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 3

Screener: Parents

OVERVIEW

Our desired participants are consumers who are parents of tweens (children ages 10 to 13).

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

Gender: Mixed

Race/Ethnicity: Mixed

Education level: Mixed (At least half of participants cite high school as the highest level of education completed)

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 other 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 tween or related spouse participating in the focus groups

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. If you qualify, we will offer you $45 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 you qualify. I have a few simple questions to ask. This should take about 5 minutes. At some point, I may end the questions if I discover you don't qualify. This has nothing to do with you. We simply are looking for people who meet certain criteria.

1a. Gender:

_______ Male

_______ Female

2a. In which of the following categories does your age fall:

______ under 18 years of age (TERMINATE)

______ 18-24 years of age (CONTINUE)

______ 25-34 years of age (CONTINUE)

______ 35-44 years of age (CONTINUE)

______ 45-54 years of age (CONTINUE)

______ 55-64 years of age (CONTINUE)

______ 65-74 years of age (CONTINUE)

______ 75 years of age or older (CONTINUE)

14a. Number of children (under age 18) living in the household:

______ None (TERMINATE)

______ 1-2 children (CONTINUE)

______ 3-4 children (CONTINUE)

______ 5 or more children (CONTINUE)

The next question is asking about your children, not you. Please answer for each of your children.

3a. In what year were they 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]

4a. What is the highest level of education you have completed? (Recruit at least half with high school as the highest level of education completed)

________ Grade school

________ Less than high school graduate/some high school

________ High school graduate or completed GED

________ Some college or technical school

________ Received four-year college degree

________ Some post graduate studies

________ Received advanced degree

________ Other: _____________________

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)