NHTSA Form 1306 Bulletin Board Screener - General

OMB Control No. 2127-0682

Expiration Date 04-30-2018

CONFIDENTIAL

NHTSA ODI CALL 001 CAMPAIGN CREATIVE TESTING

Online Bulletin Board Screener – GROUP 2: Gen Pop

This collection of information is voluntary and will be used for guidance in increasing engagement with SaferCar.gov’s consumer resources.  We will not collect any personal information that would allow anyone to identify you. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.  The OMB Control Number for this information collection is 2127-0682.  Public reporting for this collection of information is estimated to be approximately 120 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information.  All responses to this collection of information are voluntary.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590

Participant Criteria GROUP 2: Recruit n=30 for at least n=25 to show

• National geography

• Mix of genders

• Ages 18 and older

• 1/3 with children under age of 18 in home

• Possess valid drivers license

• Own and operate a vehicle at least once per week

INTRODUCTION

Heart+Mind Strategies, an independent, global opinion research firm, is conducting an important study among a select group of individuals nationwide.

We are seeking participants for an Online Bulletin Board discussion we are holding for research purposes only. An Online Bulletin Board is a web based research tool that leads participants through an engaging discussion in an online environment. This can be accessed directly from any mobile web browser, or computer with a high-speed Internet connection.

We have a few questions to see if you qualify for this upcoming study. Please note, all answers to these questions remain confidential.

S1. Given our research will happen in an online environment and questions are asked in English, are you able to read and respond (i.e. type) in English fluently?

1. Yes

2. No [TERMINATE]

S2. Do you or does any member of your household currently work for any of the following? Please select all that apply.

[RANDOMIZE 1-6]

1. A media company

2. An automobile manufacturer or dealership

3. An automotive parts manufacturer

4. A market research firm

5. An advertising firm

6. A news or journalism organization

7. None of the above [EXCLUSIVE] [ANCHOR]

[TERMINATE IF S2=1-6]

S3. Which of the following states do you live in?

1. Alabama

2. Alaska

3. Arizona

4. Arkansas

5. California

6. Colorado

7. Connecticut

8. Delaware

9. District of Columbia

10. Florida

11. Georgia

12. Hawaii

13. Idaho

14. Illinois

15. Indiana

16. Iowa

17. Kansas

18. Kentucky

19. Louisiana

20. Maine

21. Maryland

22. Massachusetts

23. Michigan

24. Minnesota

25. Mississippi

26. Missouri

27. Montana

28. Nebraska

29. Nevada

30. New Hampshire

31. New Jersey

32. New Mexico

33. New York

34. North Carolina

35. North Dakota

36. Ohio

37. Oklahoma

38. Oregon

39. Pennsylvania

40. Rhode Island

41. South Carolina

42. South Dakota

43. Tennessee

44. Texas

45. Utah

46. Vermont

47. Virginia

48. Washington

49. West Virginia

50. Wisconsin

51. Wyoming

S4. HIDDEN 9 POINT GEOCODE [RECRUIT MIX]

1. New England (S3=07,20,22,30,40,46)

2. Middle Atlantic (S3=31,33,39)

3. East North Central (S3=14,15,23,36,50)

4. West North Central (S3=16,17,24,26,28,35,42)

5. South Atlantic (S3=08,09,10,11,21,34,41,47,49)

6. East South Central (S3=01,18,25,43)

7. West South Central (S3=04,19,37,44)

8. Mountain (S3=03,06,13,27,29,32,45,51)

9. Pacific (S3=02,05,12,38,48)

S5. Are you male or female?

1. Male [RECRUIT 15]

2. Female [RECRUIT 15]

S6. Into which of the following categories does your age fall? [RECRUIT MIX]

1. Under 18 [TERMINATE]

2. 18-24 [RECRUIT 6-8]

3. 25-34 [RECRUIT 6-8]

4. 35-54 [RECRUIT 6-8]

5. 55+ [RECRUIT 6-8]

6. Prefer not to answer

S7. Do you currently have a valid drivers license?

1. Yes

2. No [TERMINATE]

S8.      Do you currently own or lease a car or truck?

1. Yes

2. No [TERMINATE]

S9. Do you personally drive this vehicle at least once per week?

1. Yes

2. No [TERMINATE]

S10. Which of the following best describes your role with regard to your vehicle’s maintenance, repairs and safety needs?

1. I am the primary decision-maker for my vehicle’s maintenance, repairs and safety needs.

2. I am the joint decision-maker for my vehicle’s maintenance, repairs and safety needs.

3.  I do not usually make decisions or have influence on my vehicle’s maintenance, repairs and safety needs.

[TERMINATE IF S10=3]

S11. Do you have regular access to the Internet through a smart phone or high speed Internet connection?

1. Yes

2. No [TERMINATE]

S12. Do you have any children under the age of 18 living at home with you?

1. Yes [RECRUIT 10]

2. No

3. Prefer not to answer

S13. Which of the following best describes your total annual household income before taxes in 2014? [RECRUIT MIX]

1. Less than $20,000

2. $20,000 to under $35,000

3. $35,000 to under $50,000

4. $50,000 to under $75,000

5. $75,000 to under $100,000

6. $100,000 to under $150,000

7. $150,000 to under $200,000

8. $200,000 or more

9. Prefer not to answer

S14. What is the last formal grade of education you have completed? [RECRUIT MIX]

1. Less than high school (8th grade or less)

2. Some high school (9th-12th grade)

3. High school graduate

4. Some college, but no degree

5. Associate’s Degree (Vocational / Technical)

6. Bachelor’s degree

7. Master’s degree

8. Professional degree

9. Doctorate degree

10. Prefer not to answer

S15. Are you of Hispanic or Latino descent?

1. Yes

2. No

S16. Select one or more of the following that best describes your race?

[ACCEPT MULTIPLE RESPONSES]

1. American Indian or Alaska Native

2. Asian

3. Black or African-American

4. Native Hawaiian or other Pacific Islander

5. White

EMAIL FOR THOSE WHO QUALIFY

Thank you for answering our questions. We would like you to participate in our Online Bulletin Board. This will be a single Bulletin Board taking place over the course of three days next week that engages a group of participants, like you, from all over the country, to discuss and react to various topics and issues. This is a research study and in no way a sales effort of any kind! We are only interested in your candid opinions. The discussion will be led by an independent moderator.

During an Online Bulletin Board, a group of participants interact with one of our discussion leaders and share opinions and reactions regarding a variety of issues, activities and items. During some points in the Bulletin Board, there are questions that are shared, meaning you will be able to view others’ responses and they will be able to view yours. As privacy is very important to us, please know that you will not be personally identified – you will be known only by a ‘screen name’ that you can make up (typically most use their first name and last initial, but this can be any reasonable name).

Your input and insight will help us explore some new areas of thought and aid in problem solving. If you qualify and participate in the study, we would like to offer you $75 as a token of our thanks for your time.

You join this confidential discussion series as an anonymous member and will not need to share any personally identifying information as part of this process. Your name will never be associated with your opinions and our findings are reported in the aggregate. We only confirm your contact information in order to send you the registration and log in instructions and in order to send your honorarium payment to an address of your choice. Again, you will receive $75 in appreciation for your time.

To be part of this online research, you will need to log on to the discussion website at least once a day on XXXXXX XX^th, XXXXXX XX^th and XXXXXX XX^th and spend at least 15-20 minutes each of those days in the discussion. You choose the time of day or night that is most convenient for you.

Are you available and interested in being part of this Online Bulletin Board?

1. Yes [CONTINUE]

2. No [TERMINATE]

We will send additional details and instructions on how to access the Online Bulletin Board via email. If you prefer for us to contact you via phone to provide this information please supply a contact number. If you would prefer to contact us for this information please email XXXX at XXXXX@heartandmindstrategies.com.

In order to send you an honorarium by check in the mail, we will also ask for your address.

First name: [TEXT BOX]

Last name: [TEXT BOX]

Email: [TEXT BOX]

Daytime phone: [TEXT BOX]

Evening phone: [TEXT BOX]

Mailing Address: [TEXT BOX]

City: [TEXT BOX]

Postal code: [TEXT BOX]

An email containing instructions and web links for the discussion will be sent to you by [INSERT DATE]. This email will supply the URL you will need to reference the group online as well as your username and password. It will be coming from [INSERT EMAIL ADDRESS].

Thank you.

NHTSA Form No 1306