OMB
NO: 2127-0646
EXPIRATION DATE: mm/dd/yyyy
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0646. Public reporting for this collection of information is estimated to be approximately 10 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave SE, Washington, D.C. 20590.
YOU DRINK AND DRIVE. YOU LOSE TELEPHONE SURVEYS
County: _________________________ Zip: _____________ Metro Status: _____
Date: ___________________________ CATI ID: ____________________
Interviewer:____________________________________________________________________
Telephone Number: ______________________________________________________________
Time Start: ______________ Time End: ______________ TOTAL TIME: _____________
READ IN: STATE
Hello, I'm __________________ calling for the U.S. Department of Transportation. We are conducting a national study of Americans' driving habits and attitudes. The interview is voluntary and the information you provide us will be used for statistical purposes only. We will not collect any personal information that would allow anyone to identify you. The interview takes about 10 minutes to complete.. [Please note that 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. The OMB control number for this information collection is 2127-XXXX] Could we begin now?
Q1. First, including yourself, how many persons age 16 and older are living in this household at least half the time, even if they are not at home right now?
NUMBER OF ADULTS IN HOUSEHOLD
None..........00 CONFIRM, THEN SCREEN OUT Q1
Refused.......99
Q2. How many of these (NUMBER FROM Q1) persons drive a motor vehicle at least a few times a year?
NUMBER OF DRIVERS IN HOUSEHOLD
None..........00 CONFIRM, THEN SCREEN OUT Q2
Refused.......99
Q3. Even if they were not driving, how many of these (NUMBER FROM Q2) drivers have had even a single beer, glass of wine or any other alcoholic beverage in the past year? (They do not have to be regular drinkers or persons who drive after drinking.)
NUMBER OF DRIVERS WHO EVER DRINK IN HOUSEHOLD
None..........00 CONFIRM, THEN SCREEN OUT Q3
Refused.......99
IF MORE THAN ONE IN Q3, ASK Q4a
Q4a. In order to select just one person to interview, could I speak to the youngest male DRIVER who has had a beer, glass of wine or other alcoholic beverage in the past year, age 16 and older?
IF NO MALE ASK: Could I speak to the youngest female DRIVER who has had a beer, glass of wine or other alcoholic beverage in the past year, age 16 and older?
ALTERNATE WORDING: Could I speak to that person?
Respondent is the person.................1 SKIP TO Q6
Other respondent comes to phone..............2 SKIP TO Q5a
Respondent is not available..............3 ARRANGE CALLBACK
Refused......................................4 ASK Q4b
Q4b. Would you please tell me why you do not want to do the interview?
______________________________________________________TERMINATE
Q5a. Hello, I'm __________________ calling for the U.S. Department of Transportation. We are conducting a study of Americans' attitudes about driving and traffic safety. The interview is completely confidential and will take 5 minutes. Could we begin now?
CONTINUE INTERVIEW............1 SKIP TO Q6
Arrange Callback..................2 CALLBACK
Refused.......................3 ASK Q5b
Q5b. Would you please tell me why you do not want to do the interview?
______________________________________________________TERMINATE
Q6. How often do you drive a motor vehicle? Almost every day, a few days a week, a few days a month, or a few days a year?
Almost every day.............1
Few days a week.................2
Few days a month.............3
Few days a year.................4
(vol) Never................5 SCREEN OUT
Other (SPECIFY) ...............6
(VOL) Don't know...........7
(VOL) Refused.................8
Q7. Is the vehicle you drive most often a car, van, motorcycle, pickup truck, sport utility vehicle, or other type of truck? (NOTE: IF RESPONDENT DRIVES MORE THAN ONE VEHICLE OFTEN, ASK:) "What kind of vehicle did you LAST drive?"
Car...............................1
Van or minivan........................2
Motorcycle........................3 SKIP TO Q9a
Pickup truck..........................4
Sport Utility Vehicle.............5
Other.................................10
Other truck (SPECIFY).............11
(VOL) Don't know.....................12
(VOL) Refused....................13
Q8. When driving this (car/truck/van), how often do you wear your seat belt? [READ ANSWERS] [IF ASKED IF THIS APPLIES TO SHOULDER BELTS OR LAP BELTS SAY SHOULDER BELTS]
All of the time...............1
Most of the time..................2
Some of the time..............3
Rarely............................4
Never.........................5
(Vol) Don't Know.................6
(Vol) Refused................7
Q9a. Now I'm going to ask you a few questions about alcohol use. During the past 30 days have you had at least one drink of any alcoholic beverage, including liquor, beer, wine or wine coolers?
Yes........................1
No............................2 SKIP TO Q14
(VOL) Don’t Know.........3 SKIP TO Q14
(VOL) Refused...............4 SKIP TO Q14
Q9b. How many days out of the past 30 days did you drink ANY alcoholic beverages (including beer, wine, wine coolers, mixed drinks or liquor)?
____________(Range=01-30) DON’T KNOW=31 REFUSED=32
Q10a. During the past 30 days, have you driven a motor vehicle within two hours after drinking any alcoholic beverages, even if you had only a little?
Yes........................1
No............................2 SKIP TO Q14
(VOL) Don’t Know.........3 SKIP TO Q14
(VOL) Refused...............4 SKIP TO Q14
Q10b. How many days out of the past 30 days did you drive within two hours after drinking any alcoholic beverages?
__________ (Range=01-30) DON’T KNOW =31 REFUSED=32
IF Q10b = 31 OR 32, THEN SKIP TO Q14
Q11. On the most recent occasion when you drove within two hours after drinking alcoholic beverages, how many drinks (of beer, wine, liquor) did you have?
ENTER NUMBER of DRINKS _____ (01-90)
Don't know....................98
Refuse...........................99
Q12a. In the past 30 days, did you drive when you thought you had too much to drink?
Yes........................1
No............................2 SKIP TO Q14
(VOL) Don’t Know.........3 SKIP TO Q14
(VOL) Refused...............4 SKIP TO Q14
Q12b. About how many times in the past 30 days did you drive when you thought you had too much to drink?
ENTER NUMBER: _____ (01 - 30)
Never..................00
Don't know..................98
Refuse.................99
Q13. Compared to other months during the past year, would you say that the number of days you drove after drinking alcohol was (lower/higher than usual, lower) than usual or the same as usual? [IF Q10b = 0 THEN SAY "LOWER"; IF Q10b > 0 THEN SAY "HIGHER THAN USUAL, LOWER"]
Higher Than Usual......1
Lower Than Usual..........2
Same as Usual..........3
(VOL) Don’t Know.......4
(VOL) Refused........5
Q14. In the past 30 days, have you seen police on the roads you normally drive [READ LIST]
More often than usual.........1
Less often the usual.............2
About the same................3
Never............................4
(vol)Don't know...............5
(vol)Refuse......................6
Q15. Suppose you drove a motor vehicle after drinking alcohol, and the amount of alcohol in your body was more than what the law allows for drivers. How likely is it that the police would stop you? Would the police be...........?
Very Likely To Stop You,...............1
Somewhat Likely To Stop You, or...........2
Not Likely To Stop.....................3
(VOL) Don’t Know........................4
(VOL) Refused........................5
Q16. Do you think the chances of being stopped have changed in the past month? That is, compared to a month ago, do you think a driver who had been drinking is more likely, less likely or about as likely to be stopped by the police?
More likely...................1
Less likely......................2
About the same................3
(vol)Don't know..................4
(vol)Refuse...................5
Q17a Now, I would like to ask you a few questions about educational or other types of activities. In the past 30 days, have you seen or heard any messages that encourage people to avoid driving after drinking? This could be public service announcements on TV, messages on the radio, signs on the road, news stories, or something else.
Yes.............1
No.................2 SKIP TO Q18a
Don’t know......3 SKIP TO Q18a
Refused............4 SKIP TO Q18a
Q17b. Where did you see or hear these messages?
[DO NOT READ--MULTIPLE RESPONSE]
TV..................................1
Radio..................................2
Friend/Relative.....................3 SKIP TO Q18a
Newspaper..............................4 SKIP TO Q18a
Personal observation/on the road....5 SKIP TO Q18a
Billboard/signs........................6 SKIP TO Q18a
I’m a police officer/judge..........7 SKIP TO Q18a
Other (specify_____)...................8 SKIP TO Q18a
Don’t know..........................9 SKIP TO Q18a
Refused................................10 SKIP TO Q18a
Q17c. Was the (TV/radio) message a commercial (or advertisement), was it part of a news program, or was it something else? [MULTIPLE RECORD]
Commercial/Advertisement..............1
Public Service Announcement..............2
News story/news program...............3
Something else (specify): _________......4
Don’t know............................5
Q.17d Would you say that the number of these messages you have seen or heard in the past 30 days that encourage people to avoid driving after drinking is more than usual, fewer than usual, or about the same as usual?
More than usual...........1
Fewer than usual............2
About the same............3
Don’t know..................4
Q18a. Yes or No--in the past 30 days, have you seen or heard of any special effort by police to reduce driving under the influence or drunk driving in your community?
Yes..........................1
No..............................2 SKIP TO Q19a
(Vol) Don’t know.............3 SKIP TO Q19a
(Vol) Refused...................4 SKIP TO Q19a
Q.18b Where did you see or hear about that special effort?
[DO NOT READ--MULTIPLE RESPONSE]
TV..................................1
Radio..................................2
Friend/Relative.....................3 SKIP TO Q19a
Newspaper..............................4 SKIP TO Q19a
Personal observation/on the road....5 SKIP TO Q19a
Billboard/signs........................6 SKIP TO Q19a
I’m a police officer/judge..........7 SKIP TO Q19a
Other (specify_____)...................8 SKIP TO Q19a
Don’t know..........................9 SKIP TO Q19a
Refused................................10 SKIP TO Q19a
Q18c. Was the (TV/radio) message a commercial (or advertisement), was it part of a news program, or was it something else? [MULTIPLE RECORD]
Commercial/Advertisement..............1
Public Service Announcement..............2
News story/news program...............3
Something else (specify): _________......4
Don’t know............................5
Q19a. In the past 30 days, have you seen or heard anything about police setting up checkpoints or other enforcement efforts to catch drivers who were driving while under the influence of alcohol or driving drunk?
Yes..................1
No.....................2 SKIP TO Q20a
(Vol) Don’t know.....3 SKIP TO Q20a
(Vol) Refused..........4 SKIP TO Q20a
Q19b. In the past 30 days, did you personally drive past, or drive through, a police checkpoint or other enforcement effort set up to catch drivers who were driving while under the influence of alcohol or driving drunk?
Yes..................1
No.......................2
(Vol) Don’t know.....3
(Vol) Refused............4
Q20a. Do you know the name or slogan of any enforcement program(s) that prevent driving under the influence or drunk driving in ____ [identify State]?
Yes..........1
No..............2 SKIP TO Q20c
Don't know...3 SKIP TO Q20c
Refuse..........4 SKIP TO Q20c
FOR Q20b MARK ALL THE MENTION. FOR Q21: ALL STATES GET 1, 2, 3, & 80.
IN ADDITION – AL 13, AK 12, AZ 12, AR 13, CA SFO 94, CA LAX 95, DE 7, DC 7,
GA 13 & 14, HI 93, IL 12, IN 4, KS 16, KY 13, MD 7, MN 17, MO 13, MS 13,
NV 5 & 18, NH 25, NJ 19, NM 20, NY 21, NC 8 & 13, ND 15, PA 6, 7 & 11, SC 22,
TN 8, 9, 10 & 13, TX 23, VA 7 & 13, WA 12, WV 7 & 13, WY 24, PR 96.
Q20b. What was the slogan or program called? [MULTIPLE MENTION]
1. Friends don't let friends drive drunk.....(PUNCH “1”) (All)
2. You Drink and Drive. You Lose.............(PUNCH “2”) (All)
3. Get the keys..............................(PUNCH “3”) (All)
4. Operation Pullover........................(PUNCH “4”)
5. Why Risk It...............................(PUNCH “5”)
6. Please Step Away from Your Vehicle. DUI...(PUNCH “6”)
7. Checkpoint StrikeForce....................(PUNCH “7”)
8. Booze It and Lose It......................(PUNCH “8”)
9. Step Away From your Vehicle...............(PUNCH “9”)
10. Checkpoint Tennessee......................(PUNCH “10”)
11. Team DUI..................................(PUNCH “11”)
12. Drive Hammered, Get Nailed................(PUNCH “12”)
13. Border to Border..........................(PUNCH “13”)
14. Operation Zero Tolerance..................(PUNCH “14”)
15. Do Buckle – Don’t Booze...................(PUNCH “15”)
16. There’s NO EXCUSE for Drunk Driving.......(PUNCH “16”)
17. Get a Designated Driver. Or Pay the Price.(PUNCH “17”)
18. Arrive Alive! Don’t Drink and Drive.......(PUNCH “18”)
19. HOLD FOR NJ...............................(PUNCH “19”)
20. Don’t Drink & Drive or We Will Stop You...(PUNCH “20”)
21. Think Safe, Drive Sober...................(PUNCH “21”)
22. Sober or SLAMMER..........................(PUNCH “22”)
23. Santa’s Coming, Don’t Hit Him.............(PUNCH “23”)
24. HOLD FOR WY...............................(PUNCH “24”)
25. DUI Hunters...............................(PUNCH “25”)
26. MADD/Mothers Against Drunk Driving........(PUNCH “26”)
27. DARE/Drug Abuse Resistance Education......(PUNCH “27”)
28. SADD/Students Against Drunk Driving.......(PUNCH “28”)
29. Don’t drink and drive.....................(PUNCH “29”)
30. Recovery Month............................(PUNCH “30”) (ALL)
93. Keoki Kool (designated driver)............(PUNCH “93”)
94. Avoid the 23..............................(PUNCH “94”)
95. Avoid the 50..............................(PUNCH “95”)
96. Si estas pica’o no guies..................(PUNCH “96”)
97. Other, specify _____________________..97
98. (VOL) Don't know..........................98
99. (VOL) Refused.........................99
Q20c. I'd like to find out if you recall seeing a particular ad on TV recently. It starts with police pulling over drivers, and asking if they had been drinking alcohol. The drivers are then told to step out of the car, and tested to see if they are breaking the drinking and driving laws. The ad ends with the drivers handcuffed, placed in a police car, and shows their mug shots. Do you recall seeing this ad in the past two weeks?
Yes..........1
No..............2 SKIP TO Q21
Don't know...3 SKIP TO Q21
Refuse..........4 SKIP TO Q21
Q20d. What was the slogan or logo used at the end of this ad?
[DO NOT READ – MULTIPLE RECORD]
You drink and drive, you lose.......1
Other (SPECIFY)........................2
Don’t drink and drive...............3
Don’t recall...........................8
Refuse..............................9
Q21. Do you recall hearing or seeing the following slogans in the past 30 days? [READ ITEMS NOT IN Q20b AND MULTIPLE RECORD]
1. Friends don't let friends drive drunk.....(PUNCH “1”) (All)
2. You Drink and Drive. You Lose.............(PUNCH “2”) (All)
3. Get the keys..............................(PUNCH “3”) (All)
4. Operation Pullover........................(PUNCH “4”) IN
5. Why Risk It...............................(PUNCH “5”) NV
6. Please Step Away from Your Vehicle. DUI...(PUNCH “6”) PA
7. Checkpoint StrikeForce....................(PUNCH “7”) DE,DC,MD,PA,VA,WV
8. Booze It and Lose It......................(PUNCH “8”) NC TN
9. Step Away From your Vehicle...............(PUNCH “9”) TN
10. Checkpoint Tennessee......................(PUNCH “10”) TN
11. Team DUI..................................(PUNCH “11”) PA
12. Drive Hammered, Get Nailed................(PUNCH “12”) AK,AZ,IL,WA
13. Border to border..........................(PUNCH “13”) AL,AR,GA,KY,MO,MS,
NC,TN,VA,WV
14. Operation Zero Tolerance..................(PUNCH “14”) GA
15. Do Buckle – Don’t Booze...................(PUNCH “15”) ND
16. There’s NO EXCUSE for Drunk Driving.......(PUNCH “16”) KS
17. Get a Designated Driver. Or Pay the Price.(PUNCH “17”) MN
18. Arrive Alive! Don’t Drink and Drive.......(PUNCH “18”) NV
19. HOLD FOR NJ...............................(PUNCH “19”) NJ
20. Don’t Drink & Drive or We Will Stop You...(PUNCH “20”) NM
21. Think Safe, Drive Sober...................(PUNCH “21”) NY
22. Sober or SLAMMER..........................(PUNCH “22”) SC
23. Santa’s Coming, Don’t Hit Him.............(PUNCH “23”) TX
24. HOLD FOR WY...............................(PUNCH “24”) WY
25. DUI Hunters...............................(PUNCH “25”) NH
30. Recovery Month............................(PUNCH “30”) (ALL)
93. Keoki Kool (designated driver)............(PUNCH “93”) HI
94. Avoid the 23..............................(PUNCH “94”) CA SF
95. Avoid the 50..............................(PUNCH “95”) CA LA
96. Si estas pica’o no guies..................(PUNCH “96”) PR
97. (VOL) None of these...................97
98. (VOL) Don't know..........................98
99. (VOL) Refused.........................99
Q22. Thinking about everything you have heard, how important do you think it is for [STATE] to enforce the drinking and driving laws more strictly . . . . very important, fairly important, just somewhat important, or not that important?
Very important....................1
Fairly important.....................2
Just somewhat important...........3
Not that important...................4
Don’t know........................5
Refused..............................6
DEMOGRAPHICS
Now I need some information about you
D1. GENDER BY OBSERVATION
Male..........1
Female..........2
D2. What is your age?
__________ AGE REFUSED=99
D3. Do you consider yourself to be Hispanic or Latino?
Yes.......................1
No.............................2
(VOL) Not sure..........3
(VOL) Refused................4
D4. Which of the following racial categories describes you? You may select more than one. [READ LIST--MULTIPLE RECORD]
American Indian or Alaska Native.............1
Asian.............................................2
Black or African American....................3
Native Hawaiian or other Pacific Islander.........4
White........................................5
Other(VOL)....................................6
___________________________________________
(VOL) Refused...................................9
D5 What is the highest grade or year of school you completed?
8th grade or less.....................9
9th grade.................................10
10th grade............................11
11th grade................................12
12th grade/GED........................13
Some college..............................14
College graduate or higher............15
(VOL) Refused...........................16
D6. Not including cell phones, and phones used primarily for fax or computer lines, do you have more than one telephone number in your household?
Yes..............1
No..................2
Don’t know.......3
That completes the survey.
Thanks for taking the time to participate in this research study
| File Type | application/msword |
| File Title | ATTACHMENT C |
| Author | MLevy |
| Last Modified By | Walter.Culbreath |
| File Modified | 2008-05-02 |
| File Created | 2008-05-02 |