OMB#0925-0046-06
Exp. Date: 2/28/13
Attachment 6B:
Trans-NIH Clinical Research Awareness Communications Plan
Message Testing Questionnaire
Assumption regarding creative concepts: We will be assessing three (3) concepts among the general public audience and three (3) among the physician audience.
Intro Text [section titles will not appear on live survey]
Welcome and thank you for responding to our survey invitation about your views on various health issues. Specifically, we will be asking you a series of questions about your attitudes and opinions regarding health issues that could impact your local community.
Our first few questions help ensure we ask you the right questions throughout the survey. Your time and opinions are greatly valued.
Public
reporting burden for this collection of information is estimated to
average 15 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the
collection of information. An
agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a
currently valid OMB control number.
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 (0925-0046-06).
Do not return the completed form to this address.
General Public Segments: Classification Questions [NOTE: THIS IS INFORMATION ALREADY ON FILE FOR EACH PANEL MEMBER]
What is your age? _____ MUST BE 18+
Are you:
Male
Female
What is your zip code? ____________ MUST BE U.S. RESIDENT
Do you consider yourself to be of Hispanic, Latino or Spanish origin?
Yes
No
How would you describe your racial background? (Multiple responses are allowed)
American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Other Pacific Islander
White
SEE QUOTAS FOR AFRICAN AMERICANS
Do you or does anyone in your family work for any of the following? Please select all that apply.
[MULTIPLE RESPONSE, RANDOMIZE]
An advertising agency or media company
A marketing or market research firm or department
A public relations company
The energy industry
Public heath
None of these [ANCHOR]
TERM IF Q6=A-C OR E
Do you, or does anyone who you are the primary caregiver for, have any of the following conditions? CHECK BOX. MULTIPLE RESPONSE. RANDOMIZE.
NOTE: Need to determine list conditions that qualify.
Condition |
I have this |
Someone I care for has this |
Congestive heart failure |
|
|
Diabetes |
|
|
Rheumatoid arthritis |
|
|
Cancer |
|
|
Depression |
|
|
Alzheimer’s |
|
|
High blood pressure |
|
|
Osteoarthritis |
|
|
QUALIFIES FOR SUFFERER/CAREGIVER QUOTA IF SELECTS ANY RESPONSES IN Q7. IF RESPONDENT QUALIFIES AS BOTH, ASSIGN TO LOWEST QUOTA
[QUESTIONS 8 & 9 ARE NOT ON FILE FOR GENERAL PUBLIC]
Which of the following statements best describes your level of understanding about clinical trials? When we refer to clinical trials research we mean controlled studies that are conducted with humans who volunteer to test the effectiveness and safety of new drugs, medical products or techniques.
I understand a lot about clinical trials
I have a general sense of what they are
I know very little about clinical trials
I have never heard of them before today
Have you ever considered participating in any type of clinical trials research?
No, never considered it
Yes, have considered it, but haven’t actually participated
I have participated in clinical trials research in the past
NOTE: We can use Q8/Q9 as our proxy to classify respondents into “Stages of Change” segments.
Medical Community: Classification Questions [NOTE: Q10-15 WILL BE ON FILE FOR PANEL MEMBERS IN MEDICAL COMMUNITY]
What is your age? _____
Are you:
Male
Female
Which of the following best describes your practice type?
INSERT LIST
How many years have you been in practice? ______
What is your zip code of the area your practice is located in? ____________
In your practice, do you diagnose or treat patients with the following conditions?
NOTE: Similar to GP audience, final condition list TBD.
Condition |
Yes |
Congestive heart failure |
|
Diabetes |
|
Rheumatoid arthritis |
|
Cancer |
|
Depression |
|
Alzheimer’s |
|
High blood pressure |
|
Osteoarthritis |
|
Have
you ever referred any of your patients to participate in clinical
trials research?
Yes
No
Main Questionnaire
Regardless of your answer to the previous question, how likely are you to participate in [For PCPs, “recommend that your patients participate in] clinical trials research in the future?
Very unlikely
Somewhat unlikely
Uncertain
Somewhat likely
Very likely
Why did you say that? That is, why are you likely, unlikely or uncertain? MANDATORY OPEN END
FOR PCPS
How do patients you discuss clinical trials research with generally react?
Very unfavorably
Somewhat unfavorably
Neither favorably nor unfavorably
Somewhat favorably
Very favorably
FOR PCPS
Why do you think that is? That is, why are they favorable or unfavorable? What do they say to you about it? Mandatory Open End
ASK ALL
How important do you think clinical trials research is to the advancement of our overall health care system?
Very unimportant
Somewhat unimportant
Neither important nor unimportant
Somewhat important
Very important
Below are some statements about clinical trial research. Please rate each using the following scale.
[5 point scale with anchors.
1=makes me much less likely to consider/recommend, and
5=makes me much more likely to consider/recommend]
Clinical trials are only conducted after preliminary testing has shown that a new treatment might be effective.
All drugs in the United States must undergo three phases of clinical trials before being approved for general use.
Clinical trials allow people to play an active role in their own health care.
Clinical trials allow people to gain access to new research treatments before they are widely available.
Clinical trials allow people to obtain expert medical care at leading health care facilities during the trial.
Clinical trials help others by contributing to medical research.
There may be unpleasant, serious or even life-threatening side effects to experimental treatment.
The experimental treatment may not be effective for the participant.
The research may require more of the patient’s time and attention than would other treatment, including trips to the study site, more treatments, hospital stays or complex dosage requirements.
Which, if any, of the following would make you strongly consider participating in a clinical trial if you had a serious disease like cancer? MULTIPLE RESPONSE.
My earlier treatment did not work
My doctor recommended it
They can promise me I won’t get a placebo
It won’t cost me any extra money
It won’t take a lot of my extra time and effort
It may not help me personally, but could help others
Concept Exposure
Unaided reactions
We’d now like to show you an advertisement. Please review the image carefully. You may click on the image to enlarge it at any point in the survey.
SHOW FIRST AD
What do you think the main idea of this ad is? [MANDATORY OPEN END]
What, if anything, did you like or find to be positive about the ad? If you didn’t like anything, please enter “nothing.” [MANDATORY TEXT BOX]
What, if anything, did you dislike, find to be negative or confusing about the ad? If you didn’t dislike anything, please enter “nothing.” [MANDATORY TEXT BOX]
SHOW SECOND AD AND REPEAT QUESTIONS Q24-26.
SHOW third AD AND REPEAT QUESTIONS Q24-26.
THEN SHOW FIRST AD AGAIN AND ASK Q27-29
Aided Ratings
Please indicate how well much you agree or disagree with the following statements.
Strongly disagree
Somewhat disagree
Somewhat agree
Strongly agree
Ultimate attitudinal and behavioral outcomes we want to influence.
[RANDOMIZE]
This ad makes me want to go to the website to find out more information.
This ad makes me more likely to consider participating in [recommending participation in] clinical trials research.
This ad makes me think that clinical trial research plays an important role in our overall health care system
NOTE: Additional items may be added based specifically on creative execution.
.
Now please indicate how well much you agree or disagree with the following statements.
Strongly disagree
Somewhat disagree
Somewhat agree
Strongly agree
Specific benefit messages we want to relay.
[RANDOMIZE]
This ad communicates that clinical trials are safe.
This ad communicates that clinical trials allow people to play an active role in their own health care
Finally, please indicate how well much you agree or disagree with the following statements.
Strongly disagree
Somewhat disagree
Somewhat agree
Strongly agree
Execution-related elements
.
[RANDOMIZE]
This ad tells me new information.
This ad would get my attention.
This ad talks about things that are important to me.
This ad is believable.
REPEAT Q27-29 FOR SECOND AND THIRD CONCEPTS
DISPLAY ALL THREE ADS AT ONCE
You’ve now seen three different ads. Please rank them from the one that makes you the most likely to consider participating in [recommend participating in] clinical trials research. Just drag and drop the ads to move them around.
Why did you rank that ad first? That is, why would it make you the most likely to consider participating in [recommend participating in] clinical trials research? MANDATORY OPEN END
How likely are you to participate in [For PCPs, “recommend that your patients participate in] clinical trials research in the future?
Very unlikely
Somewhat unlikely
Uncertain
Somewhat likely
Very likely
Demos
The following questions are asked for statistical purposes only and are used in aggregate only. Results remain strictly confidential.
What is your approximate annual household income?
Under $25,000
$25,000-$49,999
$50,000-$74,999
$75,000-$99,999
$100,000-$149,999
$150,000 or over
What was the last grade you completed in school?
Some high school
High school graduate
Some college
College graduate
Postgraduate/professional
File Type | application/msword |
File Title | Safe Kids Worldwide |
Author | Ledvi Beza |
Last Modified By | Vivian Horovitch-Kelley |
File Modified | 2010-11-09 |
File Created | 2010-11-02 |