Survey Text

2015
2010
2005
2000
1992
1987
top
2015
Survey form view entire document:  text  image
Question ID: NAF.229_02.000

Instrument Variable Name: RCBE1_YR
Question Text:
2 of 2
*Enter year of most recent breast exam.
1880-2016 1880-2016
9996 Time period format
9997 Refused
9999 Don’t know
Universe Text: Female sample adults age 30+ who answered month of breast exam didn't know month of breast exam
Skip Instructions:
(valid year) if RCBE1_YR gt current year or
(RCBE1_YR=current year and RCBE1_MT gt current month) go to ERR1_ RCBE1_YR (future date)
elseif RCBE1_YR lt DOBY or (RCBE1_YR=DOBY and RCBE1_MT lt DOBM) go to ERR2_ RCBE1_YR (prior to birth date)
elseif RCBE1_MT=D go to RCBE2
elseif RCBE1_MT=1-12 [go to MAMHAD] (R,D) [go to RCBE2]

top
2010
Survey form view entire document:  text  image
Question ID: NAF.400_02.000

Instrument Variable Name: RCBE1_YR
QuestionText:
2 of 2
*Enter year of last breast exam.
1880-2011 1880-2011
9996 Time period format
9997 Refused
9999 Don't know
UniverseText: Female sample adults age 30+ who answered month of last breast exam or didn't know month of last breast exam
SkipInstructions:
(valid year) if RCBE1_YR gt current year or (RCBE1_YR=current year and RCBE1_MT gt current month)
goto ERR1_ RCBE1_YR (future date)
elseif RCBE1_YR lt DOBY or (RCBE1_YR=DOBY and RCBE1_MT lt DOBM)
goto ERR2_ RCBE1_YR (prior to birth date)
elseif RCBE1_MT=D
goto RCBE2
elseif RCBE1_MT=1-12
goto MRIHAD
(R,D) goto RCBE2

top
2005
Survey form view entire document:  text  image
NAF.400_02.000

Instrument Variable Name: RCBE1_YR
Question Text:
2 of 2
*Enter year of last breast exam.
1880-2006 1880-2006
9996 Time period format
9997 Refused
9999 Don't know
Universe Text: Female sample adults age 30+ who answered month of last breast exam or didn't know month of last breast exam
Skip Instructions:
(valid year) if RCBE1_MT=1-12 [goto CREHAD if AGE GE 40; else goto next section]; else if RCBE1_MT=D
[goto RCBE2] (R,D) [goto RCBE2]
IF RCBE1_MT and RCBE1_YR = a future date [goto ERR1_RCBE1_YR]
IF RCBE1_MT and RCBE1_YR = a date prior to birth date [goto ERR2_RCBE1_YR]

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)