demographic details of symptomatic individuals during March-June 2021
SN Questions Coding categories Codes Skip to
  How old were you on your last birthday? Age in completed years            
  What is your gender?   Male 1  
Female 2
Others (please specify) 99
  What is your religion?   Hindu 1            
Muslim 2
Sikh 3
Christian 4
Buddhist/neo-buddhist 5
Jain 6
Jewish 7
Parsi 8
Others (please specify) 99
  What is your caste or tribe?   Scheduled caste 1  
Scheduled tribe 2
Other backward caste 3
General 4
Others (please specify) 99
  What was your marital status during March to June 2021? Married 1  
Divorced 2
Separated 3
Widowed 4
Never married  5
Widower 6
Don’t want to tell 98
  Can you read and write? Yes, can read and write 1     ►110  
Yes, can read 2
No 3
         109. What is the highest schooling standard that you have completed?        INSTRUCTIONS: Code exact number of years of schooling.   Standard                    
Technical education after 10th Class 1
Graduate 2
Postgraduate 3
Others (please specify) 99
  What was your main occupation before the start of the COVID-19 pandemic in 2020? (i.e., Work in which maximum time is given)   Self‐employed in agriculture/ fishery/orchard/animal husbandry   1  
Self-employed in non-agriculture (like stitching, handy craft, business shop) 2
Regular salaried in government sector 3
Regular salaried in private sector 4
Daily wage labor 5
Casual wage labor in public works (e.g., MGNREGA) 6
Casual labor in agriculture 7
Casual labor in non‐agriculture other than public works 8
Traditional service occupation (Cobbler, Dhobi, Barber) 9
Unpaid family worker in agriculture/fishery/orchard/animal husbandry 10
Unpaid family worker in non-agriculture 11
Homemaker 12
Unemployed 13
Retired 14
Student 15
Other (please specify) 99
  How has your occupational status changed after the first wave of the COVID-19 pandemic in 2020?     No Change occurred; everything is same as before 1  
Occupation is lost and still searching for occupation 2
Occupation was lost but regained it before the second wave. 3
The occupation was lost but started a new occupation before the second wave. 4
Others (please specify) 99
  What was your average monthly income?        INSTRUCTIONS: Please mention the average income in a month. During January-March 2020 Rs.      
During January-March 2021 Rs.  
Do not know 98
  What was the average monthly income of all the members of your household?       INSTRUCTIONS: Please mention the average income in a month. During January-March 2020 Rs.    
During January-March 2021 Rs.  
Do not know 98
  During the second wave, what was the total number of people living in your household? 1 1  
2 2
3 3
4 4
5 5
More than 5 6
  Do you read a newspaper? Almost every day 1  
Not at all 2
Sometimes 3
  Do you watch television?   Almost every day 1  
Not at all 2
Sometimes 3
  Do you use internet on your mobile phone? Almost every day 1  
Not at all 2
Sometimes 3
  Where have you been taking health services normally for the last 5 years? Government hospitals & centers 1  
Private hospitals & nursing homes 2
Qualified solo private doctor 3
Traditional healers 4
Others (please specify) 99
    How many times did you get troubled by the following problems between March and June 2021?   INSTRUCTIONS:  Not at all-0, Several days-1, More than half a day-2, Nearly every day-3   Feeling nervous, anxious or on edge 0/1/2/3  
Not being able to stop or control worrying 0/1/2/3
Feeling down, depressed, or hopeless 0/1/2/3
Little interest or pleasure in doing things 0/1/2/3
  Have you been smoking cigarettes, bidis or any other tobacco products regularly for the last three years? Yes 1  
No 2
Do not want to tell 98
  Are you suffering from any of the following diseases which are being treated for the last three years? INSTRUCTIONS: Multiple responses are possible. [Yes-1, No-2, Not sure-3] Heart disease 1/2/3  
Diabetes 1/2/3
Lung disease 1/2/3
Kidney disease 1/2/3
Cancer 1/2/3
Others (please specify) 99
  Has any member of your house died between March 2021 to June 2021? Yes 1     ►127  
No  
Do not know 98
  Where did this death take place?   Government hospital 1  
Private hospital 2
At home 3
During transportation 4
Other places (please specify) 99
Do not know 98
  Was the deceased suffering from these new symptoms before death?     Fever 1/2/3  
Cough 1/2/3
Mild or moderate difficulty in breathing 1/2/3
  Whether the deceased was tested for COVID-19? Yes 1     ►127  
No 2
Do not know 98
  What was the COVID-19 test result of diseased? Positive 1  
Negative 2
Equivocal 3
Repeat sample 4
Report was not received 5
Do not know 98
Section 3: Factors associated with the access to and utilization of COVID-19 test
  Do you agree that fever, cough and mild or moderate difficulty in breathing were symptoms related to COVID-19? Strongly agree 1  
Agree 2
Neither agree nor disagree 3
Disagree 4
Strongly disagree 5
  When you were suffering from these symptoms, were you able to do your daily routine activities without any support? Yes 1  
No 2
Do not know 98
  Did you need to be hospitalized? Yes 1     ►132  
No 2
Do not know 98
  Did you have to be hospitalized? Yes 1 ►132  
No 2
  If you needed to be hospitalised, why weren't you admitted to the hospital? Could not get support of family members for hospitalization 1  
Hospital with available beds not found 2
Fear of adverse outcome of hospital admission 3
Others (please specify) 99
  Were people you knew getting tested when they were suffering from these symptoms? Yes 1  
No 2
Do not know 98
  What was your view on the availability of government testing facilities for COVID-19?         Instruction: Multiple responses are possible It was available for everyone who needed it 1  
It was available for symptomatic persons only 2
It was available to those who came in contact with confirmed cases 3
It was available for seriously ill patients only 4
It was available for rich and influential people only 5
Others (please specify) 99
  How reliable was the COVID-19 test in your opinion? Very reliable 1  
Reliable 2
Neither reliable nor unreliable 3
Unreliable 4
Very unreliable 5
  How useful was the COVID-19 test in knowing the level of infection? Very useful 1  
Useful 2
Neither useful nor useless 3
Useless 4
Totally useless 5
  How useful was the COVID-19 test in preventing the spread of infection? Very useful 1  
Useful 2
Neither useful nor useless 3
Useless 4
Totally useless 5
  How useful was the COVID-19 test for treatment? Very useful 1  
Useful 2
Neither useful nor useless 3
Useless 4
Totally useless 5
  How nervous were you at the thought of getting tested for COVID-19? Very nervous 1  
Nervous 2
Neither nervous nor relaxed 3
Relaxed 4
Very relaxed 5
  How embarrassing was it to get tested for COVID-19? Very embarrassing 1  
Embarrassing 2
Neither Embarrassing nor convenient 3
Convenient 4
Very convenient 5
  Which samples were being taken for the COVID-19 test?  Instruction: Multiple responses are possible Blood 1  
Urine 2
Stool 3
Cerebrospinal fluid (CSF) 4
Nasopharyngeal swab 5
Do not know 98
  How is the COVID-19 sample collection process? Painless 1  
Slightly painful 2
Did not know 3
Moderately painful 4
Very painful 5
  How were you feeling about getting a positive result of COVID-19? Very scared 1  
Scared 2
Did not know 3
Calm 4
Very calm 5
  How afraid were you of losing work if you tested COVID-19 positive? Very scared 1  
Scared 2
Did not know 3
Calm 4
Very calm 5
  What type of information is usually required for the COVID-19 test? INSTRUCTIONS ; Multiple responses are possible Who was eligible for COVID-19 test? 1                                          
When should I get tested for the COVID-19? 2
How can I get tested for COVID-19? 3
Where are the COVID-19 testing services available near me? 4
What is the cost of the COVID-19 test? 5
What types of tests are available for COVID-19? 6
Which COVID-19 test is most accurate? 7
Other (please specify) 99
  Did you get this information? Yes 1     ►147  
No 2
    What were the main sources of this information?    INSTRUCTIONS:  Multiple responses are possible.         Television channels 1  
Daily newspapers 2
Websites or online news pages 3
Social media (e.g., Facebook, Twitter, YouTube, WhatsApp) 4
Search engines (e.g., Google) 5
Conversations with family and friends 6
Conversations with colleagues 7
Consultation with family physician 8
Government campaigns 9
Government call centre 10
Government hospitals or centres 11
Advisories issued by the government 12
Elected public representatives 13
Civil societies/NGOs 14
Other sources (please specify) 99
  Where were the COVID-19 testing facilities available near you?  INSTRUCTIONS:  Multiple responses are possible. Yes-1, No-2, Not sure-3   Public sector hospital    
GOVT. Dispensary/Hospital 1/2/3
Urban Community/Primary Health Centre 1/2/3
CHC/Block PHC 1/2/3
Sub-Centre 1/2/3
Health & Wellness Centre 1/2/3
Govt. Mobile Clinic 1/2/3
Camp 1/2/3
Anganwadi/ICDS Centre 1/2/3
Asha 1/2/3
Other community-based members 1/2/3
Other Public Sector Health Facility (please specify) 1/2/3
NGO Or Trust Hospital/Clinic 1/2/3
Private health sector  
Private Hospital/ Clinic /Doctor 1/2/3
Private laboratories 1/2/3
Other private sector health facility (please specify) 1/2/3
  How far was this COVID-19 testing facility from your house? Less than 1 Km 1  
1 to 2 Km 2
2 to 3 Km 3
3 to 4 Km 4
4 to 5 Km 5
More than 5 Km 6
Do not know 98
  Was public transport like bus, auto available to reach this COVID-19 testing centre? Yes 1  
No 2
Do not know 98
  What was the cost of the COVID-19 test? It was free in the government sector 1  
It was not free in government sector 2
It was free in private sector 3
It was not free in private sector 4
It was at a capped price in the private sector 5
Do not know 98
  How easy or difficult the entire process of getting the COVID-19 test was? Very easy 1  
Easy 2
Neither easy nor difficult 3
Difficult 4
Very difficult 5
  What were the chances that you would have got the COVID-19 test done? Very unlikely 1  
Unlikely 2
Neither likely nor unlikely 3
Likely 4
Very likely 5
  When did you decide about the COVID-19 test? Within one day of developing first symptom 1  
Second day of developing first symptom 2
Third day of developing first symptom 3
Fourth day of developing first symptom 4
Fifth day of developing first symptom 5
Sixth day of developing first symptom 6
Seventh day of developing first symptom 7
After seventh day of developing first symptom 8
Never made a decision 9
Decided but don't remember when. 98
  What was your decision about the COVID-19 test? Will be tested 1      
Will not be tested 2
Do not know 98
  What influenced you to make this decision? Advise of government doctor 1  
Advise of private doctor 2
Health workers advice 3
advice from family members 4
friends advice 5
Past COVID-19 patient advice 6
Mass media campaign 7
Health campaign 8
Nobody 9
Other (please specify) 99
  Did you try for the COVID-19 test? Yes 1   ►158  
No 2
Do not know 98
  What did you try to get the COVID-19 test done?    INSTRUCTIONS:  Multiple responses are possible.   Visited hospitals/health centres 1  
Visited COVID-19 testing unit/s 2
Visited COVID-19 testing camp/campaign 3
Contacted COVID call centre 4
Contacted healthcare worker 5
Contacted social worker 6
Other (please specify) 99
  Why didn't you try for the COVID-19 test? I thought I was not sick enough for test 1  
was advised to isolate myself instead of going for test 2
My health condition was not good enough to go to a testing unit 3
There was no one to help me reach the testing unit 4
I thought the test was useless because there was no treatment for COVID-19 5
Other (please specify) 99
  Were you tested for COVID-19? Yes 1 ►162  
No 2
Do not know 98
  Why haven't you been tested? I was told that I was not eligible for the test 1  
I was told that the staff was not available for testing 2
I was told that the logistics are not available for testing 3
waited for more than five hours and therefore came back home without testing 4
There was a lot of crowd at the testing center, so I came back without getting tested 5
Other (please specify) 99
  What did you do after not having a COVID-19 test despite trying or waiting? Tried again for the test 1         ►STOP
Did not try again for the test 2
Others (please specify) 99
  If you were tested, please let me know when. The test was done within a day of trying for the test 1                                  
The test is done on the second day of trying the test 2
The test is done on the third day of trying the test 3
The test is done on the fourth day of trying the test 4
The test is done on the fifth day of trying the test 5
The test is done on the sixth day of trying the test 6
The test is done on the seventh day of trying the test 7
The test is done after the seventh day of trying the test 8
Test done but not remembering when 9
    Please tell me the waiting time between arrival and sample collection at the COVID-19 testing unit. One hour 1            
1 to 2 hours 2
2 to 3 hours 3
3 to 4 hours 4
4 to 5 hours 5
More than five hours 6
  Where were you tested? Government sector 1  
Private sector 2
Do not know 98
  Can you tell us which test was done? Instruction:  Multiple responses possible Rapid Antigen Test 1  
RT-PCR 2
CBNAAT 3
TrueNat 4
Do not know 98
  Did you pay for COVID-19 test? No 1  
Yes 2
Do not know 98
  If yes, please tell the amount in Rs. Amount in Rs.    
  What was the COVID-19 test result?     Found negative 1  
Found positive 2
Equivocal 3
Repeat sample 4
Result not received 5
Do not know 98
  When did you get the test result after the sample collection? Within 6 hours 1  
Within 6 to 12 hours 2
Within 12 to 18 hours 3
Within 18 to 24 hours 4
Within 24 to 48 hours 5
More than 48 hours 6
Never 7
  How did you receive the COVID-19 test result? From hospital/centre/lab 1  
Through a call 2
Through portal 3
Through healthcare worker 4
Others (please specify) 99
  How was the behavior of the staff during the COVID-19 testing? Very good 1  
Good 2
Neither good nor bad 3
Bad 4
Very bad 5
  Were COVID-19 appropriate practices like bearing of the mask, social distancing, and sanitization of hands strictly followed in the testing unit? Yes 1  
No 2
Cannot say 98