Form 1 #12 Sub-study survey

Pretesting of NCI's Office of Communications Messages

#12_Survey_2008_11_14 Panel Survey NG FINAL

Survey to Assess Public Understanding of Risk Estimates through Visual Displays

OMB: 0925-0046

Document [doc]
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OMB #0925-0046-12

Exp. Date: 1/31/2010



Survey to Assess Public Understanding of Risk Estimates through Visual Displays:

A Web-Based Survey to Communicate Cancer Risk Estimates


National Cancer Institute


PILOT SURVEY OF REACTIONS TO RISK COMMUNICATION MESSAGES


[Invitational/Introductory language]


You are invited to participate in a brief survey. The purpose of the survey is to learn how people understand different kinds of health information. If you qualify, the survey will take approximately 10 minutes to complete. To participate, simply click the link below or copy the URL into your browser: http://www.addsurveylinkhere.


[Once participant has clicked on URL and qualifies for survey]


Thank you for your interest in participating in this survey about health information. Your participation in this survey is completely voluntary. Please be assured that your responses will be kept confidential and will not be disclosed to anyone outside NCI or its contractor, Academy for Educational Development (AED), except as otherwise required by law. Data will be provided to the NCI in aggregate form only, with any potentially identifying information removed. You may skip any questions that you prefer not to answer.















Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN; PRA (0925-0046-12). Do not return the completed form to this address.



Section I: Demographic information


This survey will be asking you about your beliefs and opinions on colon cancer. We have a few questions we need to ask you to find out if you are eligible to participate. Your responses to these question or any that follow will not be identified, disclosed, or released to anyone, or used for any purposes other than this research project.


  1. First, have you ever been diagnosed with colon cancer?

[ ] Yes [terminate]

[ ] No


  1. What is your age? _____ [terminate if under 40]


  1. What is your sex?

[ ] Female

[ ] Male


  1. What is the highest level of education you completed?

  1. less than high school

  2. high school graduate

  3. trade or technical school

  4. some college

  5. college graduate

  6. post-graduate degree


  1. Are you Hispanic or Latino?

[ ] Yes

[ ] No


  1. Which one or more of the following describes your race?

[ ] American Indian or Alaska Native

[ ] Asian

[ ] Black or African American

[ ] Native Hawaiian or other Pacific Islander

[ ] White


  1. Please select the U.S. state or territory where you live.

[Provide a drop down of the 50 U.S. states, DC, and U.S. territories.]




Section II: Informational message


Now we would like you to read through the following information about a new tool to educate people about their risk of colon cancer. Please take as much time as you need to carefully read this information, as we will later be asking your reactions to it.


Scientists at the National Cancer Institute are developing a computer program to calculate a person’s chances of developing colon cancer in his or her lifetime. The program will calculate these chances based on a person’s answers to questions about things that have been found to affect a person’s chances of developing colon cancer. The computer program is simple to use, and can be used at home or anywhere on the Internet.

Section III: Your reactions to colon cancer risk information


In the questions that follow, we will be asking about your reactions to the colon cancer risk program you have just learned about. We’d like you to imagine that you tried out the computer program. Imagine also that the computer program calculated your chances of developing colon cancer in your lifetime, and the results are below.


We would like to know your reactions to receiving this information. Do your best to imagine that your estimate is real. Thinking carefully about how this result would make you feel, please answer the following questions, circling the one number from 1 to 5 that best indicates your response. If you are unsure of your response, just indicate your best guess, as there are no “right” or “wrong” answers to these questions.


Visual A:




Visual B:





Visual C:





Visual D:





Visual E:
















Section I: Risk perceptions


1. How confident are you that you understand what these results mean?

1 2 3 4 5

Not at all confident Very confident



2. How accurate do these results seem to you?

1 2 3 4 5

Not at all accurate Very accurate



3. How much would you trust a computer program like this?

1 2 3 4 5

Not at all Completely



4. Based on these results, how would you describe your chances of developing colon cancer in your lifetime? Would you say your chances of getting colon cancer are:

1 2 3 4 5

Very low Moderate Very high



5. If I received these results, I would tend to believe that my true chances of getting colon cancer are actually…

[ ] A lot lower than 5-13%

[ ] Somewhat lower than 5-13%

[ ] The same as calculated 5-13%

[ ] Somewhat higher than 5-13%

[ ] A lot higher than 5-13%



6. How certain do you feel about the opinions you just offered regarding your chances of developing colon cancer?

1 2 3 4 5

Not at all certain Very certain



7. If you received these results, to what extent would you feel worried about developing colon cancer?

1 2 3 4 5

Not at all worried Very worried






Section II: Attitudes about health information and risk


In the questions that follow, we will be asking you about your attitudes towards health information and risk. Please read each question carefully, and circle the one number from 1 to 5 that best indicates your response.



  1. How interested are you in using a computer program like the one described, to find out your own chances of developing colon cancer in the future?

1 2 3 4 5

Not at all interested Very interested


  1. To what extent do you believe it is possible to know an individual person’s chances of a future health problem like cancer?

1 2 3 4 5

Not at all To a great extent


  1. No matter what the statistics say about a person’s chances of getting cancer, I believe anything can happen.

[Strongly Agree / Somewhat Agree / Somewhat Disagree / Strongly Disagree]


  1. There are so many different recommendations about preventing cancer, it’s hard to know which ones to follow.

[Strongly Agree / Somewhat Agree / Somewhat Disagree / Strongly Disagree]


  1. How would you interpret the meaning of a 9% colon cancer risk estimate?

(Please check all that apply)


    1. Scientists are 9% confident that I will develop colon cancer in my lifetime.

    2. For every 100 persons like me, 9 will develop colon cancer in their lifetime.

    3. For every 100 persons like me, 91 have a greater chance of getting colon cancer than me.

    4. Other (please describe): ______________________________________________

    5. Don’t know / unsure.



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November 14, 2008

File Typeapplication/msword
File TitlePre-interview screening questions
AuthorPaul Han
Last Modified ByVivian Horovitch-Kelley
File Modified2008-11-14
File Created2008-11-14

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