National Telecommunications and Information Administration
DTV Focus Group Screener
Hello. My name is __________________ and I am working with a national agency that’s interested in hearing different opinions about a type of technology that’s used for television.
To get these opinions, we are recruiting participants to come to a 90- minute discussion group to talk about some of these issues. Everyone who participates will be paid $(amount). First, we need to ask you a few quick questions. Do you have time now to answer them now?
1. Do you or does anyone in your household work in any of the following?
( ) Advertising, public relations and/or market research Terminate
( ) No Continue
2. Do you currently have cable TV, satellite or another pay TV service (i.e., Fios) on one or more of the TV’s in your home?
( ) No Continue
( ) Yes Terminate
3. Do you currently have a TV that uses rabbit ears or a rooftop antenna with a converter box in your home?
( ) No Continue
( ) Yes Terminate
4. Who in your family usually makes cable/satellite services decisions?
( ) Self Continue
( ) Shared equally with someone else Continue
( ) Someone else Terminate
5. Which of the following best describes your race and ethnicity? (Note: Termination criterion will vary by group)
Ethnicity:
( ) Hispanic or Latino
( ) Not Hispanic or Latino
Race:
( ) Black or African American
( ) White
( ) Asian
( ) American Indian or Alaskan Native
( ) Native Hawaiian or other Pacific Islander
6. Check Gender (ensure mix of male and female participants per group)
( ) Male Continue
( ) Female Continue
Which of the following categories best describes your age? (aim for mix of ages, except for senior specific groups)
( ) 18 to 24
( ) 25 to 34
( ) 35 to 44
( ) 45 to 65
( ) 66 and above
[Questions number 8 – 10 for Hispanic/Latino participants only]
8. Do you speak English fluently?
( ) No Recruit for Spanish dominant group
( ) Yes Terminate
9. In what country were you born?
_________________________ (record country)
10. Can you tell me about an activity you like to do in your free time? (Note: This question is intended to establish whether the respondent is reasonably articulate, fluent in Spanish for Spanish dominant group and fluent in English for English dominant group, and willing to converse. If respondent has difficulty speaking, serious speech impediment or has trouble communicating (e.g., “shuts down”), thank and terminate.
11. Which of these best describes your household income? (NOTE: Income ranges may vary by market; these ranges are based on Memphis statistics, where the median HHI is 28,000 for African Americans).
Less than 15,000
16,000 to 25,000
26,000 to 30,000
31,000 to 43,000
44,000 and above …………………………………………………………….Terminate
12. Which of the following best describes your educational level? (Read and record response)?
( ) Less than high school
( ) High school graduate/GED
( ) 2 year college/trade school
( ) Bachelor’s degree Terminate
( ) Graduate degree Terminate
What is your current marital status?
( ) Single
( ) Married
( ) Divorced
( ) Widowed
Invitation
Thank you. On [date] from [time] to [time], and location, we will be holding the discussion group. Are you interested in participating? If yes, record name, phone number, address, etc. Also ask: Do you wear glasses or use a hearing aid? If so, please remember to bring them so that you may see and hear everything clearly.
If no, thank the individual and terminate.
NAME______________________________
HOME PHONE______________________
ADDRESS ____________________________________________
____________________________________________
WORK PHONE____________CELL PHONE _________E-MAIL
Thanks, again, for your time and we'll see you at the group!
| File Type | application/msword |
| File Title | Screening Instrument -- Consumers |
| Author | Susan L. Dimmick |
| File Modified | 2009-03-17 |
| File Created | 2009-03-12 |