| Youth: | □yes | □no |
| Adults | □yes | □no |
| Elderly | □yes | □no |
| Racial/ethnic minorities | □yes | □no |
| Low-income | □yes | □no |
| Urban | □yes | □no |
| Rural | □yes | □no |
| Female | □yes | □no |
| Male | □yes | □no |
| Immigrant | □yes | □no |
| Non-US | □yes | □no |
| □Other ______________ | ||
| □Refused |
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