0920-1050 Individual Screener

DrugCommsEval_Task 3_CE-T3A

Website Usability Testing Screeners – Rx Awareness Campaign

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CDC Drug Overdose Communications Evaluation Project

Website Usability Testing Screener – Individuals

OMB Control No. 0920-1050

Exp. Date 05/31/2022

Public reporting burden of this collection of information is estimated to average 5 minutes per respondent. 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 CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia, 30333; ATTN: PRA (0920-1050).

Site	URL
Rx Awareness Campaign	https://www.cdc.gov/rxawareness/
Marijuana	https://www.cdc.gov/marijuana/index.htm

Introduction

We are conducting usability tests on behalf of the Centers for Disease Control and Prevention (CDC). The purpose of these usability tests is to get feedback on a CDC website.

These online interviews will take about 45 minutes.

Please answer the following questions to see if you are eligible to participate.

Rx Awareness Campaign Site - Marijuana Site

1. How old are you?

   1. 24 years and younger (TERMINATE)

   2. 25 to 34 years (CONTINUE)

   3. 35 to 44 years (CONTINUE)

   4. 45 to 54 years (CONTINUE)

   5. 55 years and older (TERMINATE)
      
      

2. Which state do you currently live in?

3. Ethnicity

   1. Hispanic or Latino

   2. Not Hispanic or Latino

4. Race (select all that apply):

   1. American Indian or Alaska Native

   2. Asian

   3. Black or African American

   4. Native Hawaiian or Other Pacific Islander

   5. White

5. What sex were you assigned at birth, on your original birth certificate?

   1. Male

   2. Female

   3. Refused

   4. I don’t know

6. What was the highest level of education you completed?

1. Less than a high school degree

2. High school degree, GED or alternative credential

3. Some college or trade school, but no degree

4. Associate's or trade school degree

5. Bachelor's degree

6. More than a bachelor’s degree

7. Which of the following best describes your total annual household income?

1. Less than $20,000

2. $20,000 to $39,999

3. $40,000 to $59,999

4. $60,000 to $79,000

5. $80,000 to $99,999

6. $100,000 to $149,999

7. $150,000 or more

8. Do not know/Refuse to answer

8. Have you ever worked for any of the following?

	Yes	No	Do not know/ Refuse to answer
In marketing, advertising, public relations, digital media, or any other communication field	(TERMINATE)	(CONTINUE)	(TERMINATE)
In public health, or with individuals with substance use disorders	(TERMINATE)	(CONTINUE)	(TERMINATE)
Pharmaceutical companies	(TERMINATE)	(CONTINUE)	(TERMINATE)
Any federal agency	(TERMINATE)	(CONTINUE)	(TERMINATE)

9. Do you have access to a computer with high-speed internet (e.g., not dial-up) that you can use to participate in the interview and view the website?

1. Yes (CONTINUE)

2. No (TERMINATE)

Invitation

ELIGIBLE: Based on your responses you are eligible to participate in the usability testing. Your input will help us improve the website. Your participation will be very important.

• Please provide an email address and phone number best to reach you so we may set up a date/time for the interview:

Email address: _______________________________________________

Phone number: _______________________________________________

INELIGIBLE: Unfortunately, you are not eligible to participate. Thank you for your interest.

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