FocusJr

Name

Telephone number

Address

City

State

Zip code

Email address

What is your job title or position?

What is your age:

Are you:

Male
Female

Do you, yourself, have any children, or not?

Yes
No

If you have children, please let us know their ages and gender

Now, I would like to ask you a few questions about your health and health related issues. Which, if any, of the following health conditions, if any, are you, yourself, currently experiencing or suffering from?

What is your current employment status? Are you

A full-time employee
Working part-time
Laid-off / looking for work
A stay-at-home mom

Where are all the working members of your household, including yourself, currently employed, previously employed, or retired from? Any others?

Are you or is any member of your household currently employed by, previously employed by, or retired from any of the following types of companies? Please check any that apply.

An advertising agency or market research firm, marketing firm or Marketing department in your own firm
A public relations company
By the news media, such as television, radio or a newspaper
As a financial consultant, bank manager, or employed by an investment or brokerage firm 1 2 A multi-level marketing company like Amway, Mary Kay or Avon
As the manager of a grocery store, supermarket, convenience store, discount store or mass Merchandise store like Wal-Mart or Target
As an employee of a company that manufactures, distributes or sells healthcare products
None of these

Have you, yourself, participated in a marketing research study in the past six months, or not?

Yes
No

If yes to the above question, what was the topic of the study you participated in?

Are you currently scheduled to participate in any marketing research studies at any other company in the next month?

Yes
No

Please check the products that you have heard of?

Fiber supplements
Calcium Supplement
Medicated Nasal Spray
Saline Nasal Spray
Multivitamin Supplement
Probiotic Supplement

Which, if any, of the following types of over the counter products have you, yourself, purchased for your own use in the past 6 months?

Fiber supplements
Calcium Supplement
Medicated Nasal Spray
Saline Nasal Spray
Multivitamin Supplement
Probiotic Supplement

FOR PARENTS ONLY, OTHER SKIP: Which, if any, of the following types of over the counter products have you, yourself, purchased for your children’s use in the past 6 months?

Fiber supplements
Calcium Supplement
Medicated Nasal Spray
Saline Nasal Spray
Multivitamin Supplement
Probiotic Supplement

FOR THOSE THAT PURCHASED PROBIOTICS. NON USERS SKIP: You mentioned purchasing and using an over the counter probiotic supplement for yourself in the past six months. What brand or brands of over-the-counter probiotic supplements have you, yourself, used in the past six months?

FOR PARENTS WHO PURCHASED PROBIOTICS FOR THEIR CHILDREN ONLY; You mentioned purchasing an over the counter probiotic supplement for your child to use in the past six months. What brand or brands of over-the-counter probiotic supplements did your child use in the past six months?

FOR PROBIOTIC USERS ONLY NON USERS SKIP THIS QUESTION: In your own words, please tell me what are all the reasons why YOU take the current brand you purchase? Please be as detailed as possible when answering this question.

During a typical week, on average, how often do you, yourself, use your current over-the-counter probiotic supplement product? Would you say…

Daily
5-6 days a week
3-4 days a week
Less than 3 days a week

FOR PROBIOTIC USERS ONLY, NON USERS SKIP THIS QUESTION: In your own words, please tell me what are the benefits of using probiotic supplements? What do you know about probiotic supplements?

FOR NON PROBIOTIC USERS ONLY: Would you be interested in using probiotic in the future?

Yes, I would be interested and open to using probiotics in the future
No, I would not be interested and open to using probiotics in the future

FOR CURRENT NON PROBIOTIC USERS THAT WOULD BE INTERESTED IN USING PROBIOTICS IN THE FUTURE ONLY, OTHERS SKIP THIS QUESTION: In your own words, please tell me why you are interested in using probiotic supplements in the future? What would you be using it for? What has stopped you from using probiotic supplements?

The remaining questions are for Probiotics Users and Non Users.

Thinking about your health-related questions and care, please tell me to what degree you, yourself, are the decision maker for your own health. Would you say you…

Are the primary decision maker for health-related questions and care
Equally share the responsibility for health-related questions and care
Take part in the responsibility for health-related questions and care
Rarely or never make decision related to your own health questions and care

Thinking about health and wellness products, please tell me which of the following best describes you. Would you say…

Are the primary decision maker for health and wellness products that I use
Share equally with my partner/spouse the decision-making responsibility for health And wellness products that I use
Your partner/spouse normally or always recommends the brands of health and Wellness products that I use
You do not use health and wellness products

What is your total yearly household income?

$29,999 or less
$30,000-39,999
$40,000-49,999
$50,000-59,999
$60,000-69,999
$70,000-79,000
$80,000-89,999
$90,000-99,999
$100,000 or more

Please tell me what level of education have you, yourself, have completed. Would that be…

Attended high school, but did not graduate
High school graduate
Completed some college
Graduate of a 2 - year college
Graduate of a 4 - year college
Post graduate/study/degree
Other

Do you own an smart phone?

Yes
No

For each of the following, please tell me how much this statement describes you, yourself, if at all using a scale from one to five. 1 means the statement does not describe you at all and 5 means the statement describes you perfectly.

I am a person who enjoys expressing my opinions and ideas

5
4
3
2
1

I enjoy doing projects that allow me to be creative

5
4
3
2
1

I am always looking for new, exciting activities to participate in

5
4
3
2
1

I enjoy participating in group discussions and activities

5
4
3
2
1

I am interested in how things work

5
4
3
2
1

I like activities like puzzles, crosswords and games

5
4
3
2
1

I like a good debate and exchange of ideas

5
4
3
2
1

I think of myself as a creative person

5
4
3
2
1

I’m comfortable talking with others even if I haven’t met them before

5
4
3
2
1

Health Study Nationwide 2018