I agree to participate in this study* must provide value
Are you filling out the survey for yourself or your child? * must provide value
Have you ever been told by a doctor or other health professional that you had eczema or atopic dermatitis? * must provide value
Has your child ever been told by a doctor or other health professional that they had eczema or atopic dermatitis?* must provide value
In the past 12 months, have you been told by a doctor or other health professional that you still had eczema or atopic dermatitis?* must provide value
In the past 12 months, has your child been told by a doctor or other health professional that they still had eczema or atopic dermatitis?* must provide value
How old are you?* must provide value
How old is your child?* must provide value
How old were you when you were first diagnosed with eczema or atopic dermatitis?* must provide value
How old was your child when they were first diagnosed with eczema or atopic dermatitis?* must provide value
In the past 12 months, how would you describe your eczema?* must provide value
In the past 12 months, how would you describe your child's eczema?* must provide value
Over the last week, on how many days has your skin been itchy because of the eczema?* must provide value
Over the last week, on how many nights has your sleep been disturbed because of eczema?* must provide value
Over the last week, on how many days has your skin been bleeding because of the eczema?* must provide value
Over the last week, on how many days has your skin been weeping or oozing clear fluid because of the eczema?* must provide value
Over the last week, on how many days has your skin been cracked because of the eczema?* must provide value
Over the last week, on how many days has your skin been flaking off because of the eczema?* must provide value
Over the last week, on how many days has your skin felt dry or rough because of the eczema?* must provide value
Over the last week, on how many days has your child's skin been itchy because of the eczema?* must provide value
Over the last week, on how many nights has your child's sleep been disturbed because of eczema?* must provide value
Over the last week, on how many days has your child's skin been bleeding because of the eczema?* must provide value
Over the last week, on how many days has your child's skin been weeping or oozing clear fluid because of the eczema?* must provide value
Over the last week, on how many days has your child's skin been cracked because of the eczema?* must provide value
Over the last week, on how many days has your child's skin been flaking off because of the eczema?* must provide value
Over the last week, on how many days has your child's skin felt dry or rough because of the eczema?* must provide value
Over the past week, how much has itch bothered you?
Over the past week, how much has itch bothered your child?
In the past year, what parts of your body were typically affected by eczema?* must provide value
Please check all that apply
In the past year, what parts of your child's body were typically affected by eczema?* must provide value
Please check all the apply
Over the last week, how severe do you think your child's eczema has been?
Over the last week, how much has your child been itching and scratching?
Over the last week, what has your child's mood been?
Over the last week, approximately how much time on average has it taken to get your child to sleep each night?
Over the last week, what was the total time that your child's sleep was disturbed on average each night?
Over the last week, has your child's eczema interfered with playing or swimming? Over the last week, has your child's eczema interfered with your child taking part in or enjoying other family activities? Over the last week, have there been problems with your child at mealtimes because of eczema? Over the last week, have there been problems with your child caused by the treatment? Over the last week, has your child's eczema meant that dressing and undressing the child has been uncomfortable? Over the last week, how much has your child having eczema been a problem at bath-time? Over the last week, how much effect has your child having eczema had on housework, e.g. washing, cleaning? Over the last week, how much effect has your child having eczema had on food preparation and feeding? Over the last week, how much effect has your child having eczema had on the sleep of others in the family? Over the last week, how much effect has your child having eczema had on family leisure activities, e.g. swimming? Over the last week, how much effect has your child having eczema had on time spent on shopping for the family? Over the last week, how much effect has your child having eczema had on your expenditure, e.g. costs related to treatment, clothes, etc? Over the last week, how much effect has your child having eczema had on causing tiredness or exhaustion in your child's parents/carers? Over the last week, how much effect has your child having eczema had on causing emotional distress such as depression, frustration or guilt in your child's parents/carers? Over the last week, how much effect has your child having eczema had on relationships between the main carer and partner or between the main carer and other children in the family? Over the last week, how much effect has helping with your child's treatment had on the main carer's life? On average, how many hours of sleep do you get in a 24-hour period?
On average, how many hours of sleep does your child get in a 24-hour period?
During the past 30 days, for about how many days did you find yourself unintentionally falling asleep during the day?
During the past 30 days, for about how many days did your child unintentionally fall asleep during the day?
During the past 30 days, have you ever nodded off or fallen asleep, even just for a brief moment, while driving?
During the past 30 days, did you have difficulties in school or at work because of sleepiness?
During the past 30 days, did your child have difficulties in school or at work because of sleepiness?
How many times did you go to an urgent care center or emergency department for your eczema?
How many times did your child go to an urgent care center or emergency department for their eczema?
What were the reasons for you going to an urgent care center or emergency department for your eczema?
What were the reasons for your child going to an urgent care center or emergency department for their eczema?
How many times did you go to an urgent care center or emergency department for injuries or accidents?
How many times did your child go to an urgent care center or emergency department for injuries or accidents?
For what type of injury did you go to an urgent care center or emergency department?
For what type of injury did your child go to an urgent care center or emergency department?
What is your gender?* must provide value
What is your child's gender?* must provide value
What is your race (Choose all that apply)
What is your child's race (Choose all that apply)
What group best represents your Hispanic origin or ancestry?* must provide value
What group best represents your child's Hispanic origin or ancestry?* must provide value
In what country were you born?* must provide value
United States United States Minor Outlying Islands Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo The Democratic Republic of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Federated States of Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Province of China Tajikistan United Republic of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe In what country was your child born?* must provide value
United States United States Minor Outlying Islands Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo The Democratic Republic of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Federated States of Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Province of China Tajikistan United Republic of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe In what country do you currently live?* must provide value
United States United States Minor Outlying Islands Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo The Democratic Republic of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Federated States of Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Province of China Tajikistan United Republic of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe In what country does your child currently live?* must provide value
United States United States Minor Outlying Islands Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo The Democratic Republic of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Federated States of Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Province of China Tajikistan United Republic of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe In what state do you currently live?* must provide value
Alabama - AL Alaska - AK American Samoa - AS Arizona - AZ Arkansas - AR California - CA Colorado - CO Connecticut - CT Delaware - DE District of Columbia - DC Federated States of Micronesia* - FM Florida - FL Georgia - GA Guam - GU Hawaii - HI Idaho - ID Illinois - IL Indiana - IN Iowa - IA Kansas - KS Kentucky - KY Louisiana - LA Maine - ME Marshall Islands* - MH Maryland - MD Massachusetts - MA Michigan - MI Minnesota - MN Mississippi - MS Missouri - MO Montana - MT Nebraska - NE Nevada - NV New Hampshire - NH New Jersey - NJ New Mexico - NM New York - NY North Carolina - NC North Dakota - ND Northern Mariana Islands - MP Ohio - OH Oklahoma - OK Oregon - OR Palau* - PW Pennsylvania - PA Puerto Rico - PR Rhode Island - RI South Carolina - SC South Dakota - SD Tennessee - TN Texas - TX Utah - UT Vermont - VT Virgin Island - VI Virginia - VA Washington - WA West Virginia - WV Wisconsin - WI Wyoming - WY In what state does your child currently live?* must provide value
Alabama - AL Alaska - AK American Samoa - AS Arizona - AZ Arkansas - AR California - CA Colorado - CO Connecticut - CT Delaware - DE District of Columbia - DC Federated States of Micronesia* - FM Florida - FL Georgia - GA Guam - GU Hawaii - HI Idaho - ID Illinois - IL Indiana - IN Iowa - IA Kansas - KS Kentucky - KY Louisiana - LA Maine - ME Marshall Islands* - MH Maryland - MD Massachusetts - MA Michigan - MI Minnesota - MN Mississippi - MS Missouri - MO Montana - MT Nebraska - NE Nevada - NV New Hampshire - NH New Jersey - NJ New Mexico - NM New York - NY North Carolina - NC North Dakota - ND Northern Mariana Islands - MP Ohio - OH Oklahoma - OK Oregon - OR Palau* - PW Pennsylvania - PA Puerto Rico - PR Rhode Island - RI South Carolina - SC South Dakota - SD Tennessee - TN Texas - TX Utah - UT Vermont - VT Virgin Island - VI Virginia - VA Washington - WA West Virginia - WV Wisconsin - WI Wyoming - WY What is your highest level of education
What is the highest level of education of the child's parents?
What is your marital status?
What is the marital status of the child's parents?
What is your total household income?
What is the total household income for the child's home?
Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
Does your child have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
Do you have one or more person you think of as your personal doctor(s) or health care provider(s)?
Does your child have one or more person you think of as their personal doctor(s) or health care provider(s)?
Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?
Was there a time in the past 12 months when your child needed to see a doctor but could not because of cost?
About how long has it been since you last visited a doctor for a routine checkup?
About how long has it been since your child last visited a doctor for a routine checkup?
During the past 30 days, have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
During the past 30 days, how many days per week did you have at least one drink of any alcoholic beverage?
One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?
Have you smoked at least 100 cigarettes in your entire life?
Does anyone smoke inside your child's home?
Do you now smoke cigarettes every day, some days, or not at all?
How long has it been since you last smoked cigarettes regularly?
Do you currently use chewing tobacco, snuff, or snus every day, some days, or not at all?
How much do you weigh (in pounds)? How much did your child weigh at birth (in pounds)? How much do your child currently weigh (in pounds)? How tall are you (in inches)? How tall is your child (in inches)? What is your waist size (inches)? What is your child's waist size (inches)? When you are at work, which of the following best describes what you do? Would you say you are -
include all jobs
Aside from work, in a usual week, on how many days do you do moderate activities for at least 10 minutes at a time?
On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Aside from work, in a usual week, how many days do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
Aside from school, in a usual week, how many days does your child do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
On days when your child does vigorous activities for at least 10 minutes at a time, how much total time per day do they spend doing these activities?
Have you ever been offered to participate in research for your eczema?* must provide value
Have you ever been offered to participate in research for your child's eczema?* must provide value
Did you agree to participate in any research?* must provide value
Did you agree for your child to participate in any research?* must provide value
Would you like to be contacted to participate in future research studies for eczema / atopic dermatitis?* must provide value
Please note that your information will only be used for research purposes and will not be shared with any third party organizations or companies.
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