Appendix D Screener Questionnaire for Participant Recruitment_03172021

Appendix D: Screener Questionnaire for Participant Recruitment

The U.S. Department of Agriculture is planning a survey of to gather information on how and where Americans obtain food. It will help USDA make sure that all Americans can afford to get healthy food. We are recruiting participants to help evaluate a data entry instrument. Thank you for your interest in participating in this study. Due to the nature of this study, only certain individuals are eligible to participate. To determine if you are eligible, I would like to ask you a few questions. Please answer each question honestly.

1. Are you the person who does most of the shopping for food in your family?

Yes

No (STOP RECRUITMENT)

2. Do you currently own a smartphone?

Yes

No (STOP RECRUITMENT)

3. What smartphone are you using?

iPhone

Android phone

Other (STOP RECRUITMENT)

4. How long have you been using a smartphone on daily basis? (Check one of the following)

Less than 1 year (STOP RECRUITMENT)

1 year or more

5. Would you be willing to use your smartphone for this study?

Yes

No (STOP RECRUITMENT)

6. In order to collect the data of your food acquisitions, we need to install a mobile app on your smartphone. Would you be OK with that?

Yes

No (STOP RECRUITMENT)

7. The study mobile app may use your own wireless data service when you are not on Wi-Fi.

Would you be OK with that?

Yes

No (STOP RECRUITMENT)

8. Have you ever used a map on the smartphone?

Yes

No (STOP RECRUITMENT)

9. Would you be willing to share the GPS position of your smartphone for the purposes of this study?

Yes

No (STOP RECRUITMENT)

10. Do you have an internet and Wi-Fi service at home (e.g., Verizon Fios)?

Yes

No (STOP RECRUITMENT)

11. Do you have a laptop or desktop computer at home? (If Yes) Is it connected to the internet?

Yes

No (STOP RECRUITMENT)

12. In order to conduct the virtual-lab usability testing, we need to install secure audio-video communication software on your laptop/desktop computer. Would you be OK with it?

Yes

No (STOP RECRUITMENT)

13. How many children, who are attending a K-12 school or younger, live in your household?

14. Is your household currently receiving food assistance, such as WIC or SNAP? (WIC stands for the Special Supplemental Food Program for Women, Infants, and Children. This program provides food assistance and nutritional screening to low-income pregnant and postpartum women and their infants, as well as to low-income children up to age 5. SNAP stands for Supplemental Nutrition Assistance Program, also known as the Food Stamp Program. SNAP benefits are provided on a food stamp benefit card/EBT card)

Yes

No

15. What is the zip code of your current home? (for RUCA lookup)