Respondents- Individuals/Households (Parents/Children/Teens)

OMB Control No: 0584-XXXX

Expiration Date: XX/XX/20XX

Appendix G2. Household Eligibility Screener

WEB SCREENER

Ask all

Q1: Do any children 18 years or younger currently live in your home?

Please include all children who currently live in your home for most of their time.

1. Yes [go to Q2]

2. No [Not eligible—end screener]

Q2: This summer 2018, have any or will any of these children go to <SITE NAME>, at <ADDRESS>, and get free meals?

By free meals we mean that you will not or did not pay a fee or a reduced fee.

1. Yes [Eligible participant—end screener and go to survey instructions]

2. No [Go to Q3]

Q3: This summer 2018, have any or will any of these children go somewhere else to get free meals?

1. Yes [Not eligible – end screener]

2. No [Eligible non-participant—end screener and go to survey instructions]

Web Screener Survey Instructions

You and your child are eligible to take part in the Summer Meals Study! Before we provide survey instructions, please let us know your contact information in case we need to get in touch with you about the study.

HOME PHONE NUMBER:

CELL PHONE NUMBER:

Westat is conducting the Summer Meals Study on behalf of the U.S. Department of Agriculture’s Food and Nutrition Service to answer questions like:

• Where do children spend their summer months?

• Do your children attend any summer programs?

• What would make your children more likely to attend summer programs that serve free meals?

Please complete the Summer Meals Survey and have your child complete the child/teen section of the survey. It should take you 20 minutes each to complete and your responses will provide valuable information about how summer meal programs can best serve families and their children. Please complete the survey as soon as possible.

After we receive your completed survey, we will send you $10 in cash.

Your participation in this survey is completely voluntary. Please know that your responses will be kept private as required by law and will not be shared with anyone not involved with conducting the study. Neither your name nor any other information about your identity will be used in any reports. The information you provide will be combined with information from everyone who participates in the study. You may skip any question that you prefer not to answer. If you decide not to participate, there will be no loss of benefits. As described in the system of record notice (SORN) titled FNS-8 USDA/FNS Studies and Reports (published in the Federal Register on April 25, 1991, volume 56, pages 19078-19080), FNS and contractors working on their behalf may collect and analyze this information for research purposes and are required to have safeguards in place to keep data private.

If you have any questions about the study or completing the survey, please email SUMS@westat.com or call 1-800-XXX-XXXX.

Your opinion matters to us. Thank you for helping us with this important study!

[CLICK HERE TO BEGIN THE WEB SURVEY]

PHONE SCREENER

Ask all

Q1: Do any children 18 years or younger currently live in your home? Please include all children who currently live in your home for most of their time.

1. Yes [Go to Q2]

2. No [THANK YOU FOR COMPLETING THE SCREENER. YOU ARE NOT ELIGIBLE TO TAKE PART IN THE SUMMER MEALS STUDY.]

Q2: This summer 2018, have any or will any of these children go to <SITE NAME>, at <ADDRESS>, and get free meals?

By free meals we mean that you will not or did not pay a fee or a reduced fee.

1. Yes [YOU ARE ELIGIBLE TO TAKE PART IN THE SUMMER MEALS STUDY] [Go to Phone Screener Survey Instructions]

2. No [Go to Q3]

Q3: This summer 2018, have any or will any of these children go somewhere else to get free meals?

1. Yes [THANK YOU FOR COMPLETING THE SCREENER. YOU ARE NOT ELIGIBLE TO TAKE PART IN THE SUMMER MEALS STUDY.]

2. No [YOU ARE ELIGIBLE TO TAKE PART IN THE SUMMER MEALS STUDY] [Go to Phone Screener Survey Instructions]

Phone Screener Survey Instructions

SURVEY INSTRUCTIONS FOR ELIGIBLE RESPONDENTS (PARTICIPANTS AND NONPARTICIPANTS)

You and your child are eligible to take part in the Summer Meals Study!

Before we provide survey instructions, please let us know your telephone contact information in case we need to get in touch with you about the study.

What is your HOME NUMBER?

What is your CELL PHONE NUMBER?

Thank you. You may complete the web survey or request a paper copy of the survey. For instructions on how to complete the web survey, press 1 now. To request a paper survey in the mail, press 2 now.

PRESS 1 for instructions on how to complete the web survey: Please login to the secure study website and log in using the PIN provided to you in the invitation letter. It is the same PIN that you used to complete this brief phone survey.

PRESS 2 for paper survey: Thank you. We will mail a paper survey to you at (ADDRESS ON FILE).

Public reporting burden for this collection of information is estimated to average 5 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: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.