COAV101B12302

Paid interview: Read a clinical trial summary about spinal muscular atrophy (SMA)

We're looking for parents, or caregivers, and their children to read to read and share their thoughts on a summary of results from a clinical trial. This trial learned about a possible treatment for spinal muscular atrophy (SMA). By sharing your thoughts, you'll help us improve the summary 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 summary online
Schedule a Zoom interview (it takes about 45 minutes)

After the interview, we'll email each person who took part a $75 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. Choose the options below that describe your connection to spinal muscular atrophy (SMA).
Choose all that apply. *This question is required.

I have SMA
I am the parent or guardian of a child with SMA
I am a caregiver for a child with SMA (but not their parent or guardian)
I treat people with SMA
I am a patient advocate for SMA
I don’t have a personal connection to SMA

What type of SMA do you or your child have? *This question is required.SMA types range by when symptoms happen, starting before birth (SMA Type 0) to adulthood (SMA Type 4).

What is your child's age? *This question is required.

Would your child be able to take part in the 1-hour interview?

Please enter an 'other' value for this selection.

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

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

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

6. 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.

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

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

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

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

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

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

10. 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.

COAV101B12302_SMA