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2003

Survey form view entire document: text image

Question ID:NAF.160_01.000

Instrument Variable Name:RPAP1N
QuestionText:

1 of 2
When did you have your MOST RECENT Pap smear or Pap test?
* Enter number for time since last Pap smear or Pap test.
* Enter '95' for 95 or more.

01-94 1-94
95 95+
97 Refused
99 Don't know

UniverseText:Female sample adults 18+ who selected number and time period format for most recent Pap smear test from the initial month screen
SkipInstructions:

(1-95) goto RPAP1T
(R,D) store "R","D" in RPAP1T and goto RPAP2

Question ID:NAF.160_02.000

Instrument Variable Name:RPAP1T
QuestionText:

2 of 2
* Enter time period for time since most recent Pap smear or Pap test.

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

UniverseText:Female sample adults 18+ who answered 1-95 for number part of this 2 part question
SkipInstructions:

(1-3) goto PAPREAS
(4) if RPAP1N=4
set RPAP2=4
goto PAPREAS
elseif RPAP1N gt 5 and RPAP1N gt AGE
goto ERR_RPAP1T (greater than persons age)
elseif RPAP1N gt 5 and RPAP1N le AGE
set RPAP2=5
goto PAPREAS
elseif RPAP1N=1,2,3,5
goto RPAP2
(R,D) goto RPAP2

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2000

Survey form view entire document: text image

Check item NAFCCI03: Refer to Household Composition, Basic Module.
SEX/HHC.110 and AGE/HHC.120.
(1) Male 18-39 (under 30) (END_NAF)
(2) Male 40+ (Check Item NAFCCI09)
(3) Female (NAF.080)

NAF.150

When did you have your MOST RECENT Pap smear test?

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

Month:

RPAP1_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 (RPAP1_NO)

Year:

RPAP1_YR

(1950-2000) 1950-2000 (NAF.170)
(9997) Don't know (NAF.160)
(9999) Refused (NAF.160)

When did you have your MOST RECENT Pap smear test?

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

[ ] Number

RPAP1_NO

(01-94) 1-94 (RPAP1_TP/NAF.150)
(95) 95+ (RPAP1_TP/NAF.150)
(97) Don't know (NAF.160)
(99) Refused (NAF.160)

[ ] Time Period

RPAP1_TP

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

[Go to NAF.170]

NAF.160

FR: SHOW CARD CAN19

Was it: (READ CATEGORIES BELOW)

Card CAN19

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

RPAPCA

(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

Survey form view entire document: text image

14a. When did you have your most recent Pap smear test?

Month ____ [if 3 years ago or less (15); if more than 3 years ago (16)]
Year 19____ [if 3 years ago or less (15); if more than 3 years ago (16)]
OR

Number ____

1[] Days ago [if 3 years ago or less (15); if more than 3 years ago (16)]
2[] Weeks ago [if 3 years ago or less (15); if more than 3 years ago (16)]
3[] Months ago [if 3 years ago or less (15); if more than 3 years ago (16)]
4[] Years ago [if 3 years ago or less (15); if more than 3 years ago (16)]

999[] DK (14b)

b. Was it within the past year, between 1 and 3 years ago, or over 3 years ago?

1[] Within the past year (15)
2[] 1 to 3 years ago (15)
3[] Over 3 years ago (16)
9[] DK (16)

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1987

Survey form view entire document: text image

c. When did you have your last Pap smear?

If 3 years ago or less (2)
if More than 3 years ago (4)

Mo. ____
Year 19_ _

OR
_____

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

999[] DK (1d)

d. Was it within the past year or a year or more ago?

1 [] Within past year (1a)
2 [] 1 year or more (1f)
9 [] DK (4)

e. Was it less than three months, or 3 or more months ago?

1 [] Less than 3 months
2 [] 3 or more months (2)
9 [] DK

f. Was it 3 years ago or less, between three and 5 years, or 5 or more years ago?

1 [] 3 years or less (2)
2 [] Between 3 and 5 years (4)
3 [] 5 or more years (4)
9 [] DK (4)

Survey Text