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Copy Testing Surveys
ICR 202304-0990-003 · OMB 0990-0476 · Object 130799101.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Copy Testing Surveys |
| Author | Microsoft Office User |
| Last Modified By | Writer |
| File Modified | 2021-01-20 |
| File Created | 2026-10-04 |
| Conversion State | complete |
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COVID-19 Public Education Media Opinions Survey Welcome // Display OMB number and exp in the bottom right off all screens // OMB No. XXXX-xxxx Exp. Date xx/xx/xxxx You have been selected to take this survey about COVID-19. The primary purpose of this survey is to help assess, among a large group of U.S. adults, perceptions of potential COVID-19 public education media that looks like what you would see in an advertisement. The survey will also assess experience and behaviors, and trusted information sources related to COVID-19. Most people take about 20 minutes to complete the survey. As mentioned, this survey will show you potential COVID-19 media and then ask you some questions about it. The media will require you to listen and/or view the media content—please make sure you have the volume of your device turned to a level that will allow you to hear the content clearly. We also have some additional information available to you about this survey. Select the additional pages you would like to read below, if any. You will then be shown a privacy statement before proceeding with the survey. [Checkbox] Frequently Asked Questions [Checkbox] Contact Us Thank you for your time and participation. [Continue] For question or concerns about this survey, email: [email protected] Privacy Advisory This survey does NOT collect or use personally identifiable information (PII) such as your name, date of birth, or contact information. Responding to this survey is voluntary. Your responses will be treated as confidential and will be maintained in a secure dataset. There is no penalty to you if you choose not to respond. However, we encourage you to answer all questions so that the data will be complete and will represent typical attitudes and beliefs of all Americans. Frequently Asked Questions (FAQ) //FAQs should link to their corresponding page positions below. “TOP” buttons should link back to top of FAQ// Why is this study being conducted? Why should I participate? Do I have to answer all questions? Can I save my answers and return to the survey later? Will my answers be kept private? Can I withdraw answers once I have started the survey? What are the costs and benefits of participating? How will my responses be used? Will I see the results of the survey? Why is this study being conducted? Top • This study is being conducted to understand people’s opinions of, experience with, and behaviors related to COVID-19 as well as reactions to advertisements about the COVID-19 vaccines. Why should I participate? Top • You may learn more about COVID-19 and ways you can help slow its spread as a result of information you learn by taking part in this survey. Do I have to answer all questions? Top • No, it is not necessary to answer every question. Your participation in this study is completely voluntary. This means that you are free to withdraw from this survey at any time or to skip any questions. There is no penalty to you if you choose not to respond. • Some questions in this survey will ask about your personal experiences with COVID-19, which may be uncomfortable to answer. You have the right to skip these questions. Additionally, if you experience any distress taking this survey, you may contact the 1) SAMHSA Disaster Distress Helpline (1-800-985-5990) or the 2) Suicide Prevention Lifeline (1-800-273-8255), which both offer free 24/7 support services. • At the bottom of your survey screen, you have two control buttons: Continue (>>), and Previous (<<). Use these buttons to navigate through the survey or skip questions. Can I save my answers and return to the survey later? Top • Yes. If you exit the survey, your progress will be saved. To return to the survey, use the same survey link provided to you. When you return to the survey website, you will be directed to the place in the survey where you had stopped. Use the control buttons, Continue (>>), and Previous (<<), to navigate through the survey to return to unanswered questions. Will my answers be kept private? Top Responses will remain private to the extent allowable by law. None of the information you provide will be used to contact you for or will be used in future research or distributed to another investigator for future studies. Survey responses will be aggregated (combined), and only group statistics will be reported. You will not be identified even if the results of this study are published. Can I withdraw answers once I have started the survey? Top • If you wish to withdraw your answers, please notify the survey helpdesk by sending an email to [email protected]. What are the costs and benefits of participating? Top • There is no cost to you for participating in this study. • This study is for research purposes only. There is no direct benefit to you for taking part in this study. Any compensation you receive is a small token to thank you for participating, if you choose to do so. • If you decide to participate, you will receive $XX for your time. How will my responses be used? Top • Your responses will be used to inform a public education campaign on scientifically proven behaviors on how to decrease COVID-19 infection rates. This is your chance to be heard on issues that directly affect you. While your survey responses will be kept confidential, summarized responses may be released to the public. Will I see the results of the survey? Top • Results from this study might appear in professional journals or scientific conferences or submitted in a report to Congress. No individual participants will be identified or linked to the results. We will not disclose your identity in any report or presentation. • Contact Us If you have questions or concerns about this survey, please email [email protected]. An external institutional review board (IRB), which is an independent committee established to help protect the rights of research subjects, has approved this study. If you have any questions about your rights as a research subject, and/or concerns or complaints regarding this research study, contact the IRB at: By mail: BRANY IRB 1981 Marcus Avenue, Suite 210 Lake Success, NY 11042 • Or call toll free: 516-470-6900 • Or by email: [email protected] Please reference the following number when contacting the Study Subject Adviser: [20-069-821]. [TERMINATION LANGUAGE] 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. SAMPLE BALANCING [PROGRAMMING NOTE: DISPLAY TEXT] This first series of questions is for informational purposes and to determine if you are qualified to participate in this study. Item #: DEM1 Question Type: Single Punch Variable Name: Gender Variable Text: What is your gender? Variable Label: Gender //PROGRAMMING NOTE: ROTATE RESPONSE OPTIONS 1-2// Value Value Label 1 Man 2 Woman 3 Prefer to self-describe (please specify) -99 Refused Item #: DEM2 Question Type: Numeric Open End Variable Name: ZIP Code Variable Text: In what ZIP code do you live? Variable Label: ZIP //PROGRAMMING NOTE: ONLY ALLOW FIVE DIGITS, CODE INTO STATE AND CENSUS REGIONS// Item #: DEM3 Question Type: Numeric Open End Variable Name: Age Variable Text: What is your age? Variable Label: Age //PROGRAMMING NOTE: SET RANGE AS: 0–115, CONTINUE IF DEM3=18+, OTHERWISE DISPLAY TERMINATION LANGUAGE AND TERMINATE// //PROGRAMMING NOTE: HARD PROMPT: Please enter your age in years using numbers.// Item #: DEM4 Question Type: Single Punch Variable Name: Hispanic/Latino Variable Text: Are you of Hispanic, Latino, or Spanish origin? Variable Label: Hispanic/Latino Ethnicity Value Value Label 1 Yes 2 No -99 Refused Item #: DEM5 Question Type: Multi Punch Variable Name: Race Variable Text: What is your race? Please select all that apply. Variable Label: Race Value Value Label 1 Yes 2 No -99 Refused Item #: DEM6 Question Type: Single Punch Variable Name: Education Variable Text: What is the highest level of school you have completed? Variable Label: Education Completion Value Value Label 1 8th grade or less 2 9th grade 3 10th grade 4 11th grade 5 12th grade—no diploma 6 High school diploma 7 High school equivalent (GED) 8 Some college, no degree 9 Associate degree 10 Bachelor’s degree 11 Master’s degree 12 Professional or doctorate degree Item #: DEM7 Question Type: Multi Punch Variable Name: Employment Status Variable Text: Which of the following best describes you? Please select all that apply. Variable Label: Employment Status Value Value Label 1 Yes 2 No -99 Refused Item #: DEM8 Question Type: Multi Punch Variable Name: Employment Type Variable Text: In the last five years, have you or a member of your immediate family worked in any of the following fields, companies, or organizations? Select all that apply. Variable Label: Employment Type //PROGRAMMING NOTE: IF YES TO OPTIONS 1-4, DISPLAY TERMINATION LANGUAGE AND TERMINATE// Value Value Label 1 Yes 2 No -99 Refused Item #: DEM9 Question Type: Single Punch Variable Name: Camera Variable Text: In order to participate, you need to have a desktop or laptop computer with a working web camera and be sitting in a well-lit area. You will also need to consent to be recorded during the survey. Will you be able to meet these requirements? Variable Label: Camera //PROGRAMMING NOTE: IF DEM9=2, DISPLAY TERMINATION LANGUAGE AND TERMINATE// Value Value Label 1 Yes 2 No -99 Refused Item #: BEH4 Question type: Single punch Variable Name: BEH4 Variable Text: Have you participated in COVID-19 vaccine clinical trial? Variable Label: BEH4: COVID-19 vaccine clinical trial participation //PROGRAMMING NOTE: IF BEH4=1, DISPLAY TERMINATION LANGUAGE AND TERMINATE// Value Value Label 0 No 1 Yes -99 Refused INTEREST AND INTENTIONS TO RECEIVE A COVID-19 VACCINE [PROGRAMMING NOTE: DISPLAY TEXT] The following questions will ask about your actions and beliefs about COVID-19 vaccine(s). The U.S. Food and Drug Administration (FDA) has authorized vaccines that protect against COVID-19, and we want to learn more about your beliefs and plans related to this vaccine. For the following questions, please assume there are enough vaccines so that everyone who wants a COVID-19 vaccine can get one. Item #: BEH0 Question type: Single punch Variable Name: BEH0 Variable Text: A Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 is now available at no cost. Have you received a COVID-19 vaccine? Variable Label: BEH0: Intention to get vaccinated //PROGRAMMING NOTE: IF BEH0=2, DISPLAY TERMINATION LANGUAGE AND TERMINATE// Value Value Label 0 No, I have not received a COVID-19 vaccine 1 Yes, but I have only received one shot out of two required shots 2 Yes, I have received all of my required shots -99 Refused Item #: BEH1 Question type: Single punch Variable Name: BEH1 Variable Text: What is the likelihood you will get a COVID-19 vaccine? Variable Label: BEH1: Intention to get vaccinated // PROGRAMMING NOTE: Ask if BEH0 (Intention to get vaccinated) = 0 "No…” or 1 “Yes, but I have only received one shot…” or -99 “Refused” // // PIPE: “complete COVID-19 vaccination” to replace “get a COVID-19 vaccine” if BEH0 = 1 // Value Value Label 1 Very unlikely 2 Somewhat unlikely 3 Neither likely nor unlikely 4 Somewhat likely 5 Very likely -99 Refused Item #: BEH2 Question type: Single punch Variable Name: BEH2 Variable Text: A Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 is now available at no cost. How soon will you get vaccinated? For this question, assume there is enough vaccine so that everyone who wants it can get it. Variable Label: BEH2: Wait to get vaccinated Value Value Label 1 I would get a vaccine as soon as I could 2 I would wait to get a vaccine for one or more reasons 3 I would never get a COVID-19 vaccine -99 Refused -100 Valid skip Item #: BEH3 Question type: Grid Variable Name: BEH3 Variable Text: You responded that you would wait to get a COVID-19 vaccine. For each of the following statements, is this a reason why you would wait to get a COVID-19 vaccine? Select yes or no for each item. Variable Label: BEH3: Reasons: Waiting to get vaccinated //PROGRAMMING NOTE: Ask if BEH2 (Wait to get vaccinated) = 2 (I would wait to get a vaccine for one or more reasons)// //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label BEH3_1 I would because of my age. BEH3_1: Age BEH3_2 I would because of my health status, allergies, or medical history. BEH3_2: Health BEH3_3 I would want to know if the vaccine is effective first. BEH3_3: Confirm effectiveness BEH3_4 I am pregnant or expect to become pregnant. BEH3_4: Pregnant BEH3_5 I would want to talk to my doctor first. BEH3_5: Talk to doctor first BEH3_6 I would want to compare the effectiveness of the different vaccines. BEH3_6: Compare vaccines BEH3_7 I would want to see if my friends and family get the vaccine. BEH3_7: Friends/family BEH3_8 I would want to see if others who get the vaccine first develop any problems. BEH3_8: Side effects BEH3_9 I want to make sure it is safe for people like me first. BEH3_9: Confirm safety BEH3_10 I would want to hear from leaders in my community about the vaccine first. BEH3_10: Hear from leaders BEH3_11 Other [Specify] BEH3_11: Other Value Value Label 0 No 1 Yes -99 Refused -100 Valid skip Item #: BEH3A Question Type: Grid Variable Name: BEH3A Variable Text: You indicated that you would wait to get a vaccine because of your health status, allergies, or medical history. Has a health care provider (e.g., primary care doctor) ever told you that you have any of the following conditions? Select yes or no for each item. Variable Label: BEH3A: Health concerns //PROGRAMMING NOTE: Ask if BEH3_2 (I would because of my health status, allergies, or medical history) = 1 (Yes)// // PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label BEH3A_1 High blood pressure or hypertension BEH3A_1: High blood pressure BEH3A_2 Diabetes or high blood sugar BEH3A_2: Diabetes BEH3A_3 High blood cholesterol level BEH3A_3: High cholesterol BEH3A_4 Cancer or a malignant tumor, excluding minor skin cancer BEH3A_4: Cancer BEH3A_5 Lung disease such as chronic bronchitis or emphysema BEH3A_5: Lung disease BEH3A_6 A heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems BEH3A_6: Heart attack BEH3A_7 A stroke BEH3A_7: Stroke BEH3A_8 Asthma BEH3A_8: Asthma BEH3A_9 A compromised immune system BEH3A_9: Compromised immune system BEH3A_10 Overweight or obesity BEH3A_10: Overweight/obesity BEH3A_11 Allergies BEH3A_11: Allergies BEH3A_12 Other health concerns, please specify: [TEXTBOX] BEH3A_12: Other BEH3A_13 None of the above BEH3A_13: None of the above Value Value Label 0 No 1 Yes -99 Refused -100 Valid skip Item #: BEH3B Question Type: Grid Variable Name: BEH3B Variable Text: You indicated that you have allergies. Has a health care provider (e.g., primary care doctor) ever told you that you are allergic to any of the following? Select yes or no for each item. Variable Label: BEH3B: Allergies // PROGRAMMING NOTE: Ask if BEH3A_11 (Allergies) = 1 (Yes). // // PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label BEH3B_1 Pollen (e.g., seasonal allergies) BEH3B_1: Seasonal BEH3B_2 Milk BEH3B_2: Milk BEH3B_3 Nuts (e.g., peanuts, tree nuts) BEH3B_3: Nuts BEH3B_4 Eggs BEH3B_4: Eggs BEH3B_5 Wheat BEH3B_5: Wheat BEH3B_6 Mold BEH3B_6: Mold BEH3B_7 Pets (e.g., dogs, cats) BEH3B_7: Pets BEH3B_8 Penicillin or other antibiotics BEH3B_8: Antibiotics BEH3B_9 Other, please specify: [TEXTBOX] BEH3B_9: Other BEH3B_10 None of the above BEH3B_10: None of the above Value Value Label 0 No 1 Yes -99 Refused -100 Valid skip Item #: ATT1 Question Type: Grid Variable Name: ATT1 Variable Text: How much do you agree or disagree with the following statements? Select one response for each item. Variable Label: ATT1: Importance: Vaccines //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ATT1_1 It is important for me to get all recommended COVID-19 vaccines. ATT1_1: Important for me to get all recommended COVID-19 vaccines ATT1_2 It is important for everyone to get all recommended COVID-19 vaccines. ATT1_2: Important for everyone to get all recommended COVID-19 vaccines ATT1_3 Getting all recommended vaccines helps to reduce the spread of COVID-19. ATT1_3: Getting all recommended vaccines helps to reduce COVID-19 Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: ATT9 Question Type: Grid Variable Name: ATT9 Variable text: How much do you agree or disagree with the following statements about COVID-19? Select one response for each item. Variable Label: ATT9: COVID vaccine worries //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ATT9_1 I would accept a COVID-19 vaccine offered during a regularly scheduled appointment with my health care provider. ATT9_1: Regular appointment ATT9_2 I am worried that a COVID-19 vaccine could give me COVID-19. ATT9_2: Worried vaccine will give me COVID-19 ATT9_3 I would rather build immunity by exposure to an infected individual than receive a COVID-19 vaccine. ATT9_3: Immunity by exposure ATT9_4 I would get a COVID-19 vaccine if it would help life return to normal more quickly. ATT9_4: Life return normal ATT9_5 I am worried about side effects of a COVID-19 vaccine for myself. ATT9_6: Worried about side effects ATT9_6 I am worried that side effects of a COVID-19 vaccine could be worse than COVID-19 itself. ATT9_7: Side effects worse than COVID-19 Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: ATT10 Question Type: Grid Variable Name: ATT10 Variable text: How much do you agree or disagree with the following statements? Select one response for each item. Variable Label: ATT10: Returning to norms //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ATT10_1 A COVID-19 vaccine will allow me to spend more time with my loved ones. ATT10_1: More time with loved ones ATT10_2 A COVID-19 vaccine will allow me to return to normal day-to-day activities. ATT10_2: Normal day-to-day activities ATT10_3 A COVID-19 vaccine will improve the economy ATT10_3: Improve the economy ATT10_4 A COVID-19 vaccine will allow schools and businesses to reopen. ATT10_4: Allow schools/businesses to reopen ATT10_5 The benefits of a COVID-19 vaccine outweigh any risks associated with it. ATT10_5: Benefits of vaccine outweigh risks Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: ATT6 Question Type: Grid Variable Name: ATT6 Variable Text: How much do you agree or disagree that each of the following actions are effective at keeping you safe from COVID-19? Select one response for each item. Variable Label: ATT6: Perceived effectiveness //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Text ATT6_1 Wearing a face mask ATT6_1: Wearing face mask ATT6_2 Washing your hands ATT6_2: Washing hands ATT6_3 Maintaining social distance ATT6_3: Maintaining social distance ATT6_4 Receiving a COVID-19 vaccine ATT6_4: Receiving vaccine Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: ATT12 Question Type: Grid Variable Name: ATT12 Variable Text: How much do you agree or disagree with the following statements? Select one response for each item. Variable Label: ATT12: Severity of COVID //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ATT12_1 Concerns regarding COVID-19 are overblown. ATT12_1: Concerns are overblown ATT12_2 There is currently too much panic around COVID-19. ATT12_2: Too much panic ATT12_3 COVID-19 is not as dangerous as the media claim. ATT12_3: Not as dangerous as media claims ATT12_4 People should not be worried about COVID-19. ATT12_4: People shouldn’t be worried about COVID-19 ATT12_5 I will go to the hospital if I get infected. ATT12_5: Will go to hospital if infected ATT12_6 Someone in my social circle (family, friends, colleagues) will die if they are infected. ATT12_6: Someone in social circle will die if infected Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: ATT13/ATT14 Question Type: Grid Variable Text: How much do you agree or disagree with the following statements? Select one response for each item. //PROGRAMMING NOTE: Rotate subitems// Variable Name Variable Text Variable Label ATT13_1 People who are important to me believe that I should receive a COVID-19 vaccine when it is available. ATT13_1: Receive a vaccine ATT14_1 Getting all recommended vaccines is the right thing to do. ATT14_1: Get all recommended vaccines Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: TRAITS Question Type: Grid Variable text: When considering getting the COVID-19 vaccine, how important is it to you personally that each of the following describes the vaccine? Select one response for each item. //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label TRAITS_1 Safe Traits_1: Safe TRAITS_2 Effective Traits_2: Effective TRAITS_3 Approved Traits_3: Approved TRAITS_4 Authorized Traits_4: Authorized TRAITS_5 Tested Traits_5: Tested TRAITS_6 Reviewed Traits_6: Reviewed TRAITS_7 Protects you from getting COVID-19 Traits_7: Protect me TRAITS_8 Free Traits_8: Free TRAITS_9 Convenient to get Traits_9: Convenient TRAITS_10 Is recommended by healthcare providers Traits_10: RecHCP TRAITS_11 Others in your community have received the vaccine Traits_11: Othersreceived TRAITS_12 Is recommended by people you trust Traits_12: RecOthers Value Value Label 1 Not important at all 2 Not too important 3 Somewhat important 4 Very important 5 Extremely important -99 Refused CREATIVE TESTING [PROGRAMMING NOTE: DISPLAY TEXT] Now, you are going to see some of the COVID-19 public education media. Then, we will ask you some questions about what you viewed. We will be using eye-tracking software to help us better understand what elements in the ad catch your attention. Please be sure you are sitting in a well-lit area where the light source is facing you with your computer on a flat surface, and your computer web camera is turned on. Click the continue button when you are ready to view the message and additional instructions for using your web camera. You will automatically proceed to the next screen once the message is finished. //SHOW RANDOMLY ASSIGNED AD// //RANDOMIZE ORDER OF ADS SHOWN// //DISPLAY THIS SET OF QUESTIONS AFTER EACH AD VIEWED, UPDATE THE XX WITH AD CODE// Item #: ADXX1 Question type: Single punch Variable Name: ADXX11 Variable Text: Were you able to see this ad on your computer? Variable Label: ADXX1: Viewing confirmation Value Value Label 0 No [Go to demos and termINATE] 1 Yes -99 Refused [Go to demos and termINATE] //PROGRAMMING NOTE: SHOW ONLY IF PRINT/VIDEO AD// Item #: ADXX2 Question type: Single punch Variable Name: ADXX2 Variable Text: Were you able to hear this ad on your computer? Variable Label: ADXX2: Viewing confirmation //PROGRAMMING NOTE: SHOW ONLY IF RADIO/VIDEO AD// Value Value Label 0 No [Go to demos and termINATE] 1 Yes -99 Refused [Go to demos and termINATE] Item #: ADXX11 Question type: Single punch Variable Name: ADXX11 Variable Text: Had you seen this advertisement before today? Variable Label: ADXX1: Exposure Value Value Label 0 No 1 Yes 2 Unsure -99 Refused Item #: ADXX3 Question type: Open-end Variable Name: ADXX3 Variable Text: What was the main message of this ad? Please be as specific as possible. Variable Label: ADXX3: OE comprehension //Limit to 1,000 characters. // Item #: ADXX4 Question type: Single punch Variable Name: ADXX4 Variable Text: How difficult was it, if at all, to understand the main message of this ad? Variable Label: ADXX4: Difficulty of ad Value Value Label 1 Not at all difficult 2 Slightly difficult 3 Moderately difficult 4 Very difficult 5 Extremely difficult -99 Refused Item #: ADXX5 Question type: Single punch Variable Name: ADXX5 Variable Text: How complicated would you say the information in the message was, if at all? Variable Label: ADXX5: Complicated Value Value Label 1 Not at all complicated 2 Slightly complicated 3 Moderately complicated 4 Very complicated 5 Extremely complicated -99 Refused Item #: ADXX6 Question type: Single punch Variable Name: ADXX6 Variable Text: How believable, if at all, do you find this message? Variable Label: ADXX6: Believability Value Value Label 1 Not at all believable 2 Not too believable 3 Somewhat believable 4 Very believable 5 Extremely believable -99 Refused Item #: ADXX10 Question type: Single punch Variable Text: How much do you agree or disagree with the following statements? //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ADXX10_1 This message is for everyone, including me. ADXX10_1: People like me ADXX10_2 This message grabbed my attention. ADXX10_2: Attention ADXX10_3 This message is powerful. ADXX10_3: Powerful ADXX10_4 This message is worth remembering. ADXX10_4: Remember ADXX10_5 This message is informative. ADXX10_5: Informative ADXX10_6 This message is meaningful to me. ADXX10_6: Meaningful ADXX10_7 This message is convincing as a reason to get a COVID-19 vaccine when it is available to me. ADXX10_7: Convincing ADXX10_8 This message told me something new. ADXX10_8: New Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused -100 Valid skip Item #: ADXX7 Question Type: Grid Variable Text: Based on the information in the messages, please indicate whether you think each of the following is true of a Food and Drug Administration (FDA)-authorized COVID-19 vaccine. Select one response for each item. //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ADXX7_1 A vaccine will protect me from COVID-19. ADXX7_1: Protect ADXX7_2 A vaccine reduces the likelihood that I will get COVID-19. ADXX7_2: Likelihood ADXX7_3 A COVID-19 vaccine is safe for me. ADXX7_3: Safe ADXX7_4 A COVID-19 vaccine is effective for preventing COVID-19. ADXX7_4: Effective ADXX7_5 By getting a COVID-19 vaccine, I am helping keep myself healthy. ADXX7_5:My_Health ADXX7_6 By getting a COVID-19 vaccine, I am helping keep my loved ones healthy. ADXX7_6: Loved_Ones_Health ADXX7_7 By getting a COVID-19 vaccine, I am helping keep my community healthy. ADXX7_7: Community_Health ADXX7_8 Getting a COVID-19 vaccine is important to helping ensure my family’s culture and traditions live on. ADXX7_8: Culture ADXX7_9 Getting the COVID-19 vaccine will help get us one step closer to normal. ADXX7_9: Normal ADXX7_10 Getting a COVID-19 vaccine will help keep me healthy so I can provide for my loved ones. ADXX7_10: Provide ADXX7_11 The COVID-19 vaccine is thoroughly reviewed to make sure the vaccine’s benefits outweigh any possible risks. ADXX7_11: RiskBen ADXX7_12 A few days of feeling flu-like symptoms is worth the benefit of being protected against COVID-19. ADXX7_12: Flu Value Value Label 1 True 2 False 3 Don’t Know -99 Refused Item #: ADXX8 Question type: Grid Variable Text: How likely are you to do each of the following? //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label ADXX 8_1 Look for more information about the COVID-19 vaccine ADXX 8_1: More_Info ADXX8_2 Get a COVID-19 vaccine at no cost ADXX 8_2: Vaccine ADXX8_3 Visit cdc.gov/coronavirus for more information ADXX 8_3: Website ADXX 8_4 Talk to your doctor about the COVID-19 vaccine ADXX 8_4: Doctor ADXX 8_5 Other [Specify] ADXX 8_5: Other Value Value Label 1 Very unlikely 2 Somewhat unlikely 3 Neither 4 Somewhat likely 5 Very likely -99 Refused Item #: ADXX8_2A Question type: Open-end Variable Name: ADXX8_2A Variable Text: You said you were [PIPE ANSWER FROM ADXX8_2] to get a COVID-19 vaccine. Please describe the main reasons why you are [PIPE ANSWER FROM ADXX8_2] to get a COVID-19 vaccine. Variable Label: ADXX8_2A: OE Vaccine //Limit to 1,000 characters. Cannot skip this question// Item #: ADXX9 Question type: Single punch Variable Name: ADXX9: Efficacy Variable Text: How likely is it that a Food and Drug Administration (FDA)-authorized COVID-19 vaccine would reduce your risk of getting the disease? Variable Label: ADXX9: Efficacy Value Value Label 1 Very unlikely 2 Somewhat unlikely 3 Neither 4 Somewhat likely 5 Very likely -99 Refused TRUSTED MESSENGERS [PROGRAMMING NOTE: DISPLAY TEXT] The following questions are about your trust in individuals in science, research, medical fields, and government. Item #: SCI2 Question Type: Grid Variable Name: SCI2 Variable Text: How much do you agree or disagree with the following statements regarding government public health experts? A government public health expert is a person with a degree and career in protecting and promoting community health that works for a government agency such as the CDC or the FDA. Select one response for each item. Variable Label: SCI2: Trust in government //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label SCI2_1 I trust the information I receive from government public health experts SCI2_1: Trust experts SCI2_2 Government public health experts have their own agenda SCI2_2: Experts have agenda SCI2_3 Government public health experts have my best interests in mind SCI2_3: Experts have my best interests in mind SCI2_4 Information provided by government public health experts changes too often for me [Reverse coded] SCI2_4: Information from experts changes too often SCI2_5 Information provided by governmental public health experts has been helpful to me in the past SCI2_5: Information from experts has been helpful SCI2_6 I have been misled by government public health experts in the past [Reverse coded] SCI2_6: Misled by experts Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused Item #: CAM21 Question Type: Grid Variable Name: CAM21 Variable Text: How much do you trust each of the following sources to provide accurate COVID-19 information? Select one response for each item. Variable Label: CAM22: Trust sources on COVID //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label CAM21_1 Official U.S. government websites CAM21_1: Official government websites CAM21_2 The President of the United States/The White House CAM21_2: President/White House CAM21_3 U.S. Department of Health and Human Services (HHS) CAM21_3: HHS CAM21_4 U.S. Food and Drug Administration (FDA) CAM21_4: FDA CAM21_5 World Health Organization (WHO) CAM21_5: WHO CAM21_6 U.S. Centers for Disease Control and Prevention (CDC) CAM21_6: CDC CAM21_8 The Surgeon General of the United States CAM21_8: Surgeon General CAM21_9 My State, County, or City health department CAM21_9: State/County/ City health department CAM21_10 My State Governor CAM21_10: Governor CAM21_11 National Institute of Health (NIH) CAM21_11: NIH CAM21_12 U.S. Military/Department of Defense CAM21_12: DoD CAM21_13 My personal doctor or family physician CAM21_13: Doctor CAM21_14 My friends/family who are doctors or other health care professionals CAM21_14: Friends_Dr CAM21_15 My friends/family who are not doctors or other health care professionals CAM21_15: Friends_NonDr Value Value Label 1 Not at all 2 Somewhat 3 Mostly 4 Completely -99 Refused COVID-19 EXPERIENCE [PROGRAMMING NOTE: DISPLAY TEXT] The following questions are about your experience with COVID-19. Item #: COV8 Question type: Grid Variable Name: COV8 Variable Text: For each of the following statements, have you experienced the following? Select yes or no for each item. Variable Label: COV8: Tested: Reasons //PROGRAMMING NOTE: Randomize subitems// Variable Name Variable Text Variable Label COV8_1 I have tested positive for COVID-19 COV8_1: I tested positive COV8_2 An immediate member of my household has tested positive for COVID-19 COV8_2: Household member tested positive COV8_3 An extended family member outside of my household has tested positive for COVID-19 COV8_3: Extended family member tested positive COV8_4 A friend outside of my household has tested positive for COVID-19 COV8_4: Friend tested positive COV8_5 A roommate who lives with me has tested positive for COVID-19 COV8_5: Roommate tested positive COV8_6 A coworker has tested positive for COVID-19 COV8_6: Coworker tested positive COV8_7 A friend of a friend has tested positive for COVID-19 COV8_7: Friend of a friend tested positive COV8_8 I do not know anyone who has tested positive for COVID-19 COV8_8: Don’t know anyone who tested positive Value Value Label 0 No 1 Yes 60 I do not want to share this information -99 Refused Item #: COV13 Question type: Single punch Variable Name: COV13 Variable Text: How severe was your COVID-19 infection? Variable Label: COV13: Severity of COVID // Ask if Q COV8_1 (I tested positive) = 1 (Yes)// Value Value Label 1 No symptoms/mild symptoms 2 Moderate symptoms, but did not seek health care 3 Moderate symptoms and sought health care 4 Severe symptoms/hospitalization -99 Refused -100 Valid skip Item #: COV14 Question type: Single punch Variable Name: COVXX Variable Text: How much do you agree or disagree that you are fully recovered from your COVID-19 infection? Variable Label: COV14: recovered from COVID // Ask if Q COV8_1 (I tested positive) = 1 (Yes)// Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused -100 Valid skip Item #: COV15 Question type: Single punch Variable Name: COV15 Variable Text: Do you know anyone who has been hospitalized with COVID-19? Variable Label: COV15: Hospitalized for COVID Value Value Label 0 No 1 Yes 60 I do not want to share this information -99 Refused FINAL DEMOS [PROGRAMMING NOTE: DISPLAY TEXT] These final questions are about you background, which may be important when understanding your COVID-19 experience. Item #: DEM10 Question Type: Single Punch Variable Name: ESS_SERVICE Variable Text: Does where you work (e.g., state/territory) designate your occupation as providing “essential” services? “Essential” may vary depending on where you live, but may include those who provide: • Public health and safety (janitors and cleaners, registered nurses, police and sheriff’s patrol officers, physicians and surgeons, EMT’s and paramedics, pharmacists) • Essential products (cashiers, hand laborers and freight/stock/material movers, delivery truck drivers and driver/sales workers, agricultural workers, food processing workers, postal service workers) • Other infrastructure support (general maintenance and repair workers, engineers, electricians, computer support specialists, financial managers, plant and system operators, information security analysts, hazard materials removal workers) Variable Label: DEM10: Essential service status // PROGRAMMING NOTE: Ask if employed (DEM7_1-3 = 1) // Value Value Label 1 No 2 Yes -99 Refused -100 Valid skip Item #: DEM11 Question Type: Open-End Numeric Variable Name: HOUSEHOLD_UNDER18 Variable Text: How many people under 18 years-old currently live in your household? Please enter a number. Variable Label: DEM11: Number of minors living in household // PROGRAMMING NOTE: Response must be a numerical number between 0-99. // Item #: DEM12 Question Type: Open-end numeric Variable Name: OTH_ESSERVICE Variable Text: How many people in your household, excluding yourself, work in occupations that are designated as providing “essential” services? “Essential” may vary depending on where you live, but may include those who provide: • Public health and safety (janitors and cleaners, registered nurses, police and sheriff’s patrol officers, physicians and surgeons, EMT’s and paramedics, pharmacists) • Essential products (cashiers, hand laborers and freight/stock/material movers, delivery truck drivers and driver/sales workers, agricultural workers, food processing workers, postal service workers) • Other infrastructure support (general maintenance and repair workers, engineers, electricians, computer support specialists, financial managers, plant and system operators, information security analysts, hazard materials removal workers) Variable Label: DEM12: Number of essential workers in household (excluding self) // PROGRAMMING NOTE: Response must be a numerical number between 0-99. // Item #: DEM13 Question Type: Single Punch Variable Name: INCOME Variable Text: Last year, that is in [2019/2020/2021], what was your total household income from all sources, before taxes? Variable Label: DEM13: Family income Value Value Label 1 Less than $15,000 2 $15,000 to $24,999 3 $25,000 to $34,999 4 $35,000 to $49,999 5 $50,000 to $74,999 6 $75,000 to $99,999 7 $100,000 to $149,999 8 $150,000 to $199,999 9 $200,000 and over -99 Don’t know/Refused Item #: DEM14 Question Type: Single Punch Variable Name: Health_Insurance Variable Text: Are you now covered by any form of health insurance or health plan? A health plan would include any private insurance plan through your employer or a plan that you purchased yourself, as well as a government program like Medicare or Medicaid. Variable Label: DEM14: Health_Insurance Value Value Label 0 No 1 Yes 2 Unsure -99 Refused Item #: DEM15 Question Type: Single Punch Variable Name: Insurance_Type Variable Text: Which of the following is your main source of health insurance coverage? Variable Label: DEM15: Insurance_Type // Programming Note: Ask if DEM14 (Health Insurance) = 1 (Yes). // Value Value Label 0 A plan through your employer 1 A plan through your spouse's employer 2 A plan you purchased yourself directly from an insurance company 3 Medicare or Medicaid 4 Some other source 5 Unsure -99 Refused Item #: DEM16 Question Type: Single Punch Variable Name: Political_View Variable Text: In general, do you think of yourself as…? Variable Label: DEM16: Political_View // Programming Note: For half of participants, show reverse order for answer options. // Value Value Label 1 Extremely liberal 2 Liberal 3 Slightly liberal 4 Moderate, middle of the road 5 Slightly conservative 6 Conservative 7 Extremely conservative -99 Refused