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Survey Questions on Clinical Trials: Field Study
Clinical trials are a type of medical research in which volunteers choose to participate in a study to test the safety and effectiveness of certain treatments, drugs, or devices.
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1) Have you ever heard of a clinical trial
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Yes
No
Unsure
2) Do you know of anyone who has participated in a clinical trial?
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Yes
No
Unsure
3) Has your doctor or other health care professional ever talked to you about participating in a clinical trial?
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Yes
No
Unsure
4) Assuming appropriate private protections are in place, would you be willing to share your personal health information: So researchers can better understand diseases and develop new ways to prevent, treat and cure them?
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Yes
No
Unsure
5) Assuming appropriate private protections are in place, would you be willing to share your personal health information: To advance medical science?
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Yes
No
Unsure
6) Assuming appropriate private protections are in place, would you be willing to share your personal health information: So health care providers can improve patient care?
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Yes
No
Unsure
7) Assuming appropriate private protections are in place, would you be willing to share your personal health information: So public health officials can better track disease
*
Yes
No
Unsure
8) Assuming appropriate private protections are in place, would you be willing to share your personal health information: If you participated in a clinical trial, would you prefer to have clinical trial information and results delivered through your phone?
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Yes
No
Unsure
9) Health care professionals should discuss clinical trial opportunities with patients as part of a routine medical care?
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Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
10) By taking part in clinical trials I am providing a valuable service to our health care system.
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Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
11) It is important for everyone to take part in a clinical trial if they are asked to do so.
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Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
12) I would take part in a clinical trial if I was asked by someone I trust.
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Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
13) People should participate in clinical trials as a routine health behavior, whether they are healthy or ill.
*
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
14) Participants in clinical trials should have access to the results.
*
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
15) Clinical trials are important to advancing science.
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Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
16) Clinical trials are important to improving our nation’s health.
*
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly Disagree
17) Which of the following do you believe to be a reliable source for clinical trial information? (Check all that apply)
*
Doctor/health care provider
Clinical trial registry (
clinicaltrials.gov
)
National Institutes of Health
Online/Internet
Food and Drug Administration
Universities
Patient advocacy organizations, like American Cancer Society
Media (TV, radio, online and print publications)
Industry (e.g. pharmaceutical companies, medical device companies)
Advertisements
Friends or family
Foundations/charity organizations, like United Way
Military (e.g. Walter Reed Army Institute of Research)
Other
Required
18) Which organizations listed below would you say have the greatest responsibility in educating the public about clinical trials? (Choose ONLY one)
*
Doctors and other health care providers
Government organizations, e.g. the National Institutes of Health (NIH)
Health Plans or pharmaceutical companies
Patient advocacy organizations
Industry (e.g. pharmaceutical companies, medical device companies)
Military
Universities
Other
19) How likely are you to use technology such as apps, phones to share your personal health data for clinical research?
*
Very likely
Maybe
Not likely
Not sure
If you need a CEU certificate, please let us know which of the following you would like.
*
Community Health Worker CEU
Community Health Worker- Instructor CEU
None
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