Attach 18

OMB #: 0925-NEW
Expiration Date: xx/xxxx
This survey should take approximately 20 minutes to complete

Genomics, Race, Ancestry, and Identity Survey
Section I:
The first group of questions is about genetic ancestry testing. Genetic ancestry testing is done on an individual
basis, in an attempt to determine the ancestral origins or population(s) of origin for a person or a family.
* Have you ever had a genetic ancestry test?
Q1.

<1> Yes (go to Section II)
<2> No
* If you have not had a genetic ancestry test, would you consider having a genetic ancestry test?

Q2.

<1> Yes
<2> Maybe
<2> No

Section II:
We would like to know your opinion on the following statements. There is no right or wrong answer. Please indicate
whether you strongly agree, somewhat agree, somewhat disagree, strongly disagree or neither agree nor disagree
with each statement.
* Doctors should use genetic ancestry information to help diagnose certain conditions or diseases.
<1> Strongly agree
<2> Somewhat agree
Q3.

<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree

* Doctors should use genetic ancestry information in deciding how to treat certain conditions or diseases.
<1> Strongly agree
Q4.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree
* United States law enforcement should use genetic ancestry information to genetically profile suspects when
necessary.
<1> Strongly agree

Q5.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree
* Colleges & universities should use genetic ancestry testing to confirm the self-racial or ethnic identification of
applicants.
<1> Strongly agree

Q6.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree
* I believe genetic ancestry testing supports biological beliefs of race.
<1> Strongly agree

Q7.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree

* I believe genetic ancestry testing challenges biological beliefs of race.
<1> Strongly agree
Q8.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree

Section III :
The next group of questions is about race and genetics. We would like to know your opinion on the following
statements. There is no right or wrong answer.
The United States Census categories of race (White, Black or African American, Indian or Alaska Native, Hawaiian
Northern Pacific Islander, Asian) correspond with genetic differences among people.

Q9.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999

**A doctor’s best predictor of how a patient will respond to medical treatment is their race.

Q10.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999

**Race identifies individuals who can benefit from screening for certain diseases.

Q11.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999

**There are genetic differences among racial groups that influence health.

Q12.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999

**Genetic differences provide clues in determining the primary causes of racial and ethnic health disparities in the
United States.
Q13.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999

**Knowing a person’s race is important to understanding his/her genetic risks.

Q14.

<1> All of the time

1

<2> Most of the time

2

<3> Some of the time

3

<4> A little of the time

4

<5> None of the time

5

**A person’s race plays an important role in doctors’ decisions about prescribing medications.

Q15.

<1> All of the time

1

<2> Most of the time

2

<3> Some of the time

3

<4> A little of the time

4

<5> None of the time

5

With the increase in personalized medicine, doctors will not need to use their patients’ race in health care decisions.

Q16.

<1> Strongly agree

1

<2> Somewhat agree

2

<3> Neither agree nor disagree

3

<4> Somewhat disagree

4

<5> Strongly disagree

5

* The human population may be subdivided into biological races.
<1> Strongly agree
Q17.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree
* Racial categories are determined by biology.
<1> Strongly agree

Q18.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree

* There are discrete biological boundaries among races.
<1> Strongly agree
Q19.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree
* The term “race”, as used to describe human groups, should be replaced by a more precise term.
<1> Strongly agree

Q20.

<2> Somewhat agree
<3> Neither agree nor disagree
<4> Somewhat disagree
<5> Strongly disagree

Section IV
The next group of questions asks about your thoughts on doctors using your race in clinical decision making
encounters. There are no right or wrong answers. Please select the answer that best reflects your views.
**Doctors should consider my race when determining what age I should begin to be screened for certain diseases.

Q21.

<1> All of the time

1

<2> Most of the time

2

<3> Some of the time

3

<4> A little of the time

4

<5> None of the time

5

**Doctors should consider my race in determining how aggressively to treat particular diseases.

Q22.

<1> All of the time

1

<2> Most of the time

2

<3> Some of the time

3

<4> A little of the time

4

<5> None of the time

5

**My race provides important information about my risk for certain diseases.

Q23.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999

**My race is the best way for doctors to identify my genetic risk of disease and health.

Q24.

<1> Strongly agree

0

<2> Somewhat agree

1

<3> Somewhat disagree

2

<4> Strongly disagree

3

<5> Unsure

999