OMB Control No. 0910-0695
Expiration date: 3/31/2024
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 3/31/2024. The time required to complete this information collection is estimated to average 3 minutes per response, including the time for reviewing instructions and completing and reviewing the collection of information.
FDA RAPID – MESSAGE #28
External Testing of Terminology Routinely Used in CDER Communications
Introduction
The U.S. Food and Drug Administration, or FDA, hired Westat to help them get opinions about health information. Plaza Research is helping Westat and FDA find people who may be interested in being interviewed about health information. To make sure you are a good fit for the interview, please take about 3 minutes to answer the questions below.
1. What is your age?
Under 18 INELIGIBLE
18 to 29
30 to 49
50 or older
2. Do you, or does any member of your household or immediate family work…?
For a market research company INELIGIBLE
For an advertising agency, communications, or public relations firm INELIGIBLE
In the media (TV, radio, newspapers, magazines) INELIGIBLE
As a healthcare professional (doctor, nurse, pharmacist, medical assistant, dietician, etc.) INELIGIBLE
In a healthcare position or for a health organization (health consultant, health advocacy, state or local health department, U.S. Department of Health and Human Services or any of its agencies) INELIGIBLE
In the pharmaceutical industry INELIGIBLE
None of the above GO TO Q3
3. In the past 30 days, have you used or taken medication for which a prescription is needed? Do not include prescription vitamins or minerals.1
4. How many different prescription medicines have you used or taken in the past 30 days?
5. What is the highest grade or level of education you have completed?
Less than High School
High School Diploma or GED
Some College, but no degree
Associate’s Degree
Bachelor’s Degree
Graduate or Professional Degree INELIGIBLE
6. Are you comfortable speaking and reading English independently and without an interpreter?
Yes
No INELIGIBLE
7. What is your sex?
Female
Male
Prefer not to answer INELIGIBLE
8. Are you of Hispanic, Latino, or Spanish origin?
Yes
No
9. What is your race? Please select one or more.
□ White
□ Black or African-American
□ American Indian or Alaska Native
□ Asian
□ Native Hawaiian or other Pacific Islander
10. What state do you live in? [DROP DOWN LIST OF US STATES, INCLUDING “OUTSIDE OF THE US”] [“OUTSIDE OF THE US” INELIGIBLE]
11. Do you have access to high-speed (in other words, not dial-up) internet?
Yes
No INELIGIBLE
12. For this discussion, the interviewer would like to share her computer screen during the interview so that you can view the health information together. Do you have a computer (laptop, tablet, or desktop) with a webcam and audio that you can use to participate?
Yes
No INELIGIBLE
13. Have you participated in an interview or focus group for a research study within the past 6 months?
Yes INELIGIBLE
No
Request for Contact Information
C1. Thank you for answering the questions. Based on your answers, you may be selected for a 45-minute interview. If selected, you will receive $50 as a token of appreciation for your participation. At the start of the interview, the interviewer will ask if it’s okay to audio record it. This helps Westat to make sure they correctly hear everything you say. Are you okay with being audio recorded during the interview?
Yes
No INELIGIBLE
C2. As stated earlier, Plaza Research is helping to identify people interested in providing opinions about health information. If you are chosen for an interview, you will get an email for this study. Make sure you have access to your email during the interview. Is it okay with you for Plaza Research to share your contact information with Westat?
Yes
No INELIGIBLE
Thank and Terminate
Thank you for taking our survey. Unfortunately, based on your responses, you are not eligible for this study. However, we appreciate you taking the time to answer our questions today.
Contact Information
C3. In the space below, please provide us with your contact information, including phone number and email address. Westat will not share your contact information with anyone else, including the FDA. Your personal information will be deleted upon completion of the research project.
Name ______________________________________________________________________
Phone Number _______________________________________________________________
Email Address ________________________________________________________________
Technology Preferences
C4. The Westat interviewer would like to share her computer screen during the interview so that you can view the health information together. Westat will send directions for how to do this. Which app do you prefer for screen sharing? [SINGLE SELECT]
Zoom
WebEx
Closing
Thank you for your answers to these questions. If you are chosen for an interview, someone will contact you within the next 1-2 days.
1 Based on 2013-2014 National Health and Nutrition Examination Survey (NHANES)
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Weinberg, Jessica |
File Modified | 0000-00-00 |
File Created | 2022-07-01 |