Screener- Recruiting Call and Consent

Focus Group Screener Fruits and Veggies: More Matters Concept, Materials, and Message Testing

4

OMB Control No. 0920-0572
Expiration Date: 6/30/2008

Focus Group Screener

Hello, I’m _______________ with _____________________, an independent consumer research firm. We are not selling or promoting any product or service. We are conducting a research study to help public health planners understand what Americans think about choosing and eating foods for a healthier diet. Everyone who participates in these discussions will receive $50 compensation. I would like to ask you some questions to see if you qualify for one of the discussion groups. These questions will only take a few moments to answer. The groups will be held at [times] on [date] at [location] and will last about one-and-a-half to two hours. Refreshments will be served and you will receive [amount] when the group ends. Do you have time now to answer a few questions?

Recruit 12 to seat 9 respondents in the room

1. Have you or anyone in your home worked in or retired from any of the following industries?

(Read and record response)

( ) Marketing or public relations Terminate

( ) Advertising Terminate

( ) Market research Terminate

( ) None of the above Continue

NOTE: Use the following language to “terminate” call throughout screening process:

“Thank you for taking the time to answer our questions. Unfortunately, the category you fall into is currently full. If it should open back up, may we call you back?”

Public reporting burden for this collection of information is estimated to average five minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0572).

2. We want to talk with people with different eating habits. To what extent do you agree or disagree with the following statement: I am actively trying to eat a healthy diet. Would you say you…

( ) Strongly agree Continue

( ) Moderately agree Continue

( ) Neither agree not disagree Terminate

( ) Moderately disagree Terminate

( ) Strongly disagree Terminate

3. On average, how many servings of fruits and vegetables would you say you eat in a typical day?

( ) 1 or less Continue

( ) 2 Continue

( ) 3 Continue

( ) 4 Continue

( ) 5 Continue

( ) 6 Continue

( ) 7 or more Terminate

(Note: The purpose of this question is to screen out individuals who are consuming the recommended amount of fruits and vegetables each day.)

4. How confident are you that you can eat five fruits and vegetables every day, starting this week and continuing for at least one month? Please rate your confidence on a scale of 1 to 10, with 1 being very low confidence and 10 being very high confidence.

4a.

1	2	3	4	5	6	7	8	9	10
Very low confidence									Very high confidence

(Record response)

Terminate if 4 or less

5. Are you a vegetarian?

( ) Yes Terminate

( ) No Continue

6. Is anyone in your household on a medically prescribed diet or on a special diet for health reasons? (Note: Weight loss programs initiated by the participant are okay.)

( ) Yes Terminate

( ) No Continue

7. Have you ever participated in a market research study, in which you were paid $20 or more to provide your opinions regarding a product, a service, or advertising?

( ) Yes Continue to 7a

( ) No Continue to 8

Recruit a mix

7a. How many of these studies have you participated in?

(Record response)

Terminate if 5 or more, ever

7b. How long ago was the last study?

(Record response)

Terminate if 6 months ago or less

8. So that we can be sure that all backgrounds are represented in our study, please tell me your race or ethnic origin. Are you . . . ?

( ) Black or African American Continue

( ) White Continue

( ) Hispanic or Latino Continue

( ) Asian Continue

( ) American Indian or Alaska Native Continue

( ) Native Hawaiian or Other Pacific Islander Continue

Recruit no more than half Caucasian

9. Which of the following best describes your age?

( ) 35 or under Continue

( ) 36-45 Continue

( ) 46-55 Continue

( ) 56-64 Continue

( ) 65 or older Continue

Recruit a mix

10. Record gender

(ask if unclear)

( ) Male Continue

( ) Female Continue

Recruit a mix

11. What is your annual household income before taxes?

( ) Less than $25,000 Continue

( ) $25,001 - $49,000 Continue

( ) $49,001 - $75,000 Continue

( ) $75,001 or more Continue

Recruit a mix

Thank you for answering my questions. As I mentioned earlier, we are conducting a research project to help public health planners understand what Americans think about choosing and eating foods for a healthier diet, and would like to hear your views. In order to hear them first-hand, we are conducting an informal, round-table discussion to be held on [DATE] at [TIME]. The discussion will last about 1 ½ - 2 hours and will be both fun and informative. No one will try to sell you anything, and no one will call on you as a result of your participation. You will receive [amount] to compensate you for any expenses. This is an important project, and we hope that you will be part of it. We can only invite about a dozen people to take part. Can we schedule your attendance?

(If Yes, read…)

During the session we will be reviewing some printed (written) materials regarding health, wellness, and nutrition. Would you be comfortable reading through the materials and discussing them in a group situation?

(If Yes, read…)

Please be sure to arrive about 15 minutes early, so that you’ll have time to review some materials before your meeting. We are counting on your participation, so please be sure to contact us as soon as possible if something comes up and you can't attend. (GIVE PHONE NUMBER). Also, if you need glasses for reading please be sure to bring them. Before we hang up, let me get the correct spelling of your name, and your address and phone numbers so we can send you a confirmation letter with directions to our facility and give you a reminder call.

NAME______________________________

HOME PHONE______________________

ADDRESS ____________________________________________

____________________________________________

WORK PHONE____________CELL PHONE _________

E-MAIL