U
.S.
Food and Drug Administration
OMB
No. 0910-0677
Expires July 31, 2012
Online Pharmacies: Focus Groups for Concept Testing
Participant Screener
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Food
and Drug Administration
Office of the Chief Information
Officer
1350 Piccard Drive, 420A
Rockville, MD 20850
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 Office of Management and Budget (OMB) control number.
Prescription Purchasing History |
Chicago |
Los Angeles |
Online Focus Groups |
Purchase from independent online pharmacies (60%) Purchase from online services connected to health insurance or national chain retail stores (40%) |
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Introduction |
Good day. I hope you are doing well. My name is ________________ and I am calling today from XXX to see if you are interested in participating in a focus group we are conducting for the U.S. Food and Drug Administration. Participants will share opinions on a certain topic, in this case buying prescription drugs from online pharmacies. Would you mind answering a few questions to determine if you meet our criteria? All of the information you provide will remain private to the extent permitted by law.
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Question 1 |
Have you bought prescription medicines online? Please consider prescription medicine any medicine requiring a doctor’s prescription to treat an illness or chronic condition. Please do not include contact lenses, pet medications, or other medicines or herbal remedies that can be purchased over the counter. If they have never purchased prescription medicines online, go to not selected and end of call. |
Question 2 |
Which of the following online prescription services have you used? Please state all that apply. Read list. We wish to have 60% of our participants to have purchased from an independent online pharmacy. They do not need to be separated into different focus group sessions. Online services connected to your health insurance. Online services connected to a chain pharmacy (for example, CVS, RiteAid, Walgreens) An independent online pharmacy |
Question 3 |
To the best of your knowledge, have you purchased from an online pharmacy based in a country outside the U.S.? Please record for background purposes. |
Demographic Questions |
What is your gender? Please include a good mix. How old are you? __________ years. Please ensure that we have at least some representation across the spectrum, from some in their 20s to some in their 60s (possibly 70s) and everything in between. What is your current household income? [Record] Less than $30,000 $30,000 to $50,000 $50,000 to $75,000 $75,000 to $100,000 More than $100,000 What is the highest level of education that you have completed? Read list. Please ensure some diversity of education across focus groups. Less than a high school diploma High school graduate or GED Technical/vocational school Some college credit, but no degree Associate’s degree (AA, AS) Bachelor’s degree (BA, AB, BS) Master’s, doctoral, or professional school degree (MA, MS, MEd, MEng, MBA, MSW, PhD, MD, JD, DVM, EdD) Are you Hispanic or Latino? Record. Yes No What is your ethnicity? Please select one or more. Read list. We wish to have no more than 65% of our participants include white people. White Black or African American American Indian or Alaska Native Asian Native Hawaiian or Pacific Islander
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Focus Group Details/ Request for Participation |
Thank you very much for your time. You are a perfect candidate for our focus group. Each focus group will be approximately 90 minutes long, and will be held on <date/time> at <location>. You will be compensated $75 for your time, and light refreshments will also be available. Also, so you are aware, the focus group session will be audio taped to ensure accuracy. However, your participation and everything you say during the discussion will be private to the extent permitted by law. Would you be willing to participate in our focus group? If yes, continue to Reminder Email/Phone Call. If no, go to End of Call.
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Reminder Email/ Phone Call |
We will provide you a reminder two to three days in advance of the focus group, which will include the address of the facility and the day and time. Would you prefer we call you or send you an email with this information? Email: Would you please provide me your email address so I can send you the information? Phone: Is this the best number to reach you at or would you prefer we call a different number? What is that number? Next go to End of Call
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Not Selected |
Thank you for your willingness to participate; however, based on our criteria, we will not need your help in this set of focus groups. |
End of Call |
That is everything I have today. Thank you very much for your time. Have a great day. |
File Type | application/msword |
File Title | VHA Strategic Outreach Support |
Author | 554856 |
Last Modified By | stewartf |
File Modified | 2011-08-26 |
File Created | 2011-08-26 |