Form #8 Form #8 Knowledge and Attitudes Pre-test Survey

Attachment C: Knowledge and Attitudes Pre-Test Survey

Form Approved
OMB No. XXXX-XXXX
Exp. Date XX/XX/20XX

COMMUNITY FORUM

Knowledge and Attitudes Survey

SURVEY INSTRUCTIONS

♦ You should only fill out this survey if you have been selected to participate in the Community Forum project. Do not fill out this survey if you will not participate in this project.

♦ Answer all the questions by checking the box to the left of your answer.

Public reporting burden for this collection of information is estimated to average 30 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0176) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

Community Forum Knowledge and Attitudes Survey

Thank you for agreeing to participate in the Community Forum project.

The Agency for Healthcare Research and Quality is sponsoring the American Institutes for Research to conduct this survey as part of our evaluation of the Community Forum. It includes questions about your opinions on healthcare topics, your knowledge of healthcare issues, and some additional questions about you. It will take about 30 minutes to complete.

The first set of questions asks you about your opinions on how doctors should make treatment recommendations.

1.

How important is it that doctors provide treatments that are based on a patient’s preferences?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

2.

How important is it that doctors provide treatments that are based on their expert medical opinion?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

3.

How important is it that doctors provide treatments based on medical research results?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

The next set of questions asks you for your opinions on the factors doctors should consider when making treatment recommendations.

4.

How important is it that doctors consider the side effects when recommending treatments?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

5.

How important is it that doctors consider how much a person has to pay when recommending treatments?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

6.

How important is it that doctors consider how much health insurance companies have to pay when recommending treatments?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

The next set of questions asks you about your opinions on how medical research results should be used when you and your doctor make treatment decisions.

7.

How important is it for you to know the results from medical research when making treatment decisions with your doctor?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

8.

How important is it for people to know the medical research results when making treatment decisions with their doctor?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

9.

How important is it that people ask their doctors about medical research results related to their health problem?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

10.

How important is it for you to ask your doctor about medical research results related to your health problem?

1



Not important at all

2



Not important

3



No opinion

4



Important

5



Very Important

11.

Which factor is most important when making treatment decisions with your doctor?

1



The results of medical research

2



The doctor’s knowledge about me

3



Medical research results and the doctor’s knowledge are equally important.

4



No opinion

12.

Some people think the results of medical research should be the most important factor when making a medical treatment decision. Others think doctor’s knowledge about the patient is the most important factor. Some people think both factors are important but one should get more weight than the other. On a scale from 1 to 5, where 1 means you believe that only medical research counts and 5 means that only the doctor’s knowledge counts, mark the number that indicates where you fall on this scale.

Results of Medical Research

1

2

3

4

5

Doctor’s Knowledge about me

13.	How important is it that doctors tell you about medical research results that are related to your treatments?
1			Not important at all
2			Not important
3			No opinion
4			Important
5			Very Important
14.	In your opinion, which of the following best determines when medical treatments are ‘proven to be effective’:
1		‘Proven to be effective’ is best determined by the results of medical research
2		‘Proven to be effective’ is best determined by each doctor based on his or her own experience
3		‘Proven to be effective’ is best determined by people who know their bodies best and can say what is effective and what is not.
4			No opinion
In the next section, please indicate whether you agree with the following statements about the use of medical research results when making treatment decisions.
15.	Doctors should always make treatment recommendations based on medical research results, even though research is always being updated.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
16.	People should be able to get a medical treatment they prefer, even if medical research results show it won’t work for them.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
17.	Doctors should be able to provide a medical treatment even if medical research results show it won’t work for the patient.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
18.	People should be able to get a medical treatment they prefer, even if medical research results show it might not work for them.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
19.	Doctors should be able to provide a medical treatment even if medical research results show it might not work for the patient.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
20.	People should be able to get a medical treatment they prefer, even if medical research shows there is another treatment that works better.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
21.	Doctors should be able to provide a medical treatment they prefer, even if medical research shows that there is another treatment that works better.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
22.	People should be able to get any medical treatment, no matter how much the treatment costs.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
23.	Doctors should be able to provide any medical treatment, no matter how much the treatment costs.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
24.	Doctors should be able to provide an expensive medical treatment, even if medical research shows there is a treatment that costs less and works the same.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
25.	Health insurance should pay for a treatment that a person prefers, even if medical research results show that it does not work.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
26.	For health problems that are not life threatening, doctors should be able to recommend any medical treatment, no matter how much the treatment costs.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
27.	People with health insurance should consider the effect of their treatment decisions on the cost of health insurance premiums for everyone in their health plan.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly

The next questions ask about whether parents, schools, or the government should limit the consumption of high-fat, high calorie foods. Medical research has shown that many Americans consume too much unhealthy food that is high in fat and high in calories. Medical research results indicate that these behaviors can lead to obesity and further health problems, such as heart disease and diabetes. How much do you agree or disagree with the following:
28.	Parents should limit how much unhealthy food their children eat.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
29.	Teachers should teach their students healthy eating habits.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
30.	Schools should limit how much unhealthy food children are served.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
31.	The government should limit advertising of unhealthy food to children.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
32.	The government should tax unhealthy food to discourage people from buying it.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
33.	The government should limit the sale of unhealthy foods in the United States.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
34.	The government should ban the sale of food that research has shown to cause heart disease.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
The next questions ask you for your opinions about the use of antibiotics, a type of medicine used to treat some types of infections.
Antibiotics treat infections caused by bacteria. But, antibiotics do not work against infections caused by viruses. Sometimes it is difficult to tell whether the infection is viral or bacterial without a special test. When antibiotics are used too often or for the wrong reasons, bacteria become stronger and the antibiotics stop working. This means antibiotics may not work in the future for people with infections caused by bacteria. How much do you agree or disagree with the following:
35.	People should be able to get an antibiotic if they want it, even if it might not help.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
36.	The doctor should be able to prescribe an antibiotic to treat infections, even if there is a small chance it would help.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
37.	The government should limit when doctors can prescribe antibiotics.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
The next set of questions asks you for your opinions about how successful hospitals are at performing surgeries.
Medical research results show that success rates for some types of surgeries are better in hospitals that do a lot of surgeries (called high-volume hospitals) compared to hospitals that do fewer surgeries (called low-volume hospitals). For example, 4 out of 100 children die from heart surgery in high-volume hospitals. In contrast, 15 out of 100 children die from heart surgery in low-volume hospitals. How much do you agree or disagree with the following:
38.	Insurance companies should require children who need heart surgery to be treated at high-volume hospitals.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
39.	Hospitals should be required to achieve a high success rate in order to continue performing heart surgery on children.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly
40.	Doctors who treat patients at low-volume hospitals should tell their patients if other high-volume hospitals have better results.
1		Disagree strongly
2		Disagree
3		Neither disagree or agree
4		Agree
5		Agree strongly

Please indicate how much you oppose or support the following statements:
41.	People who are obese have more health problems and live shorter lives than people with healthy weights. How much do you support the government spending money to help obese people lose weight?
1		Strongly oppose
2		Oppose
3		Neither oppose or support
4		Support
5		Strongly Support
42.	How much do you support the government spending money to help people stop smoking?
1		Strongly oppose
2		Oppose
3		Neither oppose or support
4		Support
5		Strongly Support

In the next section, please indicate your opinion on health care costs for each question.
43.		Which of the following statements comes closer to your own view?
1				Health insurance plans should pay for any drug or medical treatment that has been approved as being safe and effective for saving lives or improving people’s health, regardless of what it costs.
2				There are so many new, expensive prescription drugs and medical or surgical treatments that it is too expensive for health insurance plans to pay for all of them.
3				Don’t know
4				Refused
44.		Which of the following statements comes closer to your own view?
1				Government should pay for any drug or medical treatment that has been approved as being safe and effective for saving lives or improving people’s health, regardless of what it costs.
2				There are so many new, expensive prescription drugs and medical or surgical treatments that it is too expensive for government to pay for all of them.
3				Don’t know
4				Refused
45.		In many countries there are concerns about slowing the growth of health care costs. It has been suggested that some medical or surgical treatments that have been shown to be safe and effective should not be paid for by the government because their high cost is not felt to be justified by the amount of benefit they provide. Do you favor or oppose doing this?
1				Favor
2				Oppose
3				Don’t know
4				Refused
46.		In many countries there are concerns about slowing the growth of health care costs. It has been suggested that some medical or surgical treatments that have been shown to be safe and effective should not be paid for by health insurance plans because their high cost is not felt to be justified by the amount of benefit they provide. Do you favor or oppose doing this?
1				Favor
2				Oppose
3				Don’t know
4				Refused
47.		Do you favor or oppose the U.S. having a government decision-making body that recommends whether government programs should pay for or provide medical or surgical treatments if they think they cost too much?
1				Favor
2				Oppose
3				Don’t know
4				Refused
48.		Do you favor or oppose the government paying for a more expensive medical or surgical treatment recommended by your doctor even if it has not been shown to work better than less expensive treatments?
1				Favor
2				Oppose
3				Don’t know
4				Refused
49.		Do you favor or oppose the your health insurance plan paying for a more expensive medical or surgical treatment recommended by your doctor even if it has not been shown to work better than less expensive treatments?
1				Favor
2				Oppose
3				Don’t know
4				Refused
50.		In another country, the national government decided against paying for a new drug for treating an advanced form of cancer. On average, the drug costs $35,000 per patient. The drug does not cure the disease, but medical research results suggest that using the drug can add, on average, about six months to a patient’s life. Some patients would gain only a short period, while others could gain a lot more time. If this decision not to pay for this drug were made in the U.S., would you approve or disapprove of the decision?
1				Approve
2				Disapprove
3				Don’t know
4				Refused
5				Very Important
51.		In another country, the national government decided against paying for a new drug for treating an advanced form of cancer. On average, the drug costs $75,000 per patient. The drug does not cure the disease, but medical research results suggest that using the drug can add, on average, about six months to a patient’s life. Some patients would gain only a short period, while others could gain a lot more time. If this decision not to pay for this drug were made in the U.S., would you approve or disapprove of the decision?
1				Approve
2				Disapprove
3				Don’t know
4				Refused
5				Very Important
52.		In another country, the national government decided against paying for a new drug for treating an advanced form of cancer. On average, the drug costs $100,000 per patient. The drug does not cure the disease, but medical research results suggest that using the drug can add, on average, about six months to a patient’s life. Some patients would gain only a short period, while others could gain a lot more time. If this decision not to pay for this drug were made in the U.S., would you approve or disapprove of the decision?
1				Approve
2				Disapprove
3				Don’t know
4				Refused
5				Very Important
The next set of questions asks how much you agree or disagree with statements about your health and healthcare.
53.		When all is said and done, I am the person who is responsible for managing my health.
1			Disagree strongly
2			Disagree
3			Neither disagree or agree
4			Agree
5			Agree strongly
54.		Taking an active role in my own health care is the most important factor in determining my health and ability to function.
1			Disagree strongly
2			Disagree
3			Neither disagree or agree
4			Agree
5			Agree strongly
55.		I am confident that I can take actions that will help prevent or minimize health problems.
1			Disagree strongly
2			Disagree
3			Neither disagree or agree
4			Agree
5			Agree strongly

The purpose of the next set of questions is to help us understand what people know about medical research. You may not know all the answers. That is okay. We are just trying to learn more about how much people understand about medical research.
56.	For a new medicine to be approved for use in the United States, medical research results have to show that: [MARK ALL THAT YOU THINK ARE TRUE.]
1					The new medicine works better than medicines already approved
2					The new medicine is effective
3					The new medicine is safe
4					The new medicine is approved in other countries
5					Don't know
57.	Comparative Effectiveness Research is a type of research that can: [MARK ALL THAT YOU THINK ARE TRUE.]
1					Tell us which existing treatments work better.
2					Tell us which existing treatments have fewer side effects.
3					Discover new treatments.
4					Test new treatments
5					Don’t know
58.	The results of comparative effectiveness research can be used to develop quality standards for treating people.
1					Definitely true
2					Probably true
3					Probably false
4					Definitely false
5					Don’t know
59.	When people in health plans get more care than they need (called unnecessary care), this affects the overall costs for everyone in the health plan.
1					Definitely true
2					Probably true
3					Probably false
4					Definitely false
5					Don’t know
60.	More expensive medical treatments work better than less expensive treatments.
1					Definitely true
2					Probably true
3					Probably false
4					Definitely false
5					Don’t know
61.	Doctors usually make treatment recommendations based on medical research results.
1					Definitely true
2					Probably true
3					Probably false
4					Definitely false
5					Don’t know
62.	Who pays the largest portion of total health care costs in the United States?
1			Individuals and families
2			Government (Federal, state, and local)
3			Private business including health insurance companies
4			Other (e.g., charities)
5			Don’t know
63.	Hospitals that perform many hip replacement surgeries each year get better results than hospitals that perform fewer hip surgeries.
1				Definitely true
2				Probably true
3				Probably false
4				Definitely false
5				Don’t know

The last set of questions asks your age, race, ethnicity and some additional questions. These questions help us make sure that people with different backgrounds get included in the project and help us understand how different people think and feel about the healthcare issues raised in the Community Forum Project.
64.	Are you male or female?
1		Male
2		Female
65.	How old are you?
1		Age in years______
66.	What is your current marital status?
1		Never married
2		Living with a partner
3		Married
4		Widowed
5		Divorced
6		Separated
7		Refused
67.	What is the highest grade or level of school that you have completed?
1		8th grade or less
2		Some high school, but did not graduate
3		High school graduate or GED
4		Some college or 2-year degree
5		4-year college graduate
6		More than 4-year college degree
68.	How would you describe your employment status at this time?
1		I am employed for pay full-time or part-time.
2		I am currently unemployed or employed less than full-time and I am looking for work.
3		I am not employed for pay but I am a student, a homemaker or volunteer.
4		I am retired.
5		My health does not permit me to be employed for pay
69.	Using the categories below, please indicate the annual income of your household (yourself and anyone with whom you live and have common finances):
1		Less than $15,000
2		$15,000 to $29,999
3		$30,000 to $59,999
4		$60,000 to $100,000
5		More than $100,000
70.	Are you Hispanic or Latino/Latina?
1		Yes
2		No
71.	What is your race?  Please select one or more.
1		American Indian or Alaska Native
2		Asian
3		Native Hawaiian or other Pacific Islander
4		Black or African American
5		White
72.	Do you speak a language other than English at home?
1		Yes
2		No
73.	(If yes) What is this language?
1		_______________________
74.	(If yes) How well do you speak English?
1		Very well
2		Well
3		Not well
4		Not at all

1