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2018

Survey form view entire document: text image

Question ID:NAF.260_01.000

Instrument Variable Name: RMAM1_MT
Question Text:

1 of 2
[Fill1: Earlier you said you had a mammogram.]
When did you have your MOST RECENT mammogram?
*Enter month of last mammogram.
*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 mammogram
SkipInstructions:

(1-12,D) [goto RMAM1_YR]
(R) store 'R' in RMAM1_YR [goto RMAM2]
(96) store '9996' in RMAM1_YR [goto RMAM1N]

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2015

Survey form view entire document: text image

Question ID: NAF.260_01.000

Instrument Variable Name: RMAM1_MT
Question Text:

1 of 2
When did you have your MOST RECENT mammogram?
*Enter month of last mammogram.
*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 mammogram
Skip Instructions:

(1-12,D) [go to RMAM1_YR]
(R) store "R' in RMAM1_YR [go to RMAM2]
(96) store "9996" in RMAM1_YR [go to RMAM1N]

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2013

Survey form view entire document: text image

Question ID:NAF.260_01.000

Instrument Variable Name: RMAM1_MT
Question Text:

1 of 2
[Fill1: Earlier you said you had a mammogram.]
When did you have your MOST RECENT mammogram?
*Enter month of last mammogram.
*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 mammogram
SkipInstructions:

(1-12,D) [goto RMAM1_YR]
(R) store 'R' in RMAM1_YR [goto RMAM2]
(96) store '9996' in RMAM1_YR [goto RMAM1N]

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2010

Survey form view entire document: text image

Question ID: NAF.260_01.000

Instrument Variable Name: RMAM1_MT
QuestionText:

1 of 2
When did you have your MOST RECENT mammogram?
*Enter month of last mammogram.
*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 mammogram
SkipInstructions:

(1-12,D) [goto RMAM1_YR] (R) store "R' in RMAM1_YR [goto RMAM2] (96) store "9996" in
RMAM1_YR [goto RMAM1N]

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2008

Survey form view entire document: text image

Question ID:NAF.260_01.000

Instrument Variable Name:RMAM1_MT
QuestionText:

1 of 2
The next few questions are about your recent mammograms. When did you have your MOST RECENT mammogram?
* Enter month of last mammogram.
* 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 mammogram
SkipInstructions:

(1-12,D) goto RMAM1_YR
(R) store "R" in RMAM1_YR and goto RMAM2
(96) store "96" in RMAM1_YR and goto RMAM1N
(13-95) goto ERR_RMAM1_MT

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2005

Survey form view entire document: text image

NAF.260_01.000

Instrument Variable Name: RMAM1_MT
Question Text:

1 of 2
The next few questions are about your recent mammograms. When did you have your MOST RECENT mammogram?
*Enter month of last mammogram.
*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 mammogram
Skip Instructions:

(1-12,D) [goto RMAM1_YR] (R) store "R' in RMAM1_YR [goto RMAM2] (96) store "96" in RMAM1_YR
[goto RMAM1N]

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2003

Survey form view entire document: text image

Question ID:NAF.260_01.000

Instrument Variable Name:RMAM1_MT
QuestionText:

1 of 2
The next few questions are about your recent mammograms. When did you have your MOST RECENT mammogram?
* Enter month of last mammogram.
* 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 mammogram
SkipInstructions:

(1-12,D) goto RMAM1_YR
(R) store "R" in RMAM1_YR and goto RMAM2
(96) store "96" in RMAM1_YR and goto RMAM1N
(13-95) goto ERR_RMAM1_MT

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2000

Survey form view entire document: text image

Check item NAFCCI05: Refer to Household Composition, Basic Module.
AGE/HHC.120 "What is {name/your} age...?"
(1)Female 18-29 (under 30) (Check item NAFCCI07)
(2)Female 30+ (NAF.230)

NAF.260

When did you have your MOST RECENT mammogram?

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

Month:

RMAM1_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 (RMAM1_NO)

Year:

RMAM1_YR

(1950-2000) 1950-2000 (NAF.280)
(9997) Don't know (NAF.270)
(9999) Refused (NAF.270)

When did you have your MOST RECENT mammogram?

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

[ ] Number

RMAM1_NO

(01-94) 1-94 (RMAM1_TP/NAF.260)
(95) 95+ (RMAM1_TP/NAF.260)
(97) Refused (NAF.270)
(99) Don't know (NAF.270)

[ ] Time Period

RMAM1_TP

(1) Days ago
(2) Weeks ago
(3) Months ago
(4) Years ago
(7) Refused
(9) Don't know

[Go to NAF.280]

NAF.270

FR: SHOW CARD CAN24

Was it: (READ CATEGORIES BELOW)

Card CAN24

1. A year ago or less
2. More than 1 year but not more 2 years
3. More than 2 years but not more 3 years
4. More than 3 years but not more 5 years
5. Over 5 years ago

RMAMCA

(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

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1992

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20a. When did you have your (most recent) mammogram?

Month ____ [if 3 years ago or less (21); if more than 3 years ago (24)]
Year 19____ [if 3 years ago or less (21); if more than 3 years ago (24)]
OR

Number ____

1[] Days ago [if 3 years ago or less (21); if more than 3 years ago (24)]
2[] Weeks [if 3 years ago or less (21); if more than 3 years ago (24)]
3[] Months ago [if 3 years ago or less (21); if more than 3 years ago (24)]
4[] Years ago [if 3 years ago or less (21); if more than 3 years ago (24)]

999[] DK (20b)

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1987

Survey form view entire document: text image

c. When did you have your last mammogram?

(If 3 years ago or less (16), If more than 3 years ago (18))

Mo. ____
Year 19_ _

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

999 [] DK

Survey Text