Table 2 Questionnaires
Category | Variables |
|---|---|
Baseline Questionnaire | |
 Demographics | Age, race, ethnicity, education, income, occupation |
 Gastric Symptoms | Stomach ache, heartburn, acid reflux, hunger pains, nausea, rumbling in stomach, feeling bloated, burping, passing gas, constipation, diarrhea, loose stools, hard stools, urgent need to have bowel movement, not completely emptying bowels |
 Family History | Cancer, 1st degree relatives, if occurred before age 50; stomach ulcers, gastritis, H. pylori |
 Medication Use | Use of antibiotics, aspirin, acetaminophen, peptic ulcer medication, pills for diabetes, insulin, allergy pills, asthma |
 Medical History | Heart trouble, high blood pressure, anemia, asthma, hayfever, skin allergy, food allergy, emphysema, COPD, stomach ulcer, duodenal ulcer, IBD, gastritis, H. pylori, GERD, heartburn, pancreatitis, TB, hepatitis, HPV, MS, diabetes |
 Cancer Screening | Women (pap smear, mammogram, sigmoidoscopy, colonoscopy), men (digital rectal exam, PSA blood test, sigmoidoscopy, colonoscopy) |
 Smoking | Smoking status, number per day, age first smoked, number of years; chewing tobacco, snuff/dip, pipes, cigars |
 Alcohol | Current use, type of drink, amount and how often |
 Physical Activity | Average sleep during week/week-end, vigorous and moderate activity, walking, sitting |
 Height and weight | Self-reported height/weight |
Follow-up Questionnaire | |
 Gastric Symptoms | Same as those in the baseline questionnaire (Table 2above) |
 Family History | Any 1st degree relatives during the past six months being diagnosed with cancer, ulcers, gastritis, H. pylori |
 Medical History | Changes in the past 6 months regarding anemia, stomach ulcer, duodenal ulcer, IBD, gastritis, GERD, diabetes |
 Interaction with doctor | Hp + only - communication with doctor about infection (in person, over the phone, via email), timeline from diagnosis to doctor’s visit, did doctor re-test prior to treatment, did doctor retest after treatment, what was prescribed (number of pills/day/duration), adherence to prescribed medication, cost |
 Experience with physician | Scale of very poor, poor, fair, good, very good; friendliness, explanation about their condition, concern about questions/worries, involvement in decision making, information about medications, follow-up care, amount of time spent with provider, confidence in provider, recommend provider |
 Height and weight | Self-reported height/weight |