Cancer, Other
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me “Yes,” “No,” or you’re “Not sure.”
(Ever told) you had any other types of cancer?

(EXCLUDES SKIN CANCER)
 
Cancer, Skin
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
(Ever told) you had skin cancer?
 
Cancer Survivorship
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Only one Ask: At what age were you told you had cancer?

More than 1 Ask: At what age was your first diagnosis of cancer?

INTERVIEWER NOTE: This question refers to the first time they were told about their first cancer.
 
Have you ever been told by a doctor that you have cancer?
 
Have you EVER been told by a doctor, nurse, or other health professional that you had cancer?

READ ONLY IF NECESSARY: By "other health professional" we mean a nurse practicioner, a physician's assistant, social worker, or some other licensed professional.
 
How long ago has it been since a doctor or other health professional first told you that you had cancer?
 
How many different types of cancer have you had?
 

Only one Ask: What type of cancer was it?

More than 1 Ask: With your most recent diagnoses of cancer, what type of cancer was it?

INTERVIEWER NOTE: Please read list only if respondent needs prompting for cancer type [1-28].

Breast

  • Breast Cancer

Femal reproductive (Gynecologic)

  • Cervical cancer (cancer of the cervix)
  • Endometrial cancer (cancer of the uterus)
  • Ovarian cancer (cancer of the ovary)

Head/Neck

  • Head and neck cancer
  • Oral cancer
  • Pharyngeal (throat) cancer
  • Thyroid

Gastrointestinal

  • Colon (intestine) cancer
  • Esophageal (esophagus)
  • Liver cancer
  • Pancreatic (pancreas) cancer
  • Rectal (rectum) cancer
  • Stomach

Leukemia/Lymphoma (lymph nodes and bone marrow)

  • Hodgkin's Lymphoma (Hodgkin's disease)
  • Leukemia (blood) cancer
  • Non-Hodgkin's Lymphoma

Male reproductiv

  • Prostate cancer
  • Testicular cancer

Skin

  • Melanoma
  • Other skin cancer

Thoracic

  • Heart
  • Lung

Urinary cancer

  • Bladder cancer
  • Renal (kidney) cancer

Others

  • Bone
  • Brain
  • Neuroblastoma
  • Other
 
Cardiovascular Disease
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
After you left the hospital following your [Fill in (heart attack) if "yes" to Q3a or Q3a and Q3c; fill in (stroke) if "Yes" to Q3c and "No" to Q3a], did you go to any kind of outpatient rehabilitation? This is sometimes called "rehab."
 
At what age did you have your first stroke?
 
At what age did you have your first heart attack?
 
Do you have a health problem or condition that makes taking aspirin unsafe for you?
If "Yes," ask "Is this a stomach condition?" [Code upset stomach as stomach problems]
 
Do you take aspirin daily or every other day?
 
Has a doctor ever told you that you had any of the following?
  • Heart attack or myocardial infarction
  • Angina or coronary heart disease
  • Stroke
  • Heart failure
1997s
 
Has a doctor, nurse or other health professional ever told you that you had any of the following?
... A heart attack, also called a myocardial infarction
2004ofor Has a doctor, nurse or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction , 2005cfor Has a doctor, nurse or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction , 2006cfor Has a doctor, nurse or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction , 2007cfor Has a doctor, nurse or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction , 2008cfor Has a doctor, nurse or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction , 2010cfor Has a doctor, nurse or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction
 
Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me “Yes,” “No,” or you’re “Not sure.”
(Ever told) you that you had a heart attack also called a myocardial infarction?
 
(Has a doctor, nurse or other health professional ever told you that you had any of the following?)
... Angina or coronary heart disease
2004ofor (Has a doctor, nurse or other health professional ever told you that you had any of the following?) Angina or coronary heart disease , 2005cfor (Has a doctor, nurse or other health professional ever told you that you had any of the following?) Angina or coronary heart disease , 2006cfor (Has a doctor, nurse or other health professional ever told you that you had any of the following?) Angina or coronary heart disease , 2007cfor (Has a doctor, nurse or other health professional ever told you that you had any of the following?) Angina or coronary heart disease , 2008cfor (Has a doctor, nurse or other health professional ever told you that you had any of the following?) Angina or coronary heart disease , 2010cfor (Has a doctor, nurse or other health professional ever told you that you had any of the following?) Angina or coronary heart disease
 
Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me “Yes,” “No,” or you’re “Not sure.”
(Ever told) you had angina or coronary heart disease?
 
(Has a doctor, nurse or other health professional ever told you that you had any of the following?)
.... A stroke
 
Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me “Yes,” “No,” or you’re “Not sure.”
(Ever told) you had a stroke?
 
Have you ever had any of the following medical procedures?
  • Heart bypass surgery
  • Angioplasty (balloon surgery)
1997s
 
To lower your risk of developing heart disease or stroke, are you.
a. Eating fewer high fat or high cholesterol foods?
 
(To lower your risk of developing heart disease or stroke, are you.)
b. Eating more fruits and vegetables?
 
(To lower your risk of developing heart disease or stroke, are you.)
c. More physically active?
 
Why do you take aspirin.
a. To relieve pain?
 
(Why do you take aspirin.)
b. To reduce the chance of a heart attack?
 
(Why do you take aspirin.)
c. To reduce the chance of a stroke?
 
Within the past 12 months, has a doctor, nurse, or other health professional told you to.
a. Eat fewer high fat or high cholesterol foods?
 
(Within the past 12 months, has a doctor, nurse, or other health professional told you to.)
b. Eat more fruits and vegetables?
 
(Within the past 12 months, has a doctor, nurse, or other health professional told you to.)
c. Be more physically active?
 
Cardiovascular Health
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
After you left the hospital following your heart attack did you go to any kind of outpatient rehabilitation? This is sometimes called "rehab."
 
After you left the hospital following your stroke did you go to any kind of outpatient rehabilitation? This is sometimes called "rehab."
 
Do you take aspirin daily or every other day?
 
Do you have a health problem or condition that makes taking aspirin unsafe for you?
If "Yes," ask "Is this a stomach condition?" Code upset stomach as stomach problems.
 
Care Giver
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
During the past month, did you provide any such care or assistance to a friend or family member?
 
Care Giving
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
There are situations where people provide regular care or assistance to a family member or friend who is elderly or has a long-term illness or disability. During the past month, did you provide any such care or assistance to a family member or friend who is 60 years of age or older?
 
Who would you call to arrange short or long-term care in the home for an elderly relative or friend who was no longer able to care for themselves?
 
Chickenpox
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
How many of the children ages 0 to 4, living in your household have ever had chickenpox?
1998s
 
The varicella vaccine is a vaccine given to children to prevent chickenpox. How many of the children ages 1 to 4, living in your household have had the varicella vaccine (or chickenpox vaccine)?
1998s
 
Child Immunization Supplement-Flu Vaccination Shortage
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Has a doctor, nurse, or other health professional ever that [Fill: he/she] has any of the following health problems?

Read each problem listed below:
  • Asthma
  • Lung problems, other than asthma
  • Heart problems
  • Diabetes
  • Kidney problems
  • Weakened immune system caused by a chronic illness, such as cancer or HIV/AIDS, or medicines, such as steroids
  • Must take aspirin every day
  • Sickle cell anemia or other anemia
2005o
 
Does [Fill: he/she] still have (this/any of these) problem(s)?
2005o
 
If child is less than 6 months old, go to next module otherwise ask: During the past 12 months, has [Fill: he/she] had a flu shot? A flu shot is a flu vaccine injected in a child's arm or thigh.
2005o
 
During the past 12 months, has [Fill: he/she] had a flu vaccine sprayed in the nose? The flu vaccine that is sprayed in the nose is FluMist™ .
2005o
 
During what month and year did [Fill: he/she] receive the most recent flu vaccination? If "Yes" to both Question 3 and Question 4, also say: "The most recent flu vaccination may have been either the flu shot or the flu spray."
2005o
 
What is the MAIN reason [Fill: he/she] has not received a flu vaccination for this current flu season? [Interviewer note: The current flu season = Sept. '04 - Mar. '05]
2005o
 
If Random Child Selection Question 1 date is 06/2003 to present, go to next module; if Question 5 is 09/2003 to 03/2005 go next module, otherwise continue.: Did [Fill: he/she] get the flu vaccine during the 'last flu season' in other words during the months of September 2003 through March 2005?
2005o
 
Children's Lead Exposure
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Do any of the children under age 5 in your household regularly visit a residence built before 1978?
1998s
 
Do you live in a residence built before 1950?
1998s
 
Does your residence have peeling or chipping paint, or has it undergone any remodeling within the past 6 months?
1998s
 
Has any health care provider ever talked to you about childhood lead poisoning?
1998s
 
Have any of the children in your household ever been tested for lead poisoning?
1998s
 
Were the results of the test normal?
1998s
 
Where was the lead testing done?
1998s
 
Child Selection, Random
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
What is the birth month and year of the “Xth” child?
 
Is the child a boy or a girl?
 
Is the child Hispanic or Latino?
 
Which one or more of the following would you say is the race of the child?
[Check all that apply]
, 2010o for Which one or more of the following would you say is the race of the child? [Check all that apply]
 
Which one of these groups would you say best represents the child's race?
 
How are you related to the child?
 
Child Vehicle Safety
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
During the past 30 days, how often did the [randomly selected child] ride in the back seat?
 
During the past 30 days, how often did the [randomly selected child] use a child safety seat, booster seat, or seat belt when riding in a car, van, sports utility vehicle, or truck?
 
During that time, did the [randomly selected child] use: a child safety seat?
 
(During that time, did the [randomly selected child] use): a booster seat?
 
(During that time, did the [randomly selected child] use): a seat belt only?
 
How often does the [fill in age]-year-old child in your household use a... car safety seat [for child under 5] or seatbelt [for child 5 or older] ...when they ride in a car?
 
How often does the oldest child (of children under age 15) in your household use a... car safety seat [for child under 5] or seatbelt [for child 5 or older] ...when they ride in a car?
1993c, 1994o
 
Next, I have a few questions related to children’s health issues. In general, do you feel a child between 4 and 8 years of age is safer in a seat belt, child safety seat, booster seat, or without a restraining device while riding in a vehicle?
 
Previously, you indicated there were [number from core] children under age 18 in your household. What is the age of the [randomly selected -- oldest, second oldest, etc.] child?
 
What is the gender of this child?
 
Cholesterol Awareness
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
About how long has it been since you last had your blood cholesterol checked?
1993c, 1994c, 1995c, 1997c, 1999cfor About how long has it been since you last had your blood cholesterol checked?, 2001cfor About how long has it been since you last had your blood cholesterol checked?, 2003cfor About how long has it been since you last had your blood cholesterol checked?, 2004ofor About how long has it been since you last had your blood cholesterol checked?, 2005cfor About how long has it been since you last had your blood cholesterol checked?, 2007cfor About how long has it been since you last had your blood cholesterol checked?, 2008sfor About how long has it been since you last had your blood cholesterol checked?, 2009cfor About how long has it been since you last had your blood cholesterol checked?, 2011cfor About how long has it been since you last had your blood cholesterol checked?
 
Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
1993c, 1994c, 1995c, 1997c, 1999cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2001cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2003cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2004ofor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2005cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2007cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2008sfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2009cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?, 2011cfor Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
 
Have you ever been told by a doctor or other health professional that your blood cholesterol is high?
1993c, 1994c, 1995c, 1997c, 1999cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2001cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2003cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2004ofor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2005cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2007cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2008sfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2009cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?, 2011cfor Have you ever been told by a doctor or other health professional that your blood cholesterol is high?
 
Chronic Disease Management
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
If answered "Yes" to any of CDC Section: Chronic Health Conditions questions, then continue. Else, go to next module.

Now I would like to ask you some questions about chronic disease management.

You said that a medical professional has told you that you have or have had [Fill in list of chronic diseases from CDC Section]. During the last 12 months, have you gotten information about how to take care of your [Fill in ‘illness’/’illnesses’]?
 
During the last 12 months, where did you get information about taking care of your [Fill in ‘illness’/’illnesses’]?
[MARK ALL ANSWERS THAT APPLY]
 
Having an illness often means doing different tasks and activities to manage your condition. How confident are you that you can do all the things necessary to manage your [Fill in ‘condition’/’conditions’]on a regular basis?
 
Chronic Health Conditions
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Now I would like to ask you some questions about general health conditions.

Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me "Yes," "No," or you’re "Not sure."

(Ever told) you that you had a heart attack also called a myocardial infarction?
 
(Ever told) you had angina or coronary heart disease?
 
(Ever told) you had a stroke?
 
(Ever told) you had asthma?
 
Do you still have asthma?
 
(Ever told) you had skin cancer?
 
(Ever told) you had any other types of cancer?
 
(Ever told) you have Chronic Obstructive Pulmonary Disease or COPD, emphysema or chronic bronchitis?
 
(Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
 
(Ever told) you have a depressive disorder, including depression, major depression, dysthymia, or minor depression?
 
(Ever told) you have kidney disease? Do NOT include kidney stones, bladder infection or incontinence.
 
Do you have any trouble seeing, even when wearing glasses or contact lenses?
 
(Ever told) you have diabetes?
 
Chronic Joint Symptoms and Possible Arthritis
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
How many months or years ago did those joint symptoms first begin?
 
Were those symptoms present on most days for at least one month?
 
Over the past 7 days, how many days have you had pain, aching, or stiffness from arthritis or joint symptoms?
 
On a scale of 0 to 10 where 0 is no pain or aching and 10 is pain or aching as bad as it could be, over the past 7 days, how bad was your joint pain or aching ON AVERAGE.
 
Tell me which joints are affected?
Note to Interviewer: check all that apply - [Do not read]: list. Notice list of joints below goes from top of body to bottom.
  • Neck
  • Shoulder
  • Elbow
  • Wrist
  • Hand
  • Fingers/thumb
  • Back
  • Hip
  • Knee
  • Ankle
  • Foot
  • Toes
  • Other Joint (specify)
 
Have you taken any prescription or non-prescription medication for these joint symptoms in the past 7 days?
 
Earlier you said you had never seen a doctor about your joint symptoms.
Please tell me why you did not see a doctor about your joint symptoms?
  • not that bad/ not serious/ not important
  • costs too much/ no insurance
  • don't like doctors/ didn't want to go
  • self treatment works
  • just occurred/ going to doctor soon
  • no transportation/ too far
  • other specify _______________
 
Earlier you said you had seen a doctor for your joint symptoms. What did the doctor say was the cause of your joint symptoms?
  • injury/ work-related
  • bursitis/ tendonitis/ tennis elbow/ carpal tunnel
  • bone spurs
  • doctor didn't say/ doctor didn't know
  • cartilage
  • body weight
  • age
  • other specify ________
 
Chronic Pain
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Do you suffer from any type of chronic pain, that is pain that occurs constantly or flares up frequently?
 
Is this pain caused by cancer of any type?
 
How long have you been experiencing this type of pain?
 
About how often do you experience this pain? Would you say...

[Please read]:
  • It is constant, always there
  • At least once a day
  • At least once a week
  • Not ever week, but at least once a month
  • Less often
 
Using a 1 to 10 scale where 1 means no pain at all and 10 means the worst pain imaginable, how severe would you say your pain has been on average over the past three months?
 
Have you ever seen or talked to your doctor about your pain?
 
How satisfied are you with how your doctor is helping you manage your pain?
 
Clinical Trials
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
A clinical trial is a type of research study that involves people to test new methods of screening, prevention, diagnosis, or treatment of a disease. Has your health care provider ever talked to you about participating in a clinical trial?
 
This Question was asked if respondent reported having cancer in previous module.

Have you ever been enrolled in a cancer clinical trial managed by your Kansas health care provider?
 
COPD, Chronic Obstructive Pulmonary Disease
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Did you have to visit an emergency room or be admitted to the hospital in the past 12 months because of your COPD, chronic bronchitis, or emphysema?
 
Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me “Yes,” “No,” or you’re “Not sure.”
(Ever told) you have (COPD) chronic obstructive pulmonary disease, emphysema or chronic bronchitis?
 
Have you ever been given a breathing test to diagnose your COPD, chronic bronchitis, or emphysema?
 
Have you ever been told by a doctor or health professional that you have chronic obstructive pulmonary disease (COPD), emphysema or chronic bronchitis?
 
How many different medications do you currently take each day to help with your COPD, chronic bronchitis, or emphysema?
 
Other than a routine visit, have you had to see a doctor in the past 12 months for symptoms related to shortness of breath, bronchitis, or other COPD, or emphysema flare?
 
Would you say that shortness of breath affects the quality of your life?
 
Colorectal Cancer
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?
1997c, 1999cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2001cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2002cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2004cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2006cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2008cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2010cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?, 2012cfor A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?
 

A digital rectal exam is when a doctor or other health professional inserts a finger in the rectum to check for cancer or other health problems. Have you ever had this exam?

1993c, 1994c, 1995c
 
A sigmoidoscopy or colonoscopy is when a tube is inserted in the rectum to view the bowel for signs of cancer and other health problems. Have you ever had this exam?
 
A sigmoidoscopy or proctoscopy is when a tube is inserted in the rectum to view the bowel for signs of cancer and other health problems. Have you ever had this exam?
1997c
 
A proctoscopic exam is when a tube is inserted in the rectum to check for cancer and other health problems. Have you ever had this exam?
1993c, 1994c, 1995c
 
For a SIGMOIDOSCOPY, a flexible tube is inserted into the rectum to look for problems. A COLONOSCOPY is similar, but uses a longer tube, and you are usually given medication through a needle in your arm to make you sleepy and told to have someone else drive you home after the test. Was your MOST RECENT exam a sigmoidoscopy or a colonoscopy?
2008c for For a SIGMOIDOSCOPY, a flexible tube is inserted into the rectum to look for problems. A COLONOSCOPY is similar, but uses a longer tube, and you are usually given medication through a needle in your arm to make you sleepy and told to have someone else drive you home after the test. Was your MOST RECENT exam a sigmoidoscopy or a colonoscopy? , 2010c for For a SIGMOIDOSCOPY, a flexible tube is inserted into the rectum to look for problems. A COLONOSCOPY is similar, but uses a longer tube, and you are usually given medication through a needle in your arm to make you sleepy and told to have someone else drive you home after the test. Was your MOST RECENT exam a sigmoidoscopy or a colonoscopy? , 2012c for For a SIGMOIDOSCOPY, a flexible tube is inserted into the rectum to look for problems. A COLONOSCOPY is similar, but uses a longer tube, and you are usually given medication through a needle in your arm to make you sleepy and told to have someone else drive you home after the test. Was your MOST RECENT exam a sigmoidoscopy or a colonoscopy?
 
 
How long has it been since you had your last blood stool test using a home kit?
 
How long has it been since you had your last sigmoidoscopy or colonoscopy?
 
I also previously asked you whether or not you have had tests for colorectal cancer. Has a doctor or other health professional ever talked to you about getting tested for colorectal cancer, or cancer of the bowel?
 
Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?
2002c for Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?, 2004c for Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?, 2006c for Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?, 2008c for Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?, 2010c for Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?, 2012c for Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?
 
When did you have your last blood stool test using a home kit?
 
When did you have your last digital rectal exam?
1993c, 1994c, 1995c
 
When did you have your last sigmoidoscopy or colonoscopy?
 
When did you have your last sigmoidoscopy or proctoscopy?
1997c
 
When did you have your last proctoscopis exam?
1993c, 1994c, 1995c
 
Community Involvement
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question

During the past 5 years, have you been active in a coalition or civic group which attempted to address one or more community problems?

 

How long have you lived in the community in which you now live?

 

How would you rate your community as a place to live?

 

(How would you rate your community on its)... Availability of effective leadership for solving community problems?

 

(How would you rate your community on its)... Availability of people in the community with skills to solve community problems?

 

(How would you rate your community on its)... Community decision making shared among community members and among community organizations?

 

(How would you rate your community on its)... Community investment of financial resources in community problem-solving?

 

(How would you rate your community on its)... Cooperation and communication between community organizations, including government, civic organizations, and social agencies?

 

(How would you rate your community on its)... Past history of community success at problem solving?

 

(How would you rate your community on its)... People sharing a sense of belonging to the community?

 

(How would you rate your community on its)... Self-honesty and ability to learn from mistakes?

 

(How would you rate your community on its)... Shared values and vision among community citizens?

 

How would you rate your community on it's... Willingness of citizens to become involved in community issues?