Pretest Screener

1
Pretest and Main Study Screener
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Quick notes:
 Block names are highlighted in yellow
 Notes for programming are highlighted in green
 [Notes for interviewer are in brackets and in blue]
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//PROGRAMMING NOTE: INCLUDE ONE VARIABLE IN DATA SET, RESPONDENT ID (A UNIQUE
IDENTIFIER)//
//NEW SCREEN//
Question Type: Single Punch
T1. Type of phone [DO NOT READ, BUT SELECT THE TYPE OF PHONE YOU ARE CALLING TO]
Variable Label: T1: Type of phone
Value
01
02
-98

Value Label
Landline
Cell Phone
Don’t know [DO NOT READ]

//PROGRAMMING NOTE: IF T1=1 GO TO “LINTRO1”, IF T1=2 GO TO “CINTRO1”//
//NEW SCREEN//
[LANDLINE INTRODUCTION]
LINTRO1
Hello. My name is [INTERVIEWER’S NAME] and I’m calling from SSRS, a well-respected national
research firm, to conduct a survey on behalf of a government agency.
[IF ASKED: This interview takes about 15 minutes.]
[IF NECESSARY: This is NOT a sales or fundraising call.]
[CONTINUE TO CONSENT]
//PROGRAMMING NOTE: GO TO “CONSENT” NEXT//
//NEW SCREEN//
[CELLPHONE INTRODUCTION]

2
CINTRO1
Hello. My name is ______________ and I’m calling from SSRS, a well-respected national research
firm, to conduct a survey on behalf of a government agency.
[IF ASKED: This interview takes about 15 minutes.]
[IF NECESSARY: This is NOT a sales or fundraising call.]
Question Type: Single Punch
CINTRO1_A. Before we continue, are you driving?
Variable Label: CINTRO1_A: Cellphone driving
Value
00
01
02
-99

Value Label
Not driving
Driving
This is NOT a cell phone [DO NOT READ]
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF “CINTRO1_A”=O GO TO “CONSENT”; IF “CINTRO1_A”=1 GO TO
“CINTRO1_B”; IF “CINTRO1_A”=2 OR -99 GO TO “TERMINATE”//
Question Type: Open-Ended
CINTRO1_B. When would be the best time to call back?
Variable Label: CINTRO1_B: Call back information driving
Date: [ENTER DATE IN FORMAT: MM/DD/YYYY]

Time: [ENTER TIME IN FORMAT: HH:MM AM/PM]

Name to ask for:

[THANK AND END CALL]
//PROGRAMMING NOTE: FINISH QUESTIONNAIRE WHEN INTERVIEWER CLICKS “NEXT”//
[VERBAL CONSENT]
CONSENT

I would like to ask you some questions about access to prescription drug advertising
materials and learn about your background. This survey will last about 15 minutes. The
survey may be audio recorded for quality control purposes. Your personal information
will be kept private. This research study is voluntary, you can refuse to answer or skip
any question, and you can stop at any time.

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Is it OK if I ask you a few questions?
READ IF NEEDED: The purpose of the research study is to learn about peoples’ access
to prescription drug advertising materials. There is no direct benefit to you for being in
this research study. However, results from this research study will help the researchers
learn how people access and understand information about prescription drugs. There
is no compensation for participating in this research study.
Question Type: Single Punch
CONSENT_A. Is it OK to ask you some questions and begin audio recording now?
Variable Label: CONSENT_A: Accept consent
Value
00
01

Value Label
No
Yes

//PROGRAMMING NOTE: IF “CONSENT_A” = 1 GO TO I2 ; IF “CONSENT_A” = 0 GO TO ‘TERMINATE”//
//NEW SCREEN//
AGE
Question Type: Open-Ended Numerical
I2. Could you please tell me your age?
Variable Label: I2: AGE1

[ENTER AGE IN YEARS; ENTER -99 IF REFUSED TO ANSWER]
//PROGRAMMING NOTE: IF 0= 18 GO TO S1
//NEW SCREEN//
Question Type: Single Punch
B1. May I please speak with an adult 18 or older living in this household?
Variable Label: B1: Ask for adult in household
Value
00
01
-99

Value Label
No
Yes
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF B1=1 GO TO “INTRO”; IF B1<1 GO TO “TERMINATE”//
//NEW SCREEN//

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[INTERNET USE]
Question Type: Single Punch
S1. Have you browsed the internet in the past month?
Variable Label: S1: Browsed internet past month
Value
00
01
-98
-99

Value Label
No
Yes
Don’t know [DO NOT READ]
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF S1=0 GO TO S4; IF S1=1 GO TO S2; IF (S1<0 AND T1=1) GO TO S3; IF
(S1<0) AND (T1=2) GO TO “TERMINATE”//
//NEW SCREEN//
Question Type: Single Punch
S2. How many times in the past month have you browsed the internet?
Variable Label: S2: Browsed internet past month
Value
01
02
-99

Value Label
Two or fewer
Three or more
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF S2=1 GO TO S4; IF S2= (-99 OR 2) AND (T1=1) GO TO S3; IF S2= (-99 OR
2) AND (T1=2) GO TO “TERMINATE”//
//NEW SCREEN//
Question Type: Single Punch
S3. Is there another adult in your household who has not browsed the internet or browsed it
infrequently in the last month?
Variable Label: S3: Other infrequent user in household
Value
01
02
03
-99

Value Label
Yes, available now [ASK TO SPEAK WITH]
Yes, not available right now
No, everyone in the household uses the
internet often
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF S3=1 GO TO “INTRO”; IF S3=2, GO TO S3_A; IF S3= -99 OR 3, GO TO
“TERMINATE”//

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//NEW SCREEN//
Question Type: Open-Ended
S3_A. When would be the best time to call back?
Variable Label: S3_A: Call back information
Date: [ENTER DATE IN FORMAT: MM/DD/YYYY]

Time: [ENTER TIME IN FORMAT: HH:MM AM/PM]
Name to ask for:

//NEW SCREEN//
[TELEVISION ACCESS]
Question Type: Single Punch
S4. Do you watch television at least occasionally?
Variable Label: S1: Watch television occasionally
Value
00
01
-98
-99

Value Label
No
Yes
Don’t know [DO NOT READ]
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF S4=(0 OR -98 OR -99) GO TO “TERMINATE”//
//NEW SCREEN//
[RX USE]
Question Type: Open-Ended Numerical
S5. How many different prescription medications are you taking on a regular or ongoing basis?
Variable Label: S5: Number of prescription drugs currently taking

[ENTER NUMBERS ONLY, ENTER -98 IF DON’T KNOW; ENTER -99 IF REFUSED TO ANSWER]
//PROGRAMMING NOTE: IF S5<1 GO TO S6; IF S5>0 GO TO SURVEY (PARTICIPANT QUALIFIES)//
//NEW SCREEN//
Question Type: Single Punch

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S6. Have you ever regularly taken a prescription drug in the past?
Variable Label: S6: Taken prescription drug in the past
Value
00
01
-98
-99

Value Label
No
Yes
Don’t know [DO NOT READ]
Refused [DO NOT READ]

//PROGRAMMING NOTE: IF S6=1 GO TO MAIN QUESTIONNAIRE (PARTICIPANT QUALIFIES); IF S6<1
GO TO “TERMINATE”//