Healthcare Professional Main Study Screener

Disclosures in Professional and Consumer Prescription Drug Promotion

Appendix A - Screeners

Healthcare Professional Main Study Screener

OMB: 0910-0860

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Appendix A: Participant Screeners


Consumer Survey Screener


Thank you for your interest in participating in this study. Please answer all of the following questions during this initial screening process to determine if you are eligible to participate in this study.


Question Type: Numeric

  1. What is your age?


Variable Label: S1: What is your age?


Value

Value Label

-99

Refused [Terminate]



[If under 18, terminate]



Question Type: Single Punch

  1. Do you live in the United States?


Variable Label: S2: Do you live in the United States?


Value

Value Label

00

No [Terminate]

01

Yes

-99

Refused [Terminate]



Question Type: Single Punch

  1. What is the highest level of school you have completed or the highest degree you have received?


Variable Label: S3: What is the highest level of school you have completed or the highest degree you have received?


Value

Value Label

01

Less than high school

02

High school graduate—high school diploma or the equivalent (for example, GED)

03

Some college but no degree

04

Associate degree in college

05

Bachelor’s degree (for example, BA, AB, BS)

06

Advanced or postgraduate degree (for example, master’s degree, MD, DDS, JD, PhD, EdD)

-99

Refused [Terminate]



Question Type: Single Punch

  1. What is your gender?


Variable Label: S4: What is your gender?


Value

Value Label

00

Female

01

Male

-99

Refused [Terminate]



Question Type: Single Punch

  1. Are you Hispanic or Latino?


Variable Label: S5: Are you Hispanic or Latino?


Value

Value Label

00

No

01

Yes

-99

Refused [Terminate]



Question Type: Multi-punch

  1. What is your race? You may select one or more races.


Variable Label: S6: What is your race? You may select one or more races.


Value

Value Label

01

American Indian or Alaska Native

02

Asian

03

Black or African American

04

Native Hawaiian or other Pacific Islander

05

White

06

Some other race

-99

Refused [Terminate]





Question Type: Single Punch

  1. Are you trained or employed as a health care professional?


Variable Label: S7: Are you trained or employed as a health care professional?


Value

Value Label

00

No

01

Yes [Terminate]

-99

Refused [Terminate]



Question Type: Single Punch

  1. Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Variable Label: S8: Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Value

Value Label

00

No

01

Yes [Terminate]

-99

Refused [Terminate]



Question Type: Single Punch

  1. When, if ever, was the last time you participated in a marketing research study?


Variable Label: S9: When, if ever, was the last time you participated in a marketing research study?


Value

Value Label

01

Within the past three months [Terminate]

02

More than three months ago

03

Never

-99

Refused [Terminate]





Physician Survey Screener


Thank you for your interest in participating in this study. Please answer all of the following questions during this initial screening process to determine if you are eligible to participate in this study.


Question Type: Numeric

  1. What is your age?


Variable Label: S1: What is your age?


Value

Value Label

-99

Refused [Terminate]


[If under 18, terminate]


Question Type: Single Punch

  1. What is your gender?


Variable Label: S2: What is your gender?


Value

Value Label

00

Female

01

Male

-99

Refused [Terminate]



Question Type: Single Punch

  1. Are you Hispanic or Latino?


Variable Label: S3: Are you Hispanic or Latino?


Value

Value Label

00

No

01

Yes

-99

Refused [Terminate]


Question Type: Multi-punch

  1. What is your race? You may select one or more races.


Variable Label: S4: What is your race? You may select one or more races.


Value

Value Label

01

American Indian or Alaska Native

02

Asian

03

Black or African American

04

Native Hawaiian or other Pacific Islander

05

White

06

Some other race

-99

Refused [Terminate]



Question Type: Single Punch

  1. Do you live in the United States?


Variable Label: S5: Do you live in the United States?


Value

Value Label

00

No [Terminate]

01

Yes

-99

Refused [Terminate]



Question Type: Single Punch

  1. What is your specialty?


Variable Label: S6: What is your specialty?


Value

Value Label

01

General practice

02

Family medicine

03

Internal medicine

04

Primary care

05

All others [Terminate]

-99

Refused [Terminate]



Question Type: Single Punch

  1. Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Variable Label: S7: Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Value

Value Label

00

No

01

Yes [Terminate]

-99

Refused [Terminate]





Consumer Eye-Tracking Screener


Thank you for your interest in participating in this study. Please answer all of the following questions during this initial screening process to determine if you are eligible to participate in this study.


Question Type: Numeric

  1. What is your age?


Variable Label: S1: What is your age?


Value

Value Label

-99

Refused [Terminate]



[If under 18, terminate]



Question Type: Single Punch

  1. Do you live in the United States?


Variable Label: S2: Do you live in the United States?


Value

Value Label

00

No [Terminate]

01

Yes

-99

Refused [Terminate]



Question Type: Single Punch

  1. What is the highest level of school you have completed or the highest degree you have received?


Variable Label: S3: What is the highest level of school you have completed or the highest degree you have received?


Value

Value Label

01

Less than high school

02

High school graduate—high school diploma or the equivalent (for example, GED)

03

Some college but no degree

04

Associate degree in college

05

Bachelor’s degree (for example, BA, AB, BS)

06

Advanced or postgraduate degree (for example, master’s degree, MD, DDS, JD, PhD, EdD)

-99

Refused [Terminate]





Question Type: Single Punch

  1. What is your gender?


Variable Label: S4: What is your gender?


Value

Value Label

00

Female

01

Male

-99

Refused [Terminate]



Question Type: Single Punch

  1. Are you Hispanic or Latino?


Variable Label: S5: Are you Hispanic or Latino?


Value

Value Label

00

No

01

Yes

-99

Refused [Terminate]



Question Type: Multi-punch

  1. What is your race? You may select one or more races.


Variable Label: S6: What is your race? You may select one or more races.


Value

Value Label

01

American Indian or Alaska Native

02

Asian

03

Black or African American

04

Native Hawaiian or other Pacific Islander

05

White

06

Some other race

-99

Refused [Terminate]





Question Type: Single Punch

  1. Are you trained or employed as a health care professional?


Variable Label: S7: Are you trained or employed as a health care professional?


Value

Value Label

00

No

01

Yes [Terminate]

-99

Refused [Terminate]



Question Type: Single Punch

  1. Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Variable Label: S8: Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Value

Value Label

00

No

01

Yes [Terminate]

-99

Refused [Terminate]



Question Type: Single Punch

  1. When, if ever, was the last time you participated in a marketing research study?


Variable Label: S9: When, if ever, was the last time you participated in a marketing research study?


Value

Value Label

01

Within the past three months [Terminate]

02

More than three months ago

03

Never

-99

Refused [Terminate]




Question Type: Single Punch

  1. Do you need to wear corrective lenses to view a computer screen for normal use (for example, browsing the web or creating or reading emails or other documents)?


Variable Label: S10: Do you need to wear corrective lenses to view a computer screen for normal use (for example, browsing the web or creating or reading emails or other documents)?


Value

Value Label

00

No

01

Yes, I wear glasses only [Terminate]

02

Yes, I wear contacts only

03

Yes, I can wear either glasses or contacts

-99

Refused [Terminate]





Physician Eye-Tracking Screener


Thank you for your interest in participating in this study. Please answer all of the following questions during this initial screening process to determine if you are eligible to participate in this study.


Question Type: Numeric

  1. What is your age?


Variable Label: S1: What is your age?


Value

Value Label

-99

Refused [Terminate]


[If under 18, terminate]


Question Type: Single Punch

  1. What is your gender?


Variable Label: S2: What is your gender?


Value

Value Label

00

Female

01

Male

-99

Refused [Terminate]



Question Type: Single Punch

  1. Are you Hispanic or Latino?


Variable Label: S3: Are you Hispanic or Latino?


Value

Value Label

00

No

01

Yes

-99

Refused [Terminate]


Question Type: Multi-punch

  1. What is your race? You may select one or more races.


Variable Label: S4: What is your race? You may select one or more races.


Value

Value Label

01

American Indian or Alaska Native

02

Asian

03

Black or African American

04

Native Hawaiian or other Pacific Islander

05

White

06

Some other race

-99

Refused [Terminate]



Question Type: Single Punch

  1. Do you live in the United States?


Variable Label: S5: Do you live in the United States?


Value

Value Label

00

No [Terminate]

01

Yes

-99

Refused [Terminate]



Question Type: Single Punch

  1. Are you a primary care physician?


Variable Label: S6: Are you a primary care physician?


Value

Value Label

00

No [Terminate]

01

Yes

-99

Refused [Terminate]



Question Type: Single Punch

  1. Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Variable Label: S7: Do you work for a pharmaceutical company, an advertising agency, a market research company, or the U.S. Department of Health and Human Services?


Value

Value Label

00

No

01

Yes [Terminate]

-99

Refused [Terminate]





Question Type: Single Punch

  1. Do you need to wear corrective lenses to view a computer screen for normal use (for example, browsing the web or creating or reading emails or other documents)?


Variable Label: S8: Do you need to wear corrective lenses to view a computer screen for normal use (for example, browsing the web or creating or reading emails or other documents)?


Value

Value Label

00

No

01

Yes, I wear glasses only [Terminate]

02

Yes, I wear contacts only

03

Yes, I can wear either glasses or contacts

-99

Refused [Terminate]



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