Pretest 1 and 2 Screener

Appendix B – Screener (Pretests and Main Studies)

[The OMB control number and expiration date will appear at the bottom of every screen.]

[Screen 1]

S1. What is your age? ______ [open ended, permit responses 0-100]

[IF S1 <18, TERMINATE after S3; GO TO S2]

[Screen 2]

S2. Have you ever been diagnosed with any of the following health conditions by a doctor or other qualified health care provider? (Select all that apply)

1. Diabetes (Type I or Type II)

2. Fibromyalgia

3. Generalized anxiety disorder

4. Psoriatic arthritis

5. Rheumatoid arthritis

6. Ulcerative colitis

7. None of the above

8. Don’t know/Don’t remember

[IF S2=2 “Rheumatoid arthritis” OR S2=4 “Diabetes”, CONTINUE]

[ALL ELSE, SET EFLAG= 0 “Ineligible” – TERMINATE after S3 GO TO S3]

[Screen 3]

S3. What is your occupation?

1. Healthcare provider (e.g., physician, nurse, counselor, physical therapist)

2. Pharmaceutical company employee (e.g., pharma rep)

3. Market research company employee or advertising agency employee

4. Department of Health and Human Services employee

5. None of the above

[IF S3 = 5, UNCHECK ALL OTHER OPTIONS]

[IF S3 = 1, 2, 3, 4, OR REFUSED, SET EFLAG=0 “Ineligible” – TERMINATE after S3]

[IF S3=5, CONTINUE TO S4]

[Screen 4]

S4. What is your sex?

1. Male

2. Female

3. Prefer not to answer

[Screen 5]

S5. Are you Hispanic or Latino?

1. Yes

2. No

3. Prefer not to answer

[Screen 6]

S6. What is your race? (You may select one or more races.)

1. American Indian or Alaska Native

2. Asian

3. Black or African American

4. Native Hawaiian or other Pacific Islander

5. White

6. Prefer not to answer

[Screen 7]

S7. What is the highest level of school you have completed or the highest degree you have received?

1. Less than high school

2. High school graduate—high school diploma or the equivalent (for example: GED)

3. Some college but no degree

4. Vocational or Technical School degree

5. Associate’s degree

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

7. Some postgraduate work but no degree

8. Advanced or post-graduate degree (for example: Master’s degree, MD, DDS, JD, PhD, EdD)

[DISPLAY IF EFLAG=0 ‘INELIGIBLE’]

[Thank and Terminate—Ineligible]

[Screen 8]

We’re sorry, but you are not eligible for this study. There are many possible reasons why people are not eligible for this study. These reasons were decided earlier by the researchers. However, thank you for your interest in this study and for taking the time to answer our questions today.

[TERMINATE IF EFLAG=0 ‘INELIGIBLE’]

[IF EFLAG=1 ‘ELIGIBLE’; CONTINUE, RANDOMLY ASSIGN PARTICIPANTS TO A STUDY CONDITION]

[Screen 8]

You are eligible to participate in the study.