What disease was the participant assigned to?
please give a percentage estimate for your own risk level for XX
Cancer or comparison measure
What gender do you identify with?
What is your age? (please enter a whole number).
Which of the following best represents your household income?
Do you have health insurance?
Do you receive Medicare benefits?
Do you receive Medicaid benefits?
What is the highest degree or level of school that you have completed?
What is your ethnicity? (check all that apply)
Trait anxiety
Have you been diagnosed with XX before?
Do you have any family members who were diagnosed with XX?
Do you have any friends who were diagnosed with XX?
Do you have any colleagues who were diagnosed with XX?
Do you have any acquaintances who were diagnosed with XX?
Perceived likelihood or susceptibility to the disease
Perceived severity of the disease
Perceived effectiveness of treatment for the disease
Perceived likelihood or susceptibility to treatment side effects
Perceived severity of treatment side effects
Perceived self efficacy to deal with treatment side effects
How many days of exercise in the last seven days?
How often engages in tanning practices?
Fear scale
w vs. w/o experience with disease