Screener
HRSA Interviews Related to Organ Donation
Summary of recruiting specifications
Mix of men and women Support
organ donation Are
not registered organ donors
Mix
of educational levels Do
not work in the field of market research, religion, education,
healthcare or related to organ donation Have
not been in a focus group or paid interview in the past six months Meet
specific demographic criteria for each interview type (see table at
end of screener)
(RECRUIT 9 PER SEGMENT)
1. Thank you for your interest in this project. We are recruiting people to participate in an interview that will last an hour. All participants will be paid $35/40 for their time. If you are eligible for the study, would you be interested in participating?
Yes (CONTINUE)
No (THANK AND END)
Note whether respondent is male or female and recruit a mix.
Male
Female
2. To begin, thinking about organ donation, do you do you strongly support, support, oppose, or strongly oppose organ donation?
Strongly support (CONTINUE)
Support (CONTINUE)
Oppose (THANK AND END)
Strongly Oppose (THANK AND END)
3. Are you a registered organ donor, either by registering on your driver’s license, a donor card, or an organ donor registry?
Yes (THANK AND END)
No (CONTINUE)
4. Now, I need to ask you some basic information. Which category best describes your age?
Under 21 (THANK AND END)
21–35 (CONTINUE) [QUALIFIES FOR YOUNG ADULT INTERVIEW; max of 2 interviews for most types, see chart]
36–49 (CONTINUE)
50–65 (CONTINUE) [QUALIFIES FOR 50+; max of 2 interviews for most types, see chart]
66 or older (CONTINUE) [QUALIFIES FOR 50+; max of 2 for 50+]
Recruit a mix of ages.
5. What is the highest grade you have completed in school? [READ LIST IF NECESSARY]
8th grade or less (CONTINUE)
Some high school (grades 9, 10, or 11) (CONTINUE)
High school graduate or GED (High school equivalency) (CONTINUE)
Some college/2-year college/technical school/associate degree (CONTINUE)
College graduate (CONTINUE)
Some graduate school/post-graduate degree (CONTINUE)
Recruit a mix of education levels.
6. We want to make sure we represent different ethnic and racial groups in our study. Would you describe yourself as… ?
Hispanic or Latino/Latina (CONTINUE)
Not Hispanic or Latino/Latina (CONTINUE)
(If Hispanic)
At home do you primarily speak:
English (CONTINUE) [QUALIFIES FOR ENGLISH HISPANIC INTERVIEW]
Spanish (CONTINUE) [QUALIFIES FOR SPANISH HISPANIC INTERVIEW]
7. Next, would you describe yourself as…?
White (CONTINUE)
Black or African American (CONTINUE) [QUALIFIES FOR AFRICAN AMERICAN INTERVIEW]
American Indian or Alaskan Native (CONTINUE) [QUALIFIES FOR ANHOPI INTERVIEW]
Asian (CONTINUE) [QUALIFIES FOR ANHOPI INTERVIEW]
Native Hawaiian or Other Pacific Islander (CONTINUE) [QUALIFIES FOR ANHOPI INTERVIEW]
Recruit a mix of ethnic and racial backgrounds.
8. What is your present occupation? ___________________
Related to organ donation (THANK AND END)
Market research (THANK AND END)
Teacher (THANK AND END)
Religion (THANK AND END)
Healthcare (THANK AND END)
All others (CONTINUE)
9. Have you ever participated in a focus group or been paid to be part of a discussion group or interview?
Yes (CONTINUE)
No (SKIP TO Q12)
10. How recently did you participate in this focus group, discussion, or interview?
Within the past six months (THANK AND END)
More than six months ago (CONTINUE)
11. Thank you. We are conducting informal interviews on issues related to organ donation, and your views would be valuable in helping us better understand this issue. The discussion will last one hour, and there will be no attempt to sell you anything or convince you to register as a donor. We are simply interested in your opinions. We will pay you $35/40 as a way of thanking you for participating. Would you be interested in attending?
No (THANK AND END)
Yes (CONTINUE)
12. Great! We would like to schedule a time that will work for you. Can you please provide me with your …?
NAME:
E-MAIL ADDRESS:
PHONE NO:
** Double check spelling of name and read back phone and e-mail to confirm ***
13. What are some times that you are available during the week of [date]? _________
14. Finally, can you please let me know where you heard about this project? _________________________________________________________________________
Thank you for your time and for agreeing to participate. We look forward to hearing from you!
Recruiting table: Interview type x Screening Criteria
|
Gender |
Age |
Educ |
Race |
General Public |
Mix |
Mix, but limit 2 50+ and 2 21-35 (at least half only qualify for this group) |
Mix |
Mix |
Hispanic English |
Mix |
Mix, but limit 2 50+ and 2 21-35 |
Mix |
Hispanic |
Hispanic Spanish |
Mix |
Mix, but limit 2 50+ and 2 21-35 |
Mix |
Hispanic |
African American |
Mix |
Mix, but limit 2 50+ and 2 21-35 |
Mix |
AA |
ANHOPI |
Mix |
Mix, but limit 2 50+ and 2 21-35 |
Mix |
ANHOPI |
Young adult |
Mix |
21-35 |
Mix |
Mix |
50+ |
Mix |
50+, but limit 2 65+ |
Mix |
Mix |
File Type | application/msword |
File Title | Focus Group Screener |
Author | Christine Brittle |
Last Modified By | RMaldonado |
File Modified | 2012-01-26 |
File Created | 2011-11-20 |