Storyboard Testing Focus Groups for "No Trespassing Means No Trespassing" Campaign

Form Approved

OMB No. 0920-0572

Exp. Date: 2/28/2015

ATSDR Task Order 15-4 Storyboard Testing

Attachment 2

Screener: Tweens

OVERVIEW

Our desired participants are consumers who are tweens, ages 10 to 13.

Participants should represent a mix of education levels, race/ethnicities, and income levels.

Gender: Mixed

Age: 10 to 13

Race/Ethnicity: Mixed

Income: Mixed

Geographic Location: Holyoke MA, Zip codes 01040 and 01041

We will exclude from participation people who:

• Have participated in any other focus groups, interviews, or research studies within the past 6 months

• Conduct market research or work in advertising or public relations

• Are unable to speak and read English well enough to complete the focus group

• Have a parent or sibling tween participating in the focus group

Public reporting burden of this collection of information varies from 5 to 10 minutes with an estimated average of 10 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0572).

SCRIPT

Hello,

My name is [name] from Fieldwork Boston and I’m calling on behalf of CommunicateHealth and the Agency for Toxic Substances and Disease Registry (ATSDR), a federal public health agency of the U.S. Department of Health and Human Services. CommunicateHealth is getting feedback to help develop materials to educate kids about the dangers of playing in abandoned buildings. We’re interested in talking to children ages 10 to 13. If your child is interested and qualifies, we will offer your child a $45 cash gift as a token of appreciation to participate in a 90-minute focus group discussion session in Holyoke, MA.

This is a feedback session. We are not selling anything. Other people who have participated in similar focus groups have found it to be interesting and fun. Does it sound like something you would be interested in?

[IF YES]

Great. Let's find out if your child qualifies. I have a few simple questions to ask about your child. This should take about 5 minutes. At some point, I may end the questions if I discover your child does not qualify. This has nothing to do with you, or them. We simply are looking for people who meet certain criteria. Remember all of the questions I’m about to ask apply to your child, not to you.

1a. Gender:

_______ Male

_______ Female

3a. In what year were you born?

• _______________[Record year of birth]

• Don’t know/Not sure /(Do not read)

• Refused (Do not read)

[CONTINUE IF BORN BETWEEN 2000 AND 2004. OTHERWISE TERMINATE]

5a. Please tell me your race or ethnic background. Do you consider yourself?

Ethnicity:

• Hispanic or Latino

• Not Hispanic or Latino

• Don’t Know/Not sure (DO NOT READ)

• Refused (DO NOT READ)

Race

• White

• Black or African-American

• American Indian or Alaska Native

• Native Hawaiian or Other Pacific Islander

• Asian

• Don’t Know/Not Sure (DO NOT READ)

• Refused (DO NOT READ)

8a. In what state, city, and zip code do you currently live? [ENTER FIVE DIGIT ZIP CODE]

13a. Which of the following categories best describes your total, annual household income?

______ Under $20,000/year

______ $20,001 - $30,000/year

______ $30,001 - $40,000/year

______ $40,001 - $50,000/year

______ $40,001 - $50,000/year

______ $50,001 - $60,000/year

______ $60,001 - $80,000/year

______ $80,000 - $100,000/year

______ Over $100,000/year

______ Prefer not to answer

1b. Do you, or does any member of your household or immediate family work for:

• a market research company

• an advertising agency or public relations firm

• the media (TV/radio/newspapers/magazines)

• as a healthcare professional (doctor, nurse, pharmacist, dietician, etc.)

_______ Yes (TERMINATE)

_______ No (CONTINUE)

2b. Have you participated in a focus group, intercept interview, telephone survey, and/or online survey in which you were asked your opinions regarding a product, a service, or advertising within the past six months?

_______ Yes (TERMINATE)

_______ No (CONTINUE)

54a. Are you related to anyone already participating in this project?

_______ Yes (TERMINATE)

_______ No (CONTINUE)