Form Approved OMB
No. 0920-0572 Exp.
Date: 2/28/2015
OVERVIEW
Our desired participants are consumers.
Participants should represent a mix of education levels, race/ethnicities, and income levels.
Gender: Mixed
Age: 18 and over
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: Washington D.C. metro area
We will exclude from participation people who:
Are under the age of 18
Have participated in any research 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 study
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,
This is NAME from COMPANY. We are doing a research study to help develop new messages on behalf of the Agency of Toxic Substances and Disease Registry (ATSDR), which is a federal agency of the Centers for Disease Control and Prevention (CDC). If you qualify to participate in the focus group, we will offer you $40 as a token of appreciation to participate in a 1-hour focus group in Rockville, Maryland.
This is a research study. We are not selling anything. Other people who have participated in similar studies have found it to be interesting and fun. Does it sound like something you would be interested in?
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.
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)
13a. Which of the following categories best describe your total, annual household income?
________ Under $20,000/year (CONTINUE)
________ $20,001 - $30,000/year (CONTINUE)
________ $30,001 - $40,000/year (CONTINUE)
________ $40,001 - $50,000/year (CONTINUE)
________ $50,001 - $60,000/year (TERMINATE)
________ $60,001 - $80,000/year (TERMINATE)
________ $80,001 - $100,000/year (TERMINATE)
________ Over $100,000/year (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: _____________________
1a. Gender:
_______ Male
_______ Female
5a. Are you Hispanic, Latino/a,or Spanish
Origin?
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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)
1 This request is for a one-time data collection.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Sandra Williams Hilfiker |
File Modified | 0000-00-00 |
File Created | 2021-01-25 |