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Demographic questionnaire.
| Item | Question | Response |
| Age | What is your age? | 18-29 years old |
| 30-49 years old | ||
| 50-64 years old | ||
| 65 years and older | ||
| Gender | What is your gender? | Male (M) |
| Female (F) | ||
| Ethnicity origin (or race) | Please specify your ethnicity. | Black or African American |
| Asian | ||
| White | ||
| Latino |
