Survey Text

2015
2010
2005
2000
1992
1987
top
2015
Survey form view entire document:  text  image
Question ID: NAF.229_01.000

Instrument Variable Name: RCBE1_MT
Question Text:
1 of 2
When did you have your MOST RECENT breast exam?
*Enter month of last breast exam.
*Enter '96' to go to number and time period format.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know
Universe Text: Female sample adults 30+ who have ever had a breast exam
Skip Instructions:
(1-12,D) [go to RCBE1_YR]
(R) store "R' in RCBE1_YR [go to RCBE2]
(96) store "9996" in RCBE1_YR [go to RCBE1N]

top
2010
Survey form view entire document:  text  image
Question ID: NAF.400_01.000

Instrument Variable Name: RCBE1_MT
QuestionText:
1 of 2
When did you have your MOST RECENT breast exam?
*Enter month of last breast exam.
*Enter '96' to go to number and time period format.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know
UniverseText: Female sample adults 30+ who have ever had a breast exam
SkipInstructions:
(1-12,D) [goto RCBE1_YR] (R) store "R' in RCBE1_YR [goto RCBE2] (96) store "9996" in RCBE1_YR
[goto RCBE1N]

top
2005
Survey form view entire document:  text  image
NAF.400_01.000

Instrument Variable Name: RCBE1_MT
Question Text:
1 of 2
When did you have your MOST RECENT breast exam?
*Enter month of last breast exam.
*Enter '96' to go to number and time period format.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know
Universe Text: Female sample adults 30+ who have ever had a breast exam
Skip Instructions:
(1-12,D) [goto RCBE1_YR] (R) store "R' in RCBE1_YR [goto RCBE2] (96) store "96" in RCBE1_YR [goto RCBE1N]

top
2000
Survey form view entire document:  text  image
Check item NAFCCI08: Refer to Household Composition, Basic Module.
AGE, HHC.120 "What is {name/your} age...?"
(1)Female 18-29 (under 30) (END_NAF)
(2)Female 30+ (NAF.390)

NAF.400

When did you have your MOST RECENT breast exam?

FR: ENTER "T" TO USE TIME PERIOD FORMAT.

Month:
RCBE1_MT
(01) January
(02) February
(03) March
(04) April
(05) May
(06) June
(07) July
(08) August
(09) September
(10) October
(11) November
(12) December
(97) Don't know
(99) Refused
(T) Time Period (RCBE1_NO)

Year:
RCBE1_YR
(1950-2000) 1950-2000 (Check item NAFCCI09)
(9997) Don't know (NAF.410)
(9999) Refused (NAF.410)

When did you have your MOST RECENT breast exam?

FR: IF GREATER THAN "95", ENTER "95".

[ ] Number
RCBE1_NO
(01-94) 1-94 (RCBE1_TP/NAF.400)
(95) 95+(RCBE1_TP/NAF.400)
(97) Refused (NAF.410)
(99) Don't know (NAF.410)

[ ] Time Period
RCBE1_TP
(1) Days ago
(2) Weeks ago
(3) Months ago
(4) Years ago
(7) Refused
(9) Don't know

[Go to Check item NAFCCI09]

NAF.410

FR: SHOW CARD CAN27

Was it: (READ CATEGORIES BELOW)
Card CAN27
1. A year ago or less
2. More than 1 year but not more than 2 years
3. More than 2 years but not more than 3 years
4. More than 3 years but not more than 5 years
5. Over 5 years ago
RCBE2
(1) A year ago or less?
(2) More than 1 year but not more than 2 years?
(3) More than 2 years but not more than 3 years?
(4) More than 3 years but not more than 5 years?
(5) Over 5 years ago?
(7) Refused
(9) Don't know

top
1992
Survey form view entire document:  text  image
27a. When did you have your most recent breast physical exam?

Month ____ [if 3 years ago or less (28); if more than 3 years ago (29)]
Year 19____ [if 3 years ago or less (28); if more than 3 years ago (29)]
OR

Number ____
1[] Days ago [if 3 years ago or less (28); if more than 3 years ago (29)]
2[] Weeks [if 3 years ago or less (28); if more than 3 years ago (29)]
3[] Months ago [if 3 years ago or less (28); if more than 3 years ago (29)]
4[] Years ago [if 3 years ago or less (28); if more than 3 years ago (29)]


999[] DK (27b)

top
1987
Survey form view entire document:  text  image
c. When did you have your last breast physical exam?

If 3 years ago or less (10).
If more than 3 years ago (12)

Mo. ____
Year 19_ _

OR
_____
1 [] Days ago
2 [] Weeks ago
3 [] Months ago
4 [] Years ago

999 [] DK (9d)