Form 1 Appendix A

Appendix A – Online Qualitative Testing Screener Questionnaire

Purpose: To recruit and screen participants for Campaign Testing Online Qualitative Sessions.

Sample Design:

• N = 100 General Population (Diverse Mass)

• N = 32 Black/African American

• N = 32 Hispanic, English proficient

• N = 32 Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ)

• N = 32 People with young children living in the household

• N = 32 Young People

Sampling Methodology:

• Participants will be recruited via online panels to participate in a five-day online qualitative session.

• Participants will be screened via an online screener questionnaire, which is accessible via desktop/laptop computer, tablet, or mobile device.

• Team Y&R researchers will review and approve all eligible participants before inviting them to the online qualitative platform.

Notes:

• Text within ## HASHES ## denotes comments

• Text with /* BRACKETS */ denotes survey coding logic

Introduction

/* DISPLAY */ PSB, an independent research firm, is conducting interviews on behalf of the U.S. Census Bureau.

Participation is voluntary, but your responses are important. Answers will be kept confidential. At the end of the interview, you will be provided with an email address where you can send any comments or questions about this survey. This survey has been approved by U.S. Office of Management and Budget approval number 0607-0978, expiring on August 31, 2020.

If you agree to participate, we will begin by asking you a few questions to see if you qualify to participate in the study. The survey takes approximately five minutes to complete. If you are eligible, you will receive an email invitation from the panel provider to join the study. There is a $75 incentive for participating in this study.

Screening Questions

/* QSAMPLE */ Audience Sample Codes /* CODE */ ## We set quotas to ensure a mix of demographic characteristics. See quota tables at the end for details. ##

1. General Populations (GP)

2. BAA

3. Hispanics

4. LGBTQ

5. Households with young children

6. Young People

## HARD PROMPTS ## ##All questions are required to determine eligibility. If a respondent elects not to answer a question required for eligibility, s/he will be thanked, and the survey will end. If respondents elect to skip eligibility questions, they will be prompted with ‘This question is required for eligibility to participate in the study’. ##

/* QMARKET */ In the past 5 years, have you or anyone in your household worked for any of the following industries? /* MULTIPLE RESPONSES PERMITTED */ /* RANDOM ROTATE CHOICES */

1. Advertising or public relations /* TERMINATE */

2. Marketing or market research /* TERMINATE */

3. Federal government /* TERMINATE */

4. Journalism, media or the press /* TERMINATE */

5. Education

6. Medicine

7. Engineering

8. Other /* SPECIFY */ /* DO NOT ROTATE */

9. None of the above/Don’t know /* EXCLUSIVE */ /* DO NOT ROTATE */

/* QREAD */ How well do you read in English?

1. Very well

2. Well

3. Not well /* TERMINATE */

4. Not at all /* TERMINATE */

/* QWRITE */ How well do you write in English?

1. Very well

2. Well

3. Not well /* TERMINATE */

4. Not at all /* TERMINATE */

/* QGENDER */ Are you...

1. Male

2. Female

3. Prefer to self-describe /* SPECIFY */

/* QSEXUAL_ORIENTATION */ Which of the following best represents how you think of yourself?

1. Lesbian or gay

2. Straight, that is not lesbian or gay

3. Bisexual

4. Something else /* SPECIFY */

5. I don’t know the answer

/* QSEXUAL_ORIENTATION_CODE */ Code sexual orientation

1. ## IF QSEXUAL_ORIENTATION = C1 OR C3 OR C4 ## Not straight

2. ## IF QSEXUAL_ORIENTATION = C2 ## Straight

3. ## IF QSEXUAL_ORIENTATION = C5 ## Don’t know

/* QAGE */ Please enter your age. /* OPEN END NUMERIC (0 TO 100) */ ## 3 DIGITS ## ## TERMINATE IF UNDER 18 ##

/* QAGECODE */ /* CODE */ Age brackets for quotas

1. 18-24

2. 25-34

3. 35-44

4. 45-54

5. 55+

/* QZIP */ What is your five digit zip code? /* OPEN END NUMERIC (00000 TO 99999) */

/* QSTATE */ /* CODE */ /* STATE */ ## AUTOCODE BASED ON QZIP ##

/* QREGION */ /* CODE */ Region

1. Northeast ## CT, ME, MA, NH, RI, VT, NJ, NY, PA ##

2. Midwest ## IN, IL, MI, OH, WI, IA, KS, MN, MO, NE, ND, SD ##

3. South ## DE, DC, FL, GA, MD, NC, SC, VA, WV, AL, KY, MS, TN, AR, LA, OK, TX ##

4. West ## AZ, CO, ID, NM, MT, UT, NV, WY, AK, CA, HI, OR, WA ##

/* QHISP */ Do you consider yourself to be of Latino or Hispanic origin?

1. Yes

2. No

/* QRACE */ What is your race? You may provide more than one response. /* MULTIPLE RESPONSES PERMITTED */

1. White

2. Black or African American

3. Asian

4. American Indian or Alaska Native

5. Native Hawaiian or Pacific Islander

6. Some other race /* SPECIFY */

/* QRACE_CODE */ /* CODE */ Race

1. ## QHISP = C1 ## Hispanic, Latino, or Spanish

2. ## IF QRACE = C1 AND QHISP = C2 ## White, Not Hispanic

3. ## IF QRACE = C2 AND QHISP = C2 ## Black or African American, Not Hispanic

4. ## IF ELSE ## Other, Not Hispanic

/* QRACE2 */ ## IF QRACE=C2 ## What is your ancestry or ethnic origin? /* OPEN END 1 BOXES 1 REQ */

/* QCHILDREN */ Are there any children aged 4 years old or younger currently living in your household?

1. Yes

2. No

/* QRELATIONSHIP */ What is your relationship with the child or children under 4 years old living in your household? /* MULTIPLE RESPONSES PERMITTED */

1. Parent

2. Grandparent

3. Other relative /* SPECIFY */

4. Not related

/* QEDU */ What is the highest degree or level of school you have completed?

1. Less than high school

2. Some high school

3. High school graduate or equivalent (for example GED)

4. Some college, but degree not received or is in progress

5. Associate degree (for example: AA, AS)

6. Bachelor’s degree (for example: BA, BS, AB)

7. Graduate degree (for example: master’s, professional, doctorate)

8. Prefer not to answer

/* EDU_CODE*/ /* CODE */ Education Attainment

1. ## IF QEDU = C1 OR C2 ## Less than High School

2. ## IF QEDU = C3 ## High School Graduate

3. ## IF QEDU = C4 OR C5 ## Some College

4. ## IF QEDU = C6 OR C7 ## College +

/* QRENT */ Do you rent or own your house or apartment?

1. Owned or being bought by you or someone in your household

2. Rented by you or someone in your household

3. Occupied without payment of rent

/* QMOVE */ Have you moved primary residences in the past 4 years?

1. Yes

2. No

/* QMARRIAGE */ What is your marital status?

1. Now married

2. Divorced

3. Separated

4. Widowed

5. Never married

/* QINCOME */ In 2018, what was your total household income before taxes?

1. Less than $25,000

2. $25,000 – $34,999

3. $35,000 – $49,999

4. $50,000 – $74,999

5. $75,000 – $99,999

6. $100,000 – $149,999

7. More than $150,000

/* DISPLAY */ Now we’d like to ask you a few questions about the U.S. census.

/* QCENSUS1 */ How familiar are you with the U.S. census? /* REVERSE CHOICES */ ## IF QORDER =C1 THEN KEEP WRITTEN ORDER ##

1. 1 – Extremely familiar

2. 2 – Very familiar

3. 3 – Somewhat familiar

4. 4 – Not too familiar

5. 5 – Not at all familiar

/* DISPLAY */ The U.S. census is the count of all the people who live in the United States. It happens every 10 years. It asks questions such as how many people live in your household, their age, race, and ethnicity. This survey is not the census. The next census is in 2020.

/* QCENSUS2 */ If the census were held today, how likely would you be to fill out the census form? /* REVERSE CHOICES */ ## IF QORDER =C1 THEN KEEP WRITTEN ORDER ##

1. 1 – Extremely likely

2. 2 – Very likely

3. 3 – Somewhat likely

4. 4 – Not too likely

5. 5 – Not at all likely

/* DISPLAY */ ## IF QUALIFIED ## Thank you. Based on your answers, you are eligible to participate in the study. You will receive an email invitation within five (5) business days from the panel provider. If you have any questions or comments about this study, you may send them to Ketzirah.Lesser@YR.com.

/* DISPLAY */ ## IF NOT QUALIFIED ## Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to Ketzirah.Lesser@YR.com.

Quota Tables

Diverse Mass

Characteristics	Subcategories	Recruits
Educational attainment	High school or less	60
	Some college	30
	College graduate or postgraduate degree	10
Gender	Female	50
	Male	50
Race/ethnicity	White, NH	65
	Hispanic	15
	Black/African American, NH	15
	Other, NH	5
Age	18-24	10
	25-34	20
	35-44	20
	45-54	35
	55 or older	15
Region	Northeast	20
	Midwest	25
	South	30
	West	25

Black or African American:

• Self-identify as Non-Hispanic Black/African American

• QRACE_CODE = C3

Characteristics	Subcategories	Recruits
Educational attainment	High school or less	17
	Some college	10
	College graduate or postgraduate degree	5
Gender	Female	16
	Male	16
Race/ethnicity	Black/African American, NH	32
	Others	0
Age	18-24	4
	25-34	6
	35-44	5
	45-54	11
	55 or older	6
Region	Northeast	6
	Midwest	7
	South	12
	West	7

Hispanic/Latino/Spanish:

• Self-identify as Hispanic/Latino/Spanish

• QRACE_CODE = C1

Characteristics	Subcategories	Recruits
Educational attainment	High school or less	17
	Some college	10
	College graduate or postgraduate degree	5
Gender	Female	16
	Male	16
Race/ethnicity	Hispanic	32
	Not Hispanic	0
Age	18-24	4
	25-34	6
	35-44	5
	45-54	11
	55 or older	6
Region	Northeast	6
	Midwest	7
	South	12
	West	7

Lesbian, Gay, Bisexual, Transgender, Queer:

• Self-identify as LGBTQ

• QSEXUAL_ORIENTATION_CODE = C1 OR C3 OR C4

• QGENDER = C3

Characteristics	Subcategories	Recruits
Educational attainment	High school or less	15
	Some college	10
	College graduate or postgraduate degree	7
Gender	Female	16
	Male	16
Age	18-24	4
	25-34	6
	35-44	5
	45-54	11
	55 or older	6
Region	Northeast	6
	Midwest	7
	South	12
	West	7

People with young children in household:

• Live with a child or children age 4 years or younger

• QCHILDREN = C1

Characteristics	Subcategories	Recruits
Educational attainment	High school or less	15
	Some college	10
	College graduate or postgraduate degree	7
Gender	Female	16
	Male	16
Age	18-24	4
	25-34	6
	35-44	5
	45-54	11
	55 or older	6
Region	Northeast	6
	Midwest	7
	South	12
	West	7
Relationship with young children	Parent	5
	Grandparent	5
	Other	4

Young People:

• Age 18-24 (QAGECODE = C1)

• Renters (QRENT = C2)

• Unmarried (QMARRIAGE = C5)

• Has moved in the past 4 years (QMOVE = C1)

Characteristics	Subcategories	Recruits
Educational attainment	High school or less	17
	Some college	10
	College graduate or postgraduate degree	5
Gender	Female	16
	Male	16
Age	18-24	32
	25-34	0
	35-44	0
	45-54	0
	55 or older	0
Region	Northeast	6
	Midwest	7
	South	12
	West	7