Endorsement in Direct-to-Consumer Promotion: Cognitive Interviews

Data to Support Drug Product Communications

Cognitive Interview Discussion Guides

Endorsement in Direct-to-Consumer Promotion: Cognitive Interviews

OMB: 0910-0695

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0910-0695 can be found here:

Document [docx]

Download: docx | pdf

Cognitive Interview Discussion Guides

Study 1 Protocol – Print Advertisement

A. Introduction

Hello, my name is ______________ and I work for Westat, a survey research company in Rockville, Maryland. Thank you for taking the time to participate in this research study.

Westat is working with the Food and Drug Administration (FDA) to develop a communication and health survey about prescription drug advertising and how it might affect the attitudes and behaviors of adults.

Before surveys are conducted, it’s important to try out questions with the help of people such as yourself. It is important that the questions make sense, are easy to answer, and that everyone understands the questions the same way.

If you agree to take part in this study, I will ask you to view some materials, complete a paper questionnaire, and then respond to some questions about the materials you viewed and items you answered. There are no right or wrong answers. Our purpose is not to collect information about you. Instead, your interview along with those of several others will show us how to improve the questionnaire and materials.

B. Verbal Informed Consent

The survey and interview will take about an hour and you will receive $50 for your time. Your participation is voluntary. You may choose not to answer any question and you can stop this interview any time. There are no known risks to taking part in the study. Your answers and information will be kept secure to the extent allowable by law, and we will never use your name in our reports. Direct quotes may be used in our final report, but you will not be individually identified and your responses will be used for research purposes only. There are also no direct benefits to taking part, but your answers will help us with an important study.

With your permission, I would like to record this interview. Sometimes it is helpful to review a portion of a recording as we make recommendations for improving the materials and/or questionnaire. If the audio recording is reviewed later, it will only be by project staff. The recording and all materials will be destroyed after the completion of the within a year of the end of the study.

[IF OBSERVERS ARE PRESENT] Some of the researchers developing the questions are here today to observe our interview. They are here to learn if there are things that might need to be changed.

[ASK PARTICIPANT TO REVIEW THE CONSENT FORM, ANSWER ANY QUESTIONS, AND OBTAIN CONSENT BEFORE CONTINUING.]

This form contains more information about the research and your rights in this interview. Please read it over and let me know if you have any questions. If you are willing to take part in the study, please sign and date the form at the bottom.

[GIVE SECOND COPY TO RESPONDENT TO KEEP]

[START AUDIO RECORDER AND BEGIN RECORDING AND GET ORAL PERMISSION TO RECORD.] It is [DATE AND TIME], do I have your permission to record this conversation? Thank you.

C. Advertisement Viewing

I am going to start by showing you a print advertisement for a new prescription drug. Please look at the advertisement as you normally would if you saw it in a magazine. Once you are finished with it, let me know and I will hand you a paper questionnaire to complete.

[HAND PARTICIPANT ADVERTISEMENT]

D. Questionnaire Completion

[TAKE BACK THE AD AND HAND PARTICIPANT QUESTIONNAIRE]

[NOTE: The following wording will appear at the top of first page of the questionnaire:

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0910-0695 and the expiration date is 2/28/2021. The time required to complete this information collection is estimated to average 20 minutes per response, including the time for reviewing instructions and completing and reviewing the collection of information.]

Thank you for looking at the advertisement – now we will move on to the questionnaire. This would normally be a web survey that you would complete online using a laptop or desktop computer. So as best we can, let’s act like you are at home, completing this survey on your own.

E. Retrospective Probes

Thank you for completing the questionnaire. Now we’ll talk about how you answered the questions.

General Probes

Overall, what is your reaction to this questionnaire?

[IF NEEDED] What did you think about it?

Overall, how easy or difficult was it to answer the questions? What made it easy/difficult?

Would it have been easier to complete the questionnaire if you were able to look at the ad while answering the questions?

[IF YES:] Can you tell me more about that?

What about the length of the questionnaire?

[IF NEEDED] Do you think that it is short, long, or about right?

[IF NEEDED] Can you tell me more about what make you feel that way?

Item Probes

Do you remember seeing a statement that indicates whether the spokesperson was paid for their endorsement of this product? [UNAID_DC_1A]

Yes  Continue
No  Skip to Question 3

In your own words, please describe what the disclosure statement in the ad said. [UNAID_DC_1B]

Shape1

Q2 PROBES:

In your own words, what does the phrase “disclosure statement” mean to you?

How easy or difficult was it to answer this question?

[IF DIFFICULT:] What made it difficult to answer?

[IF PARTICIPANT RECEIVED THE AD WITH THE DISCLOSURE STATEMENT]: Here is a copy of the ad again. Can you please show me where you saw the disclosure statement in this ad?

What does the statement “paid endorsement” mean to you?

Refer to the area marked on the image on the right. Do you remember seeing this statement? [AID_DC1]

[INSERT THUMBNAIL/IMAGE]

Based strictly on the information in the ad, please indicate whether any of the following were mentioned in the ad as a benefit of taking [DRUG NAME].

Benefit A [BEN_RX_1A]
Benefit B [BEN_RX_1B]
Benefit C [BEN_RX_1C]
Benefit D [BEN_RX_1D]
Benefit E [BEN_RX_1E]
Benefit F [BEN_RX_1F]
Benefit G [BEN_RX_1G]

Based strictly on the information in the ad, please indicate whether any of the following were mentioned in the ad as a risk of taking [DRUG NAME].

Risk A [RISK_RX_1A]
Risk B [RISK_RX_1B]
Risk C [RISK_RX_1C]
Risk D [RISK_RX_1D]
Risk E [RISK_RX_1E]
Risk F [RISK_RX_1F]
Risk G [RISK_RX_1G]

Q4/Q5 PROBES:

Let’s look at questions 4 and 5. How did you decide on your answers for these questions?

Were they easy or difficult to answer?

[IF DIFFICULT]: What made them difficult to answer?

[IF NEEDED]: Was one question easier or more difficult than the other?

[IF YES:] Which one? Can you tell me more about that?

Refer to the area marked on the image to the right. How much, if any, of that risk information did you read? [RET_RISK1]

None of the information
Only a little of the information
About half of the information
Almost all of the information
All of the information

[INSERT THUMBNAIL/IMAGE HERE]

Q6 PROBES:

How did you decide on your answer? How sure are you of your response?

How did you pick that instead of [FILL WITH SCALE POINTS ON EITHER SIDE OF THEIR ANSWER]?

This endorser was paid for this ad.

Yes
No
Don’t know

Q7 PROBES:

Can you tell me in your own words what led you to answer [YES/NO/DON’T KNOW] to question 7?

[IF YES AND IF NEEDED]: Was there anything in the ad that signaled to you that the endorser was paid?

What in the ad signaled to you that the endorser [WAS/ WAS NOT] paid?

[IF NOT SURE] What about the ad made you unsure that the endorser was paid?

The next questions ask for your opinions based on reading the ad for [DRUG NAME].

To me, this ad for [DRUG NAME] is:

a. [DSI_1A]

1	2	3	4	5
Unimportant				Important
○	○	○	○	○

b. [DSI_1B]

1	2	3	4	5
Unexciting				Exciting
○	○	○	○	○

c. [DSI_1C]

1	2	3	4	5
Unappealing				Appealing
○	○	○	○	○

d. [DSI_1D]

1	2	3	4	5
Irrelevant				Relevant
○	○	○	○	○

e. [DSI_1E]

1	2	3	4	5
Not needed				Needed
○	○	○	○	○

Q8 PROBES:

Q8a-e. How easy or difficult was it to answer this question? Why was it {easy/difficult}?

I think the advertisement was…

	Strongly Disagree	Somewhat Disagree	Neither Disagree nor Agree	Somewhat Agree	Strongly Agree
a. Honest [ATT_AD_1A]	○	○	○	○	○
b. Trustworthy [ATT_AD_1B]	○	○	○	○	○
c. Convincing [ATT_AD_1C]	○	○	○	○	○
d. Unbiased [ATT_AD_1D]	○	○	○	○	○
e. Credible [ATT_AD_1E]	○	○	○	○	○

Q9 PROBES:

For parts a and b, how did you decide on your answers?

For part c, how did you decide on your answer? What does it mean if the advertisement was “convincing”?

For part d, how did you decide on your answer? What does it mean if the advertisement was “unbiased”?

For part e, how did you decide on your answer? What does it mean if the advertisement was “credible”?

Now we are going to ask you some questions about your attitudes and opinions regarding [DRUG NAME].

How well would [DRUG NAME] reduce [adult acne]? [WELLRED1]

Not at all well
Slightly well
Somewhat well
Quite well
Extremely well

How effective would [DRUG NAME] be in treating [adult acne]? [EFFTRT1]

Not at all effective
Slightly effective
Somewhat effective
Quite effective
Extremely effective

Q10/Q11 PROBES:

To you, are Q10 and Q11 similar or different questions? How are they {similar/different}?

How likely is it that you would experience at least one side effect if you took [DRUG NAME]? [EXP_SE1]

Not at all likely
Slightly likely
Somewhat likely
Quite likely
Extremely likely

To what extent do you think [DRUG NAME]’s side effects would affect your physical health? [SE_HLTH1]

Not at all likely
Slightly likely
Somewhat likely
Quite likely
Extremely likely

In addition to treating [adult acne], there are other advantages to taking [DRUG NAME]. [OTH_ADV1]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

How difficult or easy would it be to take [DRUG NAME]? [EASE1]

Extremely difficult
Somewhat difficult
Neither difficult nor easy
Somewhat easy
Extremely easy

How likely is it that taking [DRUG NAME] would improve your quality of life? [IMP_QOL1]

Not at all likely
Slightly likely
Somewhat likely
Quite likely
Extremely likely

The benefits of [DRUG NAME] outweigh any side effects it may have. [BENES1]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

Q12 – Q17 PROBES:

Let’s look at questions 12 through 17. How did you decide on your answers to these questions?

[IF NEEDED]: Were some questions easier or more difficult than others?

[IF YES:] Which one(s)? Can you tell me more about that?

Based on this ad, would you do any of the following:

	Yes	No
a. Ask my doctor to prescribe [DRUG NAME]. [DTC_BI_1A]	○	○
b. Question the advice of my doctor. [DTC_BI_1B]	○	○
c. Talk with my pharmacist about [DRUG NAME] or [adult acne]. [DTC_BI_1C]	○	○
d. Talk with friends and relatives about [adult acne]. [DTC_BI_1D]	○	○
e. Learn more about [adult acne] treatment options and medical conditions. [DTC_BI_1E]	○	○
f. Learn about the risks and benefits [DRUG NAME]. [DTC_BI_1F]	○	○

Q18 PROBES:

How easy or difficult was it to answer these items? Why was it {easy/difficult}?

[IF R DOES NOT HAVE ACNE OR HAD DIFFICULTY ANSWERING]: What response option would better reflect your answer?

Now we would like to ask you some questions related to your attitudes towards and perceptions of the endorser in the ad.

Please rate your attitude towards [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME], using the following scales below: [Attitudes toward endorser] [Programmer: Randomize Q31a – Q31f]

a. [ATT_END_1A]

1	2	3	4	5
Bad				Good
○	○	○	○	○

b. [ATT_END_1B]

1	2	3	4	5
Unpleasant				Pleasant
○	○	○	○	○

c. [ATT_END_1C]

1	2	3	4	5
Unfavorable				Favorable
○	○	○	○	○

d. [ATT_END_1D]

1	2	3	4	5
Unconvincing				Convincing
○	○	○	○	○

e. [ATT_END_1E]

1	2	3	4	5
Unbelievable				Believable
○	○	○	○	○

f. [ATT_END_1F]

1	2	3	4	5
Biased				Unbiased
○	○	○	○	○

Q19 PROBES:

How easy or difficult was it to answer these questions? What made them {easy/difficult}?

To me, [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] is…

a. [CRED_END_1A]

1	2	3	4	5
Unattractive				Attractive
○	○	○	○	○

b. [CRED_END_1B]

1	2	3	4	5
Not classy				Classy
○	○	○	○	○

c. [CRED_END_1C]

1	2	3	4	5
Plain				Elegant
○	○	○	○	○

d. [CRED_END_1D]

1	2	3	4	5
Not an expert				Expert
○	○	○	○	○

e. [CRED_END_1E]

1	2	3	4	5
Inexperienced				Experienced
○	○	○	○	○

f. [CRED_END_1F]

1	2	3	4	5
Unknowledgeable				Knowledgeable
○	○	○	○	○

g. [CRED_END_1G]

1	2	3	4	5
Unqualified				Qualified
○	○	○	○	○

h. [CRED_END_1H]

1	2	3	4	5
Undependable				Dependable
○	○	○	○	○

i. [CRED_END_1I]

1	2	3	4	5
Dishonest				Honest
○	○	○	○	○

j. [CRED_END_1J]

1	2	3	4	5
Unreliable				Reliable
○	○	○	○	○

k. [CRED_END_1K]

1	2	3	4	5
Insincere				Sincere
○	○	○	○	○

l. [CRED_END_1L]

1	2	3	4	5
Untrustworthy				Trustworthy
○	○	○	○	○

Q20 PROBES:

How easy or difficult was it to answer these items? What made them {easy/difficult}?

I think the combination of [PRODUCT] and [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME]… [END_CONG1]

Does not go together at all
Slightly goes together
Somewhat goes together
Pretty much goes together
Definitely goes together

My personal views and those of [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] are likely to be similar. [IDENT_END_1A]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I prefer a product recommended by [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] because of [his/her] background. [IDENT_END_1B]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

My attitude toward this prescription drug is primarily based on the similarities of my values and those of [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME]. [IDENT_END_1C]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

What [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] stands for is important to me. [IDENT_END_1D]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

Q22 –Q25 PROBES [ONLY PROBE IF PARTICIPANT HAD DIFFICULTIES ANSWERING AN ITEM]:

Let’s look at questions 22 through 25. Tell me what you thought about answering this series of questions.

Were any questions more difficult to answer than others?

[IF YES]: Which items were more difficult? Can you tell me more about that?

[CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] makes me feel like I know [him/her] well. [PS_INVOL_1A]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

If [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] appeared on a TV program, I would watch that program. [PS_INVOL_1B]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I see [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] as a natural, down-to-earth person. [PS_INVOL_1C]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

If I saw a newspaper, magazine, or online story about [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME], I would read it. [PS_INVOL_1D]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I would like to meet [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] in person. [PS_INVOL_1E]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I feel that I understand the emotions [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] experiences. [PS_INVOL_1F]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I do not have any feelings about [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME]. [PS_INVOL_1G]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

[IF IN CELEBRITY CONDITION, ASK:] I sometimes go to the Internet to obtain more information about [CELEBRITY NAME 1]. [PS_INVOL_1H]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

[IF IN CELEBRITY CONDITION, ASK:] Sometimes I feel like calling or writing [CELEBRITY NAME 1]. [PS_INVOL_1I]
- Strongly disagree
- Somewhat disagree
- Neither disagree nor agree
- Somewhat agree
- Strongly agree

[CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] understands the kinds of things I want to know. [PS_INVOL_1J]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

[IF IN CELEBRITY CONDITION, ASK:] I am very much aware of the details of [CELEBRITY NAME 1]'s life. [PS_INVOL_1K]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I feel like I have very little understanding of [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME] as a person. [PS_INVOL_1L]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

I am not really interested in [CELEBRITY NAME 1/PHYSICIAN NAME/PATIENT NAME]. [PS_INVOL_1M]

Strongly disagree
Somewhat disagree
Neither disagree nor agree
Somewhat agree
Strongly agree

Q26 –Q38 PROBES

Let’s look at questions 26 through 38. Tell me what you thought about answering this series of questions.

Were any questions more difficult to answer than others?

[IF YES]: Which items were more difficult? Can you tell me more about that?

Q34. Let’s look at question 34. What was your reaction when you read this question?

Finally, a few questions about you.

Has a doctor or other health care professional ever told you that you have [adult acne]? [DIAGNOSE]

Are you currently taking, or have you taken in the past, any prescription medications for [adult acne]? [TAKE_RX]

Are you now covered by any form of health insurance or health plan? This 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. [INSURE]

Yes  Continue
No  Skip to Q43

Does your current health insurance plan help pay for prescription medicines, or not? [INSURE_RX_COV]

In general, would you say your health these days is… [HEALTH1]

Excellent
Very good
Good
Fair
Poor

On a scale of 1-5, where 1 is completely negative and 5 is completely positive, how would you rate your experience of taking part in this survey? [DEBRIEF_1A]

Completely negative
Somewhat negative
Neither negative nor positive
Somewhat positive
Completely positive

Please tell us the main reasons for your rating score. [DEBRIEF_1B]

F. Advertisements

Now we’ll talk about the ads you looked at earlier.

[SHOW PARTICIPANT THE FIRST AD AGAIN]

PROBES:

What did you think about this ad?

When you looked at this ad, what drew your attention first?

[IF NEEDED]: Why did that draw your attention?

How does the amount of time you spent reading this ad compare to what you normally spend on reading ads?

What about this ad did you find appealing?

What about this ad was not appealing?

What are your overall reactions to the presentation of the risks and benefits of the prescription drug in the ad?

Was the information clear?

Can you tell me more why you thought it was [CLEAR/UNCLEAR]?

[SHOW R 2^ND AD]

Now I would like to show you another version of the print advertisement. Please look at the advertisement and let me know when you are finished.

PROBES:

What’s your general impression of this ad?

When you looked at this ad, what drew your attention?

[IF NEEDED]: Why did that draw your attention?

What are your thoughts about the endorser for this ad?

Thinking about the endorser in each of the materials you viewed, which one do you prefer?

What makes you say that?

G. Debriefing and Incentive

Is there anything we haven't discussed that you would like to mention?

CHECK WITH OBSERVERS FOR ANY ADDITIONAL QUESTIONS

HAND RESPONDENT DRUG DISCLOSURE PAPER

That’s all the questions I have for you today. Before we end, I would like to hand you this debriefing statement about the study. Please review it, and let me know if you have any questions.

[ANSWER R’S QUESTIONS IF ANY ARISE]

Thank you for your help!

STOP RECORDER AND PROVIDE INCENTIVE

Study 2 Protocol – Instagram Post

A. Introduction

Hello, my name is ______________ and I work for Westat, a survey research company in Rockville, Maryland. Thank you for taking the time to participate in this research study.

Westat is working with the Food and Drug Administration (FDA) to develop a communication and health survey about prescription drug Instagram Posts and how they might affect the attitudes and behaviors of adults.

B. Verbal Informed Consent

[IF OBSERVERS ARE PRESENT] Some of the researchers developing the questions are here today to observe our interview. They are here to learn if there are things that might need to be changed.

[ASK PARTICIPANT TO REVIEW THE CONSENT FORM, ANSWER ANY QUESTIONS, AND OBTAIN CONSENT BEFORE CONTINUING.] This form contains more information about the research and your rights in this interview. Please read it over and let me know if you have any questions. If you are willing to take part in the study, please sign and date the form at the bottom. [GIVE SECOND COPY TO RESPONDENT TO KEEP]

[START AUDIO RECORDER AND BEGIN RECORDING AND GET ORAL PERMISSION TO RECORD.] It is [DATE AND TIME], do I have your permission to record this conversation? Thank you.

C. Instagram Post Viewing

I am going to start by showing you an Instagram post about a new prescription drug. Please look at the post as you normally would if you saw it on your Instagram feed. Once you are finished with it, let me know and I will hand you a paper questionnaire to complete.

[HAND PARTICIPANT ADVERTISEMENT]

D. Questionnaire Completion

[TAKE BACK THE AD AND HAND PARTICIPANT QUESTIONNAIRE]

[NOTE: The following wording will appear at the top of first page of the questionnaire:

Thank you for looking at the post– now we will move on to the questionnaire. This would normally be a web survey that you would complete online using a computer or mobile device. So as best we can, let’s act like you are at home, completing this survey on your own.

E. Retrospective Probes

Thank you for completing the questionnaire. Now we’ll talk about how you answered the questions.

General Probes

Overall, what is your reaction to this questionnaire?

[IF NEEDED] What did you think about it?

Overall, how easy or difficult was it to answer the questions? What made it easy/difficult?

Would it have been easier to complete the questionnaire if you were able to look at the Instagram post while answering the questions?

[IF YES:] Can you tell me more about that?

What about the length of the questionnaire?

[IF NEEDED] Do you think that it is short, long, or about right?

[IF NEEDED] Can you tell me more about what make you feel that way?

Questionnaire Introduction Probes

This questionnaire asks about prescription drug Instagram posts and how they might affect your attitudes and behaviors.

PROBES:

Let’s take a look at the sentence that says, “This survey asks about prescription drug Instagram posts and how they might affect your attitudes and behaviors.”

What did the statement “prescription drug Instagram posts” make you think of when you first read it?

Item Probes

Do you remember seeing a statement that indicates whether the spokesperson was paid for their endorsement of this product? [UNAID_DC_2A]

Yes  Continue
No  Skip to Question 3

In your own words, please describe what the disclosure statement in the post said. [UNAID_DC_2B]

Q2 PROBES:

In your own words, what does the phrase “disclosure statement” mean to you?

How easy or difficult was it to answer this question?

[IF DIFFICULT:] What made it difficult to answer?

[IF PARTICIPANT RECEIVED THE AD WITH THE DISCLOSURE STATEMENT]: Here is a copy of the ad again. Can you please show me where you saw the disclosure statement in this ad?

What does the statement [#sponsored/#sp] mean to you?

[IF INDIRECT AD #sp]: What if the ad said #sponsored? What does that statement mean to you?

How is that different than #sp?

[IF NEEDED:] Is it more or less direct than #sp?

[IF DIRECT AD #sponsored]: What if the ad said #sp? What does that statement mean to you?

How is that different than #sponsored?

[IF NEEDED:] Is it more or less direct than #sponsored?

Refer to the area marked on the image below. Do you remember seeing this statement? [AID_DC2]

[INSERT THUMBNAIL/IMAGE]

Based strictly on the information in the post, please indicate whether any of the following were mentioned in the post as a benefit of taking [DRUG NAME].

Benefit A [BEN_RX_2A]
Benefit B [BEN_RX_2B]
Benefit C [BEN_RX_2C]
Benefit D [BEN_RX_2D]
Benefit E [BEN_RX_2E]
Benefit F [BEN_RX_2F]
Benefit G [BEN_RX_2G]

Based strictly on the information in the post, please indicate whether any of the following were mentioned in the post as a risk of taking [DRUG NAME].

Risk A [RISK_RX_2A]
Risk B [RISK_RX_2B]
Risk C [RISK_RX_2C]
Risk D [RISK_RX_2D]
Risk E [RISK_RX_2E]
Risk F [RISK_RX_2F]
Risk G [RISK_RX_2G]

Q4/Q5 PROBES:

Let’s look at questions 4 and 5. How did you decide on your answers for these questions?

Were they easy or difficult to answer?

[IF DIFFICULT]: What made them difficult to answer?

[IF NEEDED]: Was one question easier or more difficult than the other?

[IF YES:] Which one? Can you tell me more about that?

Refer to the area marked on the image below. How much, if any, of that risk information did you read? [RET_RISK2]

None of the information
Some of the information
Most of the information
All of the information

[INSERT THUMBNAIL/IMAGE HERE]

Q6 PROBES:

How did you decide on your answer? How sure are you of your response?

How did you pick that instead of [FILL WITH SCALE POINTS ON EITHER SIDE OF THEIR ANSWER]?

The next questions ask for your opinions based on reading the post for [DRUG NAME].

The Instagram post was advertising. [REC_AD]

Yes
No
Don’t know

This endorser was paid for this Instagram post. [REC_END_PD]

Yes
No
Don’t know

Q7/Q8 PROBES:

Can you tell me in your own words what led you to answer [YES/NO/DON’T KNOW] to question 7?

What was it about the Instagram post that made you think [IT WAS/ IT WAS NOT/ YOU WERE NOT SURE IT WAS] advertising?

What about question 8? Tell me what led you to answer [YES/NO/DON’T KNOW] to that question?

[IF YES AND IF NEEDED]: Was there anything in the Instagram post that signaled to you that the endorser was paid?

What in the Instagram post signaled to you that the endorser [WAS/ WAS NOT] paid?

[IF NOT SURE] What about the Instagram post made you unsure that the endorser was paid?

The next questions ask for your opinions based on reading the Instagram post for [DRUG NAME].

To me, this post for [DRUG NAME] is:

a. [DSI_2A]

1	2	3
Unimportant	Neither unimportant nor important	Important
○	○	○

b. [DSI_2B]

1	2	3
Unexciting	Neither unexciting nor exciting	Exciting
○	○	○

c. [DSI_2C]

1	2	3
Unappealing	Neither unappealing nor appealing	Appealing
○	○	○

d. [DSI_2D]

1	2	3
Irrelevant	Neither irrelevant nor relevant	Relevant
○	○	○

e. [DSI_2E]

1	2	3
Not needed	Neither not needed nor needed	Needed
○	○	○

Q9 PROBES:

Q9a-e. How easy or difficult was it to answer this question? Why was it {easy/difficult}?

Was the scale able to accurately reflect your response? Can you tell me more about that?

I think the post was…

a. Honest [ATT_AD_2A]

1	2	3
Disagree	Neither disagree nor agree	Agree
○	○	○

b. Trustworthy [ATT_AD_2B]

1	2	3
Disagree	Neither disagree nor agree	Agree
○	○	○

c. Convincing [ATT_AD_2C]

1	2	3
Disagree	Neither disagree nor agree	Agree
○	○	○

d. Unbiased [ATT_AD_2D]

1	2	3
Disagree	Neither disagree nor agree	Agree
○	○	○

e. Credible [ATT_AD_2E]

1	2	3
Disagree	Neither disagree nor agree	Agree
○	○	○

Q10 PROBES:

For parts a and b, how did you decide on your answers?

For part c, how did you decide on your answer? What does it mean if the Instagram post was “convincing”?

For part d, how did you decide on your answer? What does it mean if the Instagram pose was “unbiased”?

For part e, how did you decide on your answer? What does it mean if the Instagram post was “credible”?

Was the scale able to accurately reflect your response? Can you tell me more about that?

Now we are going to ask you some questions about your attitudes and opinions regarding [DRUG NAME].

How well would [DRUG NAME] reduce [endometriosis]? [WELLRED2]

Not well
Neither not well nor well
Well

How effective would [DRUG NAME] be in treating [endometriosis]? [EFFTRT2]

Ineffective
Neither ineffective nor effective
Effective

Q11/Q12 PROBES:

To you, are Q11 and Q12 similar or different questions? How are they {similar/different}?

How likely is it that you would experience at least one side effect if you took [DRUG NAME]? [EXP_SE2]

Not at all likely
Somewhat likely
Extremely likely

To what extent do you think [DRUG NAME]’s side effects would affect your physical health? [SE_HLTH2]

Not at all likely
Somewhat likely
Extremely likely

In addition to treating [endometriosis], there are other advantages to taking [DRUG NAME]. [OTH_ADV2]

Disagree
Neither disagree nor agree
Agree

How difficult or easy would it be to take [DRUG NAME]? [EASE2]

Difficult
Neither difficult nor easy
Easy

How likely is it that taking [DRUG NAME] would improve your quality of life? [IMP_QOL2]

Not at all likely
Somewhat likely
Extremely likely

The benefits of [DRUG NAME] outweigh any side effects it may have. [BENES2]

Disagree
Neither disagree nor agree
Agree

Q13-Q18 PROBES:

Let’s look at questions 13 through 18. How did you decide on your answers to these questions?

[IF NEEDED]: Were some questions easier or more difficult than others?

[IF YES:] Which one? Can you tell me more about that?

Based on this post, would you do any of the following: [DTCA promoted behavioral intention]

a. Ask my doctor to prescribe [DRUG NAME]. [DTC_BI_2A]

b. Question the advice of my doctor. [DTC_BI_2B]

c. Talk with my pharmacist about [DRUG NAME] or [endometriosis]. [DTC_BI_2C]

d. Talk with friends and relatives about [endometriosis]. [DTC_BI_2D]

e. Learn more about [endometriosis] treatment options and medical conditions. [DTC_BI_2E]

f. Learn about the risks and benefits of [DRUG NAME]. [DTC_BI_2F]

Q19 PROBES:

How easy or difficult was it to answer these items? Why was it {easy/difficult}?

[IF R DOES NOT HAVE ENDOMETRIOSIS OR HAD DIFFICULTY ANSWERING]: What response option would better reflect your answer?

Now we would like to ask you some questions related to your attitudes towards and perceptions of the endorser in the post.

Please rate your attitude towards [INFLUENCER NAME 1/PATIENT NAME], using the following scales below: [Attitudes toward endorser]

a. [ATT_END_2A]

1	2	3
Bad	Neither bad nor good	Good
○	○	○

b. [ATT_END_2B]

1	2	3
Unpleasant	Neither unpleasant nor pleasant	Pleasant
○	○	○

c. [ATT_END_2C]

1	2	3
Unfavorable	Neither unfavorable nor favorable	Favorable
○	○	○

d. [ATT_END_2D]

1	2	3
Unconvincing	Neither unconvincing nor convincing	Convincing
○	○	○

e. [ATT_END_2E]

1	2	3
Unbelievable	Neither unbelievable nor believable	Believable
○	○	○

f. [ATT_END_2F]

1	2	3
Biased	Neither biased nor unbiased	Unbiased
○	○	○

Q20 PROBES:

How easy or difficult was it to answer these questions? What made them {easy/difficult}?

To me, [INFLUENCER NAME 1/PATIENT NAME] is…

a. [CRED_END_2A]

1	2	3
Unattractive	Neither unattractive nor attractive	Attractive
○	○	○

b. [CRED_END_2B]

1	2	3
Not classy	Neither not classy nor classy	Classy
○	○	○

c. [CRED_END_2C]

1	2	3
Plain	Neither plain nor elegant	Elegant
○	○	○

d. [CRED_END_2D]

1	2	3
Not an expert	Neither not an expert nor an expert	Expert
○	○	○

e. [CRED_END_2E]

1	2	3
Inexperienced	Neither inexperienced nor experienced	Experienced
○	○	○

f. [CRED_END_2F]

1	2	3
Unknowledgeable	Neither unknowledgeable nor knowledgeable	Knowledgeable
○	○	○

g. [CRED_END_2G]

1	2	3
Unqualified	Neither unqualified nor qualified	Qualified
○	○	○

h. [CRED_END_2H]

1	2	3
Undependable	Neither undependable nor dependable	Dependable
○	○	○

i. [CRED_END_2I]

1	2	3
Dishonest	Neither dishonest nor honest	Honest
○	○	○

j. [CRED_END_2J]

1	2	3
Unreliable	Neither unreliable nor reliable	Reliable
○	○	○

k. [CRED_END_2K]

1	2	3
Insincere	Neither insincere nor sincere	Sincere
○	○	○

l. [CRED_END_2L]

1	2	3
Untrustworthy	Neither untrustworthy nor trustworthy	Trustworthy
○	○	○

Q21 PROBES:

How easy or difficult was it to answer these items? What made them {easy/difficult}?

I think the combination of [PRODUCT] and [INFLUENCER NAME 1/PATIENT NAME]… [END_CONG2]

Does not go together
Neutral
Goes together

My personal views and those of [INFLUENCER NAME 1/PATIENT NAME] are likely to be similar. [IDENT_END_2A]

Disagree
Neither disagree nor agree
Agree

I prefer a product recommended by [INFLUENCER NAME 1/PATIENT NAME] because of [his/her] background. [IDENT_END_2B]

Disagree
Neither disagree nor agree
Agree

My attitude toward this prescription drug is primarily based on the similarities of my values and those of [INFLUENCER NAME 1/PATIENT NAME]. [IDENT_END_2C]

Disagree
Neither disagree nor agree
Agree

What [INFLUENCER NAME 1/PATIENT NAME] stands for is important to me. [IDENT_END_2D]

Disagree
Neither disagree nor agree
Agree

Q22 – Q26 PROBES [ONLY PROBE IF PARTICIPANT HAD DIFFICULTIES ANSWERING AN ITEM]:

Let’s look at questions 22 through 26. Tell me what you thought about answering this series of questions.

Were any questions more difficult to answer than others?

[IF YES]: Which items were more difficult? Can you tell me more about that?

[INFLUENCER NAME 1/PATIENT NAME] makes me feel like I know [him/her] well. [PS_INVOL_2A]

Disagree
Neither disagree nor agree
Agree

If [INFLUENCER NAME 1/PATIENT NAME] appeared on a TV program, I would watch that program. [PS_INVOL_2B]

Disagree
Neither disagree nor agree
Agree

I see [INFLUENCER NAME 1/PATIENT NAME] as a natural, down-to-earth person. [PS_INVOL_2C]

Disagree
Neither disagree nor agree
Agree

If I saw a newspaper, magazine, or online story about [INFLUENCER NAME 1/PATIENT NAME], I would read it. [PS_INVOL_2D]

Disagree
Neither disagree nor agree
Agree

I would like to meet [INFLUENCER NAME 1/PATIENT NAME] in person. [PS_INVOL_2E]

Disagree
Neither disagree nor agree
Agree

I feel that I understand the emotions [INFLUENCER NAME 1/PATIENT NAME] experiences. [PS_INVOL_2F]

Disagree
Neither disagree nor agree
Agree

I do not have any feelings about [INFLUENCER NAME 1/PATIENT NAME]. [PS_INVOL_2G]

Disagree
Neither disagree nor agree
Agree

[IF IN INFLUENCER CONDITION, ASK:] I sometimes go to the Internet to obtain more information about [INFLUENCER NAME 1]. [PS_INVOL_2H]

Disagree
Neither disagree nor agree
Agree

[IF IN INFLUENCER CONDITION, ASK:] Sometimes I feel like calling or writing [INFLUENCER NAME 1]. [[PS_INVOL_2I]

Disagree
Neither disagree nor agree
Agree

[INFLUENCER NAME 1/PATIENT NAME] understands the kinds of things I want to know. [PS_INVOL_2J]

Disagree
Neither disagree nor agree
Agree

[IF IN INFLUENCER CONDITION, ASK:] I am very much aware of the details of [INFLUENCER NAME 1]'s life. [[PS_INVOL_2K]

Disagree
Neither disagree nor agree
Agree

I feel like I have very little understanding of [INFLUENCER NAME 1/PATIENT NAME] as a person. [PS_INVOL_2L]

Disagree
Neither disagree nor agree
Agree

I am not really interested in [INFLUENCER NAME 1/PATIENT NAME]. [PS_INVOL_2M]

Disagree
Neither disagree nor agree
Agree

Q27 –Q39 PROBES

Let’s look at questions 27 through 39. Tell me what you thought about answering this series of questions.

Were any questions more difficult to answer than others?

[IF YES]: Which items were more difficult? Can you tell me more about that?

Q35. Let’s look at question 35. What was your reaction when you read this question?

Finally, a few questions about you.

Has a doctor or other health care professional ever told you that you have [endometriosis]? [DIAGNOSE]

Are you currently taking, or have you taken in the past, any prescription medications for [endometriosis]? [TAKE_RX]

Are you now covered by any form of health insurance or health plan? This 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. [INSURE]

Yes  Continue
No  Skip to Question 44

Does your current health insurance plan help pay for prescription medicines, or not? [INSURE_RX_COV]

In general, would you say your health these days is… [HEALTH2]

Excellent
Good
Fair
Poor

On a scale of 1-5, where 1 is completely negative and 5 is completely positive, how would you rate your experience of taking part in this survey? [DEBRIEF_2A]

Completely negative
Somewhat negative
Neither negative nor positive
Somewhat positive
Completely positive

Please tell us the main reasons for your rating score. [DEBRIEF_2B]

F. Instagram Posts

Now we’ll talk about the Instagram post you looked at earlier.

[SHOW PARTICIPANT THE FIRST POST AGAIN]

PROBES:

What did you think about this Instagram post?

When you looked at this post, what drew your attention first?

[IF NEEDED]: Why did that draw your attention?

How does the amount of time you spent reading this post compare to what you normally spend on reading Instagram posts?

What about this post did you find appealing?

What about this post was not appealing?

What are your overall reactions to the presentation of the risks and benefits of the prescription drug in the Instagram post?

Was the information clear?

Can you tell me more why you thought it was [CLEAR/UNCLEAR]?

[SHOW R 2^ND POST]

Now I would like to show you another version of the Instagram post. Please look at the post and let me know when you are finished.

PROBES:

What’s your general impression of this Instagram post?

When you looked at this post, what drew your attention?

[IF NEEDED]: Why did that draw your attention?

What are your thoughts about the endorser for this post?

Thinking about the endorser in each of the posts you viewed, which one do you prefer? What makes you say that?

G. Debriefing and Incentive

Is there anything we haven't discussed that you would like to mention?

CHECK WITH OBSERVERS FOR ANY ADDITIONAL QUESTIONS

HAND RESPONDENT DRUG DISCLOSURE PAPER

That’s all the questions I have for you today. Before we end, I would like to hand you this debriefing statement about the study. Please review it, and let me know if you have any questions.

[ANSWER R’S QUESTIONS IF ANY ARISE]

Thank you for your help!

STOP RECORDER AND PROVIDE INCENTIVE

B-75

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	O'Donoghue, Amie
File Modified	0000-00-00
File Created	2021-01-15