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Pretest Screener

ICR 202207-0910-005 · OMB 0910-0900 · Object 123675401.

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Record metadata
File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePretest Screener
AuthorMelanie Chansky
Last Modified ByWriter
File Modified2021-06-24
File Created2026-09-15
Conversion Statecomplete

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Physician Survey of Research Data about Prescription Drugs
Oncologists: Email, Screener, and Invitation
Recruitment Email
We are recruiting for an upcoming online survey study sponsored by the Food and Drug Administration (FDA). The study is not selling or promoting any products. Participants will be asked to review prescription drug informational materials and complete a brief questionnaire.  Eligible study participants will receive $62 for completing the study.  
Recruitment Screener
We need you answer a few questions to see if you are eligible for the study.  Are you interested in participating?
    • YES    	 continue TO SCREENER
    • NO	 Thank you for your time. END SURVEY 
    1. Are you a board certified oncologist? 
    • YES 	 continue 
    • NO 	 END AND go to INELIGIBLE SCRIPT
    2. In an average week, what percent of your time is spent on direct patient care, such as seeing patients and reviewing their medical records? 
    • 50 PERCENT OR MORE		 CONTINUE 
    • LESS THAN 50 PERCENT		 END AND GO TO INELIGIBLE SCRIPT 
    3. How many prescriptions do you write on average each week? 
    • 5O OR MORE PRESCRIPTIONS EACH WEEK           CONTINUE 
    • LESS THAN 50 PRESCRIPTIONS EACH WEEK          END AND GO TO INELIGIBLE SCRIPT  

    4. Do you work for any of the following? 
    • A market research firm		 END AND go to INELIGIBLE SCRIPT 
    • An advertising firm 		 END AND go to INELIGIBLE SCRIPT
    • A pharmaceutical company	 END AND go to INELIGIBLE SCRIPT
    • U.S. Dept. of Health and Human Services 
 END AND go to INELIGIBLE SCRIPT
    • None of the above		 CONTINUE	
    5. Have you participated in a focus group or interview-based research in the past 3 months?
    • NO   	 CONTINUE
    • YES	 END AND go to INELIGIBLE SCRIPT
    6. How many years have you been practicing medicine? 
[INFORMATION ONLY]
    • FEWER THAN 5 YEARS			 
    • 5 TO 14 YEARS 				
    • 15 TO 24 YEARS
    • 25 YEARS OR LONGER
    7. Which of these categories best describes where you practice? [INFORMATION ONLY]
    • Office-based (e.g., private practice, HMO)
    • Clinic
    • In-patient care (e.g., nursing home, hospice care)
    • Other (specify): _____________________________
    8. What is your gender? [Recruit a mix]
    • MALE	 
    • FEMALE
    • NON-BINARY		 
    9. Are you of Hispanic or Latino origin? [Recruit a mix]
    • YES                  
    • NO                  
    10. What is your race?  You may choose one or more categories.
[Recruit a mix]
    • White 		 
    • Black or African American	
    • Asian 
    • Native Hawaiian or other Pacific Islander
    • American Indian or Alaska Native
    • Prefer not to answer 
    11. What is your age? [RECRUIT A MIX]  
    • YOUNGER THAN 35 				 
    • 35-45 				
    • 46-55
    • 56-65
    • 66 OR OLDER
					

AFTER COMPLETING QUESTION 11, ELIGIBLE PARTICIPANTS GO DIRECTLY TO informed consent and survey.


Ineligible Script
Thank you very much for your interest. Unfortunately, you do not qualify for this study, but we hope to include you in a future study.   

Physician Survey of Research Data about Prescription Drugs
PCPs: Screener and Invitation
Recruitment Email

We are recruiting for an upcoming online survey study sponsored by the Food and Drug Administration (FDA). The study is not selling or promoting any products. Participants will be asked to review prescription drug informational materials and complete a brief questionnaire.  Eligible study participants will receive $46 for completing the study.  

We need you answer a few questions to see if you are eligible for the study.  Are you interested in participating?
    • YES    	 continue TO SCREENER
    • NO	 Thank you for your time. END SURVEY 
Recruitment Screener
    12. Are you board certified in any of the following clinical specialties?
    • Internal medicine		 continue
    • General practitioner	 continue
    • Family medicine		 continue
    • None of the above	 END AND go to INELIGIBLE SCRIPT
    13. In an average week, what percent of your time is spent on direct patient care, such as seeing patients and reviewing their medical records? 
    • 50 PERCENT OR MORE		 CONTINUE 
    • LESS THAN 50 PERCENT		 END AND GO TO INELIGIBLE SCRIPT 
    14. How many prescriptions do you write on average each week? 
    • 5O OR MORE PRESCRIPTIONS EACH WEEK           CONTINUE 
    • LESS THAN 50 PRESCRIPTIONS EACH WEEK          END AND GO TO INELIGIBLE SCRIPT  

    15. Do you work for any of the following? 
    • A market research firm		 END AND go to INELIGIBLE SCRIPT 
    • An advertising firm 		 END AND go to INELIGIBLE SCRIPT
    • A pharmaceutical company	 END AND go to INELIGIBLE SCRIPT
    • U.S. Dept. of Health and Human Services 
 END AND go to INELIGIBLE SCRIPT
    • None of the above		 CONTINUE	
    16. Have you participated in a focus group or interview-based research in the past 3 months?
    • NO   	 CONTINUE
    • YES	 END AND go to INELIGIBLE SCRIPT
    17. How many years have you been practicing medicine? 
[INFORMATION ONLY]
    • FEWER THAN 5 YEARS			 
    • 5 TO 14 YEARS 				
    • 15 TO 24 YEARS
    • 25 YEARS OR LONGER
    18. Which of these categories best describes where you practice? [INFORMATION ONLY]
    • Office-based (e.g., private practice, HMO)
    • Clinic
    • In-patient care (e.g., nursing home, hospice care)
    • Other (specify): _____________________________
    19. What is your gender? [Recruit a mix]
    • MALE	 
    • FEMALE
    • NON-BINARY		 
    20. Are you of Hispanic or Latino origin? [Recruit a mix]
    • YES                  
    • NO    
              
    21. What is your race?  You may choose one or more categories.
[Recruit a mix]
    • White 		 
    • Black or African American	
    • Asian 
    • Native Hawaiian or other Pacific Islander
    • American Indian or Alaska Native
    • Prefer not to answer 
    22. What is your age? [RECRUIT A MIX]  
    • YOUNGER THAN 35 				 
    • 35-45 				
    • 46-55
    • 56-65
    • 66 OR OLDER
					

AFTER COMPLETING QUESTION 11, ELIGIBLE PARTICIPANTS GO DIRECTLY TO INFORMED CONSENT AND SURVEY.

Ineligible Script

Thank you very much for your interest. Unfortunately, you do not qualify for this study, but we hope to include you in a future study.