Healthcare Study

Appendix A

Questionnaire

PROPRIETARY NAMES STUDY

This survey will take about 20 minutes to complete. If possible, we ask you to complete the study in one sitting (without taking any breaks) in order to avoid distractions.

You will be shown several different drug names and then will be asked questions about each one. Please answer the questions to the best of your ability.

The following 7 drugs have recently been developed. Please carefully read over this list of names before advancing to the next screen.

[SHOW A RANDOM 7 OF THE 14 DRUG NAMES. RANDOMIZE ORDER]

[DRUG 1]

[DRUG 2]

[DRUG 3]

[DRUG 4]

[DRUG 5]

[DRUG 6]

[DRUG 7]

[NEXT SCREEN]

Recognition

Q1_1. Please place a check mark next to any names that appeared on the list you just saw:

[Show SAME 7 names in FIRST SET plus four foils; FOILS AND NAMES TO BE PRESENTED IN RANDOM ORDER.]

□ [DRUG 1]
□ [DRUG 2]

□ [DRUG 3]

□ [DRUG 4]

□ [DRUG 5]

□ [DRUG 6]

□ [DRUG 7]

□ Artidine (foil)
□ Fabcholest (foil)

□ Bancidrex (foil)
□ Elimacid (foil)

[NEXT SCREEN]

[SHOW SECOND SET OF 7 NAMES]

Here are 7 more drugs that have recently been developed. Please carefully read over this list of names before advancing to the next screen.

[SHOW REMAINING 7 DRUG NAMES. RANDOMIZE ORDER]

[DRUG 8]

[DRUG 9]

[DRUG 10]

[DRUG 11]

[DRUG 12]

[DRUG 13]

[DRUG 14]

[NEXT SCREEN]

Recognition

Q1_2. Please place a check mark next to any names that appeared on the list you just saw:

[Show SAME 7 names in Second SET plus four foils; FOILS AND NAMES TO BE PRESENTED IN RANDOM ORDER.]

□ [DRUG 8]
□ [DRUG 9]

□ [DRUG 10]

□ [DRUG 11]

□ [DRUG 12]

□ [DRUG 13]

□ [DRUG 14]
□ Jorvatrex (foil)
□ Preven-LDL (foil)
□ Calvidared (foil)
□ Famodine (foil)

[NEXT SCREEN]

Now, please consider each of the following drugs independently and answer the questions that follow to the best of your ability.

[NEXT SCREEN]

Manipulation check – Perceived Indication

[Q2 TO BE ASKED IN RANDOM ORDER FOR ALL 14 NAMES (ONE NAME AT A TIME)]

Q2. What health condition do you think [DRUG] is used to treat? Please make your best guess. (Choose only one.)

[RANDOMIZE ORDER OF CONDITIONS IN LIST BELOW]

1. Rheumatoid arthritis

2. Gastroesophageal Reflux Disease (also known as “acid reflux”)

3. Asthma

4. Diabetes

5. High cholesterol

[Once Q2 has been asked for all 14 names, randomize TO EITHER GERD OR HC FIRST and ask Q3-Q7 for each of the 7 names in that module, then Ask Q8-Q11 for the names in that MODULE]

[RANDOMIZE ORDER OF Q3-Q7]

PERCEIVED EFFICACY MAGNITUDE

[PROVIDER VERSION]

Q3. Overall, how effective do you think [DRUG] would be in managing [CONDITION] for your patients?

Not at all effective 1	2	3	4	5	6	Extremely effective 7
○	○	○	○	○	○	○

[CONSUMER VERSION]

Q3a. Overall, how effective do you think [DRUG] would be in managing [CONDITION] if you had it?

Not at all effective 1	2	3	4	5	6	Extremely effective 7
○	○	○	○	○	○	○

PERCEIVED SEVERITY OF RISKS

Q4. How serious would you guess the side effects or risks of [DRUG] would be?

Not serious at all 1	2	3	4	5	6	Extremely serious 7
○	○	○	○	○	○	○

PERCEIVED BALANCE OF RISKS AND BENEFITS

Q5. The benefits of [DRUG] outweigh any side effects it may have.

Strongly disagree 1	2	3	4	5	Strongly agree 6
○	○	○	○	○	○

AttitudES

Q6. When answering these questions, please use the scale from 1 to 7, where 1 represents the word/idea on the left and 7 represents that word/idea on the right. Your answer can fall on the ends or anywhere in between.

I feel [DRUG] is:

	1	2	3	4	5	6	7
Bad								Good
Desirable								Undesirable
Harmful								Beneficial
Valuable								Worthless

Perceived attributes of the drug

Q7. I think [DRUG] is:

	1	2	3	4	5	6	7
Friendly	○	○	○	○	○	○	○	Unfriendly
Modern	○	○	○	○	○	○	○	Outdated
Useful	○	○	○	○	○	○	○	Not useful
Popular	○	○	○	○	○	○	○	Unpopular
Gentle	○	○	○	○	○	○	○	Harsh
Artificial	○	○	○	○	○	○	○	Natural
Soft	○	○	○	○	○	○	○	Hard
Sharp	○	○	○	○	○	○	○	Blunt
Cheerful	○	○	○	○	○	○	○	Gloomy
Warm	○	○	○	○	○	○	○	Cold
Gentle	○	○	○	○	○	○	○	Harsh
Smooth	○	○	○	○	○	○	○	Rough

[IN Q8–Q11, LIST The 7 names in tHE module (either GERD or HC). NAMES TO BE PRESENTED IN RANDOM ORDER]

Now we have some questions about the full list of 7 drugs you saw.

IntentionS

Q8. How likely would you be to [talk to your doctor about/prescribe] each of the following drugs?

	Not at all likely 1	2	3	4	5	6	Extremely likely 7
Drug 1	○	○	○	○	○	○	○
Drug 2	○	○	○	○	○	○	○
Drug 3	○	○	○	○	○	○	○
Drug 4	○	○	○	○	○	○	○
Drug 5	○	○	○	○	○	○	○
Drug 6	○	○	○	○	○	○	○
Drug 7	○	○	○	○	○	○	○

Familiarity/similarity/typicality

SIMILARITY

Q9. How similar does each of the following drug names sound to other drug names you’ve heard?

	Not at all similar 1	2	3	4	5	6	Very similar 7
	○	○	○	○	○	○	○
Drug 1
Drug 2
Drug 3
Drug 4
Drug 5
Drug 6
Drug 7

TYPICALITY

Q10. For each of the following drug names, please answer whether you agree or disagree that it sounds like a typical name for a drug used to treat [CONDITION].

	Strongly disagree 1	2	3	4	5	6	Strongly agree 7
	○	○	○	○	○	○	○
Drug 1
Drug 2
Drug 3
Drug 4
Drug 5
Drug 6
Drug 7

FAMILIARITY

Q11. I have heard of each of the following drug names before:

	Strongly disagree 1	2	3	4	5	6	Strongly agree 7
	○	○	○	○	○	○	○
Drug 1
Drug 2
Drug 3
Drug 4
Drug 5
Drug 6
Drug 7

[REPEAT PROCEDURE FOR QUESTIONS 3-11 FOR MODULE 2]

DEBRIEFING SCREEN:

This concludes the survey. Our goal was to gather people’s reactions to information about prescription drug names. To get your true reaction to this information, we used fake drug names in this study.

None of the names shown are for real drugs. They are not available for use or sale.

[CONSUMERS ONLY] Please see your healthcare professional for questions about your health and your medical conditions.

Thank you very much for your time.