What year were you born? [AGE]
[DROP DOWN MENU WITH YEARS: 1920 - 2019] terminate if year between 2002 and 2019.
Do you work for a pharmaceutical company, an advertising agency, or a market research company? [OCC_EXCL]
Yes terminate
No continue
Do you work for the Department of Health and Human Services? [HHS_EXCL]
Yes terminate
No continue
[Programmer: Add page break]
When was the last time you participated in a research interview or focus group? [LAST_PART]
Less than 6 months ago terminate
6 months ago or more continue
Never continue
[Programmer: Add page break]
Are you comfortable reading in English? [READ_ENG]
Yes continue
No terminate
[Programmer: Add page break]
How familiar are you with [CELEBRITY NAME 1]? [FAM_END_1A]
Not at all familiar
Somewhat familiar
Very familiar
Extremely familiar
How familiar are you with [CELEBRITY NAME 2]? FAM_END_1B]
Not at all familiar
Somewhat familiar
Very familiar
Extremely familiar
How familiar are you with [CELEBRITY NAME 3]? [FAM_END_1C]
Not at all familiar
Somewhat familiar
Very familiar
Extremely familiar
[NOTE: FOR STUDY 1 COGNITIVE TESTING RECRUITMENT, PARTICIPANTS NEED TO BE “VERY FAMILIAR” OR “EXTREMELY FAMILIAR” WITH CELEBRITY 1 IN Q6.]
[Programmer: Add page break]
How familiar are you with [INFLUENCER NAME 1]? [FAM_END_2A]
Not at all familiar
Somewhat familiar
Very familiar
Extremely familiar
How familiar are you with [INFLUENCER NAME 2]? [FAM_END_2B]
Not at all familiar
Somewhat familiar
Very familiar
Extremely familiar
How familiar are you with [INFLUENCER NAME 3]? [FAM_END_2C]
Not at all familiar
Somewhat familiar
Very familiar
Extremely familiar
[NOTE: FOR STUDY 2 COGNITIVE TESTING RECRUITMENT, PARTICIPANTS NEED TO BE “VERY FAMILIAR” OR “EXTREMELY FAMILIAR” WITH AT LEAST ONE OF THE INFLUENCERS LISTED IN Q9 – Q11.]
[Programmer: Add page break]
How often do you use the following social media platforms?
|
Daily |
Weekly |
Less Often |
a. Twitter [SMP_TWIT] |
○ |
○ |
○ |
b. Facebook [SMP_FACE] |
○ |
○ |
○ |
c. Snapchat [SMP_SNAP] |
○ |
○ |
○ |
d. Instagram [SMP_GRAM] |
○ |
○ |
○ |
e. LinkedIn [SMP_LI] |
○ |
○ |
○ |
f. YouTube [SMP_YT] |
○ |
○ |
○ |
[NOTE: FOR STUDY 2 COGNITIVE TESTING RECRUITMENT, PARTICIPANTS NEED TO BE A “DAILY” OR “WEEKLY” USER OF INSTAGRAM IN Q12D.]
[Programmer: Add page break]
What is your gender? [GENDER] [RECRUIT A MIX]
Male
Female
Prefer not to answer
[NOTE: RECRUIT ANY GENDER TO STUDY 1 COGNITIVE TESTS; RECRUIT ONLY FEMALES TO STUDY 2 COGNITIVE TESTS.]
Are you: [ETHNIC] [RECRUIT A MIX]
Hispanic or Latino
Not Hispanic or Latino
What is your race? You may select one or more races. [RECRUIT A MIX]
American Indian/Alaska Native [RACE1]
Asian [RACE2]
Black or African American [RACE3]
Native Hawaiian or other Pacific Islander [RACE4]
White [RACE5]
[Programmer: Add page break]
What is the highest level of school you have completed or the highest degree you have received? (Select one.) [EDUC] [RECRUIT A MIX]
Less than high school
High school graduate – high school diploma or equivalent (for example: GED)
Some college, but no degree
Associate or two-year college degree
Bachelor’s degree (for example: BA, AB, BS)
Advanced or post-graduate degree (for example: Master’s degree, MD, DDS, JD, PhD, EdD)
[Programmer: Add page break]
[QUALIFICATION TEXT]
Congratulations, based on your answers, you qualify for the study! It is important for you to know not everyone who qualifies for the study will be selected for an interview.
If you are willing to participate in a 60-minute in-person interview at Westat, please give us the best information to contact you by phone and email in the text boxes below:
Name [NAME]:
Telephone Number [PHONE]:
E-mail Address [EMAIL]:
[Programmer: Add page break]
Thank you for your answers to these questions. If you are chosen for an interview, someone will contact you within the next 1-2 days.
[TERMINATION TEXT]
Unfortunately you do not qualify for this particular study. There are a number of reasons people do not qualify. Thank you for your willingness to participate in this research.
OMB Control No. 0910-0695
Expiration date: 2/28/2021
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | O'Donoghue, Amie |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |