Cognitive Interview Screener

Oncology Indications Study

Cognitive Testing – Recruitment Screener

[Ask to speak to an adult age 18 or older living in the household.]

Hello, my name is _______________ and I’m from [name of company]. I’m calling on behalf of RTI International, a non-profit research organization, about a study being sponsored by a public health agency. We’re calling to recruit people to take part in a research study about medication advertising. We are not selling or promoting any product. The study involves watching some ads and then taking a survey on a computer to answer some questions about what you saw.

RTI will be conducting interviews with several people, and we would like to see if you are eligible. We have various time slots available and will work with you to find a time that fits your schedule. The interview will last up to 60 minutes. In appreciation for your participation, you will be given a token of appreciation.

To see if you are eligible for this study, I need to ask you a few questions. All of your responses will be kept private. My questions will only take a few minutes. May I proceed?

Yes  CONTINUE

No  [Thank respondent and end call.]

1. How old are you? ______________ (try for mix of ranges below)

[ASSIGN RESPONSE TO AGE RANGE BELOW]

17 or younger		TERMINATE
18-20		CONTINUE
21-29		CONTINUE
30-39		CONTINUE
40-49		CONTINUE
50-59		CONTINUE
60 or older		CONTINUE

[ATTEMPT MIX]

2. What is the highest level of education you have completed? (try for lower education levels as below)

________________________Degree

[ASSIGN RESPONSE TO EDUCATION LEVEL BELOW]

Less than high school		CONTINUE (aim for 2)
High school graduate—high school diploma or the equivalent (for example: GED)		CONTINUE (aim for 3)
Some college but no degree		CONTINUE
Associate degree in college		CONTINUE
Bachelor’s degree (for example: BA, AB, BS)		CONTINUE (no more than 3)
Advanced or post-graduate degree (for example: Master’s degree, MD, DDS, JD, PhD, EdD)		CONTINUE (no more than 2)

[AIM FOR AT LEAST 6 PARTICIPANTS WITH SOME COLLEGE OR LESS]

3. Are you Hispanic or Latino/a?

No		CONTINUE
Yes		CONTINUE (recruit at least 3)

4. What is your race? (recruit mix) ______________________

[ASSIGN RESPONSE TO CATEGORY BELOW]

American Indian / Alaskan Native		CONTINUE
Asian		CONTINUE
Black or African American		CONTINUE
Native Hawaiian or other Pacific Islander		CONTINUE
White		CONTINUE
More than one race		CONTINUE

[NO MORE THAN FIVE PARTICIPANTS OF A SINGLE RACE]

5. What is your sex?

Male		CONTINUE (recruit 6)
Female		CONTINUE (recruit 6)

6. What is your current occupation? ________________

[ASSIGN RESPONSE TO CATEGORY BELOW]

Market research employee or advertising employee		 TERMINATE
Employee of the Department of Health and Human Services		 TERMINATE
Pharmaceutical employee(e.g., as a pharmaceutical rep)		 TERMINATE
A healthcare professional (e.g., physician, nurse, counselor, physical therapist)		 TERMINATE
All other occupations		 CONTINUE

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

[Include at least 3 participants with a score of 3 or lower]

Not at all		 CONTINUE
A little bit		 CONTINUE
Somewhat		 CONTINUE
Quite a bit		 CONTINUE
Extremely		 CONTINUE

Invitation for Eligible Participants:

Thank you for answering all of my questions. We would like to invite you to take part in a one-on-one interview. The interviews are being scheduled on [DATES].

The discussion will last up to 60 minutes. No one will attempt to sell you anything, and no one will call you for other studies as a result of your participation in this study. In appreciation for your time, effort, and travel expenses, you will receive $75 at the time of the interview. This is an important research effort, and we hope that you will be part of it. I also want to let you know that the interviews will be audio recorded. They will only be listened to by project staff and will be deleted at the end of the project.

Can we schedule you now?

Yes  CONTINUE TO SCHEDULING

No  TERMINATE

Closing Scripts

SCHEDULING
[IF ELIGIBLE AND AVAILABLE, SCHEDULE INTERVIEW]

During the interview, we will ask you to review an advertisement on a computer and answer some questions about what you saw. If you wear reading glasses, please remember to bring them to the interview.

Closing for Ineligible Participants:

Thank you for answering our questions. At this time, you are not eligible to be in this study. However, we appreciate your willingness to help us. Have a good day.

**NOTE** THIS PAGE MUST BE STORED SEPARATELY FROM THE SCREENER AND COGNITIVE INTERVIEW DATA. PLEASE DESTROY UPON COMPLETION OF COGNITIVE INTERVIEW.

NAME: ____________________________________________________________

ADDRESS: ________________________________________________________

CITY: _________________________________________________

ZIP CODE: _________________________________________________

E-MAIL_______________________________________________________

What is the best time to reach you? What is the best telephone number to reach you at that time?

BEST TIME TO BE REACHED: ________________________________________

BEST PHONE NUMBER: ________________________________________

Is there another time and number we can try if we miss you?

ALTERNATE TIME:

ALTERNATE PHONE NUMBER:

Thank you. That’s all the questions I have today. Please try to arrive at least 15 minutes before the starting time. If you have any questions or find that you are unable to attend, please call [facility’s phone number] as soon as possible. Thank you again for your time. We look forward to seeing you at [TIME] on [DATE].

Read if necessary:

If you have any questions about the study, you may contact Vanessa Boudewyns of RTI at 1‑800‑334‑8571, extension 22092. If you have concerns about how participants are being treated in the study, you may contact RTI’s Office of Research Protection toll-free at 1-866-214-2043.