Main Study Screener

Risk and Benefit Perception Scale Development

QUESTIONNAIRE 0784 6-9-2015

Main Study Screener

OMB: 0910-0784

Document [docx]
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Measures Study

Survey


INTRODUCTION (TELEVISION ADS)

Thank you for agreeing to participate in this study today. Make sure you are comfortable and can read the screen from where you sit. The survey will include some audio, so please make sure the sound is on and the speaker volume is turned up.

This study will take about 30 minutes to complete. We ask you to please complete the study in one sitting (without taking any breaks) in order to avoid distractions.

This study is about a new prescription drug. The study has two parts: There are three parts: First, we will show you an advertisement about the new medication. Second, we will ask you some questions about the medication. Finally, we will show you a few more ads for medications and ask you which medications you like best.

PRODUCT ADVERTISEMENT (TELEVISION ADS)

On the next screen, you will see an advertisement for a new drug. The ad may take 15-30 seconds to start playing. Please click the Next button to view the ad.



[PROGRAMMER: Display ad correspondent to the participant’s experimental condition. Record duration of time spent watching ad and also time spent on each screen answering questions. Each ad should run twice. Also, please disable the “Next” button while each ad is playing to prevent participant from skipping ahead.]

We would like you to watch the ad a second time. Please click the Next button to view the ad.

[PROGRAMMER: Show ad twice.]



INTRODUCTION (PRINT ADS)

Thank you for agreeing to participate in this study today. Make sure you are comfortable and can read the screen from where you sit.

This study will take about 30 minutes to complete. We ask you to please complete the study in one sitting (without taking any breaks) in order to avoid distractions.

This study is about a new medication. There are three parts: First, we will show you an advertisement about the new medication. Second, we will ask you some questions about the medication. Finally, we will show you a few more ads for medications and ask you which medications you like best.

PRODUCT ADVERTISEMENT (PRINT ADS)

On the next screen, you will see an advertisement for a new drug. Please read this ad as if it were in a magazine. You can take as much time as you want to review it.

The ad has two pages. You can enlarge and flip between the pages by clicking on the “Next” and “Back” buttons at the bottom of each page. Once you finish reading, please click “Next” to move to the next part of the study.

[PROGRAMMER: Display ad correspondent to the participant’s experimental condition. Record time spent viewing ad.]



[NOTE: Items will be organized into modules, and we will select which modules to present in each survey wave. We also may randomly assign participants to complete specific modules within each survey wave.]








SURVEY QUESTIONS

Perceived Risk Likelihood

[Present survey instruction before each module.]

Most people don’t know how a prescription drug will affect them until they’ve taken the drug. But we’d like you to make your best guess based on the ad you just saw. Please answer the following questions based on what you saw in the ad.

  1. How likely it is that taking [Coravaz / Dolafex] would cause permanent negative side effects?

1

Not at all likely

2

3

4

5

6

Extremely likely


  1. [Coravaz / Dolafex] has very few risks and negative side effects.

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. How likely is it that you would experience at least one negative side effect if you took [Coravaz / Dolafex]?

1

Not at all likely

2

3

4

5

6

Extremely likely


  1. How often do you think [Coravaz / Dolafex] causes unwanted side effects?

1

Never

2

3

4

5

6

Always


  1. There is a good chance that I would develop at least one negative side effect from taking [Coravaz / Dolafex].

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. If 100 people take [Coravaz / Dolafex], how many do you think will have at least one negative side effect? Please enter a number from 0 to 100: ( __ people)




  1. What is the chance that you would develop each of the following side effects from taking [Coravaz/Dolafex]?

    1. [Heart failure / Suicidal thoughts]

      1

      Very low chance

      2

      3

      4

      5

      6

      Very high chance

    2. [Extreme fatigue / Restlessness or agitation]

      1

      Very low chance

      2

      3

      4

      5

      6

      Very high chance

    3. Dry mouth

1

Very low chance

2

3

4

5

6

Very high chance


  1. How likely is it that you would experience the following side effects if you took [Coravaz/Dolafex]?

    1. [Heart failure / Suicidal thoughts]

      1

      Not at all likely

      2

      3

      4

      5

      6

      Extremely likely

    2. [Extreme fatigue / Restlessness or agitation]

      1

      Not at all likely

      2

      3

      4

      5

      6

      Extremely likely

    3. Dry mouth

1

Not at all likely

2

3

4

5

6

Extremely likely



Perceived Risk Magnitude

  1. How serious are [Coravaz / Dolafex]’s side effects?

1

Not at all serious

2

3

4


5

6

Extremely serious


  1. How serious are each of the following side effects of [Coravaz/Dolafex]?

    1. [Heart failure / Suicidal thoughts]


      1

      Not at all serious

      2

      3

      4

      5

      6

      Extremely serious

    2. [Extreme fatigue / Restlessness or agitation]


      1

      Not at all serious

      2

      3

      4

      5

      6

      Extremely serious

    3. Dry mouth


1

Not at all serious

2

3

4

5

6

Extremely serious


  1. If I took [Coravaz / Dolafex] and had any negative side effects, they would probably be:

1

Very minor

2

3

4

5

6

Very serious


  1. To what extent do you think [Coravaz / Dolafex]’s side effects would affect your physical health ?

1

Not at all

2

3

4

5

6

Extremely


  1. If [Coravaz / Dolafex] did cause you to have negative side effects, how serious would they be?

1

Not at all serious

2

3

4

5

6

Extremely serious


  1. If [Coravaz /Dolafex] caused you to have the following side effects, how serious would each of them be?

    1. [Heart failure / Suicidal thoughts]

      1

      Not at all serious

      2

      3

      4

      5

      6

      Extremely serious

    2. [Extreme fatigue / Restlessness or agitation]

      1

      Not at all serious

      2

      3

      4

      5

      6

      Extremely serious

    3. Dry mouth

1

Not at all serious

2

3

4

5

6

Extremely serious


  1. To what extent do you think [Coravaz / Dolafex]’s side effects would affect your physical health and ability to function (strength, energy levels, etc.)?


1

Not at all

2

3

4

5

6

Extremley


Perceived Risk Onset

  1. If negative side effects were to occur, how soon after taking [Coravaz / Dolafex] would they start?

    Minutes

    Hours

    Days

    Weeks








  2. How soon after taking [Coravaz / Dolafex] would you expect side effects to occur?

1

Never

2

3

4

5

6

Very soon


  1. If [Coravaz / Dolafex] did cause you to have negative side effects, how quickly would they occur after taking the drug?

1

Not at all quickly

2

3

4

5

6

Very quickly



Perceived Risk Duration

  1. How long will [Coravaz / Dolafex]’s negative side effects last once they begin?

    1

    Minutes

    2

    Hours

    3

    Days

    4

    Weeks

    5

    Months

    6

    Years

    7

    Never

  2. Do you think [Coravaz / Dolafex]’s side effects would be short lived or long lasting?

1

Short-lived

2

3

4

5

6

Long-lasting



Perceived Efficacy Likelihood


  1. How likely is it that [Coravaz / Dolafex] would [relieve your chronic pain/lower your high blood pressure] if you took it?

1

Not at all likely

2

3

4

5

6

Extremely likely


  1. How often do you think [Coravaz / Dolafex] [lowers blood pressure/reduces chronic pain]?

1

Never

2

3

4

5

6

Always


  1. If 100 people take [Coravaz / Dolafex], for how many will the drug [lower blood pressure/reduce chronic pain]? Please enter a number in the box below.

(___ people)


  1. I would be able to participate in my usual activities after taking [Coravaz / Dolafex].

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. [Coravaz / Dolafex is more likely to help my [chronic pain / high blood pressure] than other prescription drugs.

1

Strongly disagree

2

3

4

5

6

Strongly agree

Perceived Efficacy Magnitude

  1. How well would [Coravaz / Dolafex] relieve [chronic pain/treat high blood pressure]?

1

Not at all well

2

3

4

5

6

Extremely well


  1. How effective would [Coravaz / Dolafex] be in treating your [chronic pain / high blood pressure]?

1

Not at all effective

2

3

4

5

6

Extremely effective


  1. How much relief would [Coravaz / Dolafex] give you from your [chronic pain / high blood pressure]?

1

Very little relief

2

3

4

5

6

Complete relief


  1. Taking [Coravaz / Dolafex] for [ high blood pressure / chronic pain] ] would…

1

Improve my [high blood pressure / chronic pain] a little

2

3

4

5

6

Improve my [high blood pressure / chronic pain] a lot



  1. Taking [Coravaz / Dolafex] for [chronic pain/high blood pressure] would be…

1

Not at all helpful

2

3

4

5

6

Extremely helpful


  1. If I took [Coravaz / Dolafex], it would help my [chronic pain/high blood pressure].

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. How well would [Coravaz / Dolafex] prevent the need for other treatments for your [chronic pain/high blood pressure]?

1

Not at all well

2

3

4

5

6

Extremely well



  1. If I used [Coravaz / Dolafex], I would not need to take any other medications for my [high blood pressure/chronic pain].

    1

    Strongly disagree

    2

    3

    4

    5

    6

    Strongly agree

  2. How much would [Coravaz / Dolafex] improve your [ high blood pressure / chronic pain]?

1

No improvement

2

3

4

5

6

Substantial Improvement



  1. How consistently would [Coravaz / Dolafex] [relieve your chronic pain/ treat you high blood pressure]? (For example, would it work sometimes but not other times?)

1

Does not work consistently

2

3

4

5

6

Works very consistently


  1. If I took [Coravaz / Dolafex], it would probably help my [chronic pain / high blood pressure] a lot.

1

Strongly disagree

2

3

4

5

6

Strongly agree

Perceived Efficacy Onset

  1. How quickly would you notice if [Coravaz / Dolafex] was working?

1

Within minutes

2

Within hours

3

Within days

4

Within weeks

5

Within months



  1. [Coravaz / Dolafex] would work fast.

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. How long do you think it would take for [Coravaz / Dolafex] to improve your [chronic pain/high blood pressure]?

    1

    A very long time

    2

    3

    4

    5

    6

    A very short time

  2. How fast would [Coravaz / Dolafex] [relieve your chronic pain/ lower your high blood pressure]?

1

Very slow

2

3

4

5

6

Very fast



Perceived Efficacy Duration

  1. How long would [Coravaz / Dolafex]’s positive effects last, once the drug started working?

1

Minutes



Hours

3

Days



Weeks



Months



Years



Never


  1. How long would one dose of [Coravaz / Dolafex] last before your [chronic pain / high blood pressure] symptoms returned?

1

A short time

2

3

4

5

6

A long time


  1. How long would [Coravaz / Dolafex] treat your [chronic pain / high blood pressure] before you needed to take another dose?

1

A short time

2

3

4

5

6

A long time


  1. Do you think [Coravaz / Dolafex]’s positive effect on [chronic pain/high blood pressure] would be short lived or long lasting?

1

Short-lived

2

3

4

5

6

Long-lasting


Perceived Benefit General

  1. [Coravaz / Dolafex] has extra benefits besides treating [chronic pain/high blood pressure].

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. In addition to treating [chronic pain/high blood pressure] there are other advantages to taking [Coravaz / Dolafex].

1

Strongly disagree

2

3

4

5

6

Strongly agree



  1. If [Coravaz / Dolafex] did have benefits other than treating [chronic pain/high blood pressure], how valuable would they be?

1

Not at all valuable

2

3

4

5

6

Very valuable


Perceived Benefit Positive Characteristics

  1. How difficult or easy would it be to take [Coravaz / Dolafex]?

1

Extremely difficult

2

3

4

5

6

Extremely easy


  1. [Coravaz / Dolafex] is more convenient than other [chronic pain / high blood pressure] prescription drugs.

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. It is easier to take [Coravaz / Dolafex] than other [chronic pain / high blood pressure] prescription drugs.

1

Strongly disagree

2

3

4

5

6

Strongly agree



  1. It is easier to tolerate [Coravaz / Dolafex] than other [chronic pain / high blood pressure] prescription drugs.

1

Strongly disagree

2

3

4

5

6

Strongly agree


Perceived Benefit Secondary Medical Benefits


  1. Taking [Coravaz / Dolafex] would result in medical benefits other than an improvement in [chronic pain/high blood pressure].

    1

    Strongly disagree

    2

    3

    4

    5

    6

    Strongly agree

  2. How likely it is that taking [Coravaz / Dolafex] would improve your quality of life?

    1

    Not at all likely

    2

    3

    4

    5

    6

    Extremely likely

  3. How likely it is that taking [Coravaz / Dolafex] would make you feel better?

1

Not at all likely

2

3

4

5

6

Extremely likely



Risk / Benefit Tradeoff



  1. The good things about this drug [(pain relief)/(lower blood pressure)] outweigh the bad things (side effects).

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. The benefits of [Coravaz / Dolafex] outweigh all the things I have to do to obtain it (appointments, prescriptions, leave).

1

Strongly disagree

2

3

4

5

6

Strongly agree



  1. The benefits of [Coravaz / Dolafex] outweigh any side effects it may have.

1

Strongly disagree

2

3

4

5

6

Strongly agree





Validity Testing

67.

[RANDOMIZE ORDER]

1

2

3

4

5

6


Strongly disagree





Strongly agree

  1. The majority of prescription drugs work the way they are supposed to work.







  1. Prescription drugs are the best option for treating most health conditions.







  1. Prescription drugs are an effective way to treat most health conditions.







  1. Prescription drugs are a safe way to treat most health conditions (reverse coded)







  1. Most people who take a prescription drug will experience at least one side effect.







  1. Most prescription drug side effects that people experience are minor (reverse code).







  1. Over the counter products are safer than prescription drugs.

















  1. We would like to ask you about your personal views on prescription medicines in general. These are statements other people have made about their medicines. Please indicate the extent to which you agree or disagree with them by checking the appropriate box. There are no right or wrong answers. We are interested in your personal views.

[RANDOMIZE ORDER]

1

2

3

4

5

6

7


Strongly disagree






Strongly agree

  1. If doctors had more time, they would prescribe fewer medicines.








  1. Doctors place too much trust in medicines.








  1. Doctors use too many medicines








  1. Natural remedies are safer than medicines.








  1. Most medicines are addictive.








  1. Medicines do more harm than good.








  1. All medicines are poisons.








  1. People who take medicines should stop their treatment for a while every now and again.










  1. Are you currently taking or have you ever taken any drugs for [chronic pain/high blood pressure]?

1

Currently taking

2

Previously taken but not currently taking

3

Never taken





  1. How satisfied are you with the ability of your current drug(s) to treat your [chronic pain / high blood pressure]?

1

Very dissatisfied

2

3

4

5

6

Very satisfied


  1. How much does your [chronic pain/high blood pressure] affect your daily life?

1

Not at all

2

3

4

5

6

Very much


  1. How much does your [chronic pain/high blood pressure] limit your daily activities?

1

Not at all

2

3

4

5

6

Very much


  1. How severe is your [chronic pain/high blood pressure] without medication?

Not at all severe (1)…very severe (6)

1

Not at all severe

2

3

4

5

6

Very severe


  1. I can cope without my [chronic pain/high blood pressure] medication.

1

Strongly disagree

2

3

4

5

6

Strongly agree



  1. [RANDOMIZE ORDER]

1

2

3

4

5

6


Strongly disagree





Strongly agree

  1. a. Seeing the list of [Coravaz / Dolafex]’s negative side effects is overwhelming.







  1. I would be very worried about experiencing negative side effects if I took [Coravaz / Dolafex].







c. Thinking about the negative side effects from [Coravaz / Dolafex] makes me anxious.









76. Please mark how likely or unlikely you are to do the following behaviors.

[RANDOMIZE ORDER]

1

2

3

4

5

6


Very unlikely





Very likely

  1. ask your doctor for more information about [Coravaz / Dolafex].







  1. ask your doctor toprescribe [Coravaz / Dolafex].







  1. look for information about [Coravaz / Dolafex] on the Internet.







  1. talk with a friend or family member about [Coravaz / Dolafex].







  1. ask other people who’ve taken [Coravaz / Dolafex] about their experience.







  1. ask your pharmacist about [Coravaz / Dolafex].







  1. try [Coravaz / Dolafex] if your doctor gave you a prescription for it.







Moderators

  1. I experience prescription drug side effects more frequently than other people my age.

1

Strongly disagree

2

3

4

5

6

Strongly agree






  1. Whenever I take prescription drugs, they tend to work the way they are supposed to work.

1

Strongly disagree

2

3

4

5

6

Strongly agree


  1. [RANDOMIZE ORDER]

1

2

3

4

5

6

7


Strongly disagree






Strongly agree

a. We can depend on getting the truth in most prescription drug advertising.








b. Prescription drug advertising’s aim is to inform the consumer.








c. I believe prescription drug advertising is informative.








d. Prescription drug advertising is generally truthful.








e. Prescription drug advertising is a reliable source of information about the risks and benefits of drugs.








f. Prescription drug advertising is truth well told.








g.In general, prescription drug advertising presents a true picture of the drug being advertised.








  1. I feel I’ve been accurately informed after viewing most prescription drug advertising.








  1. Most prescription drug advertising provides consumers with essential information.








  1. Most prescription drug advertising provides consumers with essential information.










  1. How many prescription drugs are you currently taking?



  1. How many prescription drugs are you currently taking for [chronic pain / high blood pressure]?


  2. How long have you been taking your current prescription drug for [chronic pain/high blood pressure]?


  3. Have you ever experienced a serious side effect from a prescription drug?

Yes / No



  1. [RANDOMIZE ORDER]

1

2

3

4

5

6


Strongly disagree





Strongly agree

  1. There are many effective treatments available for [chronic pain / high blood pressure].







  1. I have a lot of options when it comes to treating my [chronic pain / high blood pressure].









  1. [Ask only of those currently taking drug for target condition]How satisfied are you with your current prescription drug for [chronic pain / high blood pressure]?

1

Very dissatisfied

2

3

4

5

6

Very satisfied



Early adopter questions (for use in GfK’s calibration/weighting process):

  1. [RANDOMIZE ORDER]

1

2

3

4

5


Strongly disagree

Disagree

Neither agree nor disagree

Agree

Strongly agree

  1. I usually try new products before other people do






  1. I often try new brands because I like variety and get bored with the same old thing






  1. When I shop I look for what is new






  1. I like to be the first among my friends and family to try something new






  1. I like to tell others about new brands or technology








DRUG CHOICE EXERCISE

  1. Next you will view an ad for another [chronic pain / high blood pressure] medication. We will then ask you to answer one question about the new ad.

[PRESENT KESTERIN OR ZINTRIA AD]

If they cost the same, which drug would you choose to take?

  • [Coravaz / Dolafex]

  • The other medication, [Zintria / Kesterin]


  1. Next you will view both the original [Coravaz / Dolafex] ad and an ad for a different version of [Coravaz / Dolafex]. The second ad is the similar to the first one, but some of the information about [Coravaz / Dolafex] is different. We will then ask you to answer one question about the ads.

[PRESENT ORIGINAL AD]

[PRESENT ALTERNATE AD]

If they cost the same, which drug would you choose to take?

  • The version of [Coravaz / Dolafex] described in the first ad

  • The version of [Coravaz / Dolafex] described in the second ad

CLOSING

Those are all the questions we have for you today. The purpose of this study is to learn how consumers interpret and use prescription drug information. In order to get a real-life reaction, we used pretend products in this study. [Coravaz / Dolafex] is not a real product and is not available for sale.

Please see your healthcare provider for any questions about [chronic pain / high blood pressure] and treatments for this condition.

You have been very helpful. Thank you very much for your participation!



OMB Control No: __________________ Expires: _______________


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