Summary of Modifications

Summary of Modifications to the HMTS Question Bank, June 2010 (by HMTS instrument)
New or Modified HMTS Question (with origin, if new)	Origin	Modification to HMTS Instrument
		Demographics (a)	Introductory (c )	Core (d)	Follow-up (f)

Have you smoked at least 100 cigarettes in your entire life? SINGLE RESPONSE. Yes No	New (from TUS-CPS)	X
Do you now smoke cigarettes every day, some days, or not at all? SINGLE RESPONSE. Every day Some days Not at all	New (from TUS-CPS)	X
During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking? SINGLE RESPONSE. Yes No	New (from TUS-CPS)	X
About how long has it been since you completely quit smoking cigarettes? FILL IN NUMBER FOR UNIT THAT APPLIES _____ Days _____ Weeks _____ Months _____ Years	New (from TUS-CPS)	X
On how many of the past 30 days did you smoke cigarettes? Enter number:	New (from TUS-CPS)	X
On the average, on those (INSERT QUESTION #11 RESPONSE) days, how many cigarettes did you usually smoke each day? FILL IN NUMBER.	New (from TUS-CPS)	X
Which of these best describes the area in which you work most of the time? Mainly work indoors Mainly work outdoors Travel to different buildings or sites In a motor vehicle, or Somewhere else Varies	New (from TUS-CPS)	X
Please indicate your race or ethnic background. Are you? Ethnicity: Hispanic or Latino Not Hispanic or Latino Race: SELECT ONE OR MORE. White/Caucasian Black or African-American American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Asian 6 Vietnamese 7 Cambodian 8 Filipino 9 Japanese 10 Korean 11 Chinese	Modified HMTS Question Question Stem Changed	X
In general, how much would you trust information about health or medical topics? Would you say a lot, some, a little, or not at all? GRID FORMAT, ROTATE A-D. A lot Some A little Not at all 1 2 3 4 A. Family and friends B. Charitable organizations C. Religious organizations and leaders D. Government health agencies	Modified HMTS Question Answer Format Changed		X
Think about the most recent time you looked up information on [Smoking or quitting smoking] from any source. About how long ago was that? SINGLE RESPONSE. Days ago Weeks ago Months ago Years ago Never	Modified HMTS Question Answer Category Added		X
What type of information were you looking for in your most recent search? Please check all that apply. Information on [quitting smoking or helping someone quit smoking] Help for [quitting smoking] Where to get medical care for [quitting smoking] Medication for quitting smoking Information on complementary alternative or unconventional treatments for [quitting smoking] Other (Please specify):_______________________________________	Modified HMTS Question Answer Categories Added		X
Is this message believable? GRID FORMAT, ROTATE LIST AS RELEVANT. (MESSAGES TO BE INSERTED BASED ON SPOTS). Yes No INSERT MESSAGE 1 FROM AD INSERT MESSAGE 2 FROM AD INSERT MESSAGE 3 FROM AD INSERT MESSAGE 4 FROM AD	Modified HMTS Question Question Stem Changed			X
Who would you say they are trying to reach? Please check all that apply. You People like you Someone else None of these	Modified HMTS Question Answer Format Changed			X
Now that you’ve seen all of these ads, which one catches your attention the most by placing a 1 by the ad you liked the most, a 2 by your (NEXT) favorite, etc SINGLE RESPONSE. SCREEN CAPTURES FROM THE ADS WILL BE INSERTED FOR VISUAL RECALL OF THE ADS. PICTURE/DESCRIPTION OF FIRST SPOT VIEWED PICTURE/DESCRIPTION OF SECOND SPOT VIEWED PICTURE/DESCRIPTION OF THIRD SPOT VIEWED PICTURE/DESCRIPTION OF FOURTH SPOT VIEWED PICTURE/DESCRIPTION OF FIFTH SPOT VIEWED	Modified HMTS Question Question Stem Changed			X
Looking over all of the different messages which two or three are the most effective? INSERT LIST OF MESSAGES VIEWED IN THE 5 SPOTS. MULTIPLE MENTION. Please check up to three.	Modified HMTS Question Question Stem Changed			X
Are any of the five advertisements memorable? 1. Yes 2. No	OSH-New Question			X
Please rank these five advertisements by placing a 1 by the ad you felt was the most memorable, a 2 by your second-most memorable, etc.  RANKING QUESTION UP TO TOP 5, FORCE EXACTLY ONE RESPONSE FOR EACH OF 1 THROUGH 5.  ROTATE 1-5.   PICTURE/DESCRIPTION OF FIRST SPOT VIEWED PICTURE/DESCRIPTION OF SECOND SPOT VIEWED PICTURE/DESCRIPTION OF THIRD SPOT VIEWED PICTURE/DESCRIPTION OF FOURTH SPOT VIEWED PICTURE/DESCRIPTION OF FIFTH SPOT VIEWED	OSH-New Question			X
Do you think you will talk about any of these ads with others? 1 Yes 2 No	OSH-New Question			X
Please rank these five advertisements by placing a 1 by the ad you felt you are more likely to talk about with others, a 2 by your second-most likely to talk about, etc.  RANKING QUESTION UP TO TOP 5, FORCE EXACTLY ONE RESPONSE FOR EACH OF 1 THROUGH 5.  ROTATE 1-5. PICTURE/DESCRIPTION OF FIRST SPOT VIEWED PICTURE/DESCRIPTION OF SECOND SPOT VIEWED PICTURE/DESCRIPTION OF THIRD SPOT VIEWED PICTURE/DESCRIPTION OF FOURTH SPOT VIEWED PICTURE/DESCRIPTION OF FIFTH SPOT VIEWED	OSH-New Question			X
Did you think any of these ads was effective to motivate you or someone else to quit smoking? 1. Yes 2. No	OSH-New Question			X
Please rank these five advertisements by placing a 1 by the ad you felt was the most effective in motivating you or someone else to quit smoking, a 2 by the second-most effective in motivating you to quit, etc.  RANKING QUESTION UP TO TOP 5, FORCE EXACTLY ONE RESPONSE FOR EACH OF 1 THROUGH 5.  ROTATE 1-5.   PICTURE/DESCRIPTION OF FIRST SPOT VIEWED PICTURE/DESCRIPTION OF SECOND SPOT VIEWED PICTURE/DESCRIPTION OF THIRD SPOT VIEWED PICTURE/DESCRIPTION OF FOURTH SPOT VIEWED PICTURE/DESCRIPTION OF FIFTH SPOT VIEWED	OSH-New Question			X
Are you seriously considering quitting smoking within the next 6 months? SINGLE RESPONSE. Yes No	New (From TUS-CPS)				X
Are you planning to quit within the next 30 days? SINGLE RESPONSE. Yes No	New (from TUS-CPS)				X
Overall on a scale from 1 to 10 where 1 is not at all interested and 10 is extremely interested, how interested are you in quitting smoking? SINGLE RESPONSE. Not at all interested Extremely interested	New (from TUS-CPS)				X
Overall, on a scale from 0 to 10, where 0 is not at all confident and 10 is extremely confident, how confident are you right now that you can quit smoking? SINGLE RESPONSE. 0 Not at all confident Extremely confident	OSH-New Question				X
After watching these ads, how likely are you to talk about [quitting smoking] with your family in the next week or so?	Modified HMTS Question				X
After watching these ads, how likely are you to talk about [quitting smoking] with your friends in the next week or so?	Modified HMTS Question				X
After watching these ads, will you bring up [quitting smoking] the next time you visit your healthcare provider? Yes No	Modified HMTS Question				X

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