Pretest for a Study on Quantitative Information in Direct-to-Consumer Television Advertisements

Appendix B

Eligibility Screener

Thank you for your interest in the study. Please answer the following questions to determine if you are eligible to participate.

	Programming Notes. [THESE WILL NOT APPEAR ON THE SCREEN]. When the quota has been met, go to ineligibility statement.
S1. What is your age? ____ [Permit responses 0-100]	If <60, skip to ineligibility statement.
S2. How many years of education have you had? Less than high school Completed high school Some college Associate’s degree (2-year) Bachelor’s degree (4-year) Some postgraduate work Postgraduate degree (M.A., Ph.D., M.D., J.D., etc.)	Quota: 50% of sample completed high school or less than high school; 50% completed some college or higher.
S3. What is your sex? Male Female	Quota: 50% male / 50% female
S4. Are you Hispanic or Latino? No Yes	No Quota
S5. What is your race? You may select one or more races. American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Some other race S6. Do you work for a pharmaceutical company, an advertising agency, or a market research company? No Yes	[ALLOW MULTIPLE RESPONSES] Quota: At least 10% of sample African American. If yes, skip to ineligibility statement.
Ineligibility statement: Thank you for completing these questions. You are not eligible for this study.

Research authorized by Section 1701(a)(4) of the Public Health Service Act (42 U.S.C. 300u(a)(4)). Confidentiality protected by 5 U.S.C. 552(a) and (b) and 21 CFR part 20.

OMB Control #0910-0695 Expires 12/31/2017