Survey Text

2023 2015 2005 1998
2021 2013 2003
2019 2010 2000
2018 2008 1999
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2023

No questionnaire text is available for this sample.


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2021
Survey form view entire document:  text  image
Question ID: PRV.0370.00.2
Variable: MAMWHEN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:
About how long has it been since your MOST RECENT mammogram?
Response:
1 - Within the past year (anytime less than 12 months ago)
2 - Within the past 2 years (1 year but less than 2 years ago)
3 - Within the past 3 years (2 years but less than 3 years ago)
4 - Within the past 5 years (3 years but less than 5 years ago)
5 - Within the past 10 years (5 years but less than 10 year ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Female Sample Adults 30+ who have had a mammogram
Skip Instructions:
1-6,RF,DK [goto MAMPAY_A]

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2019
Survey form view entire document:  text  image
Question ID: PRV.0370.00.1
Variable: MAMWHEN_S
Interview Module: Adult
Content Type: Rotating Core

Question Text:

About how long has it been since your MOST RECENT mammogram?
Response:
1 Within the past year (anytime less than 12 months ago)
2 Within the past 2 years (1 year but less than 2 years ago)
3 Within the past 3 years (2 years but less than 3 years ago)
4 Within the past 5 years (3 years but less than 5 years ago)
5 Within the past 10 years (5 years but less than 10 year ago)
6 10 years ago or more
7 Refused
9 Do not Know
Universe:
Female Sample Adults 30+ who have had a mammogram
Skip Instructions:
1-6,RF,DK = [goto MAMREASON_A]

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2018
Survey form view entire document:  text  image
Question ID: NAF.275_00.000

Instrument Variable Name: RMAM2
Question Text:
Was it:
*Read answer categories.
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
UniverseText: Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
SkipInstructions:
(1-5,R,D) if answer code is grayed out [goto ERR_RMAM2] else [goto MAMREAS]
Hard Edit:
ERR_RMAM2
*That is not a valid response.
*Please correct.

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2015
Survey form view entire document:  text  image
Question ID: NAF.275_00.000

Instrument Variable Name: RMAM2
Question Text:
Was it:
*Read answer categories.
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
Universe Text: Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
Skip Instructions:
(1-5,R,D) if answer code is grayed out [go to ERR_RMAM2] else [go to MAMPAY]
ERR_RMAM2
Hard Edit:
*That is not a valid response.
*Please correct.

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2013
Survey form view entire document:  text  image
Question ID: NAF.275_00.000

Instrument Variable Name: RMAM2
Question Text:
Was it:
*Read answer categories.
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
UniverseText: Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
SkipInstructions:
(1-5,R,D) if answer code is grayed out [goto ERR_RMAM2] else [goto MAMREAS]
Hard Edit:
ERR_RMAM2
*That is not a valid response.
*Please correct.

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2010
Survey form view entire document:  text  image
Question ID: NAF.275_00.000

Instrument Variable Name: RMAM2
QuestionText:
Was it:
*Read answer categories.
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
UniverseText: Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
SkipInstructions:
(1-5,R,D) if answer code is grayed out [goto ERR_RMAM2]
else [goto MAMREAS]

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2008
Survey form view entire document:  text  image
Question ID:NAF.275_00.000

Instrument Variable Name:RMAM2
QuestionText:
(book) CAN3
Was it:
* Read answer categories.
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
UniverseText:Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
SkipInstructions:
(1-5,R,D) goto MAMREAS

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2005
Survey form view entire document:  text  image
NAF.275_00.000

Instrument Variable Name: RMAM2
Question Text:
(book) CAN14
Was it:
*Read answer categories.
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
Card CAN14
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
Universe Text: Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
Skip Instructions:
(1-5,R,D) [goto MAMWHER]

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2003
Survey form view entire document:  text  image
Question ID:NAF.275_00.000

Instrument Variable Name:RMAM2
QuestionText:
(book) CAN3
Was it:
* Read answer categories.
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
UniverseText:Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
SkipInstructions:
(1-5,R,D) goto MAMREAS

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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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1999
Survey form view entire document:  text  image
Question ID: NAF.275_00.000

Instrument Variable Name: RMAM2
QuestionText:
Was it:
*Read answer categories.
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
UniverseText: Female sample adults 30+ who failed to give a complete date in either the month or year format or failed to give a complete date in the number and time period format, or entered years ago in the time period format (excluding those whose last mammogram was over 5 years ago)
SkipInstructions:
(1-5,R,D) if answer code is grayed out [goto ERR_RMAM2]
else [goto MAMREAS]

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1998
Survey form view entire document:  text  image
PAI.110

FR: SHOW CARD A23.

When did you have your most recent mammogram? Was it a year ago or less, more than 1 year but not more than 2 years, more than 2 years but not more than 3 years, more than 3 years but not more than 5 years, or over 5 years ago?
Card A23
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
RMA
(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