Legacy_Novo_ Nordisk_Sickle cell disease

Paid focus group: Share your thoughts on a material about sickle cell disease

HLM is partnering with Novo Nordisk to carry out focus groups to gather feedback on a material about sickle cell disease (SCD). We're looking for people who have SCD, or their caregivers, to read and share their thoughts on a material about SCD and clinical trials. By sharing your thoughts, you'll help us improve the material and make it easier for others to understand.

If you’re interested, sign up by filling out the form below. It will take about 5 minutes or less.

If we select you to take part, we will send an email with links to:

Read the material on a computer
Schedule a Zoom focus group (it will take up to 90 minutes)

After the focus group, we’ll email you a $150 gift card for your help!

We are Health Literacy Media (HLM), a nonprofit that specializes in clear health communication. Visit our website to learn more: www.healthliteracy.media

1. What is your first name? *This question is required.

2. What email address should we use to contact you? *This question is required. This question requires a valid email address.

3. What is your identified gender? *This question is required.

Please enter an 'other' value for this selection.

4. What sex were you assigned at birth?
This is the sex listed on your original birth certificate *This question is required.

5. Choose the options below that describe your connection to sickle cell disease (SCD).
Choose all that apply. *This question is required.

I have been diagnosed with SCD
I have been a caregiver for someone with SCD
I have a friend or loved one with SCD
I treat people with SCD
I am a patient advocate for people with SCD
I don’t have a personal connection to SCD

What type of sickle cell disease were you or your loved one diagnosed with? *This question is required.

Sickle Cell Anemia (SS)
Sickle Hemoglobin-C Disease (SC)
Sickle Beta-Plus Thalassemia
Sickle Beta-Zero Thalassemia
Other (write your own response) Please enter an 'other' value for this selection.

What is your field of work? *This question is required. Such as oncologist or nurse.

Please briefly describe your role as a patient advocate. *This question is required.

Have you or your loved one ever participated in a clinical trial? *This question is required.

Yes
No
Unsure

Who sponsored or paid for the clinical trial you took part in?
If you're unsure or prefer not to say, you can leave this question blank.

6. What is your age? *This question is required. This question requires a valid number format.

7. How would you identify your race and ethnicity?
Choose all that apply. *This question is required.

African American or Black
Asian or Pacific Islander
American Indian or Alaska Native
Hispanic or Latino
White
Prefer not to say
Other (write your own response): Please enter an 'other' value for this selection.

8. What is your highest level of education? *This question is required.

9. Do you currently live in the U.S.? *This question is required.

What U.S. state do you live in? *This question is required.

Which of these best describes the area you live in? *This question is required.

What is your ZIP code? *This question is required.

What country do you currently live in? *This question is required.

What is your postal code? *This question is required.

What phone number should we use to contact you? *This question is required. A member of our staff may call to verify your information.

10. How did you hear about this interview? *This question is required.

What is the name of the advocacy group that you heard about this from?

11. Would you like to hear about other paid surveys, interviews, or focus groups in the future?
By selecting "Yes", you agree for HLM to contact you by email about upcoming paid interviews, focus groups, or surveys. You may opt-out at any time.
*This question is required.