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CLOU064E12201_IRR SjS

Paid interview: Read a material on clinical trial results

We're looking for people with Sjögren's syndrome to read and share their thoughts on a material on clinical trial results. We're looking for people to read and share their thoughts on a material about clinical trial results. This trial learned about a possible treatment for Sjogren's syndrome. By sharing your thoughts, you'll help us improve the material and make it easier for others to understand.

If you're interested, please fill out the form below.

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

Read the material online
Schedule a Zoom interview (it takes about 1 hour)

After the interview, we'll email you a $100 Visa or Amazon 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.

Female
Male
Non-binary or gender queer
Transgender man
Transgender woman
Prefer not to say
Other Please enter an 'other' value for this selection.

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

Female (F)
Intersex (X)
Male (M)
Prefer not to say

5. Which of these best describes your connection to Sjögren's syndrome? *This question is required.

I have been diagnosed with Sjögren's syndrome
I am a caregiver for someone who has been diagnosed with Sjögren's syndrome
I have a friend or loved one has been diagnosed with Sjögren's syndrome
I have no connection to Sjögren's syndrome

6. Have you ever participated in a clinical trial?
A clinical trial is a type of research to learn about the safety and effects of a trial drug (or treatment). *This question is required.

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.

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

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

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

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

How often do you do each of the following health activities?
Use the drop-down menu on the left to choose how often you the activity. *This question is required.

	How often do you *This question is required
	How often do you *This question is required	Find or look for health information	How often do you
Understand information about your health	How often do you
Evaluate how health information relates to your life (for example, decide if and how information is relevant to your life)	How often do you
Communicate about your health to others	How often do you
Act on information about your health	How often do you

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

What U.S. state do 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.

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

12. 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.