Attachment 2A: Survey Items
OMB
No.: 0925-0642 Expiration
Date: 9/30/2014 Public
reporting burden for this collection of information is estimated to
average 30 minutes per response, including the time for reviewing
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maintaining the data needed, and completing and reviewing the
collection of information. An
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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 (0925-0642). Do not
return the completed form to this address.
Health Profile Items (items previously collected by Knowledge Networks for which data will be provided to us):
Have you been diagnosed with any of the following medical conditions?
How often did you have a drink containing alcohol in the past year?
How many drinks did you have on a typical day when you were drinking in the past year?
Life Events Questionnaire
*The X total respondents will be randomized to answer one of the following open-ended questions. Each participant will answer only one of the following questions.*
For the next five minutes, please think of the time when you felt the happiest in your life. Please write about that time in detail, while trying to re-experience the emotions involved.
For the next five minutes, please think of the time when you felt the saddest in your life. Please write about that time in detail, while trying to re-experience the emotions involved
For the next five minutes, please think of the time when you felt the angriest in your life. Please write about that time in detail, while trying to re-experience the emotions involved
For the next five minutes, please think of the time when you felt the most hopeful in your life. Please write about that time in detail, while trying to re-experience the emotions involved
For the next five minutes, please write a detailed description of a room in your house.
All participants will answer these questions:
On a scale of 1 to 7, how much do you currently feel happy?
1 2 3 4 5 6 7
Not at all Extremely
On a scale of 1 to 7, how much do you currently feel sad?
1 2 3 4 5 6 7
Not at all Extremely
On a scale of 1 to 7, how much do you currently feel angry?
1 2 3 4 5 6 7
Not at all Extremely
On a scale of 1 to 7, how much do you currently feel hopeful?
1 2 3 4 5 6 7
Not at all Extremely
Alcohol and Breast Cancer Inventory
*The X total respondents will be randomized to answer one of the two following open-ended questions. Each participant will answer only one of the following questions.*
In this study we are interested in investigating values. By values we mean the moral principles and standards by which people try to live their lives. For example, honesty might be a core value for some people. That is, they may try to be honest in all they do when dealing with other people.
Please look at the list of values below, and check the one that is most important to you.
Artistic skills
Athletics
Business/earning money
Compassion
Conscientiousness
Creativity
Friendliness
Generosity
Hedonism (the pursuit of pleasure/happiness)
Honesty
Independence
Intelligence
Kindness
Musical ability/appreciation
Politics
Relations with friends or family
Spirituality/Religiousness
Sense of Humor
Spontaneity/Living life in the moment
Trustworthiness
Other: (write in)________________________
On the previous page, you chose a value that is most important to you. Please type a short statement about why this value is important to you. Take a few minutes to think about this value and how this value has influenced your past behaviors or attitudes. Please write about how you use this value in your everyday life – at work, at home, with friends, or in dealing with strangers. If you can, try to recall and write about specific occasions on which this value determined what you did.
In this study we are interested in investigating values. By values we mean the moral principles and standards by which people try to live their lives. For example, honesty might be a core value for some people. That is, they may try to be honest in all they do when dealing with other people.
Please look at the list of values below, and check the one that is least important to you.
Artistic skills
Athletics
Business/earning money
Compassion
Conscientiousness
Creativity
Friendliness
Generosity
Hedonism (the pursuit of pleasure/happiness)
Honesty
Independence
Intelligence
Kindness
Musical ability/appreciation
Politics
Relations with friends or family
Spirituality/Religiousness
Sense of Humor
Spontaneity/Living life in the moment
Trustworthiness
Other: (write in)________________________
On the previous page, you chose a value that is least important to you. Please type a short statement about why this value could be important to another person. Take a few minutes to think about how this value may influence this person’s behaviors or attitudes. Please write about how this person may use this value in everyday life – at work, at home, with friends, or in dealing with strangers. Only think about why this value might be important to another person, and not why it is unimportant to you.
*All participants will read the following message about alcohol and breast cancer, and all will answer the questions that follow:*
Alcohol and Breast Cancer
Drinking a single alcoholic drink a day increases a woman's chance of developing breast cancer by around 6%, according to a major global study of woman's smoking and drinking behavior. The new research, published in a leading cancer journal, estimates that alcohol accounts for around 4 percent of breast cancers in the developed world - and nearly 2000 deaths from breast cancer each year in the US alone. If women's alcohol consumption continues to increase, this figure is likely to rise. In contrast, smoking, which causes a third of all cancers, was not found to contribute to breast cancer.
New Facts about alcohol
In the past it has been extremely difficult for researchers to separate the effects of tobacco from the effects of alcohol because the more women drink the more they tend to smoke and vice versa. This is a major reason why previous work has yielded conflicting results regarding the impact of drinking on cancer risk. The sheer size of the new study, including data from approximately 150,000 women around the globe, allows the researchers to disentangle the two factors and make the most accurate estimates ever of the risks associated with smoking and drinking. Dr. Richard Doll, a co-author of the study, said: "There has been a great deal of research on whether smoking or alcohol contribute to breast cancer but until now results have been confusing. For the first time we have undertaken a study large enough and detailed enough to look at the separate effects of tobacco and alcohol reliably. When we did this we found that drinking, but not smoking, increases the risk of breast cancer."
How much alcohol?
Professor Valerie Beral of the Cancer Epidemiology Center in Oxford, England, and co-author of the study said: "This research tells us there is a definite link between alcohol and breast cancer and the evidence suggests that the more a woman drinks the greater her risk." The average alcohol intake, especially for young women, has increased significantly in the last decade. This increase in alcohol consumption could have a significant impact upon breast cancer incidence. This research suggests that a woman who regularly drinks one serving a day (7 a week) has an increased risk of breast cancer of 6%, while having an average of 2.5 drinks a day (17.5 a week) will increase her risk by 15%. Current research suggests that alcohol may increase the risk of breast cancer by raising the levels of estrogen in the body. Estrogen has a well-established link with breast cancer, with research suggesting estrogen can play a role in both triggering its development and encouraging the growth of tumors.
By the age of 80 breast cancer affects 8.8 out of every 100 women.
One alcoholic drink a day raises the figure for women to 9.4 cases per 100.
Six alcoholic drinks a day raises the figure for women to 13.3 cases per 100.
What about the benefits of alcohol?
While women who drink are at a higher risk for a number of diseases, including cancers of the throat and liver, they are at a lower risk of heart disease and stroke than are non-drinkers. Dr. Gillian Reeves, who also co-authored the report, says "The balance between the harmful effects of alcohol on breast cancer and its beneficial effects on heart disease depend on a woman's age." It is not until after the age of 65 or so that the benefits of moderate drinking become apparent; before then the risk of breast cancer is far higher than that of heart disease.
Drinking too much is dangerous
The Chief Executive of the cancer charity that funded this research, Paul Nurse, said: "Large studies of this kind are very important for dissecting the complex causes of cancer. This research reinforces advice that excessive drinking can be hazardous. It seems that women's attitudes regarding alcohol are changing and this can only have a negative impact on their health. It's important that we get the message out to young women that drinking too much is dangerous." There are many things that you can do to look after your heart, including plenty of exercise and eating a healthy diet. The small benefit that alcohol brings is not large enough to recommend that those who do not drink should start. Considering the potential harmful effects of drinking, including breast cancer, it is advised that those who do drink should attempt to cut down and to have several days a week without alcohol. According to the U.S. Department of Health and Human Services, people should not exceed the following recommendations for alcohol consumption:
For women, no more than 1 serving per day (12 oz. of beer, 5 oz. of wine, or 1.5 oz. of hard liquor) and no more than 7 servings per week.
For men, no more than 2 servings per day (24 oz. of beer, 10 oz. of wine, or 3 oz. of hard liquor) and no more than 14 servings per week.
If you have any interest in altering your alcohol consumption in the next 7 days, how will you go about it? Please list below any steps that you think you will take to reduce your alcohol consumption.
How worried are you about your drinking behavior?
1 2 3 4 5 6 7
Not at all worried Extremely worried
How worried are you about developing breast cancer because of your drinking behavior?
1 2 3 4 5 6 7
Not at all worried Extremely worried
How would you rate your chance of developing breast cancer in your lifetime?
Very low
Moderately low
Neither high nor low
Moderately high
Very high
5. Overall, how do you think your chance of developing breast cancer in your lifetime compares to the average woman your age?
1 2 3 4 5
Much lower About the same Much higher
I feel very vulnerable to breast cancer.
1 2 3 4 5 6 7
Strongly disagree Strongly agree
I intend to decrease the amount I drink in the next 2 weeks.
1 2 3 4 5 6 7
Definitely will not do Definitely will do
I intend to decrease the number of times I drink in the next 2 weeks.
1 2 3 4 5 6 7
Definitely will not do Definitely will do
I intend to decrease the highest amount of alcohol I drink at one time in the next 2 weeks.
1 2 3 4 5 6 7
Definitely will not do Definitely will do
Click on the link below if you would like to be directed to resources that would help you to reduce your alcohol consumption:
http://rethinkingdrinking.niaaa.nih.gov/ToolsResources/Resources.asp
| File Type | application/msword |
| Author | Rebecca Anne Ferrer |
| Last Modified By | Rebecca Anne Ferrer |
| File Modified | 2012-03-21 |
| File Created | 2012-03-21 |