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pdfAPPENDIX A
Consent Form (Pretest and Main Study)
Any text in angled brackets “< >” indicates part of the script that will change based on
the participant or situation. The intended content (or content options) is indicated in the
brackets.
What is the Research About?
Thank you for your interest in this research study. The research involves looking at a
website for a cancer treatment and completing an online questionnaire. Viewing the website
and completing the survey will take approximately 20 minutes.
What Is the Purpose of This Study?
The purpose of the study is to learn more about websites for cancer treatments. You are
one of about people in the United
States who are being asked to take part in this survey.
Who Is Leading the Study?
RTI International, an independent nonprofit research organization, is conducting this study
on behalf of the Department of Health and Human Services. RTI is working with Kantar to
conduct this survey but is not affiliated with Kantar in any way.
Do I Have to Take Part in This Study?
Your participation in this study is completely voluntary, and you have the right to stop at
any time or to refuse to answer any question. If you decide to participate and later change
your mind, you will not be contacted again or asked for further information.
What Are the Possible Risks?
We do not expect that any of the survey questions will make you uncomfortable, but if they
do, you can refuse to answer any question. There is also a potential risk of loss of
confidentiality. Every effort will be made to protect your information, but this cannot be
guaranteed.
Will I Benefit From Taking Part in This Study?
There are no direct benefits to you for participating in this study. However, you will be
helping with an important research project.
Will I Receive Any Payment for Taking Part in This Study?
You will receive points equivalent to approximately $10 for completing this survey.
Who Will See the Information I Give?
Many precautions have been taken to protect your information. All information collected in
this survey will be kept confidential to the extent provided by law. You will never be
identified by name. The information obtained from all of the surveys will be combined into a
summary report so that details of individual questionnaires cannot be linked to a specific
participant. When we analyze the results, your responses will be combined with responses
from other people taking part in the study. You will not be identified in any published or
presented materials. The information collected in this study may be used or shared for
future research studies.
Will I Be Contacted in the Future About This Study?
You will not be contacted in the future about this research after your participation ends.
What If I Have Questions?
If you have questions about this survey, please contact your panel provider through your
member website for assistance. You will need to mention the Project # [SurveyNumber],
and someone will direct your questions to the appropriate researchers at RTI. If you have
questions about your rights as a participant, you can call RTI’s Office of Research Protection
toll-free at 1-866-214-2043.
[Consent Screen 3]
If you have read the previous screens and agree to participate, please click the
Yes button. If not, click the No button.
Yes, I agree to participate. [CONTINUE AND RANDOMLY ASSIGN
PARTICIPANT TO EXPERIMENTAL CONDITION]
No, I do not agree to participate. [TERMINATE SURVEY]
Appendix B:
Pretest and Main Study Screener
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.
OMB control#: XXX; Expiration: xxx
Thank you for your interest in this research study. The research involves looking at a
website for a cancer treatment and completing an online questionnaire. First, we need to
ask you a few screening questions to see if you are eligible to participate. Then, if you are
eligible and agree to participate, you will be asked to view a website. After viewing the
website, we will ask you to complete a survey. Viewing the website and completing the
survey will take approximately 20 minutes.
[PROGRAMMER: NEXT SCREEN]
S1. What is your age? ______ [IF <18, TERMINATE]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S2. What is your occupation?
1. Healthcare provider (e.g., physician, nurse, physical therapist) [TERMINATE]
2. Pharmaceutical employee (e.g., pharma rep) [TERMINATE]
3. Market research employee or advertising employee [TERMINATE]
4. Employee of the Department of Health and Human Services [TERMINATE]
5. None of the above [CONTINUE]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S3. Have you ever been diagnosed with cancer by a doctor or other qualified
health care provider?
1. Yes [CONTINUE TO S4s]
2. No [CONTINUE TO S4c]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S4s. When was the first time that a doctor or other health care professional told
you that you had cancer?
1. Less than six months ago
2. Between six months and less than two years ago
3. Between two years and less than five years ago
4. Between five years and less than ten years ago
5. More than ten years ago
[PROGRAMMER: NEXT SCREEN]
[SELECT ALL THAT APPLY]
S5s. What type of cancer(s) were you diagnosed with?
Acute lymphocytic (or lymphoblastic) leukemia (ALL)
Basal cell carcinoma [CONTINUE TO S4c]
Bladder cancer
Bone cancer
Breast cancer
Brain cancer
Cervical cancer
Chronic lymphocytic leukemia (CLL)
Chronic myeloid leukemia (CML)
Colon & rectal
Endometrial cancer
Kaposi's sarcoma
Kidney cancer
Leukemia, includes Acute myeloid leukemia (AML)
Lip & oral cancer
Liver cancer
Lung cancer
Lymphoma, includes non-Hodgkin lymphoma, Hodgkin lymphoma Multiple
myeloma
Melanoma
Merkel cell carcinoma [CONTINUE TO S4c]
Mesothelioma
Non-small cell lung cancer
Nonmelanoma skin cancer [CONTINUE TO S4c]
Oral cancer
Ovarian cancer
Pancreatic cancer
Prostate cancer
Sarcoma
Skin cancer [CONTINUE TO S4c]
Small cell lung cancer
Squamous cell carcinoma [CONTINUE TO S4c]
Thyroid Cancer
Other
[Note: the distribution of S5s to be examined in the pretest to determine the feasibility of
including quotas in main study]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S6s. Are you currently in active treatment for your cancer? Active treatment could
include surgery, radiation, or receiving medication like chemotherapy,
immunotherapy, or hormone therapy.
1. Yes [TERMINATE]
2. No [CONTINUE]
[PROGRAMMER: NEXT SCREEN]
[SELECT ALL THAT APPLY]
S7s. What type(s) of cancer treatment have you received for your cancer?
Select all that apply
I received medications such as pills or infusions to treat cancer (for
example: chemotherapy, immunotherapy, hormone therapy, targeted
therapy)
I received other cancer treatment (for example: surgery, radiation, stem
cell or bone marrow transplant)
I have not received any medical treatment for cancer [CONTINUE TO S4c]
[Note: the distribution of S7s to be examined in the pretest to determine the feasibility of
restricting recruitment in the main study to those who received a systemic treatment]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S4c. Have you ever provided care for or made health care decisions for someone
with cancer?
1. Yes [CONTINUE]
2. No [TERMINATE]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S5c. Was any of this care provided as part of a job (for example, as a nurse or
professional home health aide)?
1. Yes [TERMINATE]
2. No [CONTINUE]
[PROGRAMMER: NEXT SCREEN]
[SELECT ALL THAT APPLY]
S6c. Thinking about the person you provided care for, what type of cancer(s) did
they have?
Acute lymphocytic (or lymphoblastic) leukemia (ALL)
Basal cell carcinoma [TERMINATE]
Bladder cancer
Bone cancer
Breast cancer
Brain cancer
Cervical cancer
Chronic lymphocytic leukemia (CLL)
Chronic myeloid leukemia (CML)
Colon & rectal
Endometrial cancer
Kaposi's sarcoma
Kidney cancer
Leukemia, includes Acute myeloid leukemia (AML)
Lip & oral cancer
Liver cancer
Lung cancer
Lymphoma, includes non-Hodgkin lymphoma, Hodgkin lymphoma Multiple
myeloma
Melanoma
Merkel cell carcinoma [TERMINATE]
Mesothelioma
Non-small cell lung cancer
Nonmelanoma skin cancer [TERMINATE]
Oral cancer
Ovarian cancer
Pancreatic cancer
Prostate cancer
Sarcoma
Skin cancer [TERMINATE]
Small cell lung cancer
Squamous cell carcinoma [TERMINATE]
Thyroid Cancer
Other
[Note: the distribution of S6c to be examined in the pretest to determine the feasibility of
including quotas in main study]
[PROGRAMMER: NEXT SCREEN]
[SELECT ALL THAT APPLY]
S7c. Thinking about the person you provided care for, what type(s) of cancer
treatment have they received for their cancer?
Select all that apply
They received medications such as pills or infusions to treat cancer (for
example: chemotherapy, immunotherapy, hormone therapy, targeted
therapy)
They received other cancer treatment (for example: surgery, radiation,
stem cell or bone marrow transplant)
They have not received any medical treatment for cancer [TERMINATE]
I don’t know what type of cancer treatment they received
[Note: the distribution of S7c to be examined in the pretest to determine the feasibility of
restricting recruitment in the main study to those who received a systemic treatment]
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S8. What is your sex?
1. Male
2. Female
3. Prefer not to answer
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S9. Are you Hispanic or Latino?
1. Yes
2. No
3. Prefer not to answer
[PROGRAMMER: NEXT SCREEN]
[SELECT ALL THAT APPLY]
S10. What is your race? (You may select one or more races.)
1. American Indian or Alaska Native
2. Asian
3. Black or African American
4. Native Hawaiian or other Pacific Islander
5. White
6. Prefer not to answer
[PROGRAMMER: NEXT SCREEN]
[SINGLE PUNCH]
S11. What is the highest level of school you have completed or the highest degree
you have received?
1. Less than high school
2. High school graduate—high school diploma or the equivalent (for example: GED)
3. Some college but no degree
4. Vocational or Technical School degree
5. Associate’s degree
6. Bachelor’s degree (for example: BA, AB, BS)
7. Some postgraduate work but no degree
8. Advanced or post-graduate degree (for example: Master’s degree, MD, DDS, JD,
PhD, EdD)
[DISPLAY IF EFLAG=0 ‘INELIGIBLE’]
[Thank and Terminate—Ineligible]
[PROGRAMMER: NEXT SCREEN]
We’re sorry, but you are not eligible for this study. There are many possible reasons why
people are not eligible for this study. 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.
[TERMINATE IF EFLAG=0 ‘INELIGIBLE’]
[IF EFLAG=1 ‘ELIGIBLE’; CONTINUE, RANDOMLY ASSIGN PARTICIPANTS TO A STUDY
CONDITION]
[PROGRAMMER: NEXT SCREEN]
You are eligible to participate in the study. We will show you a website for a cancer
treatment. Make sure you are comfortable and can read the screen from where you sit. The
study will take about 20 minutes to complete. We ask you to complete the study in one
sitting (without taking any breaks) in order to avoid distractions.
APPENDIX C:
Accelerated Approval Study II Questionnaire
[Screener and consent to be inserted]
INTRODUCTION
Thank you for agreeing to participate in this study today. We are going to show you a website with
information about a prescription drug that treats a kind of cancer and then ask you some questions
about it.
//NEW SCREEN//
We’d like to start by telling you a bit about a kind of cancer. It’s called acute lymphoblastic leukemia.
The word “acute” means that this type of leukemia can progress very quickly and, if not treated, can
cause death within a few months.
Cancers start when cells in the body begin to grow out of control. Acute lymphoblastic leukemia is a
cancer of a certain type of white blood cell called lymphocytes. This cancer starts in the bone marrow –
the soft, spongy tissue inside bones that makes lymphocytes. It can also spread to other parts of the
body.
With this cancer, the body makes too many immature lymphocytes which are not able to mature and
work normally. These leukemia cells crowd out the normal cells in the bone marrow. This means there
is less room for mature white blood cells (which fight infection), red blood cells (which carry oxygen),
and platelets (which help blood to clot).
There are few treatment options available for people with acute lymphoblastic lymphoma.
//NEW SCREEN//
Next we will show you the website.
When you read it, imagine that someone close to you was recently diagnosed with acute
lymphoblastic leukemia and you would like to learn more about their treatment options.
Take as much time as you need to look at the website.
After you leave the website you won’t be able to return to it while answering the questions.
[Study 1: Display appropriate stimuli based on randomized experimental condition: no accelerated
approval disclosure, low prominence/ physician labeling disclosure, high prominence/physician labeling
disclosure, low prominence/consumer‐friendly disclosure, high prominence/consumer‐friendly
disclosure]
Study 1 Design
Accelerated Approval Language
Placement
1
Physician labeling version
Consumer‐friendly version
None
Condition 1: High prominence
Condition 2: Low prominence
Condition 3: High prominence
Condition 4: Low prominence
Condition 5: N/A
[Physician labeling version: This indication is based on response rate. An improvement in
survival or disease‐related symptoms has not been established. Continued approval for this
indication may be contingent upon verification of clinical benefit in subsequent trials.]
[Consumer‐friendly version: In a clinical trial, [Drug X] returned blood counts to normal.
However, we currently do not know if [Drug X] helps people live longer or feel better. We
continue to study [Drug X] in clinical trials to learn more about [Drug X]’s benefits.]
[Study 2: Display appropriate stimuli based on randomized experimental condition: approval basis,
approval basis + unknown outcomes, approval basis + confirmatory trials, approval basis + unknown
outcomes + confirmatory trials = consumer‐friendly high prominence condition from Study 1]
Study 2 Design
Confirmatory trials
Absent
Unknown
outcomes
Absent
Condition 1: In a clinical trial,
[Drug X] returned blood counts
to normal.
Present
Condition 3: In a clinical trial,
[Drug X] returned blood counts
to normal. However, we
currently do not know if [Drug
X] helps people live longer or
feel better.
Present
Condition 2: In a clinical trial, [Drug X]
returned blood counts to normal. We
continue to study [Drug X] in clinical trials
to learn more about [Drug X]’s benefits.
Condition 4: In a clinical trial, [Drug X]
returned blood counts to normal.
However, we currently do not know if
[Drug X] helps people live longer or feel
better. We continue to study [Drug X] in
clinical trials to learn more about [Drug
X]’s benefits.
//NEW SCREEN//
Question Type: Single Punch
Q1. Were you able to view the website?
Value
01
00
02
‐99
Value Label
Yes
No
Not Sure
Refused
2
[If Q1=00 OR Q1=02 OR Q1=‐99, Terminate]
//NEW SCREEN//
Question Type: Single Punch
[Randomize order of 01‐03. 04 always appears last.]
Q2. [Drug X] is a treatment option for
Value
01
02
03
04
‐99
Value Label
Human Immunodeficiency Virus
Myocardial infarction
Acute lymphoblastic leukemia
Not sure / Don’t know
Refused
//NEW SCREEN//
Question type: Text box
Q3. What can [Drug X] do for people with acute lymphoblastic leukemia?
[Open Field]
[Codes: blood cell counts return to normal, gets rid of any detectable evidence of leukemia/no signs of
leukemia/remission, cure, live longer, feel better/reduce symptoms, other codes to be determined
based on cognitive interviews and pretesting]
//NEW SCREEN//
Question Type: Single Punch
Q4. Did the website say that there are things we do not know yet about what [Drug X] can do for people
with acute lymphoblastic leukemia?
Value
01
00
02
‐99
Value Label
Yes
No
Not Sure
Refused
//NEW SCREEN//
[If Q4=01, ask Q5]
3
Question type: Text box
Q5. What don’t we know yet about what [Drug X] can do for people with acute lymphoblastic leukemia?
(Please be as detailed and specific as possible when entering your answer in the space provided.)
[Codes: blood cell counts return to normal, gets rid of any detectable evidence of leukemia/no signs of
leukemia/remission, cure, live longer, feel better/reduce symptoms, other codes to be determined
based on cognitive interviews and pretesting]
//NEW SCREEN//
Question Type: Grid
[Randomize order of Q6 A – D]
Q6. Based on the information on the website, mark whether each of the statements below is true, false,
or you don’t know:
Variable
Q6_A
Q6_B
Variable Text
[Drug X] has been shown to cure acute lymphoblastic leukemia.
[Drug X] has been shown to help people with acute lymphoblastic leukemia
live longer.
[Drug X] has been shown to help people with acute lymphoblastic leukemia
feel better.
[Drug X] helps blood cell counts return to normal.
Q6_C
Q6_D
Value
01
02
03
‐99
Value Label
True
False
Don’t Know
Refused
//NEW SCREEN//
Question Type: Grid
[Randomize order of 00‐02: first to last or last to first]
Q7. Please select one response. On average, people with acute lymphoblastic leukemia who take [Drug
X]…
Value
00
Value Label
Don’t live as long as people who don’t take [Drug X].
01
Live the same amount of time as people who don’t take [Drug X].
4
02
Live longer than people who don’t take [Drug X].
03
No one knows yet whether people who take [Drug X] live longer or not.
‐99
Refused
//NEW SCREEN//
[If Q7=02, ask Q8]
Question type: Numeric string plus drop‐down option
Q8. You mentioned that [Drug X] would help people with acute lymphoblastic leukemia live longer. On
average, how much longer do you think people with acute lymphoblastic leukemia who take [Drug X]
would live? Your best guess is fine.
(Please write a number in the space below and choose from the dropdown list whether it is weeks,
months, or years. You will need to enter a single number, so if you have a range in mind, please pick the
middle number in the range.)
(Q8_A: Open ended numeric string)
Q8_B: Unit selection answer choices
Value
1
2
Value Label
weeks longer
months longer
3
years longer
‐99
‐100
Refused
Valid skip
//NEW SCREEN//
Question Type: Single Punch
Q9. The website suggests that [Drug X] will improve the quality of life for people who take it…
[Randomize order of response options]
Value
01
02
‐99
Value Label
Disagree
Agree
Refused
//NEW SCREEN//
5
[Randomize order of Q10 – Q11]
[ASK Q10 IF PRETEST OR MAIN STUDY]
Please indicate your level of agreement with the following statements.
Question Type: Single Punch
Q10. The benefits of [Drug X] outweigh any side effects it may have.
Value
01
02
03
04
99
‐99
Value Label
1 Strongly disagree
2 Disagree
3 Agree
4 Strongly agree
Don’t know
Refused
Question Type: Single Punch
Q11. [Drug X] might have serious side effects.
Value
01
02
03
04
99
‐99
Value Label
1 Strongly disagree
2 Disagree
3 Agree
4 Strongly agree
Don’t know
Refused
//NEW SCREEN//
[DO NOT SHOW Q12 OR Q12alt IN STUDY 1; RANDOMIZE TO Q12 OR Q12alt IN STUDY 2 PRETEST]
Question Type: Single Punch
[Randomize order of Q12 A – B]
Q12. Based on the information on the website, mark whether each of the statements below is true,
false, or you don’t know: …
Variable
Q12_A
Q12_B
Variable Text
Currently, more data is needed to know whether [Drug X] helps people with
acute lymphoblastic leukemia live longer.
Currently, more date is needed to know whether [Drug X] helps people with
acute lymphoblastic leukemia feel better.
6
Value
00
01
02
‐99
Value Label
True
False
Don’t know
Refused
//NEW SCREEN//
Question Type: Multi‐Punch
Q12alt. Researchers continue to study [Drug X] in clinical trials. What do you think are the main reasons
additional clinical trials are needed? (check all that apply):
Variable
Q12alt_A
Q12alt_B
Q12alt_F
Variable Text
Because more data can help us learn even more about [Drug X]’s benefits.
Because we don’t have enough data to know whether [Drug X] helps people
with acute lymphoblastic leukemia live longer.
Because we don’t have enough data to know whether [Drug X] helps people
with acute lymphoblastic leukemia feel better.
Because more data can help us learn even more about [Drug X]’s side
effects.
Because we don’t have enough data to know whether [Drug X] improves
quality of life for people with acute lymphoblastic leukemia.
Other reason, specify
Q12alt_G
None of the above.
Q12alt_DK
Don’t know
Q12alt_C
Q12alt_D
Q12alt_E
Value
00
01
‐99
Value Label
Not checked
Checked
Refused
//NEW SCREEN//
Question Type: MultiPunch
Q13. If a loved one was diagnosed with acute lymphoblastic leukemia, I would suggest that they ask
their doctor about…
[Randomize order]
Q13_A Taking [Drug X]
Q13_B [Drug X]’s risks
Q13_C [Drug X]’s benefits
7
Q13_D [Drug X]’s FDA approval
Value
00
01
‐99
Value Label
No
Yes
Refused
//NEW SCREEN//
Question Type: Grid
[Randomize order of Q14 A – C]
Q14. Please check how much you agree or disagree with the following statements about the website
you saw.
Q14_A This website is a reliable source of information about the risks and benefits of [Drug X].
Q14_B I feel I’ve been accurately informed after viewing this website.
Q14_C This website provides consumers with essential information for deciding whether to ask a
doctor about [Drug X].
Value
01
02
03
04
05
‐99
Value Label
Strongly disagree
Disagree
Neither
Agree
Strongly Agree
Refused
//NEW SCREEN//
Question Type: Single Punch
Q15a. The following statement may or may not have been on the website you saw.
Did you see this statement on the website?
Study 1 – condition 1, 2 display: An improvement in survival or disease‐related symptoms has not been
established. Continued approval for this indication may be contingent upon verification of clinical
benefit in subsequent trials.
Study 1 – condition 3, 4 display: In a clinical trial, [Drug X] returned blood counts to normal. However,
we currently do not know if [Drug X] helps people live longer or feel better. We continue to study [Drug
X] in clinical trials to learn more about [Drug X]’s benefits.
Study 1 – condition 5 ‐ control condition: randomize displaying either physician labeling or consumer‐
friendly disclosure condition.
8
[Study 2: Unknown outcomes statement]
Study 2 – condition 1, 2, 3, 4 display: However, we currently do not know if [Drug X] helps people live
longer or feel better.
Statement: [Display the disclosure that matches the programming notes above]
Value
01
00
‐99
Value Label
Yes, I saw it on the website
No, I did not see it on the website
Refused
//NEW SCREEN//
[Keep the text below on screen for Q16a and Q17a:
Please read the statement below.
Study 1 – condition 1, 2 display: An improvement in survival or disease‐related symptoms has not been
established. Continued approval for this indication may be contingent upon verification of clinical
benefit in subsequent trials.
Study 1 – condition 3, 4 display: In a clinical trial, [Drug X] returned blood counts to normal. However,
we currently do not know if [Drug X] helps people live longer or feel better. We continue to study [Drug
X] in clinical trials to learn more about [Drug X]’s benefits.
Study 1 – condition 5 ‐ control condition: randomize displaying either physician labeling or consumer‐
friendly disclosure condition.
[Study 2: Display unknown outcomes statement]
Study 2 – condition 1, 2, 3, 4: However, we currently do not know if [Drug X] helps people live longer or
feel better.
Statement: [Display the disclosure that matches the programming notes above]
Question Type: Grid
Q16a. In my opinion, the statement is…
[RANDOMIZE ORDER OF ITEMS Q16a_1 to Q16a_4]
1
2
3
4
5
6
Q16a_1 Confusing
Clear
Q16a_2 Complex
Straightforward
Q16a_3 Unimportant
Important
Q16a_4 Misleading
Honest
9
//NEW SCREEN//
Question type: Text Box
Q17a. What does the statement mean to you?
[Open Field]
[Codes to be determined based on cognitive interviews and pretesting]
//NEW SCREEN//
[Show Q15b only in Study 2]
Question Type: Single Punch
Q15b. The following statement may or may not have been on the website you saw.
Did you see this statement on the website?
Study 2 condition 1, 2, 3, 4: We continue to study [Drug X] in clinical trials to learn more about [Drug X]’s
benefits.
Statement: [Display the disclosure that matches the programming notes above]
Value
01
00
‐99
Value Label
Yes, I saw it on the website
No, I did not see it on the website
Refused
//NEW SCREEN//
[Keep the text below on screen for Q16b and Q17b:
Please read the statement below.
[Study 2: Display confirmatory trials statement]
Study 2 condition 1, 2, 3, 4 display: We continue to study [Drug X] in clinical trials to learn more about
[Drug X]’s benefits.
Statement: [Display the disclosure that matches the programming notes above]
[Show Q16b only in Study 2]
Question Type: Grid
10
Q16b. In my opinion, the statement is…
[RANDOMIZE ORDER OF ITEMS Q16b_1 to Q16b_4]
1
2
3
4
5
6
Q16b_1 Confusing
Clear
Q16b_2 Complex
Straightforward
Q16b_3 Unimportant
Important
Q16b_4 Misleading
Honest
//NEW SCREEN//
[Show Q17b only in Study 2]
Question type: Text Box
Q17b. What does the statement mean to you?
[Open Field]
[Codes to be determined based on cognitive interviews and pretesting]
//NEW SCREEN//
[ASK Q18 IF PRETEST OR MAIN STUDY]
Question Type: Single Punch
Q18. How often do you need to have someone help you when you read instructions, pamphlets, or
other written material from your doctor or pharmacy?
Value
01
02
03
04
05
‐99
Value Label
Never
Rarely
Sometimes
Often
Always
Refused
//NEW SCREEN//
[ASK Q19 IF PRETEST OR MAIN STUDY]
11
Question Type: Single Punch
Q19. How familiar were you with treatments for acute lymphoblastic leukemia before today?
Value
01
02
03
04
05
‐99
Value Label
Not at all
A little bit
Somewhat
Quite a bit
Extremely
Refused
//NEW SCREEN//
Q20. On average, how likely would a person diagnosed with acute lymphoblastic leukemia be to live
more than 5 years?
Value
01
02
03
04
‐99
Value Label
Not at likely
Somewhat likely
Moderately likely
Very likely
Refused
[CANCER SURVIVORS ONLY]
Question Type: Multi‐Punch
Q21s. What type(s) of cancer treatment did you receive for your cancer? (check all that apply)
Q21s_A
Q21s_B
Q21s_C
Q21s_D
Q21s_E
Q21s_F
Value
00
01
‐99
Surgery
Radiation
Chemotherapy (pills or infusions)
Immunotherapy, hormone therapy, or targeted therapy
Stem cell or bone marrow transplant
Other cancer treatments
Value Label
Not checked
Checked
Refused
[CANCER CAREGIVERS ONLY]
Question Type: Multi‐Punch
12
Q21c. Thinking about the person you provided cancer‐related care for, what type(s) of cancer treatment
have they received for their cancer? (check all that apply)
Q21c_A
Q21c_B
Q21c_C
Q21c_D
Q21c_E
Q21c_F
Q21c_G
Value
00
01
‐99
Surgery
Radiation
Chemotherapy (pills or infusions)
Immunotherapy, hormone therapy, or targeted therapy
Stem cell or bone marrow transplant
Other cancer treatments
Don’t know
Value Label
Not checked
Checked
Refused
//NEW SCREEN//
Question Type: Single Punch
Q22. Have you ever heard of the term “accelerated approval” as it relates to prescription drugs and the
Food and Drug Administration?
Value
01
02
03
‐99
Value Label
Yes
No
Don’t know
Refused
//NEW SCREEN//
Question Type: Single Punch
[If Q22=01, ask Q23]
Q23. How familiar are you with the topic of accelerated approval of prescription drugs?
Value
01
02
03
‐99
Value Label
A little familiar
Somewhat familiar
Very familiar
Refused
//NEW SCREEN//
13
[CANCER CAREGIVERS ONLY]
Question Type: Single Punch
Q24c. Think about the individual for whom you are currently providing or have provided cancer‐related
care. What is your relationship to that person? They are my:
Value Value Label
01
Spouse/partner
02
Child
03
Parent
04
Sibling
05
Friend
06
Other, specify
//NEW SCREEN//
[CANCER CAREGIVERS ONLY]
Question Type: Single Punch
Q25c. Think about the individual for whom you are currently providing or have provided cancer‐related
care. About how long have you provided care for this person?
Value Value Label
01
Less than 30 days
02
1 to 6 months
03
7 months to 2 years
04
3 to 5 years
05
More than 5 years
//NEW SCREEN//
[ASK Q26 IF PRETEST OR MAIN STUDY]
Question Type: Single Punch
Q26. How much do you trust information provided by pharmaceutical companies about prescription
drugs?
Value
01
02
03
04
Value Label
Not at all
A little
Some
A lot
//NEW SCREEN//
14
[PRETEST ONLY]
Question Type: Single Punch
Q27. How similar was the website for [DRUG X] to websites that you have seen for other prescription
drugs?
Value
01
02
03
04
98
‐99
Value Label
Not at all similar
Somewhat similar
Very similar
Extremely similar
Don’t know
Refused
//NEW SCREEN//
The purpose of this study is to learn about reactions to prescription drug information. To get a real‐life
reaction, we used a pretend product in this study. While [Drug X] is not a real product and is not
available for sale, your participation in this important study helps FDA better understand how to
communicate the benefits and risks of prescription drugs to consumers clearly and usefully. Your
responses will help make prescription drug information clearer. Please see your health care professional
for questions about acute lymphoblastic leukemia.
You have been very helpful. Thank you very much for your participation!
[PRETEST ONLY]
Question Type: Text box
Q30. Please share any additional thoughts you had about the website or this survey.
[Open Field]
15
APPENDIX D:
Pretest and Main Study Recruitment Email
Hello [FIRSTNAME],
You’re so close to your next reward, [FIRSTNAME]
WANTED, YOUR OPINION!
GO NOW!
You’ve been selected amongst just a few LifePoints’ members to
fast track you to your next reward, [FIRSTNAME].
Take this survey now for the chance to collect more LPs and get
closer to your next reward.
Hurry! Use the button below to
take your next survey now.
GO NOW!
LifePoints is the rewards platform operated by Lightspeed (a
Kantar owned company). Our members complete surveys to
earn virtual points (LPs) that can be redeemed for e-gift cards
and PayPal.
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File Type | application/pdf |
File Title | Microsoft Word - Accelerated Approval Disclosures Study II Appendix A -- Consent Form.docx |
Author | DHC |
File Modified | 2022-04-07 |
File Created | 2022-04-07 |