| Stool blood test or FOBT |
| The following questions are about the stool blood test, also known as a FOBT, a test to check for colon cancer. It is done at home using a set of three cards to determine whether the stool contains blood. You smear a sample of your fecal matter or stool on a card from three separate bowel movements and return the cards to be tested. |
| Questions |
| Before this test was described, had you ever heard of a fecal occult or stool blood test? |
| •Yes |
| •No |
| •Not sure/do not know |
| If “yes” to “ever heard”: |
| Have you ever done a stool blood test using a “home” test kit? |
| •Yes |
| •No |
| •Not sure/do not know |
| If “yes” to “ever had”: |
| How many home stool blood tests have you done in the last 5 years? |
| •____ (number from 1 to 5) |
| •Not sure/do not know |
| When did you do your most recent home stool blood test? |
| •A year ago or less |
| •More than 1 but not more than 2 years ago |
| •More than 2 but not more than 5 years ago |
| •More than 5 years ago |
| •Not sure/do not know |
| If you did your most recent test within the past year, what was the month and year? |
| Month_____/Year_____ |
| Why did you do your most recent home stool blood test? |
| •Part of a routine examination or checkup |
| •Because of a symptom or health problem |
| •Follow-up of an earlier abnormal test |
| •Not sure/do not know |
| Prompt for T and F surveys: “You said that your most recent test was [insert time frame]” |
| When did you do the home stool blood test before your most recent one? |
| •None before the most recent |
| •A year ago or less* |
| •More than 1 but not more than 2 years before |
| •More than 2 years before |
| •Not sure/do not know |
| Why did you have that home stool blood test? |
| •Part of a routine examination or checkup |
| •Because of a symptom or health problem |
| •Follow-up of an earlier abnormal test |
| •Not sure/do not know |
| Stool blood test or FOBT |
| The following questions are about the stool blood test, also known as a FOBT, a test to check for colon cancer. It is done at home using a set of three cards to determine whether the stool contains blood. You smear a sample of your fecal matter or stool on a card from three separate bowel movements and return the cards to be tested. |
| Questions |
| Before this test was described, had you ever heard of a fecal occult or stool blood test? |
| •Yes |
| •No |
| •Not sure/do not know |
| If “yes” to “ever heard”: |
| Have you ever done a stool blood test using a “home” test kit? |
| •Yes |
| •No |
| •Not sure/do not know |
| If “yes” to “ever had”: |
| How many home stool blood tests have you done in the last 5 years? |
| •____ (number from 1 to 5) |
| •Not sure/do not know |
| When did you do your most recent home stool blood test? |
| •A year ago or less |
| •More than 1 but not more than 2 years ago |
| •More than 2 but not more than 5 years ago |
| •More than 5 years ago |
| •Not sure/do not know |
| If you did your most recent test within the past year, what was the month and year? |
| Month_____/Year_____ |
| Why did you do your most recent home stool blood test? |
| •Part of a routine examination or checkup |
| •Because of a symptom or health problem |
| •Follow-up of an earlier abnormal test |
| •Not sure/do not know |
| Prompt for T and F surveys: “You said that your most recent test was [insert time frame]” |
| When did you do the home stool blood test before your most recent one? |
| •None before the most recent |
| •A year ago or less* |
| •More than 1 but not more than 2 years before |
| •More than 2 years before |
| •Not sure/do not know |
| Why did you have that home stool blood test? |
| •Part of a routine examination or checkup |
| •Because of a symptom or health problem |
| •Follow-up of an earlier abnormal test |
| •Not sure/do not know |