Genomics and Family History Survey Questionsdepts.washington.edu/cgph/pdf/Compiled_Genomics... · 2008-07-11 · Genomics and Family History Survey Questions Updated March 2007 Compiled

Genomics and Family History Survey Questions Updated March 2007

Compiled by the University of Washington Center for Genomics & Public Health

This publication is distributed free of charge and supported by CDC Grant #U10/CCU025038-2. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

Compiled genomics survey questionsAt the request of our state partners, a summary document of all genomics and family-history questions used on select state and federal population-based surveys from 1999 to 2008 was compiled for reference. The compiled questions are from the following surveys:

Behavioral Risk Factor Surveillance System (BRFSS)Centers for Disease Control and Prevention HealthStyles’ SurveyNational Health and Nutrition Examination Survey (NHANES)National Health Interview SurveyCalifornia Health Interview SurveyPregnancy Risk Assessment Monitoring System

If we have missed any questions, please contact us and we will include your question(s). Email: [email protected]

How to use this toolSurvey questions are grouped together by type of survey used as well as according to year. They are listed chronologically and by type in the Table of Contents. Click on any one of the titles. The link will take you directly to that survey’s questions.A topic index is found at the end of this compilation for easy reference.

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Why is data from survey questions important? Results from these questions can provide vital information towards quantifying the health impact of family history strategies. This evidence is important to public health practitioners in order to be able to establish policies and best practices for collecting and using family history information. Answers to these questions can be revealing:

If results show a positive family history of a disease, then that translates to a prevalence of disease in populations or specific groups. If results show that people accurately collected family history information from family members, then this translates to how much the public is aware of family history as a risk factor in disease.If results show that a public health provider discussed an inherited risk of disease with them, then this information can be used to track provider practices around collecting family history information.If results show that people perceived themselves to be at high risk of disease, then this means we can better understand patients’ perception of disease risk.If results show that the public has made lifestyle changes to reduce risk, then we can better investigate beliefs about modifiable risk factors and tailor public health promotion programs to respond to those beliefs.

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Introduction

Mailto://[email protected]

Contents

1 Behavioral Risk Factor Surveillance System 2004

Connecticut Departmentof Community Health . . . . . . . . 1


Michigan Department of Community Health (BRFSS 2005) . . . 3

Oregon Department of Community Health (BRFSS 2005) . . . . 4

Utah Department of Community Health (BRFSS 2005) . . . . . 6


Connecticut Department of Community Health (BRFSS 2006) . . 7

Michigan Department of Community Health (BRFSS 2006) . . . 8

Oregon Department of Community Health (BRFSS 2006) . . . 10

Utah Department of Community Health (BRFSS 2006) . . . . 12

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Michigan Department of Community Health (BRFSS 2007) . . 14

Oregon Department of Community Health (BRFSS 2007) . . . 16

Utah Department of Community Health (BRFSS 2007) . . . . 18

Vermont Department of Community Health (BRFSS 2007) . . 19

5 CDC HealthStyles 2000-2008

CDC HEALTHSTYLES (2000) . . . . . . . . . . . . . 20








CDC DOCSTYLES (2006) . . . . . . . . . . . . . . . 32

6 National Health and Nutrition Examination Survey (NHANES)

NHANES III . . . . . . . . . . . . . . . . . . . . . 33

NHANES 99 . . . . . . . . . . . . . . . . . . . . 34

7 National Health Interview Survey (2000)

National Health Interview Survey (2000) . . . . . . . . . 35

8 California Health Interview Survey 2005

California Health Interview Survey (2005) . . . . . . . . . 43

9 Pregnancy Risk Assessment Monitoring System 2005 (Oregon)

Oregon Department of Human Services (2005 PRAMS) . . . 50

10Diabetes, Osteoporosis, Arthritis Behavioral Risk Factor Survey (Michigan) 2005

Michigan Department of Community Health (Diabetes, Osteoporosis, Arthritis Behavioral Risk Factor Survey 2005) . . . . . . . 51

11Youth Risk Behavior Survey (Utah) 2007

Utah Department of Health (2007 YRBS) . . . . . . . . . 53

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1 BehavioralRiskFactorSurveillanceSystem2004

CONNECTICUTDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2004)Topic Disease(s) Questions Alsousedin

Genetic vs. Environmental Causes of Disease

Several For the January to June 2004 EH 2 (no EH3 question) would be asked with the wording “environment”. For the July to December EH 3 would be asked worded “family history or genetics” and no EH 2 question.

It is unclear how much the environment plays a role in most diseases.

EH.2 How likely do you think the environment helps to cause the following health conditions?

Most likely Somewhat likely Not likely Don’t know Ref

a. Asthma 1 2 3 7 9b. Birth defects 1 2 3 7 9

c. Cancer 1 2 3 7 9d. Heart Disease 1 2 3 7 9e. Learning Disabilities 1 2 3 7 9f. Multiple Sclerosis 1 2 3 7 9g. Diabetes 1 2 3 7 9 h. Arthritis 1 2 3 7 9

It is unclear how much family history or genetics plays a role in most diseases.

EH.3 How likely do you think family history or genetics helps to cause the following health conditions?

Most likely Somewhat likely Not likely Don’t know Refa. Asthma 1 2 3 7 9b. Birth defects 1 2 3 7 9

c. Cancer 1 2 3 7 9d. Heart Disease 1 2 3 7 9e. Learning Disabilities 1 2 3 7 9f. Multiple Sclerosis 1 2 3 7 9g. Diabetes 1 2 3 7 9 h. Arthritis 1 2 3 7 9

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MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2004)Topic Disease(s) Questions Alsousedin

Collection of Family History

NA 1.The next questions are about your medical family history. This would include the diseases and health problems of your parents, grandparents, brothers, and sisters. Has a doctor or other health care professional ever asked you to fill out a form or personally asked you about your medical family history?

Yes No (Skip to next section)

Adopted, don’t know family history (Skip to next section)

Don’t Know (Skip to next section)

Refused (Skip to next section)

Oregon Depart-ment of Human Services 2005 BRFSS

Risk Assessment based on Family History

NA 2. Did the doctor or health care professional then discuss with you your risk for certain diseases or health problems based on your family history?

Yes No (Skip to next section)

No need because you had no family history of the illness (skip to next section)

Don’t Know (Skip to next section)

Refused (Skip to next section)

Recommendations based on Family History

NA 3. Did the doctor or health care professional make any recommendations to you based on your family history?

Yes No Don’t Know Refused


NA 4. Did they recommend that you . . .

Change your dietExercise moreStop smokingTake medicationHave routine health tests (for screening) Something else (specify)No other responsesDon’t knowRefused

MINNESOTADEPARTMENTOFHEALTH(BRFSS2004)Topic Disease(s) Questions

Family History of Diabetes

Diabetes To your knowledge, have any of your blood relatives, such as grandparents, parents or their siblings, or your brothers or sisters had diabetes?

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MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2005)Topic Disease(s) Questions Alsousedin


NA 1. Have you ever actively collected health information from your relatives for purposes of developing a family health history?


Utah Depart-ment of Health 2006 BRFSS;HealthStyles 2004

Family History: Impor-tance

NA 2. How important do you think knowledge of your family’s health history is to your personal health?

Very important Somewhat important Not at all important Don’t Know Refused

HealthStyles 2004

Family History of Colon/Rectal Cancer

Colon/Rectal Cancer

3. Next, I’m going to ask several questions about colon or rectal cancer. This is a cancer of the bowel, large intestine, or rectum. Have any of your immediate family members including your parents, brothers and sisters, and your children, ever been told by a doctor that they have colon or rectal cancer?


Family History of Colon/Rectal Cancer

Colon/Rectal Cancer

4. What is their relationship to you? (Interviewer instructions: If respondent has multiple family members with colon or rectal cancer, please code as other and specify. If respondent reports step-parent, half-sibling, step-child with colon or rectal cancer, please code as other and specify.)

Father Mother Brother Sister Son Daughter Other (specify)

Perceived Risk: Colon/ Rectal Cancer

Colon/ Rectal Cancer

5. Do you think your chances are of getting cancer of the colon or rectum in your lifetime?

Very high

High Average Low Very Low

Already has colon or rectal cancer (skip 6A & B)

Already has precan-cerous polyps (skip 6A & B)

Don’t know

Refused

If Q3=YES, ask Q6A, otherwise, ask Q6BLifestyle Changes: Colon/Rectal Cancer

Colon/Rectal Cancer

6A. After your family member was diagnosed with colon or rectal cancer, did you make any lifestyle changes to try and prevent yourself from getting the disease, such as changing your diet, exercising more, stopping smoking, or getting more routine health tests or medical tests?


6B. If you learned that you had a family history of colon or rectal cancer, how likely would you be to make lifestyle changes to try and prevent yourself from getting the disease? Lifestyle changes might include changing your diet, exercising more, stopping smoking, and getting more routine health tests or medical tests. Would you say that you would be:

Very likely to make lifestyle changes

Somewhat likely

Somewhat unlikely

Very unlikely

Neither likely or unlikely

Don’t know Refused

OREGONDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2005)Topic Disease(s) Questions AlsousedinCollection of Family History

NA The next questions ask about diseases or health problems that run in your family.

1. Has a doctor, nurse, or other health care provider ever asked you about your family history of illnesses or health problems? This would include a health care provider asking you to fill out a form or personally asking you about your family history of certain illnesses or health problems.

Yes No (Skip to Question #3) Refused (Skip to Question # 3)

Michigan Dept. of Community Health 2004 BRFSS; Oregon Dept of Human Services 2006 BRFSS

Collection of Family History of Diabetes

Diabetes 2. Has a health care provider ever asked you about your family history of diabetes, specifically?

Yes No Don’t know Not sure Refused

Oregon Dept of Human Services 2006 BRFSS

Risk Assessment: Diabetes Interviewer instructions for questions #3: Ask survey respondents who did not self-report having diabetes (response categories 2, 3,and 4 on the core diabetes prevalence question).

3. Has a doctor, nurse, or other health care provider ever discussed the chance of you getting diabetes?



Recommendations for Reducing Diabetes Risk

Multiple 4. Has a health care provider ever recommended changes in diet or exercise, to reduce your chances of getting diabetes or other illnesses like heart disease, stroke, or cancer?




Diabetes 5. Do you have a parent, brother or sister, or child related by blood who has been diagnosed with diabetes by a health care provider? Do not include female relatives who only had diabetes during pregnancy.(Interviewer instructions: if respondent volunteers that they have half-brothers or half-sisters with a history of diabetes, then code as “yes”.)

Yes No (Skip to Question #9)

No, I am adopted (if respon-dent volunteers without probing about adoption status) (Skip to Question #9)

Don’t know (Skip to Question # 9)

Not sure (Skip to Question # 9)

Refused (Skip to Question # 9)


Stratification of risk: Based on Family History of Diabetes

Diabetes We are interested in what age your relatives were diagnosed with diabetes other than pregnancy-related diabetes.

6. Other than during pregnancy, how many were diagnosed before the age of 20. IF NEEDED: for example, your mother, father, sister, brother, child.

One Two Three More than three None Don’t know/ Not sure Refused

Stratification of risk: Based on Family History of Diabetes

Diabetes 7. Other than during pregnancy, how may were diagnosed between the ages of 20- 44. IF NEEDED: for example, your mother, father, sister, brother, child.


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OREGONDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2005)Topic Disease(s) Questions AlsousedinStratification of risk: Based on Family History of Diabetes

Diabetes 8. Other than during pregnancy, how many were diagnosed at the age of 45 or older. IF NEEDED: for example, your mother, father, sister, brother, child.


Worry: Diabetes Diabetes Interviewer instructions for questions #9-10: Ask survey respondents who did not self-report having diabetes (response categories 2,3,and 4 on the core diabetes prevalence question).

9. How worried are you that you will get diabetes in the future?

Very worried Somewhat worried Slightly worried Not worried at all Don’t know/Not sure Refused


Lifestyle Changes Multiple The next question asks about lifestyle changes you’ve made to prevent disease and improve your health.

10. Have you made changes in your diet or exercise to reduce your chances of getting diabetes or other diseases like heart disease, stroke, or cancer?


Oregon Depart-ment of Human Services 2006 BRFSS

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UTAHDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2005)Topic Disease(s) Questions Alsousedin

Perceived Risk based on Family History

Multiple 1. Do you think that a family history of chronic disease, for example heart disease, stroke, diabetes or cancer increases your risk of developing the disease?

Yes No Don’t know/ Not sure Refused

Family History of Chronic Disease

Multiple 2. Now thinking about your family, including your grandparents, parents, brothers, sisters and children, both living and deceased. To the best of your knowledge, does one or more of the following diseases, such as heart disease, stroke, diabetes, or cancer tend to run in your family?[Interviewer note: Include blood relatives only. Do not include spouse.]

Yes No Adopted (Go to next section) Don’t know Refused

Utah Department of Health 2006 BRFSS

Risk Assessment based on Family History

Not specified The next questions are about your family medical history.

3. Did a doctor or other health care professional ever discuss with you your risk for certain diseases or other health problems based on your family medical history?


Michigan Department of Community Health 2004 BRFSS; Utah Department of Health 2006 BRFSS


Not specified 4. Did the doctor or health care professional make any recommendations to you based on your family medical history?


Michigan Department of Community Health 2004 BRFSS; Utah Department of Health 2006 BRFSS

Time Willing to Complete Family History

Not specified 5. How much time would you be willing to spend to complete a family medical history, either on your own or at your health care provider’s office? We are not asking you to complete a family medical history now, we just want to know how much time you would be willing to spend to complete one. [Interviewer note: If respondent says he/she has already completed a family medical history, ask how then indicate how long they took to complete it.]

DO NOT READ

0 (no time) 1-15 minutes 16-30 minutes

31-60 minutes

1-2 hours more than 2 hours

Don’t know/ Not sure

Refused


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CONNECTICUTDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions Alsousedin

Family History of Heart Disease

CVD 1. To the best of your knowledge, do you have a parent, brother or sister, or child related by blood, who has been diagnosed with heart disease by a health care provider?


Collection of Family History of Heart Disease

CVD 2. Has your doctor, nurse, or other health care provider collected information from you about your family history of heart disease?


Lifestyle Changes Based on Family History

CVD 3. If you learned that you had a family history of heart disease, how likely would you be to make lifestyle changes to try and prevent yourself from getting the disease? Lifestyle changes might include changing your diet, exercising more, stopping smoking, and getting more routine health tests or medical tests.

Would you say that you would be:

Very likely Somewhat likely

Not likely Not sure Don’t know Refused

MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions AlsousedinDirect-to-Consumer Marketing of Genetic Tests

NA 1. Some companies are advertising new ways to improve your health by testing a sample from the inside of your cheek. This sample is mailed directly to the company without involving a doctor, nurse, or other health care professional. A few weeks later, the company provides you with a personal health profile and lifestyle recommendations based on their findings. In the past 12 months, have you heard or seen anything about this type of test?

Yes No (go to next section) Don’t know/ Not sure (go to next section) Refused (go to next session)

Interviewer note: If the respondent mentions their doctor and tests that their doctor has done, please remind the respondent that these tests occur without the involvement of a doctor, nurse, or other healthcare professional.

Direct-to-Consumer Marketing of Genetic Tests

NA 2. Where did you hear or see something about this type of test?(Record response verbatim)


NA 3. In the past 12 months, have you or anyone you know obtained this type of test?


Family History of Breast Cancer

Breast Cancer 4. The next few questions are about your family history of breast cancer. Have any of your biological family members ever been diagnosed with breast cancer?

Yes No (skip to Q6) Don’t know—adopted (Skip to Q6)

Don’t know/ Not sure (Skip to Q6)

Refused (Skip to Q6)

Family History of Breast Cancer

Breast Cancer 5. How many of your biological children, parents, brothers, or sisters were diagnosed with breast cancer? For brothers and sisters, please only include those that share your same mother and father?Help Screen: In 2004, there was an estimated one new male breast cancer diagnosis for every 100,000 men in the US.

NOTE: Information about grandparents, aunts, uncles, nieces, and nephews will all be asked for in question 4. Do not include in question 2.

NOTE: Do not include any cousins, great grandparents, half sisters, half brothers, or step relatives in either question 2 or 4.

___ Number of biological relatives

None (Skip to Q4) Don’t know/not sure (Skip to Q4)


Stratification of Risk: Based on Family History of Breast Cancer

Breast Cancer 6. And how many of them were diagnosed before the age of 50?

___ Number of biological relatives None Don’t know/not sure Refused

If the respondent is not sure whether a specific relative was diagnosed before age 50, do not include them in the count.If Q3>0 or Q2>1, skip to Q6.


MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions AlsousedinStratification of Risk: Based on Family History of Breast Cancer

Breast Cancer 7. How many of your grandparents, aunts, uncles, nieces, or nephews were diagnosed with breast cancer?

Help Screen: In 2004, there was an estimated one new male breast cancer diagnosis for every 100,000 men in the US.

NOTE: Do not include any cousins, great grandparents, half sisters, half brothers, or step relatives in either question 2 or question 4.

___ Number of biological relatives None (Skip to Q6) Don’t know/not sure (Skip to Q6)


Stratification of Risk: Based on Family History of Breast Cancer

Breast Cancer 8. And how many of them were diagnosed before the age of 50?

___ Number of biological relatives None Don’t know/not sure Refused

If the respondent is not sure whether a specific relative was diagnosed before age 50, do not include them in the count.Breast Cancer Diagnosis

Breast Cancer 9. Have you ever been diagnosed with breast cancer?


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OREGONDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions AlsousedinPerceived Risk: Diabetes

Diabetes Interviewer instructions for questions #1-2: Ask survey respondents who did not self-report having diabetes (response categories 2,3,and 4 on the core diabetes prevalence question).

1. How likely do you think it is that you will get diabetes in the future? (2-4)

Very likely Somewhat likely

Slightly likely Not likely Not sure/Don’t know

Refused

Worry: Diabetes Diabetes 2. How worried are you that you will get diabetes in the future?

Very worried Somewhat worried

Slightly worried

Not worried at all

Not sure/Don’t know

Refused

Oregon Department of Human Services 2005 BRFSS


Not specified The next questions ask about illnesses or health problems that run in your family.


Yes No (Skip to Question #5) Don’t know/ Not sure (skip to Question # 5)

Refused (skip to Question # 5)



Diabetes 4. Has a health care provider ever asked you about your family history of diabetes, specifically? This would include a health care provider asking you to fill out a form or personally asking you about your family history of diabetes.



Risk Assess-ment: Diabetes

Diabetes Interviewer instructions for questions #5, 6, 7: Ask survey respondents who did not self-report having diabetes (response categories 2, 3,and 4 on the core diabetes prevalence question).

5. Has a doctor, nurse, or other health care provider ever discussed the chance of you getting diabetes?



Screening by Health Care Providers

Diabetes 6. Glucose or sugar is a substance found in your blood. Have you ever had your blood glucose or sugar tested by a health care provider to see if you have diabetes?

Yes Yes, but female only checked during pregnancy

No (Skip to #8) Not sure/Don’t know (Skip to #8)

Refused (Skip to #8)

Screening by Health Care Providers

Diabetes 7. When was the last time your blood glucose or sugar level was measured by a health care provider?

Within the past year (1 to 12 months ago)

Within the past 3 years (1 to 3 years ago)

Over three years ago

Not sure/Don’t know

Refused

OREGONDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions AlsousedinRecommen-dations for Reducing Diabetes Risk

Multiple 8. Has a health care provider ever recommended making changes in your eating habits or physical activity to reduce your chances of getting diabetes or other illnesses like heart disease, stroke, or cancer?



Family History of Diabetes Prevalence

Diabetes 9. Thinking of your close relatives, do you have a parent, brother or sister, or child related by blood who has been diagnosed with diabetes by a health care provider? Do not include female relatives who only had diabetes during pregnancy.(Interviewer instructions: if respondent volunteers that they have half-brothers or half-sisters with a history of diabetes, then code as “yes”.)

Yes No (Skip to Question #9)

No, I am adopted (if respondent volunteers without probing about adoption status) (Skip to Question #9)

Don’t know/ Not sure (Skip to Question # 9)

Refused (Skip to Question # 9)


Lifestyle Changes

Multiple The next question asks about lifestyle changes you’ve made to prevent disease and improve your health.

10. Have you made changes in your diet or exercise to reduce your chances of getting diabetes or other diseases like heart disease, stroke, or cancer?



Genetics Knowledge

Diabetes The next questions ask you about your opinion about medical information and health conditions.

11. Do you think that most cases of diabetes are caused by?·

Genes or DNA (Interview instructions: If respondent doesn’t know what “genes or DNA” are read: for example, health traits that are passed down from parents to children.)·Lifestyle (Interviewer instructions: If respondent doesn’t know what “lifestyle” is, read: for example, habits like exercising, eating or smoking)·Combination of genes and lifestyle·None of the aboveDon’t know/ Not sure (Interviewer instructions: Read this option out loud)·Refused


12. Some companies are offering genetic tests of your DNA that are advertised to improve your health and prevent disease. You can order these tests directly, without the involvement of a healthcare provider. Have you ever heard about these tests?

Yes No (skip to next section) Don’t know/ Not sure (skip to next section)

Refused (skip to next section)



13. Have you ever used any of these tests?



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UTAHDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions AlsousedinFamily History of Chronic Disease

Multiple 1. Now think about your immediate family including your grandparents, parents, brothers, sisters and children, both living and deceased. To the best of your knowledge, does one or more chronic disease, such as heart disease, stroke, diabetes, or cancer tend to run in your family? (Interviewer Note: Includes blood relatives only. Does not include spouse.)

Yes No Adopted (Skip to Question 7) Don’t know/ Not sure Refused

Utah Department of Health BRFSS 2005

Family History of Asthma

Asthma 2. Have any of your immediate family members ever been told by a doctor, nurse, or other health professional that they had asthma?(Interviewer Note: Immediate family members include grandparents, parents, brothers, sisters and children, both living and deceased. Only blood relatives.)


Risk Assess-ment based on Family History

Chronic Disease

3. The next questions are about your family medical history. Has a doctor or other health care professional ever discussed with you your risk for certain diseases or other health problems based on your family medical history?


Utah Department of Health 2005 BRFSS; Michigan Department of Community Health 2004 BRFSS

Recommenda-tions based on Family History

Chronic Disease

4. Has a doctor or other health care professional ever made any recommendations to you based on your family medical history?


Utah Department of Health 2005 BRFS; Michigan Department of Community Health 2004 BRFSS

Family History: Importance

5. In the past year, have you read or heard about the importance of knowing your family’s health history?


Collection of Family History from Relatives

NA 6. Have you ever actively collected health information from your relatives for the purpose of developing a family health history?

Yes No (skip to Question 7) Don’t know/ Not sure (skip to Question 7)

Refused (skip to Question 7)

Michigan Department of Community Health 2005 BRFSS: 2004 Healthstyles

Sharing of Family History with Health Care Providers

NA 7. Have you shared the information you collected on your family’s health history with a doctor, nurse, or other health care professional?

Yes (Skip to Question 7

No Don’t know/ Not sure (skip to Question 7)

Refused (skip to Question 7)

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UTAHDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2006)Topic Disease(s) Questions AlsousedinSharing of Family History with Health Care Providers

8. Why have you not shared your family’s health history with a medical professional?

Mark all that apply. Do not read:

Do not have a family historyIt’s not importantConfidential, not to be shared outside the familyNot yet, but I plan to in the futureWorried it may affectmyjobWorried it may affect my abilitytogethealthinsuranceWorried itmay affect my abilitytogetlifeinsuranceOther (write in)Don’t know/Not sureRefused


9. Some companies are offering genetic tests of your DNA that are advertised to improve your health and prevent disease. You can order these tests directly, without the involvement of a healthcare provider. Have you heard about these tests?




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MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2007)Topic Disease(s) Questions AlsousedinFamily History Sudden

Cardiac Death

1. Next, I’m going to ask about sudden cardiac death, or sudden unexplained death. This occurs when a young, appar-ently healthy person dies suddenly from a cardiac arrest or from an unknown cause.How many of your biological family members have had a sudden cardiac death, or sudden unexplained death, between the ages of 1 and 39?

NOTES: Do not include spouses or infants less than one year.

Do not include drug-related deaths, traumatic deaths (such as car crashes), suicides, homicides, or individuals who had a long illness (cardiac or otherwise).

Do include allbiological family members (parents, siblings, half-siblings, children, aunts, uncles, cousins, grandparents, grandchildren, great grandparents, great grandchildren, great aunts and uncles, etc.)

_ _ Record number of sudden cardiac deaths

88 None GotoQ34.177 Don’t know GotoQ34.199 Refused GotoQ34.1

Verification: If response to Q33.1 > 2, verify with “You’ve just indicated that you have [insert response] biological family members who have had a sudden cardiac death, or sudden unexplained death, between the ages of 1 and 39. Is this correct?”

MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2007)Topic Disease(s) Questions AlsousedinFamily History of Sudden Cardiac Death

Sudden Cardiac Death

2. What was their relationship to you?

NOTE: If respondent reports multiple family members, please code as other and specify. If respondent reports “spouse,” go back and recode Q 1=2.

1 Mother or father2 Brother or sister3 Half-brother or -sister4 Son or daughter5 Aunt or uncle6 Cousin7 Grandparent8 Grandchild9 Great grandparent10 Great grandchild11 Great uncle or aunt12 Other (specify)77 Don’t know99 Refused


OREGONDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2007)Topic Disease(s) Questions AlsousedinPerceived Risk: Heart Disease/Stroke

Heart Disease

Interviewer instructions for questions #1: Ask survey respondents who did not self-report having heart disease or stroke. (If response categories are 1 for any of the core cardiovascular disease prevalence question, skip this question.)

1. How likely do you think it is that you will get heart disease or stroke in the future? By “heart disease” we mean heart attack, coronary heart disease, angina, or decreased blood flow to the heart. (2-4)

Very likely Somewhat likely Not very likely Not at all likely Don’t know/ Not sure Refused


Not Specified The next questions ask about illnesses or health problems that run in your family.


Yes No (skip to Question #4) Don’t know/ Not sure (skip to Question #4)

Refused (skip to Question #4)

Oregon Department of Human Services 2005 BRFSS; Oregon Department of Human Services 2006 BRFSS


Heart Disease/Stroke

3. Has a health care provider ever asked you about your family history of heart disease or stroke, specifically? This would include a health care provider asking you to fill out a form or personally asking you about your family history of heart disease. If needed: By “heart disease” we mean heart attack, angina, coronary heart disease, or decreased blood flow to the heart.


Risk Assess-ment: Heart Disease/Stroke


Interviewer instructions for questions #4: Ask survey respondents who did not self-report having heart disease or stroke. (If response categories are 1 for any of the core cardiovascular disease prevalence questions, skip this question.)

4. Has a doctor, nurse, or other health care provider ever discussed the chance of you getting heartdiseaseorstroke? If needed: By “heart disease” we mean heart attack, coronary heart disease, angina, or decreased blood flow to the heart.


Recommen-dations for Reducing Heart Disease/Stroke Risk

Multiple 5. Has a health care provider ever recommended making changes in your eating habits or physical activity to reduce your chances of getting diseases like heart disease or stroke?



OREGONDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2007)Topic Disease(s) Questions AlsousedinFamily History of Heart Disease/Stroke Prevalence


6. Thinking of your close blood relatives, do you have a parent, brother, sister, or child who has been diagnosed with heart disease or stroke by a health care provider? If needed: By “heart disease” we mean heart attack, coronary heart disease, angina, or decreased blood flow to the heart.

If respondent volunteers that they have half-brothers or half-sisters with a history of heart disease, then code 1, Yes.

Yes No No, I am adopted(IF RESPONDENT VOLUNTEERS)

Don’t know/ Not sure Refused

Lifestyle Changes


Interviewer instructions for questions #7: Ask survey respondents who did not self-report having heart disease or stroke. (If response categories are 1 for any of the core cardiovascular disease prevalence questions, skip this question.)

The next question asks about lifestyle changes you’ve made to prevent disease and improve your health.

7. Have you made changes in your eating habits or physical activity to reduce your chances of getting diseases like heart disease or stroke?



13. Some companies are offering genetic tests of your DNA that are advertised to improve your health and prevent disease. You can order these tests directly, without the involvement of a healthcare provider.

Have you ever heard about these tests?



Utah Department of Health 2006 BRFSS; Oregon Department of Human Services 2006 BRFSS


13. Have you ever used any of these tests?





UTAHDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2007)Topic Disease(s) Questions AlsousedinFamily History of Chronic Disease

Multiple 1. Now think about your immediate family including your grandparents, parents, brothers, sisters and children, both living and deceased. To the best of your knowledge, does one or more chronic disease, such as heart disease, stroke, diabetes, or cancer tend to run in your family?

(Interviewer Note: Includes blood relatives only. Does not include spouse.)

Yes No No, adopted (Skip to Question 7)

Don’t know/ Not sure Refused

Utah Department of Health BRFSS 2005; Utah Department of Health BRFSS 2006


Diabetes 2. Have any of your immediate family members ever been told by a doctor, nurse, or other health professional that they had diabetes? Do not include a female relative who only had diabetes during pregnancy.

(Interviewer Note: Immediate family members include grandparents, parents, brothers, sisters and children, both living and deceased. Only blood relatives.)






Collection of Family History from Relatives

NA 4. Have you ever actively collected health information from your relatives for the purpose of developing a family health history?

Yes No (Skip to Question 7) Don’t know/ Not sure (Skip to Question 7)

Refused (Skip to Question 7)

Michigan Department of Community Health 2005 BRFSS; 2004 Healthstyles; Utah Department of Health 2006 BRFSS


NA 5. Have you shared the information you collected on your family’s health history with a doctor, nurse, or other health care professional?

Yes (Skip to Question 7

No Don’t know/ Not sure(Skip to Question 7)

Refused (Skip to Question 7)



6. Why have you not shared your family’s health history with a medical professional? Mark all that apply. Do not read:

Do not have a family history

It’s not important Confidential, not to be shared outside the family

Not yet, but I plan to in the future

Worried it may affectmyjob

Worried it may affect my ability to gethealthinsurance

Worried it may affect my ability togetlifeinsurance

Other (write in) Don’t know/Not sure

Refused



7. Some companies are offering genetic tests of your DNA that are advertised to improve your health and prevent disease. You can order these tests directly, without the involvement of a healthcare provider. Have you heard about these tests?


Oregon Department of Human Services 2006 BRFSS; Utah Department of Health 2006 BRFSS


VERMONTDEPARTMENTOFCOMMUNITYHEALTH(BRFSS2007)Topic Disease(s) Questions AlsousedinFamily History of Colon/Rectal Cancer

Colorectal Cancer

1. Has a doctor or other health care professional ever given you or any member of your immediate family a diagnosis of colon or rectal cancer?

(To interviewer: immediate family members of interest are “blood relatives” and include parents, siblings, and children. Do not include spouse/partner. Colon or rectal cancer refers to a cancer of the bowel, large intestine, or rectum)

(pick best answer based on response, probe only if necessary)

1 just a family member2 just respondent3 both4 no, no one7 don’t know9 refused


�0 |

5 CDChealthStyles2000-2008

CDCHEALTHSTYLES(2000)Topic Disease(s) Questions AlsousedinGenes & Infection

NA 1. A person’s genes can make them more likely to get infections such as the flu.

1 is Strongly Disagree 5 is Strongly Agree

Gene vs. Behavior vs. Environment

NA 1. A person’s health is determined more by their genes than by their behavior or their environment.


Genes & Side Effects from Medicine

NA 5. A person’s genes can make them more likely to have side effects from drugs and medications.


Genes & Susceptibility

Diseases caused by smoking

6. A person’s genes can make them more likely to develop diseases caused by cigarette smoking.


Genes & Susceptibility

Diseases caused by environ-mental exposures such as pesticides

7. A person’s genes can make them more likely to develop illness from environmental exposures such as pesticides.


Genes & health NA 8. Discoveries about human genes will lead to better health.


CDCHEALTHSTYLES(2001)Topic Disease(s) Questions AlsousedinFamily History of Asthma & Heart Disease (Mother)

Asthma, CVD

1. Has your biological mother ever had any of the following conditions? (“X” all that apply)

Asthma : Yes No Not sure

Heart Disease: Yes No Not sure

Family History of Asthma & Heart Disease (Father)

Asthma, CVD

2. Has your biological father ever had any of the following conditions (“X” all that apply)

Asthma : Yes No Not sure

Heart Disease: Yes No Not sure

Family History of Asthma & Heart Disease (Brothers)

Asthma, CVD

3. Have any of your biological brothers ever had any of the following conditions (“X” all that apply)

Asthma : Yes No Not sure No brothers

Heart Disease: Yes No Not sure No brothers

Family History of Asthma & Heart Disease (Sisters)

Asthma, CVD

4. Have any of your biological sisters ever had any of the following conditions (“X” all that apply)

Asthma : Yes No Not sure No sisters

Heart Disease: Yes No Not sure No sisters

CDChealthStyles2000-2008 | ��

CDCHEALTHSTYLES(2002)Topic Disease(s) Questions AlsousedinFamily History: Importance

NA 1. It is important for my own health to know the history of diseases that run in my family (like cancer, diabetes, or heart disease)


Concern due to Family History

NA 2. I am concerned about my own health because one of my immediate blood relatives (parents, siblings, or children) has had cancer, diabetes, or heart disease.


Disease Risk due to Family History

NA 3. Has your doctor every told you that you have an increased risk for a disease (like cancer, diabetes, or heart disease) because it runs in your family?

Yes No Not sure Not Applicable

Diet Change due to Family History

NA 4. Have you changed your diet to help reduce your risk of a disease that runs in your family (like cancer, diabetes, or heart disease)?


Exercise Change due to Family History

NA 5. Have you changed your exercise habits to help reduce your risk of a disease that runs in your family (like cancer, diabetes, or heart disease)?


�� | CDChealthStyles2000-2008

CDCHEALTHSTYLES(2003)Topic Disease(s) Questions AlsousedinCoronary Heart Disease: Self

CHD 1. Have you ever been diagnosed by your doctor as having coronary heart disease (e.g., myocardial infarction, coronary bypass graft surgery or angioplasty)?

Yes, at or before age 60 Yes, after age 60 No Don’t Know

Coronary Heart Disease: Mother

CHD 2. Has your mother ever been diagnosed as having coronary heart disease?


Coronary Heart Disease: Father

CHD 3. Has your father ever been diagnosed as having coronary heart disease?


Stroke/TIA: Self

Stroke/TIA 4. Have you ever been diagnosed by your doctor as having a stroke/TIA (mini stroke)?


HealthStyles 2005

Stroke/TIA: Mother

Stroke/TIA 5. Has your mother ever been diagnosed as having a stroke/TIA (mini stroke)?


HealthStyles 2005

Stroke/TIA: Father

Stroke/TIA 6. Has your father ever been diagnosed as having a stroke/TIA (mini stroke)?


HealthStyles 2005

CHD: Siblings (<60 yrs)

Stroke/TIA 7. How many of your brothers and sisters have been diagnosed with coronary heart disease at or before age 60?

None One Two or more Don’t Know

CHD: Siblings (>60 yrs)

CHD 8. How many of your brothers and sisters have been diagnosed with coronary heart disease after age 60?

None Don’t Know

CHD: Maternal Side (<60 yrs)

CHD 9. How many of your mother’s relatives (her sisters, brothers and parents) were diagnosed with coronary heart disease at or before age 60?


CHD: Maternal Side (>60 yrs)

CHD 10. How many of your mother’s relatives (her sisters, brothers and parents) were diagnosed with coronary heart disease after age 60?


CHD: Paternal Side (<60 yrs)

CHD 11. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with coronary heart disease at or before age 60?



CDCHEALTHSTYLES(2003)Topic Disease(s) Questions AlsousedinCHD: Paternal Side (>60 yrs)

CHD 12. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with coronary heart disease after age 60?


Stoke/TIA: Siblings (<60 yrs)

Stroke/TIA 13. How many of your brothers and sisters have been diagnosed with stroke/TIA (mini stroke) at or before age 60?


HealthStyles 2005 (responses different)

Stroke/TIA: Siblings (>60 yrs)

Stroke/TIA 14. How many of your brothers and sisters have been diagnosed with stroke/TIA (mini stroke) after age 60?



Stroke/TIA: Maternal Side (<60 yrs)

Stoke/TIA 15. How many of your mother’s relatives (her sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) at or before age 60?



Stroke/TIA: Maternal Side (>60 yrs)

Stroke/TIA 16. How many of your mother’s relatives (her sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) after age 60?



Stroke/TIA: Paternal Side (<60 yrs)

Stroke/TIA 17. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) at or before age 60?



Stroke/TIA: Paternal Side (>60 yrs)

Stroke/TIA 18. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) after age 60?




CDCHEALTHSTYLES(2004)Topic Disease(s) Questions AlsousedinRisk Assess-ment Based on Family History

Diabetes 1. Has your doctor ever told you that you have a greater chance of getting diabetes because it runs in your family?


Lifestyle Changes to Reduce Risk of Diabetes

Diabetes 2. Have you made any lifestyle changes, like diet or exercise, to reduce your chances of getting diabetes?


Type 2 Diabetes: Self

Diabetes 3. Have you ever been diagnosed by your doctor as having type 2 diabetes?


Type 2 Diabetes: Mother

Diabetes 3. Has your mother ever been diagnosed as having type 2 diabetes?


Type 2 Diabetes: Father

Diabetes 4. Has your father ever been diagnosed as having type 2 diabetes?



NA 5. Have you ever actively collected health information from your relatives for purposes of developing a family health history?


Michigan Depart-ment of Community Health 2005 BRFSS; Utah Department of Health 2006 BRFSS; Healthstyles 2005

Type 2 Diabetes: Siblings

Diabetes 6. How many of your brothers and sisters have been diagnosed with type 2 diabetes?

None One Two Three More than Three Don’t Know

Type 2 Diabetes: Maternal Side

Diabetes 7. How many of your mother’s relatives (her sisters, brothers, and parents) were diagnosed with type 2 diabetes?


Type 2 Diabetes: Paternal Side

Diabetes 8. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with type 2 diabetes?



9. How important do you think knowledge of your family’s health history is to your personal health?

Very Important Somewhat Important Not at All Important Not Sure

Michigan Department of Community Health 2005 BRFSS


CDCHEALTHSTYLES(2005)Topic Disease(s) Questions AlsousedinStroke/TIA: Self

CHD 1. Have you ever been diagnosed by your doctor as having a stroke/TIA (mini stroke)?


HealthStyles 2003

Stroke/TIA: Mother

Stroke/TIA 2. Has your mother ever been diagnosed as having a stroke/TIA (mini stroke)?


HealthStyles 2003

Stroke/TIA: Father

Stroke/TIA 3. Has your father ever been diagnoses as having a stroke/TIA (mini stroke)?


HealthStyles 2003

Stoke/TIA: Siblings (<60 yrs)

Stroke/TIA 4. How many of your brothers and sisters have been diagnosed with stroke/TIA (mini stroke) at or before age 60?

None One Two Three More than 3 Don’t Know


Stroke/TIA: Siblings (>60 yrs)

Stroke/TIA 5. How many of your brothers and sisters have been diagnosed with stroke/TIA (mini stroke) after age 60?



Stroke/TIA: Maternal Side (<60 yrs)

Stoke/TIA 6. How many of your mother’s relatives (her sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) at or before age 60?



Stroke/TIA: Maternal Side (>60 yrs)

Stroke/TIA 7. How many of your mother’s relatives (her sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) after age 60?



Stroke/TIA: Paternal Side (<60 yrs)

Stroke/TIA 8. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) at or before age 60?



Stroke/TIA: Paternal Side (>60 yrs)

Stroke/TIA 9. How many of your father’s relatives (his sisters, brothers and parents) were diagnosed with stroke/TIA (mini stroke) after age 60?




CDCHEALTHSTYLES(2005)Topic Disease(s) Questions AlsousedinFamily History: Importance


No Not Sure Yes →

If YES, from which of the following sources did you read or hear anything about the importance of knowing your family history? (“X” all that apply)

Newspaper Television Radio Magazine Internet Health Profes-sional

Friend Family Member

Other

Collection of Family History Information

11. Have you ever actively collected health information from your relatives for the purposes of developing a family history?

No Not Sure Not Applicable Yes →

If YES, have you shared the family health information you collected with a health professional?

No Yes Not yet, but I plan to in the future

Michigan Depart-ment of Community Health 2005 BRFSS; Utah Department of Health 2006 BRFSS; HealthStyles 2004


CDCHEALTHSTYLES(2006)Topic Disease(s) Questions AlsousedinKnowledge/Awareness of Genetic Testing

1. Genetic tests generally examine DNA in your blood or other tissues and are used for many purposes. Which of the following types of genetic testing have you heard or read about?

(“X” all that apply)

DNA, diet, and lifestyle assessment to manage potential health risksGenetic screening in pregnancyDiagnosis of a genetic diseaseTesting to predict the likelihood you will develop a disease in the futureScreening newborn babiesCarrier testing for a genetic diseaseGenetic testing to prescribe the correct medication or adjust the dose of medication

Knowledge/Awareness of Genetic Testing

2. Genetic tests generally examine DNA in your blood or other tissues and are used for many purposes. Have you ever had any of the following genetic tests?

(“X” all that apply)

DNA, diet, and lifestyle assessment to manage potential health risksGenetic screening in pregnancyDiagnosis of a genetic diseaseTesting to predict the likelihood you will develop a disease in the futureScreening newborn babiesCarrier testing for a genetic diseaseGenetic testing to prescribe the correct medication or adjust the dose of medication

Family History of Disease

3. Have any of your first degree relatives (father, mother, brother, sister, children) ever been told they have any of the following diseases? (“X” all that apply)

Heart Disease Diabetes (not related to pregnancy)

Stroke Breast Cancer Ovarian Cancer Colorectal Cancer


CDCHEALTHSTYLES(2006)Topic Disease(s) Questions AlsousedinDirect-to-Consumer Marketing of Genetic Tests

4. Genetic tests that analyze your DNA, diet, and lifestyle for potential health risks are currently being marketed by companies directly to consumers. Have you heard or read about these genetic tests?

Yes → Ask question below No → Stop

4A. From which of the following sources did you read or hear anything about genetic tests that analyze your DNA, diet, and lifestyle for potential health risks? (“X” all that apply)

Newspaper Television Radio Magazine Internet Health Professional

Friend Family Member

Other Not Sure

4B. Have you ever had a genetic test that analyzes your DNA, diet, and lifestyle for potential health risks?

No Yes, I ordered the test directly from the company, but I discussed the results with my health care provider

Yes, I ordered the test directly from the company and did not discuss the results with my health care provider

Docstyles 2006


CDCHEALTHSTYLES(2008)Topic Disease(s) Questions AlsousedinDirect-to-Consumer Marketing of Genetic Tests

1. Genetic tests that scan a person’s entire genetic makeup for potential health risks are currently being marketed directly to consumers by several different companies (e.g., 23andme, deCODEme, Navigenics). Have you heard or read about these genetic tests?(“X” ONE)

Yes → (Answer questions in the box below) No → (Go to Question 4)Don’t know/Not sure → (Go to Question 4)


2. From which of the following sources did you hear or read anything about genetic tests that scan a person’s entire genetic makeup for potential health risks that are marketed directly to consumers (e.g., from companies such as 23andme, deCODEme, Navigenics)? (“X” ALL THAT APPLY)

Newspaper Health professional FriendMagazine Internet OtherTV or radio Family member Don’t know


3. Have you ever had a genetic test that scanned your entire genetic makeup for potential health risks from a direct-to-consumer company (e.g., 23andme, deCODEme, Navigenics)? (“X” ONE)

NoYes, I ordered the test directly from the company, but I discussed the results with my health care providerYes, I ordered the test directly from the company, and I did not discuss the results with my health care provider

�0 | CDChealthStyles2000-2008


CDCDOCSTYLES(2006)Topic Disease(s) Questions AlsousedinDirect-to-Consumer Marketing of Genetic Tests

1. Genetic tests that analyze a persons DNA, diet, and lifestyle for potential health risks are currently being marketed by companies directly to consumers. Have you heard or read about these genetic tests?

Yes → Go to next question No → Skip 1 question

HealthStyles 2006


2. From which of the following sources did you read or hear anything about genetic tests that analyze a person’s DNA, diet, and lifestyle for potential health risks?

Select all that apply.

News-paper

Television Radio Magazine Internet Professional Organization

Scientific Meeting

Journal Article

Patients Not Sure


3. Genetic tests that analyze your DNA, diet, and lifestyle for potential health risks are currently being marketed by companies directly to consumers. Over the past year, what proportion of your patients has asked questions about having this type of genetic test?

None<1%1-10%11-30%31-50%>50%


4. Genetic tests that analyze your DNA, diet, and lifestyle for potential health risks are currently being marketed by companies directly to consumers. Over the past year, what proportion of your patients brought results from this type of genetic testing to you for discussion?

None<1%1-10%11-30%31-50%>50%


| ��

6 NationalhealthandNutritionExaminationSurvey(NhANES)

NHANESIIITopic Disease(s) Questions AlsousedinFamily History of Disease

Multiple Doctor told relatives they had diabetes?Any relatives had heart attack before age 50?Did grandmother have diabetes?Did grandfather have diabetes?Did mother have diabetes?Did father have diabetes?eDid sister have diabetes?Did brother have diabetes?Did uncle have diabetes?Did aunt have diabetes?Did cousin have diabetes?Did son have diabetes?Did daughter have diabetes?Did other relative have diabetes?

Did grandmother have heart attack?Did grandfather have heart attack?Did mother have heart attack?Did father have heart attack?Did sister have heart attack?Did brother have heart attack?Did uncle have heart attack?Did aunt have heart attack?Did cousin have heart attack?Did son have heart attack?Did daughter have heart attack?Did other relative have heart attack?Doctor told mother she had osteoporosis?Did your biological mother ever fracture hip?How many times mother fractured hip?Age of mother at first hip fracture?

NHANES99Topic Disease(s) Questions AlsousedinFamily History of Disease

Multiple Including living and deceased, were any of your biological, that is blood relatives including grandparents, parents, brothers, sisters ever told by a health professional they had . . . .

Diabetes?Alzheimer’s Disease?Asthma?Arthritis?Osteoporosis or brittle bones?High blood pressure or stroke before the age of 50?Heart attack or angina before the age of 50?

(For each “yes”, ask question below)

Which biological family member?

FatherMotherMother’s MotherMother’s FatherFather’s MotherFather’s FatherBrotherSisterOtherRefusedDon’t Know

�� | NATiONALhEALThANDNuTRiTiONExAmiNATiONSuRvEy(NhANES)

| ��

7 NationalhealthinterviewSurvey(2000)

NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Father

We would like to ask you a few questions about your family history of cancer. Did your BIOLOGICAL FATHER ever have cancer of any kind?

Yes No Adopted or don’t know biological father

Refused Don’t Know

Enter up to 3 kinds of cancer. If respondents offers more than 3 kinds of cancer, enter 96 in the fourth answer space. Enter N for no more.

Bladder Liver StomachBlood Lung TestisBone Lymphoma Throat-LarnyxBrain Melanoma ThyroidBreast Mouth/Tongue/Lip ColonPancreas Esophogas ProstrateGall Bladder Rectum OtherKidney Skin (non-melanoma) More than 3 kindsLarynx-Windpipe Skin-don’t know what kind RefusedLeukemia Soft Tissue (muscle/fat) Don’t Know

__Father (Cancer Type I) __Father (Cancer Type 2) __Father (Cancer Type 3) _( N or 96) _Was your biological father under 50 years of age when . . .

(Father Cancer Type 1) was first diagnosed? Yes No Don’t Know Refused(Father Cancer Type 2) was first diagnosed? Yes No Don’t Know Refused(Father Cancer Type 3) was first diagnosed? Yes No Don’t Know Refused

NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Mother

Did your BIOLOGICAL MOTHER ever have cancer of any kind?

Yes No Adopted or don’t know biological father


Enter up to 3 kinds of cancer. If respondent offers more than 3 kinds of cancer, enter 96 in the fourth answer space. Enter N for no more.

Bladder Liver StomachBlood Lung BoneLymphoma Throat-Larnyx BrainMelanoma Thyroid BreastMouth/Tongue/Lip Uterus CervixOvary Colon RectumPancreas Esophogas OtherKidney Gall Bladder More than 3 kindsLarynx-Windpipe Skin (non-melanoma) Don’t KnowLeukemia Skin-don’t know what kind RefusedSoft Tissue (muscle/fat)

__Mother (Cancer Type I) __Mother (Cancer Type 2) __Mother (Cancer Type 3) _( N or 96) _Was your biological mother under 50 years of age when . . .

(Mother Cancer Type 1) was first diagnosed? Yes No Don’t Know Refused(Mother Cancer Type 2) was first diagnosed? Yes No Don’t Know Refused(Mother Cancer Type 3) was first diagnosed? Yes No Don’t Know Refused

�� | NATiONALhEALThiNTERviEwSuRvEy(2000)

NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Brothers

FULL BROTHERS have the same biological mother and father as you. How many FULL BROTHERS do you have? Please include any who are alive and those who may have died.

None 1-20 brothers 21+ brothers Refused Don’t Know

If only one brother ask: Did you brother EVER have cancer of any kind?

Brother has not had any kind of cancer Brother has had cancer Refused Don’t Know

If more than one brother ask: How many of your brothers have EVER had cancer of any kind?

None 1-20 brothers 21+ brothers Refused Don’t Know

What kind(s) of cancer did your brother(s) have? Enter up to 3 kinds of cancer. If respondent offers more than 3 kinds of cancer, enter 96 in the fourth answer space. Enter N for no more.


__Brother (Cancer Type I) __Brother (Cancer Type 2) __Brother (Cancer Type 3) __( N or 96) _How many of your brothers have had (Brother Cancer Type 1) Cancer?

1-20 21+ Refused Don’t Know

If one brother had (Brother Cancer Type 1) ask: Was your brother under 50 years of age when (Brother Cancer Type 1) was diagnosed?

Brother not under 50 years of age Brother under 50 Refused Don’t Know

If two or more brothers had (Brother Cancer Type 1) ask: How many of these brothers were under 50 years of age when (Brother Cancer Type 1) was first diagnosed?

None diagnosed under 50 years 1-20 21+ Refused Don’t Know

How many of your brothers have had (Brother Cancer Type 2) Cancer?


NATiONALhEALThiNTERviEwSuRvEy(2000) | ��

NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Brothers cont.





How many of your brothers have had (Brother Cancer Type 3) Cancer?






Family History of Cancer: Sisters

FULL SISTERS have the same biological mother and father as you. How many FULL SISTERS do you have? Please include any who are alive and those who may have died.

None 1-20 sisters 21+ sisters Refused Don’t Know

If only one sister ask: Did you sisters EVER have cancer of any kind?

Sister has not had any kind of cancer Sister has had cancer Refused Don’t Know

If more than one sister ask: How many of your sisters have EVER had cancer of any kind?

None 1-20 sisters 21+ sisters Refused Don’t Know


NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Sisters cont.

What kind of cancer(s) did you sister(s) have?Enter up to 3 kinds of cancer. If respondent offers more than 3 kinds of cancer, enter 96 in the fourth answer space. Enter N for no more.


__Sister (Cancer Type I) __Sister (Cancer Type 2) __Sister (Cancer Type 3) __( N or 96) _How many of your sisters have had (Sister Cancer Type 1) Cancer?


If one sister had (Sister Cancer Type 1) ask: Was your sister under 50 years of age when (Sister Cancer Type 1) was diagnosed?

Sister not under 50 years of age Sister under 50 Refused Don’t Know

If two or more sisters had (Sister Cancer Type 1) ask: How many of these sisters were under 50 years of age when (Sister Cancer Type 1) was first diagnosed?


How many of your sisters have had (Sister Cancer Type 2) Cancer?







NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Sisters cont.

How many of your sisters have had (Sister Cancer Type 3) Cancer?






Family History of Cancer: Sons

How many BIOLOGICAL SONS do you have? Please include any sons who are alive and those that have died.

No sons 1-20 21+ Refused Don’t Know

If only one son, ask: Did your son ever have cancer of any kind?

Son has not had any kind of cancer Son has had cancer Refused Don’t Know

If more than one son, ask:How many of your sons ever have had cancer of any kind?

None 1-20 21+ Refused Don’t Know

What kind of cancers did your son(s) have? Enter up to 2 kinds. If respondent offers more than 2 kinds, enter “96” in the third answer space. Enter N for no more.


__Son (Cancer Type I) __Son (Cancer Type 2) __Son (Cancer Type 3) __( N or 96)

How many of your sons have had (Son Cancer Type 1) Cancer?


�0 | NATiONALhEALThiNTERviEwSuRvEy(2000)

NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Sons cont.

If one son had (Son Cancer Type 1) ask: Was your son under 50 years of age when (Son Cancer Type 1) was diagnosed?

Son not under 50 years of age Son under 50 Refused Don’t Know

If two or more son had (Son Cancer Type 1) ask: How many of these sons were under 50 years of age when (Son Cancer Type 1) was first diagnosed?


How many of your sons have had (Sons Cancer Type 2) Cancer?


If one son had (Son Cancer Type 2) ask: Was your son under 50 years of age when (Son Cancer Type 2) was diagnosed?

Son not under 50 years of age Son under 50 Refused Don’t Know

If two or more son had (Son Cancer Type 2) ask: How many of these sons were under 50 years of age when (Sons Cancer Type 2) was first diagnosed?


Family History of Cancer: Daughters

How many BIOLOGICAL DAUGHTERS do you have? Please include any daughters who are alive and those that have died.

No daughters 1-20 21+ Refused No biological daughters Don’t Know

If only one daughter, ask: Did your daughter ever have cancer of any kind?

Daughte has not had any kind of cancer Daughten has had cancer Refused Don’t Know

If more than one daughter, ask: How many of your daughters ever have had cancer of any kind?

None 1-20 21+ Refused Don’t Know


NationalHealthInterviewSurvey(2000)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Daughters cont.

What kind of cancers did your daughter (s) have? Enter up to 2 kinds. If respondent offers more than 2 kinds, enter “96” in the third answer space. Enter N for no more.


__Daughter (Cancer Type I) __Daughter (Cancer Type 2) __Daughter (Cancer Type 3) __( N or 96)

How many of your daughters have had (Daughter Cancer Type 1) Cancer?


If one daughter had (Daughter Cancer Type 1) ask: Was your daughter under 50 years of age when (Daughter Cancer Type 1) was diagnosed?

Daughter not under 50 years of age Daughter under 50 Refused Don’t Know If two or more daughter had (Daughter Cancer Type 1) ask: How many of these daughters were under 50 years of age when (Daughter Cancer Type 1) was first diagnosed?


How many of your daughters have had (Daughter Cancer Type 2) Cancer?


If one daughter had (Daughter Cancer Type 2) ask: Was your daughter under 50 years of age when (Daughter Cancer Type 2) was diagnosed?

Daughter not under 50 years of age Daughter under 50 Refused Don’t Know

If two or more daughters had (Daughter Cancer Type 2) ask: How many of these daughters were under 50 years of age when (Daughter Cancer Type 2) was first diagnosed?



| ��

8 CaliforniahealthinterviewSurvey2005

CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer

These next questions ask about your family history of cancer. By family we mean only your blood relatives, including half brothers and sisters. First, have any of your grandparents ever had cancer of any kind?

[If needed say: “We want you to include information about both living and deceased blood relatives. Do not include family members related through marriage such as stepfather or stepsister, or family members who were adopted.”]

Yes No Refused Don’t Know

Family History of Cancer

Have any of your parents’ brothers or sisters, that is, your uncles or aunts, ever had cancer of any kind?


Family History of Cancer

Has your father or mother, or any have any of your {brothers or sisters, sisters/brothers, sisters, sons or daughters} ever had cancer of any kind?


Family History of Cancer: Female Relatives

Breast, Ovarian, Uterine, Colon/Rectal Cancer

Now please think about your female relatives that have had cancer. By female relatives I mean mother, grandmother, aunts, {and} sisters, {and daughters}.

Have any of your female relatives been diagnosed with cancer of the breast, ovary, uterus, colon, or rectum?


Family History of Cancer: Female Relatives


Which female relatives have been diagnosed with cancer of the breast, ovary, uterus, colon, or rectum?

Was it your . . .

Grandmother(s) Aunt(s) Mother Sister(s) Daughter(s) Refused Don’t Know

Family History of Cancer: Maternal & Paternal Grandmothers


Is the grandmother on your mother’s or father’s side or both?

Mother’s Mother Father’s Mother Both Grandmothers Refused Don’t Know

{First tell me about your mother’s mother.} Did she have cancer of the breast, ovary, uterus, colon, or rectum? (probe “any others?”)

Breast Ovarian Uterine/ endometrial

Colon/ rectum

“Female problems” None of these cancer types


CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Maternal & Paternal Grandmothers cont.


{Were any of these diagnoses before age 50?} Was her diagnosis before the age of 50?

Yes No Refused Don’t Know Which of these cancers were diagnosed before age 50?


Colon/ rectum



Now tell me about your father’s mother. Did she have cancer of the breast, ovary, uterus, colon, or rectum? (probe “any others?”)


Colon/ rectum



Which of these cancers were diagnosed before age 50?


Colon/ rectum

“Female problems” Refused Don’t Know

Family History of Cancer: Aunts


Is the aunt or aunts you mentioned on your mother’s side, father’s side, or both?

Mother’s side Father’s side Both sides Refused Don’t Know

How many of your mother’s sisters had cancer of the breast, ovary, uterus, colon, or rectum?

__Number of aunts Refused Don’t Know

{Did she have cancer of the breast, ovary, uterus, colon, or rectum?}

Thinking about the (youngest, next youngest) of your mother’s sisters, did she have cancer of the breast, ovary, uterus, colon, or rectum?


Colon/ rectum



{Were any of the diagnoses before age 50?} Was her diagnosis before age 50?




Colon/ rectum



How many of your father’s sisters had cancer of the breast, ovary, uterus, colon, or rectum?

__Number of aunts Refused Don’t Know

CALiFORNiAhEALThiNTERviEwSuRvEy2005 | �� | CALiFORNiAhEALThiNTERviEwSuRvEy2005

CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Aunts cont.



Thinking about the (youngest, next youngest) of your mother’s sisters, did she have cancer of the breast, ovary, uterus, colon, or rectum?


Colon/ rectum







Colon/ rectum



Family History of Cancer: Mother


Did your mother have cancer of the breast, ovary, uterus, colon, or rectum?


Colon/ rectum







Colon/ rectum



Family History of Cancer: Sisters


How many of your sisters had cancer of the breast, ovary, uterus, colon, or rectum?

__Number of sisters Refused Don’t Know


Thinking about the (youngest, next youngest) of your sisters, did she have cancer of the breast, ovary, uterus, colon, or rectum?


Colon/ rectum







Colon/ rectum



CALiFORNiAhEALThiNTERviEwSuRvEy2005 | ��

CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Sisters cont.


Was this sister a full-sister, a half-sister on your father’s side, or a half-sister on your mother’s side?

Full Half on father’s Half on mother’s Refused Don’t Know

Family History of Cancer:Daughters


How many of your daughter’s had cancer of the breast, ovary, uterus, colon, or rectum?

__Number of daughters Refused Don’t Know


Thinking about the (youngest, next youngest) of your daughters, did she have cancer of the breast, ovary, uterus, colon, or rectum?


Colon/ rectum







Colon/ rectum



Family History of Cancer: Male Relatives

Prostrate, Colon/Rectal, Breast Cancer

Now I’ll ask about your male relatives. By male relatives, I mean your father, grandfathers, uncles, {and} brothers {and sons}.

Have any of your male relatives been diagnosed with cancer of the prostrate, colon, rectum, or breast?


Which of your male relatives were diagnosed with cancer of the prostrate, colon, rectum, or breast? Was it your . . .

Grandfather(s) Father’s Uncle(s) Brother(s) Son(s) Refused Don’t Know

Family History of Cancer: Maternal and Paternal Grandfathers


Is the grandfather on your mother’s or father’s side or both?

Mother’s Father Father’s Father Both Grandfathers Refused Don’t Know

{First tell me about your mother’s father.} Did he have cancer of the prostrate, colon, rectum, or breast?

Prostrate Colon/ rectal Breast None of these cancer types Refused Don’t know

{Were any of these diagnoses before age 50?} Was his diagnosis before age 50?


�� | CALiFORNiAhEALThiNTERviEwSuRvEy2005

CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Maternal and Paternal Grandfathers cont.




Now tell me about your father’s father. Did he have cancer of the prostrate, colon, rectum, or breast?





Prostrate Colon/ rectal Breast Refused Don’t know

Family History of Cancer: Uncles


Is the uncle or uncles you mentioned on your mother’s side, your father’s side or on both sides?

Mother’s side Father’s side Both sides Refused Don’t Know

How many of your mother’s brothers had cancer of the prostrate, colon, rectum, or breast?

__Number of uncles Refused Don’t Know

{Did he have cancer of the prostrate, colon, rectum, or breast?}

Now thinking of the {youngest/next youngest} of your mother’s brothers who had cancer did he have cancer of the prostrate, colon, rectum, or breast?






How many of your father’s brothers had cancer of the prostrate, colon, rectum, or breast?

__Number of uncles Refused Don’t Know


CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Uncles cont.



Now thinking of the {youngest/next youngest} of your father’s brothers who had cancer did he have cancer of the prostrate, colon, rectum, or breast?






Family History of Cancer: Father


Did your father have cancer of the prostrate, colon, rectum, or breast?






Family History of Cancer: Brothers


How many of your brothers had cancer of the prostrate, colon, rectum, or breast?

__Number of brothers Refused Don’t Know


Now thinking of the {youngest/next youngest} of your brothers who had cancer did he have cancer of the prostrate, colon, rectum, or breast?






Was this a full-brother, a half-brother on your father’s side, or a half-brother on your mother’s side?

Full Half on father’s Half on mother’s Refused Don’t Know

�� | CALiFORNiAhEALThiNTERviEwSuRvEy2005

CaliforniaHealthInterviewSurvey(2005)Topic Disease(s) Questions AlsousedinFamily History of Cancer: Sons


How many of your sons had cancer of the prostrate, colon, rectum, or breast?

__Number of sons Refused Don’t Know


Now thinking of the {youngest/next youngest} of your sons who had cancer did he have cancer of the prostrate, colon, rectum, or breast?







�0 |

9 PregnancyRiskAssessmentmonitoringSystem2005(Oregon)

OREGONDEPARTMENTOFHUMANSERVICES(2005PRAMS)Topic Disease(s) Questions AlsousedinGestational Diabetes

Diabetes (Gestational)

1. Have you ever been told by a health care provider that you had diabetes (high blood sugar) during any of your pregnancies? A health care provider may include a doctor, nurse, or other health care worker.

Yes No

Diabetes Diabetes 2. Have you ever been told by a health care provider that you had diabetes (high blood sugar) when you were not pregnant?

Yes No


Diabetes 3. Have any of your family members ever been told by a health care provider that they had diabetes (high blood sugar)? For each family member, circle Y (Yes) if they were told that they had diabetes or circle N (No) if they were not told.

Your two-year-old Y N DKYour two-year-old’s father Y N DKYour two-year-old’s brothers or sisters (including half brothers and sisters)

Y N DK

Your mother Y N DKYour father Y N DKYour brothers or sisters Y N DK

Asthma Asthma 4. Have you ever been told by a health care provider that you had asthma?

Yes No

Family History of Asthma

Asthma 5. Have any of your family members ever been told by a health care provider that they had asthma? For each family member, circle Y (Yes) if they were told that they had asthma or circle N (No) if they were not told.

Your two-year-old Y N DKYour two-year-old’s father Y N DKYour two-year-old’s brothers or sisters (including half brothers and sisters)

Y N DK

Your mother Y N DKYour father Y N DKYour brothers or sisters Y N DK

| ��

10 Diabetes,Osteoporosis,ArthritisBehavioralRiskFactorSurvey(michigan)2005

MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(Diabetes,Osteoporosis,ArthritisBehavioralRiskFactorSurvey2005)Topic Disease(s) Questions AlsousedinFamily History of Osteoporosis

Osteoporosis Now I am going to ask you questions about your biological or blood grandparents, parents, brothers, and sisters, including both those living and those deceased.

1.To the best of your knowledge, were any of these biological or blood relatives ever told they had osteoporosis by a doctor, nurse, or other health care provider.

Interviewer: If necessary, probe with: Remember we are thinking of your grandparents, parents, brothers, and sisters.

Yes Adopted No Refused

Collection of Family History of Osteoporosis

Osteoporosis 2. Has your doctor, nurse, or other health care provider collected information from you about your family history of osteo-porosis?

Yes No Don’t Know Refused Not applicable


Diabetes 3. To the best of your knowledge, were any of those relatives ever told they had diabetes (or “sugar”) by a doctor, nurse, or other health care provider?

Interviewer: If necessary, probe with: Remember, we are thinking of your biological blood grandparents, parents, brothers, sisters and children both those living and deceased.


Family History of Diabetes < 20

Diabetes 4. Were any of those relatives told they had diabetes before they were 20 years old by a doctor, nurse, or other health care professional?


Family History of Diabetes >20

Diabetes 5. Were any of these relatives told they had diabetes when they were 20 years old or older by a doctor, nurse, or other healthcare provider?



Diabetes 6. Has your doctor, nurse, or other healthcare provider collected information from you about your family history of diabetes?


MICHIGANDEPARTMENTOFCOMMUNITYHEALTH(Diabetes,Osteoporosis,ArthritisBehavioralRiskFactorSurvey2005)Topic Disease(s) Questions AlsousedinRisk Assess-ment Based on Family History of Diabetes

Diabetes 7. Have you and your health care provider ever discussed your risk of diabetes, based on your family history?


Recommenda-tions based on Family History of Diabetes

Diabetes 8. Based on your family history risk, has your health care provider made any recommendations?


�� | DiABETES,OSTEOPOROSiS,ARThRiTiSBEhAviORALRiSkFACTORSuRvEy(miChigAN)2005

| ��

11 youthRiskBehaviorSurvey(utah)2007

UtahDepartmentofHealth(2007YRBS)Topic Disease(s) Questions AlsousedinEducation about Family History

Multiple 85. Have you had lessons about genetics that discussed the relationship between family history and development of certain diseases such as heart disease, diabetes, asthma, or cancer?

A. Yes B. No C. Not sure

Perceived Risk Based on Family History

Multiple 86. If your parents, grandparents, or siblings had heart disease, diabetes, asthma, or cancer, would you have an increased risk of developing the disease?

A. Definitely yes B. Probably yes C. Probably not D. Definitely not

Perceived Effect of Behavior Change on Family History Risk of Disease

NA 87. If you had a family history of a disease such as heart disease, diabetes, or cancer, would changing your behaviors such as not smoking, exercising more, getting early or regular checkups for the disease, or eating a healthy diet, decrease your chance of getting the disease?


Interest in Learning About Family History

NA 88. Would you be interested in learning more about your personal healthfamily history?


�� |

Index

AAsthma 1,12,21,34,50

BBehavior Change.See also Lifestyle change; diet; exerciseBreast Cancer 8,9,28,46,47,48,49

CCancer 1,3,8,9,19,28,35,36,37,38,39,40,41,42,43,44,45,46,47,48,

49.See also Colon/Rectal Cancer;See also Breast cancerBreast Cancer 8,9,28,46,47,48,49Colon/Rectal Cancer 3,19,43,44,45,46Ovarian 28,43,44,45,46Prostrate 35,37,40,46,47,48,49Uterine 43,44,45,46

CHD 23,24,26.See also Coronary heart diseaseChronic disease 3,12,18,22,25,27.See also Family history of chronic disease;

See also Family history: DiseaseColon/Rectal Cancer 3,19,43,44,45,46Concern 22.See also worryCoronary Heart Disease 23.See also Heart disease

DDiabetes 1,2,4,5,10,11,18,25,28,30,34,50,51,52Diet 3,12,18,22,25,27.See also Lifestyle; Lifestyle changes; and ExerciseDirect-to-Consumer Marketing 8Disease Risk 22.See also Risk assessment

Recommendations for Reducing 4,11,16

EEnvironment 20

Susceptibility 20.See also Risk and Risk assessment

Exercise 2,3,12,18,22,25,27.See also Lifestyle; Lifestyle changes; and Diet

FFamily history i,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,21,

22,25,27,28,30,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53

Behavior Change 53Collection of 2,3,4,7,10,12,16,18,25,27,51Disease ii,1,2,3,4,6,7,8,10,12,14,16,17,18,19,20,21,22,23,25,

26,28,30,32,33,34,35,43,50,51,53Education 53Importance of 3,12,18,22,25,27Interest in 53Perceived risk 3,6,10,16,53Prevalence 11,17Recommendations based on 2,6,12,52.See also Lifestyle changesRisk assessment based on 2,6,12Sharing of 12,13,18Stratification of risk 4,5.See also Risk assessmentTime 6,12,18

GGenes 11,20.See also Genetics

Environment 20Susceptibility 20.See also Risk and Risk assessment

Genetics 11Knowledge of 8,11,13,17,18,29,32

Genetics Knowledge 11Genetic Testing 28.See also Genetic tests

Awareness of 28Genetic Tests 8,11,13,17,18,29,32

Direct-to-consumer marketing 8,11,13,17,18,29,32

| ��

Gestational diabetes 5,10.See also Diabetes;See also Type 2 Diabetes

HHealth Care Providers 12Heart attack 15.See also Sudden Cardiac DeathHeart Disease 1,7,16,17,21,23,28,30Heart Disease/Stroke 16,17.See also Heart Disease;See also Stroke

LLifestyle 3,5,7,11,12,17,18,22,25,27Lifestyle changes 3,5,7,11,12,17,18,22,25,27.See also Lifestyle; Diet; and

Exercise

MMichigan Department of Community Health 2,3,8,14,51

OOregon Department of Community Health 4,10,16Osteoporosis 34,51,52Ovarian cancer 28,43,44,45,46

PPerceived Risk 3,6,10,16,53Prostrate cancer 35,37,40,46,47,48,49

RRecommendations

Lifestyle Changes 4,11,16

Risk Assessment ii,2,4,6,10,12,16,25,50,52.See also Family History: Risk assessment based on

SScreening by Health Care Providers 10Stratification of risk 4Stroke 16,17,23,24,26,28.See also Stroke/TIA and Heart Disease/StrokeStroke/TIA 23,24,26.See StrokeSudden Cardiac Death 14,15.See also Heart attackSusceptibility 20.See also Risk assessment

TType 2 Diabetes 25.See also Diabetes

UUtah Department of Community Health 6,12,18Uterine cancer 43,44,45,46

VVermont Department of Community Health 19

WWorry 3,5,10,12,18,22,25,27.See also Concern

University of Washington Center for Genomics & Public Health

4225RooseveltWayNESuite100Seattle,WA98105-6099Ph:(206)616-6917F:(206)616-0688email:[email protected]://www.uwcgph.org

Documents

Genomics and Family History Survey Questionsdepts.washington.edu/cgph/pdf/Compiled_Genomics... · 2008-07-11 · Genomics and Family History Survey Questions Updated March 2007 Compiled