Appendix I
OMB No: 0910-0497 Expiration Date: 11/30/2023
Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0910-0497. The time required to complete this screening document 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.
Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRAStaff@fda.hhs.gov.
Focus Groups to Support Education on Dietary Supplements:
Older Adults, Phase 1
Appendix I: Recruitment Screener
The target audience for these focus groups is adults 55-80 years old.
Recruiting Goals
Eight (8) focus groups will be conducted. The groups will be segmented, as follows:
Group No. |
Location |
Age Bracket (years) |
Education Level |
Group 1 |
Mid Atlantic (Local) |
55-64 |
Lower Edu |
Group 2 |
Mid Atlantic (Local) |
55-64 |
Higher Edu |
Group 3 |
Mid Atlantic (Local) |
65-80 |
Lower Edu |
Group 4 |
Mid Atlantic (Local) |
65-80 |
Higher Edu |
Group 5 |
West Coast |
55-64 |
Lower Edu |
Group 6 |
West Coast |
55-64 |
Higher Edu |
Group 7 |
West Coast |
65-80 |
Lower Edu |
Group 8 |
West Coast |
65-80 |
Higher Edu |
*Data collected from mock focus group will not be included in analysis
Appendix I
OMB No: 0910-0497 Expiration Date: 11/30/2023
PARTICIPANT SCREENER SCRIPT
Hello Ms./Mr. __________________________________, my name is __________________ and I'm calling about a research study sponsored by the U.S. Food and Drug Administration in your area. We are looking for adults to take part in upcoming focus group discussions about dietary supplements.
Are you interested in participating?
Yes continue
No eliminate [thank respondent politely]
Great. I’m just going to ask you a few questions to see if you are eligible for the group.
Q1. What is your age? years
Under 55 years old eliminate [thank respondent politely]
55-64 continue [recruit to 55-64 year-old group]
65-80 continue [recruit to 65-80 year-old group]
81 and over eliminate [thank respondent politely]
Q2. Who makes most of the decisions regarding your health?
Other (e.g., spouse/partner, family member, advocate) eliminate [thank respondent politely]
Me continue
Q3. Over the past 12 months, have you regularly taken a multi-vitamin or multi-mineral supplement in the past 12 months?
(INTERVIEWER NOTE: IF NECESSARY, EXPLAIN THESE PRODUCTS ARE THINGS LIKE ONE-A-DAY, MEGA-VITAMIN, CENTRUM A-TO-ZINC, AND OTHER PRODUCTS THAT CONTAIN A VARIETY OF DIFFERENT VITAMINS, MINERALS, AND MAY ALSO CONTAIN OTHER THINGS AS WELL.)
No continue
Yes continue
Q4. Over the past 12 months, have you regularly taken a single-ingredient vitamin or mineral supplement? This could be a tablet of vitamin C or E, an iron or calcium pill, or even a B complex vitamin. Please exclude if participant ONLY takes vitamin-fortified foods or beverages (e.g., milk fortified with vitamin D).
[IF ANSWER IS NOT CLEARLY A SUPPLEMENT AND SOUNDS LIKE IT MAY BE AN INGREDIENT IN FOOD, ASK “is that in your food or is it taken separately as a supplement?” If taken as a food ingredient only, mark “No.”]
Q5. Over the past 12 months, have you regularly taken any dietary supplements other than vitamins, such as herbs or botanicals,? We are talking about things such as garlic pills, melatonin, Echinacea, ginkgo, glucosamine, St. John's wort, amino acids, fish oil, or melatonin.
[INTERVIEWER: IF ANSWER IS NOT CLEARLY A SUPPLEMENT AND SOUNDS LIKE IT MAY BE AN INGREDIENT IN FOOD, ASK “Is that in your food or is it taken separately as a supplement?” EXCLUDE fresh garlic, fresh ginseng, ginseng root, and herbs used to flavor foods in cooking such as garlic for spaghetti sauce or peppermint for tea; supplements that are not taken by mouth, such as vitamin E or aloe used on skin. If taken as a food ingredient or topical application only, mark “No.”]
No See DECISION BOX, BELOW
Yes CONTINUE
DECISION BOX
If respondent said YES to Q3, but NO to Q4 and Q5, recruit no more than 2 per group.
If respondent said YES to Q4 but NO to Q5, recruit no more than 2 per group.
If respondent said NO to Q3 and Q4 and Q5, respondent is ineligible. Thank politely.
Q6. The focus group will be conducted in English and will require reading some text. Are you comfortable understanding, speaking and reading English?
Yes continue
No eliminate [thank respondent politely]
Q7. Have you or someone from your immediate family worked for or as any of the following:
A Market Research Firm eliminate [thank respondent politely]
Nutritionist or Dietitian eliminate [thank respondent politely]
Nurse/Nurse Practitioner, Physician, Pharmacist eliminate [thank respondent politely]
Microbiologist, toxicologist, or chemist eliminate [thank respondent politely]
A Public Health Organization eliminate [thank respondent politely]
State or local food agency,
U.S. Department of Agriculture, or
U.S. Food and Drug Administration eliminate [thank respondent politely]
Q8. Have you participated in a focus group within the past 6 months? [Interviewer: participation in telephone or online surveys is allowed. If explanation is needed: A focus group is a when a small group of individuals come together to talk about a certain topic.]
Yes eliminate [thank respondent politely]
No continue
Q9. What is the highest level of education that you have completed? [RECRUIT A MIX]
High school graduate or GED recruit for lower education
Technical/vocational school recruit for lower education
Some college (1-3 years towards bachelor’s degree) recruit for higher education
College (Bachelor’s degree) recruit for higher education
Advanced degree (postgraduate degree) recruit for higher education
Q10. Are you of Hispanic or Latino origin? [RECRUIT A MIX]
Yes
No
Q11. What is your race? I am going to read several categories of race to choose from. You may choose one or more categories. Are you…? [RECRUIT A MIX]
White
Black or African American
Asian
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native
Q12. What is your gender?
Female
Male [RECRUIT NO MORE THAN 4 MALES PER GROUP]
Prefer not to answer
Elimination Script for Ineligible Participants:
Thank you for answering all of my questions. Unfortunately, you are not eligible to participate in this project. There are many possible reasons that people may not be eligible. These reasons were decided earlier by the research team. We value your interest in the focus groups. Thank you for being willing to help us.
Invitation Script for Eligible Participants:
Thank you for answering these questions. We would like to invite you to participate in a focus group to discuss issues relating to dietary supplements with about 8 other participants. The discussion will last about 90 minutes. The discussion will be video- and audio-taped, and also observed by members of a research team. Your participation and everything you say during the discussion will remain secure to the extent provided by law, and your personal identifying information will not be included in any reports. At the end of the focus group, you will receive $75 as a token of appreciation for your participation. Are you interested in participating in this focus group?
Yes
No [Thank the person for his/her time]
I’m glad that you are interested! The focus group will take place on (Day), (Date), at [X:00 or X:00 p.m.] at [site location].
Will you be available to participate at this time?
Yes
No [Thank the person for his/her time]
I would like to send you a confirmation email or letter containing directions to the facility. In order to do so, could you please tell me the best way to reach you (e.g., email and/or a phone number)?
Name:______________________________________
Address (if needed to reach participant): ___________________________________________________
City:_______________________ State:_________ Zip:_____________
or
Email (if needed to reach participant):_________________________________
Phone (if needed to reach participant):_______________________
Date of focus group:__________________ Time:________________
We are only inviting a few people, so it is very important that you notify us as soon as possible if for some reason you are unable to attend. Please call [recruiter] at [telephone number] if this should happen. We look forward to seeing you on [date] at [time]. If you use reading glasses, please bring them with you to the focus group.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Bradbard, Steve |
File Modified | 0000-00-00 |
File Created | 2021-01-12 |