Number of Completes - Screener

APPENDIX 2

Draft Screener and Questionnaires

Screener Draft

SCREENING QUESTIONS

S1. Are you at least 18 years old?

• Yes  continue

• No  eliminate [Respondents who are eliminated are thanked¹]

S2. In what year were you born? ______

If Year is > 1994 eliminate

DO NOT READ Don’t Know 8 eliminate

DO NOT READ Refused 9 eliminate

S3. [BLANK]

S4. Are you trained or employed as a health care professional?

• Yes  eliminate

• No  continue

S5. Do you work for a pharmaceutical company, an advertising agency, or a market research company?

• Yes  eliminate

• No  continue

DEMOGRAPHICS

S6. Gender

• Male

• Female

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

• Less than high school

• High school graduate—high school diploma or equivalent( for example, GED)

• Some college but no degree

• Associate’s degree in college

• Bachelor’s degree in college (for example, BA, AB, BS)

• Advanced or post-graduate degree (for example, Master’s degree, Ph.D., M.D., J.D., etc.)

S8. Are you Hispanic or Latino?

􀂉 No

􀂉 Yes

S9. What is your race? You may select one or more races.

􀂉 American Indian or Alaska Native

􀂉 Asian

􀂉 Black or African American

􀂉 Native Hawaiian or other Pacific Islander

􀂉 White

􀂉 Some other race

Disease Information Pretest Questionnaire Draft

[PROGRAMMER:

• The viewing time of each page of the ad must be timed separately in milliseconds.

• Program progresses to the questioning in a “one-way” manner

• Record time in milliseconds spent on each screen (including questions) throughout protocol and when participants click the link to go back to the ad while answering questions.

BEFORE FIELDING

• Replace [DRUG X] with appropriate drug name

• Replace [disease] with appropriate disease condition

Initial exposure: show small version of the ad on screen- all pages. If participants want to see a bigger image of any section on the page, they can enlarge that section by clicking on it, and they can flip between the pages by clicking the ”Next” and “Back” buttons at the bottom of the screen. ]

INTRODUCTION

Thank you for agreeing to participate in this study today.

Make sure you are comfortable and can read the screen from where you sit. This study is about advertising for a new product. We will show you some advertising then ask you questions about it. Your answers are private and will not be connected with your name. Your input is extremely valuable.

[NEW SCREEN]

Before we begin, we would like to find out what you know about certain topics. This will help us describe our sample of participants.

[PROGRAMMER: RANDOMIZE A1-A3]

A1. Please indicate how much you agree with the following statements about COPD.

I know a lot about COPD

I know a good bit about COPD

I know some about COPD

I know only a slight amount about COPD

I know nothing at all about COPD

A2. Please indicate how much you agree with the following statements about anemia.

I know a lot about anemia

I know a good bit about anemia

I know some about anemia

I know only a slight amount about anemia

I know nothing at all about anemia

A3. Please indicate how much you agree with the following statements about lymphoma.

I know a lot about lymphoma

I know a good bit about lymphoma

I know some about lymphoma

I know only a slight amount about lymphoma

I know nothing at all about lymphoma

INSTRUCTIONS

Let’s begin.

We will ask you questions about the advertising after you have finished reading it. Do your best to remember details about the advertising. We will ask you to explain your answers.

You can flip between the pages by clicking the “Next” and “Previous” buttons at the bottom of the screen. Once you finish reading the advertising, please click “Next” to move to the next part of the study. You may begin when you are ready.

[PROGRAMMER: Participants will be randomly assigned to medical condition and ad reference condition (available or not available). Show ONE Drug X ad.]

1. Were you able to view the ad for Drug X?

Yes

No (terminate)

Not sure (terminate)

2. What kind of product is Drug X? [PROGRAMMER: randomize responses]

_____Prescription drug

_____Over-the-counter (OTC) drug

_____Don’t know

[BEGIN AD AVAILABILITY LINK]

[PROGRAMMER: MAKE LINK TO AD AVAILABLE TO PARTICIPANTS IN AD AVAILABLE CONDITION]

3. What are the benefits of Drug X? Use one line for each benefit you remember. [open-ended] (Beliefs about benefits)

[PROGRAMMER: Five separate text boxes]

Possible Codes:

Risks (from product info)

Incorrect risks (not in ad)

Incorrect Benefits (from outcome info)

Incorrect Benefits (from non-outcome info)

Incorrect Benefits (from disease info)

Incorrect Benefits (not mentioned in ad)

Benefits (from product info)

Other

4. What are the risks of Drug X? Use one line for each risk you remember. [open-ended] (Beliefs about risks)

[PROGRAMMER: Five separate text boxes]

Possible Codes:

Risks (from product info)

Incorrect risks (not in ad)

Incorrect Benefits (from outcome info)

Incorrect Benefits (from non-outcome info)

Incorrect Benefits (from disease info)

Incorrect Benefits (not mentioned in ad)

Benefits (from product info)

Other

[PROGRAMMER: MATCH VERSION OF Q6 TO DISEASE AD SHOWN]

6_1. Based on the information in the ad, please check which of the following are benefits of taking Drug X. [COPD version]

[PROGRAMMER: randomize a-l] (Benefit Recall)

	Yes	No
a. Drug X is taken once a day	X
b. Drug X reduces the chance of COPD flare-ups	X
c. Drug X helps make your lungs work better for 24 hours	X
d. Drug X helps patients walk farther		X
e. Drug X helps patients continue to take care of themselves		X
f. Drug X helps patients do basic activities like lifting objects		X
g. Drug X reduces the effects of air pollution on the lungs		X
h. Drug X prevents dust from entering the lungs and causing COPD		X
i. Drug X prevents chemicals from damaging the lungs and causing COPD		X
j. Drug X reduces the chance of death from COPD		X
k. Drug X helps patients stop smoking		X
l. Drug X is used for long-term control of COPD symptoms	X

6_2. Based on the information in the ad, please check which of the following are benefits of taking Drug X. [Anemia version]

[PROGRAMMER: randomize a-k] (Benefit Recall)

	Yes	No
a. Drug X treats iron-deficiency anemia in adults	X
b. Drug X helps your red blood cells retain iron	X
c. Drug X is taken once a week	X
d. Drug X prevents liver damage		X
e. Drug X prevents heart damage		X
f. Drug X prevents spleen damage		X
g. Drug X prevents anemia by improving diet		X
h. Drug X reduces the chance seniors will get anemia		X
i. Drug X reduces the chance pregnant women will get anemia		X
j. Drug X reduces the chance of brain damage from anemia		X
k. Drug X prevents anemia in vegetarians		X

6_3. Based on the information in the ad, please check which of the following are benefits of taking Drug X. [Lymphoma version]

[PROGRAMMER: randomize a-l] (Benefit Recall)

	Yes	No
a. Drug X treats a type of aggressive non-Hodgkins lymphoma	X
b. Drug X is for patients who have tried at least two other chemotherapy treatments	X
c. Drug X treats diffuse large B-cell lymphoma (DLBCL)	X
d. Drug X prevents fatigue		X
e. Drug X prevents depression		X
f. Drug X reduces the chance that older people will get lymphoma		X
g. Drug X reduces the chance of getting lymphoma from infections		X
h. Drug X reduces the chance that toxic chemicals will cause lymphoma		X
i. Drug X reduces the chance of death from lymphoma		X
j. Drug X prevents weight loss caused by lymphoma		X
k. Drug X reduces the chance lymphoma will start in lymph tissue		X
l. Drug X is given by infusion	X

[If 6d = YES:]

7a. You said Drug X [Drug X outcome #1 from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6e = YES:]

7b. You said Drug X [Drug X outcome #2 from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6f = YES:]

7c. You said Drug X [Drug X outcome #3 from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6g = YES:]

7d. You said Drug X [Drug X non-outcome #1 from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6h = YES:]

7e. You said Drug X [Drug X non-outcome #2 from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6i = YES:]

7f. You said Drug X [Drug X non-outcome #3 from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6j = YES:]

7g. You said Drug X [Drug X outcome, other from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6k = YES:]

7g. You said Drug X [Drug X non-outcome, other from disease awareness info]. What in the ad for [INSERT DRUG X] made you say that? (open-ended)

[If 6d = NO:]

8a_1. Was there anything in the ad that suggested [Drug X outcome #1]?

Yes [ask 8a_2]

No

8a_2. What in the ad made you say that? (open-ended)

[If 6e = NO:]

8b_1. Was there anything in the ad that suggested [Drug X outcome #2]?

Yes [ask 8b_2]

No

8b_2. What in the ad made you say that? (open-ended)

[If 6f = NO:]

8c_1. Was there anything in the ad that suggested [Drug X outcome #3]?

Yes [ask 8c_2]

No

8c_2. What in the ad made you say that? (open-ended)

[For each YES answer to 6a-l]

9a-l. How confident are you that Drug X [insert text of each item 6a through 6l]?

1	2	3	4	5
Not at all confident	Somewhat confident	Confident	Very confident	Completely confident

10. If you took [INSERT Drug X], how likely or unlikely do you think it is that [INSERT Drug X], would help your [INSERT CONDITION]?

1	2	3	4	5
Very Unlikely				Very Likely

Q11. If [INSERT DRUG X] did help your [INSERT CONDITION], how effective do you think [INSERT DRUG X] would be?

1	2	3	4	5
Not at all Effective				Very Effective

12. Based on the information in the ad for [INSERT Drug X], how easy or difficult is it to treat disease X with [INSERT Drug X]?

1	2	3	4	5
Very difficult	Somewhat difficult	Neither difficult nor easy	Somewhat easy	Very easy

Manipulation Checks

13a. How many ads did you see?

1

2 (ask 13b)

3 (ask 13b)

4 (ask 13b)

13b. How different or similar were the ads you saw?

1	2	3	4	5
Very different	Somewhat different	Neither different nor similar	Somewhat similar	Very similar

14. Did the ad for [DRUG X] include information about the possible negative outcomes of [disease condition]?

Yes

No

Don’t know

15. Did the ad for [DRUG X] include information on the possible causes of [disease condition]?

Yes

No

Don’t know

16. Did the ad for [DRUG X] include information on who may be at risk of [disease condition]?

Yes

No

Don’t know

17. Was the information about [DRUG X] separate from the information about [disease condition]?

Yes

No

Don’t know

17a: Was the information about [DRUG X] mixed with the information about [disease condition]?

Yes

No

Don’t know

18. Was it hard to tell the difference between the information about [DRUG X] and the information about [disease].

Yes

No

Don’t know

19. Did you notice the drug company name and logo?

Yes

No

Don’t know

20. Where did it appear? Choose all that apply.

Top right

Bottom right

Middle

Top left

Bottom left

21. What is the purpose of having the company logo on advertisements? (open-ended)

[For separated conditions, show ad again with logo circled on both sides]

22. What does it mean when you see the company logo presented in this way? (open-ended)

23. What do you think about the information when you see the company logo presented in this way? (open-ended)

[New page]

Those are all the questions we have for you!

The purpose of this study is to learn about how people understand information about prescription drugs in advertisements. In order to get a real-life reaction to this information, we created a brand to use in this study.

The advertisement you read is not a real advertisement for a product to treat [DISEASE CONDITION]. The negative outcomes of [DISEASE CONDITION] discussed in this advertisement were used as examples only. Please see your healthcare professional for any questions about [DISEASE CONDITION], treatments for [DISEASE CONDITION], and outcomes of untreated [DISEASE CONDITION]. [Drug X] is not a real product and is not available for sale.

You have been very helpful. Thank you very much for your participation!

OMB Control #____________ Expires ___________

OMB Control #____________ Expires ___________

Disease Information Main Study Questionnaire Draft

[PROGRAMMER:

• The viewing time of each page of the ad must be timed separately in milliseconds.

• Program progresses to the questioning in a “one-way” manner

• Record time in milliseconds spent on each screen (including questions) throughout protocol.

Show small version of the ad on screen- all three pages. If participants want to see a bigger image of any section on the page, they can enlarge that section by clicking on it, and they can flip between the pages by clicking the ”Next” and “Back” buttons at the bottom of the screen. ]

INTRODUCTION

Thank you for agreeing to participate in this study today.

Make sure you are comfortable and can read the screen from where you sit. This study is about advertising for a new product. We will show you some advertising then ask you questions about it. Your answers are private and will not be connected with your name. Your input is extremely valuable.

Before we begin, we would like to find out what you know about certain topics. This will help us describe our sample of participants.

[PROGRAMMER: RANDOMIZE A1-A3]

A1. Please indicate how much you agree with the following statements about COPD.

I know a lot about COPD

I know a good bit about COPD

I know some about COPD

I know only a slight amount about COPD

I know nothing at all about COPD

A2. Please indicate how much you agree with the following statements about anemia.

I know a lot about anemia

I know a good bit about anemia

I know some about anemia

I know only a slight amount about anemia

I know nothing at all about anemia

A3. Please indicate how much you agree with the following statements about lymphoma.

I know a lot about lymphoma

I know a good bit about lymphoma

I know some about lymphoma

I know only a slight amount about lymphoma

I know nothing at all about lymphoma

INSTRUCTIONS

Let’s begin.

We will ask you questions about the advertising after you have finished reading it. Do your best to remember details about the advertising. We will ask you to explain your answers.

You can flip between the pages by clicking the ”Next” and “Previous ” buttons at the bottom of the screen. Once you finish reading the advertising, please click “Start Next Part of Study” to move to the next part of the study. You may begin when you are ready.

[PROGRAMMER: Participants will be randomly assigned to medical condition and ad condition. Show ONE Drug X ad.]

1. Were you able to view the ad for Drug X?

Yes

No (terminate)

Not sure (terminate)

2. What kind of product is Drug X? [PROGRAMMER: randomize responses]

_____Prescription drug

_____Over-the-counter (OTC) drug

_____Don’t know

[BEGIN AD AVAILABILITY LINK]

[PROGRAMMER: MAKE LINK TO AD AVAILABLE]

3. What are the benefits of Drug X? Use one line for each benefit you remember. [open-ended] (Beliefs about benefits)

[PROGRAMMER: Five separate text boxes]

Possible Codes:

Risks (from product info)

Incorrect risks (not in ad)

Incorrect Benefits (from outcome info)

Incorrect Benefits (from non-outcome info)

Incorrect Benefits (from disease info)

Incorrect Benefits (not mentioned in ad)

Benefits (from product info)

Other

(Beliefs about risks)

4. What are the risks of Drug X? Use one line for each risk you remember. [open-ended]

[PROGRAMMER: Five separate text boxes]

Possible Codes:

Risks (from product info)

Incorrect risks (not in ad)

Incorrect Benefits (from outcome info)

Incorrect Benefits (from non-outcome info)

Incorrect Benefits (from disease info)

Incorrect Benefits (not mentioned in ad)

Benefits (from product info)

Other

[PROGRAMMER: MATCH VERSION OF Q6 TO DISEASE AD SHOWN]

6_1. Based on the information in the ad, please check which of the following are benefits of taking Drug X. [COPD version]

[PROGRAMMER: randomize a-l] (Benefit Recall)

	Yes	No
a. Drug X is taken once a day	X
b. Drug X reduces the chance of COPD flare-ups	X
c. Drug X helps make your lungs work better for 24 hours	X
d. Drug X helps patients walk farther		X
e. Drug X helps patients continue to take care of themselves		X
f. Drug X helps patients do basic activities like lifting objects		X
g. Drug X reduces the effects of air pollution on the lungs		X
h. Drug X prevents dust from entering the lungs and causing COPD		X
i. Drug X prevents chemicals from damaging the lungs and causing COPD		X
j. Drug X reduces the chance of death from COPD		X
k. Drug X helps patients stop smoking		X
l. Drug X is used for long-term control of COPD symptoms	X

6_2. Based on the information in the ad, please check which of the following are benefits of taking Drug X. [Anemia version]

[PROGRAMMER: randomize a-k] (Benefit Recall)

	Yes	No
a. Drug X treats iron-deficiency anemia in adults	X
b. Drug X helps your red blood cells retain iron	X
c. Drug X is taken once a week	X
d. Drug X prevents liver damage		X
e. Drug X prevents heart damage		X
f. Drug X prevents spleen damage		X
g. Drug X prevents anemia by improving diet		X
h. Drug X reduces the chance seniors will get anemia		X
i. Drug X reduces the chance pregnant women will get anemia		X
j. Drug X reduces the chance of brain damage from anemia		X
k. Drug X prevents anemia in vegetarians		X

6_3. Based on the information in the ad, please check which of the following are benefits of taking Drug X. [Lymphoma version]

[PROGRAMMER: randomize a-l] (Benefit Recall)

	Yes	No
a. Drug X treats a type of aggressive non-Hodgkins lymphoma	X
b. Drug X is for patients who have tried at least two other chemotherapy treatments	X
c. Drug X treats diffuse large B-cell lymphoma (DLBCL)	X
d. Drug X prevents fatigue		X
e. Drug X prevents depression		X
f. Drug X reduces the chance that older people will get lymphoma		X
g. Drug X reduces the chance of getting lymphoma from infections		X
h. Drug X reduces the chance that toxic chemicals will cause lymphoma		X
i. Drug X reduces the chance of death from lymphoma		X
j. Drug X prevents weight loss caused by lymphoma		X
k. Drug X reduces the chance lymphoma will start in lymph tissue		X
l. Drug X is given by infusion	X

[If 6d = YES:]

7a. You said Drug X [Drug X outcome #1 from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6e = YES:]

7b. You said Drug X [Drug X outcome #2 from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6f = YES:]

7c. You said Drug X [Drug X outcome #3 from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6g = YES:]

7d. You said Drug X [Drug X non-outcome #1 from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6h = YES:]

7e. You said Drug X [Drug X non-outcome #2 from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6i = YES:]

7f. You said Drug X [Drug X non-outcome #3 from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6j = YES:]

7g. You said Drug X [Drug X outcome, other from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

[If 6k = YES:]

7g. You said Drug X [Drug X non-outcome, other from disease awareness info]. What in the ad for Drug X made you say that? (open-ended)

8a-l. How confident are you that Drug X [insert text of each item 6a through 6l]?

1	2	3	4	5
Not at all confident	Somewhat confident	Confident	Very confident	Completely confident

[PROGRAMMER: RANDOMIZE Q9-11]

9. If you took [INSERT Drug X], how likely or unlikely do you think it is that [INSERT Drug X], would help your [INSERT CONDITION]?

1	2	3	4	5
Very Unlikely				Very Likely

10. If [INSERT DRUG X] did help your [INSERT CONDITION], how effective do you think [INSERT DRUG X] would be?

1	2	3	4	5
Not at all Effective				Very Effective

11. Based on the information in the ad for [INSERT Drug X], how easy or difficult is it to treat disease X with [INSERT Drug X]?

1	2	3	4	5
Very difficult	Somewhat difficult	Neither difficult nor easy	Somewhat easy	Very easy

[PROGRAMMER: MATCH VERSION OF Q12 TO DISEASE AD SHOWN]

12_1. Based on the information in the ad, please check which of the following are risks of taking Drug X. [COPD version]

[PROGRAMMER: randomize a-h] (Risk Recall)

	Yes	No
a. Drug X may cause pneumonia	X
b. Drug X may make glaucoma worse	X
c. Drug X may cause sore throat	X
d. A swollen throat, tongue or difficulty breathing is a sign of a serious allergic reaction to Drug X	X
e. Do not take Drug X if you are allergic to aspirin		X
f. Drug X may cause osteoporosis		X
g. Drug X may cause muscle damage		X
h. Drug X may cause heart damage		X

12_2. Based on the information in the ad, please check which of the following are risks of taking Drug X. [anemia version]

[PROGRAMMER: randomize a-h] (Risk Recall)

	Yes	No
a. Do not take Drug X if you have high levels of iron in your blood	X
b. Drug X may cause internal bleeding	X
c. Drug X may cause nausea	X
d. A swollen throat, tongue or difficulty breathing is a sign of a serious allergic reaction to Drug X	X
e. Drug X may cause headaches		X
f. Drug X may cause kidney failure		X
g. Drug X may cause liver damage		X
h. Drug X may cause heart damage		X

12_3. Based on the information in the ad, please check which of the following are risks of taking Drug X. [lymphoma version]

[PROGRAMMER: randomize a-h] (Risk Recall)

	Yes	No
a. Do not take Drug X if you have an infection	X
b. Drug X may cause severe mouth sores	X
c. Drug X may cause kidney damage	X
d. Drug X may cause heart damage	X
e. Drug X may cause tiredness		X
f. Drug X may cause low blood sugar		X
g. Drug X may cause liver damage		X
h. Drug X may cause headaches		X

[PROGRAMMER: randomize Q13-15]

13. If you took [INSERT Drug X], how likely or unlikely do you think it is that you would have any side effects or negative outcomes?

1	2	3	4	5
Very Unlikely				Very Likely

14. If [INSERT DRUG X] did cause you to have side effects or negative outcomes, how serious would they be?

1	2	3	4	5
Not at all Serious				Very Serious

15. Thinking overall about the risks and benefits of Drug X, would you say it has: (Risk/Benefit Balance)

1	2	3	4	5
Many more risks than benefits	Somewhat more risks than benefits	Equal risks and benefits	Somewhat more benefits than risks	Many more benefits than risks

[PROGRAMMER: counterbalance 16-17 and 18-19]

16. If someone with this medical condition saw this ad, how likely would that person be to ask their doctor about Drug X? (Behavioral Intention)

1	2	3	4	5
Very unlikely	Somewhat unlikely	Neither likely nor unlikely	Somewhat likely	Very likely

17. If someone with this medical condition saw this ad, how likely would that person be to look for more information about Drug X? (Behavioral Intention)

1	2	3	4	5
Very unlikely	Somewhat unlikely	Neither likely nor unlikely	Somewhat likely	Very likely

18. If someone with this medical condition saw this ad, how likely would that person be to look for more information about [disease condition]? (Behavioral Intention)

1	2	3	4	5
Very unlikely	Somewhat unlikely	Neither likely nor unlikely	Somewhat likely	Very likely

19. If one of your family members had this medical condition, how likely would you be to mention Drug X to them? (Behavioral Intention)

1	2	3	4	5
Very unlikely	Somewhat unlikely	Neither likely nor unlikely	Somewhat likely	Very likely

20. How persuasive is this ad? (Perceived persuasiveness)

1	2	3	4	5
Not at All Persuasive				Very Persuasive

Manipulation Checks

21a. How many ads did you see?

1

2 (ask 21b)

3 (ask 21b)

4 (ask 21b)

21b. How different or similar were the ads you saw?

1	2	3	4	5
Very different	Somewhat different	Neither different nor similar	Somewhat similar	Very similar

22. Did the ad for [INSERT Drug X] include information about the possible negative outcomes of [disease condition]?

Yes

No

Don’t know

23. Did the ad for [INSERT Drug X] include information about the possible causes of [disease condition]?

Yes

No

Don’t know

24. Did the ad for [INSERT Drug X] include information about who may be at risk of [disease condition]?

Yes

No

Don’t know

25. Was the information about [DRUG X] separate from the information about [disease condition ]?

Yes

No

Don’t know

Q25a: Was the information about [DRUG X] mixed with the information about [disease condition]?

Yes

No

Don’t know

26. Was it hard to tell the difference between the information about [DRUG X] and the information about [disease condition]?

Yes

No

Don’t know

27. Are you currently taking any prescription drug medicines?

_____Yes

_____No

28. How long have you been taking prescription drug medicines?

_____Less than 2 weeks

_____At least 2 weeks but less than 2 months

_____At least 2 months but less than 6 months

_____At least 6 months but less than 1 year

_____At least 1 year but less than 5 years

_____At least 5 years

29. How often do you have someone (like a family member or friend) help you read instructions, pamphlets, or other written material from your doctor or pharmacy?

1	2	3	4	5
Never	Occasionally	Sometimes	Often	Always

30. How confident are you filling out medical forms by yourself?

1	2	3	4	5
Not at all confident	A little bit	Somewhat	Quite a bit	Extremely confident

31. What is your household income?

_____Less than $30,000 per year

_____$30,000 - $75,000 per year

_____$75,001 - $150,000 per year

_____$150,001+ per year

32. Has a doctor or other healthcare provider ever said you have any of the following health problems? [RANDOMIZE ORDER]

a. Asthma _____Yes _____No [filler]

b. Obesity _____Yes _____No [filler]

c. Acid reflux or GERD _____Yes _____No [filler]

d. Lymphoma _____Yes _____No

e. Anemia _____Yes _____No

f. Chronic Obstructive Pulmonary Disease or COPD _____Yes _____No

[If YES to 32d, 32e or 32f]:

33. In what year were you diagnosed with that condition?

______ (year)

[PROGRAMMER: NEW PAGE]

Those are all the questions we have for you!

The purpose of this study is to learn about how people understand information about prescription drugs in advertisements. In order to get a real-life reaction to this information, we created a brand to use in this study.

The advertisement you read is not a real advertisement for a product to treat [DISEASE CONDITION]. The negative outcomes of [DISEASE CONDITION] discussed in this advertisement were used as examples only. Please see your healthcare professional for any questions about [DISEASE CONDITION], treatments for [DISEASE CONDITION], and outcomes of untreated [DISEASE CONDITION]. Drug X is not a real product and is not available for sale.

You have been very helpful. Thank you very much for your participation!

OMB Control #____________ Expires ___________

1 For ELIMINATED 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.

Click here to see if other studies are available or to update your profile!

OMB Control #____________ Expires ___________