Supplemental Table 2.

Palau Hybrid Survey Indicators.⁸

Variable	Source Question	Response Options
General Health	Would you say that your general health is…	Excellent, very good, good, fair or okay, poor or not good
Last doctor visit	About how long has it been since you last visited a medical provider for an annual checkup?	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Last dental visit	How long has it been since you last visited a dentist or a dental clinic for any reason?	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Teeth missing	How many of your permanent teeth have been removed because of tooth decay or gum disease?	1–5, ≥6 but not all, all, none
Body Mass Index category	Calculated by weight (kg) over height (cm) squared.	Underweight <18.5, normal 18.5–24.9, overweight 25–29.9, obese ≥30
Hypertension	Measured blood pressure and self-reported high blood pressure and medication status was used to categorize hypertension.	Hypertension = BP ≥140/90 and/or if they self-reported being diagnosed with hypertension and were taking medication for their hypertension
High blood sugar or diabetes	Measured fasting blood glucose and self-reported diagnosis of diabetes and medication status was used to categorize high blood sugar/diabetes.	Diabetes = fasting blood glucose ≥126mg/dL and/or self-report for diabetes and were on medication for their diabetes.
High Total Cholesterol	Measured total cholesterol was used.	Elevated cholesterol = total cholesterol ≥190mg/dL; high total cholesterol = total cholesterol ≥240mg/dL.
Low HDL Cholesterol	Measured HDL cholesterol was used.	Low HDL = HDL cholesterol <40mg/dL.
Low HDL = HDL cholesterol <40mg/dL.	Have you ever been told by a doctor that you have gout, arthritis, asthma, ulcer, other heart disease, heart disease, tuberculosis, depression, stroke, lung disease, cancer? (separate variables for each)	Yes or no
Infertility	At any time did you try for more than 12 months and not become pregnant?	Yes or no
Ectopic pregnancy	Were you ever told that you had an ectopic pregnancy (tubal pregnancy that resulted in a miscarriage)?	Yes or no
Pelvic Inflammatory Disease	Have you ever been treated with antibiotics for an infection in your fallopian tubes, womb, or ovaries, also called a pelvic infection, pelvic inflammatory disease, or P.I.D.?	Yes or no
Cigarette Use	During the past 30 days, on how many days did you smoke cigarettes?	0 days = no use; 1–29 days = some use; 30 days = everyday use
Quit cigarette use	Do you want to quit smoking cigarettes?	Yes or no
E-cigarette use	During the past 30 days, on how many days did you use E-Cigarettes or a personal vaporizer (PV), or electronic nicotine?	0 days = no use; 1–29 days = some use; 30 days = everyday use
Home 2nd hand smoke	During the past 7 days, on how many days did someone other than you smoke tobacco inside your home while you were at home?	0 days = no exposure; 1–7 days = some exposure
Work 2nd hand smoke	During the past 7 days, on how many days did you breathe tobacco smoke at your workplace from someone else other than you who was smoking tobacco?	0 days = no exposure; 1–7 days = some exposure
Vehicle 2nd hand smoke	During the past 7 days, on how many days did you ride in a vehicle where someone other than you was smoking tobacco?	0 days = no exposure; 1–7 days = some exposure
Any 2nd hand smoke exposure	Answered yes to any of the 2nd hand smoke questions	Yes or no
Betel nut use	During the past 30 days, on how many days did you chew betel nut?	0 days = no use; 1–29 days = some use; 30 days = everyday use
Use tobacco in betel nut use	What kind of tobacco do you most often add to your betel nut chew?	Cigarette Sticks, imported loose tobacco, locally grown tobacco, other type of tobacco
Quit betel nut use	Do you want to quit chewing betel nut with tobacco?	Yes or no
Alcohol consumption	During the past 30 days, on how many days did you have at least one standard drink of any alcohol?	0 days = no use; 1–29 days = some use; 30 days = everyday use
Binge alcohol frequency	During the past 30 days, how many days did you have (for men, ≥5 standard alcoholic drinks; for women ≥4 standard alcoholic drinks):	0 days = no binge, 1–29 days = some binge, 30 days = everyday binge
Fruit and vegetable consumption	Sum of usual daily fruit consumption and daily vegetable consumption.	<1 servings, 1–<3 servings, 3–<5 servings, ≥5 servings
Watching salt intake	Are you currently watching or reducing your sodium or salt intake?	Yes or no
Importance of lowering salt in diet	How important is lowering salt in your diet?	Very important, somewhat important, not at all important
Processed meat consumption	In a regular day, how many times do you eat processed meats? This does not include canned fish.	0 servings, 1 serving, ≥2 servings
Sugar-sweetened beverage consumption	In a regular day, how many sugary drinks do you drink? This does not include diet drinks made with artificial sweeteners.	0 servings, 1 serving, ≥2 servings
Physical activity level	Based on GPAQ questions and calculations which is a combination of how many weeks a person is vigorously or moderately active due to work, transportation, or recreational activities AND the total number of METs in a week. METs are commonly used in the analysis of physical activity. MET (Metabolic Equivalent): The ratio of the work metabolic rate to the resting metabolic rate. One MET is defined as 1 kcal/kg/hour and is equivalent to the energy cost of sitting quietly. A MET is also defined as oxygen uptake in ml/kg/min with one MET equal to the oxygen cost of sitting quietly, around 3.5 ml/kg/min.	High-Level
		• If vigorous PA due to work or leisure on more than 3 days a week and Total physical activity MET minutes per week is greater than or equal to 1500
		• If moderate PA due to work or leisure on 7 days a week and Total physical activity MET minutes per week is greater than or equal to 3000
		Moderate-Level
		• If vigorous PA due to work or leisure on more than 3 days a week that totals 60 or more minutes
		• If moderately PA due to work or leisure on 5 days a week that totals 150 or more minutes
		• If moderate PA due to work or leisure at least 5 days a week and Total physical activity MET minutes per week is greater than or equal to 600
		Low-Level
		• Doesn't meet any of the above criteria
Colonoscopy screening	How long has it been since your last colonoscopy? (adults ≥50)	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Blood stool test	A blood stool test is a test that determines whether the stool contains blood. How long has it been since your last blood stool test? (adults ≥50)	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Mammogram screening	How long has it been since you had your last mammogram? (women 50–74)	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Clinical breast exam	A clinical breast exam is when a doctor, nurse, or other health professional feels the breasts for lumps. How long has it been since your last clinical breast exam?	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Pap smear screening	How long has it been since you had your last Pap test? (women 21–65)	≤1 year, ≤2 years, ≤5 years, ≤5 years, never
Drug use	During the past 30 days, report on how many days you used any of the following substance: prescription drugs, inhalants, LSD, heroin, marijuana. (separate variables for each)	No use = 0 days, use = ≥1 day
Perceptions of drugs as risky	How much do people risk harming themselves physically and in other ways when they engage in the following behaviors? Cigarettes, alcohol, marijuana, betel nut with tobacco, heroin, LSD, inhalants, prescription drugs without doctor's orders	Great risk, moderate, slight, no risk
Disapproval of drug use	How much do you approve or disapprove of the following substances? ≥1 pack of cigarettes per day, betel nut with tobacco everyday, marijuana ≥1 time a month, ≥2 alcohol beverages a day	Strongly disapprove, somewhat disapprove, don't disapprove (includes: approve, somewhat approve, and neither approve or disapprove)