Appendix D - Study Screener 2019

Accelerated Approval Disclosures on Direct-to-Consumer Prescription Drug Websites

Appendix D - Study Screener 2019

OMB: 0910-0872

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SCREENER

[INTRO TEXT]

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


//NEW SCREEN//


Question Type: Open End Numerical

S1. How old are you?

Variable Label: S1: How old are you?




years old


Value

Value Label

-99

Refused


Question Type: Single Punch

S2. Are you trained or employed as a health care professional?
Variable Label: S2: Are you trained or employed as a health care professional?


Value

Value Label

01

Yes

00

No

-99

Refused


Question Type: Single Punch

S3. Do you work for the U.S. Department of Health and Human Services (HHS)?

Variable Label: S3: Do you work for the U.S. Department of Health and Human Services (HHS)?


Value

Value Label

01

Yes

00

No

-99

Refused


Question Type: Single Punch

S4. Do you work for a pharmaceutical company, an advertising agency, or a market research company?

Variable Label: S4: Do you work for a pharmaceutical company, an advertising agency, or a market research company?


Value

Value Label

01

Yes

00

No

-99

Refused


[PLEASE TERMINATE IF S1< 18 OR S1=-99 OR S2=01 OR S2=-99 OR S3=01 OR S3=-99 OR S4=01 OR S4=-99]


[Note: We will use a quota for health literacy to ensure a range of health literacy skills. Low literacy will be defined as S6 ≥03,]


Question Type: Single Punch

S6. How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?

Variable Label: S6: How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?


Value

Value Label

01

Never

02

Rarely

03

Sometimes

04

Often

05

Always

-99

Refused



Question Type: Single Punch

S25. What is the highest level of education that you have completed?

Variable Label: S25. What is the highest level of education that you have completed?


Value

Value Label

01

Less than high school

02

Completed high school

03

Some college

04

Associate’s degree

05

Bachelor’s degree

06

Postgraduate degree (MA, PhD, MD, JD, etc.)

-99

Refused


Question Type: Single Punch

Are you?

S26. Are you (Male/Female)?

Variable label: S26 Are you (Male/Female)?


Value

Value Label

01

Male

02

Female

-99

Refused



Question Type: Single Punch

S27. Are you Hispanic or Latino?

Variable label: S27 Are you Hispanic or Latino?

Value

Value Label

00

Not Hispanic or Latino

01

Hispanic or Latino

-99

Refused


Question Type: Single Punch

S28. What is your race? You may select one or more races

Variable label: S28. 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

-99

Refused


[CLOSING FOR INELIGIBLE PARTICIPANTS]

I’m sorry, but you are not eligible for this study. There are many possible reasons why people are not eligible. 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.


//NEW SCREEN//


[DISPLAY IF ELIGIBLE]

You are eligible to participate in the current study. Please click the button below to read through our consent form and continue to the survey.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSullivan, Helen W (CDER)
File Modified0000-00-00
File Created2022-05-23

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