Appendix C_Providers Online Screener Instructions

OMB Control Number: 0970-0531

Expiration date: 7/31/2022

Appendix C

Providers Online Screener Instructions

Communications Focus Groups for Remaking the Safety Net

Paperwork Reduction Act of 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering information to provide constituent research designed to understand target audiences with experience with economic and social safety net programming. The focus group and research will help identify experiences and perception of participants, and identify ways for the Office of Family Assistance (OFA) to produce communications messaging about safety net programming in a clear and resonant manner. The focus group will assist the program office in; (1) gathering feedback on safety net programming, (2) creating resonant communications messages, and (3) identifying trustworthy and relevant channels for communication with program service providers and beneficiaries. Public reporting for this collection of information is estimated to average 15 minutes per respondent, including time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is not required to retain a benefit. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # for this collection is 0970-0531 and the expiration date is 7/31/2022. If you have any comments on this collection of information, please contact Lizeth Hester, Program Specialist, Training and Technical Assistance - Office of Family Assistance, Lizeth.Hester@acf.hhs.gov (202) 205-8283. 

[EMAIL MESSAGE LINKING TO ONLINE SCREENER]:

Hello [INSERT PARTICIPANT NAME]!

STUDY TOPIC: Remaking the Safety Net

STUDY NUMBER: [TBD – ASSIGNED BY RECRUITING PARTNER]

WHEN: [INSERT DATES OF ONLINE FOCUS GROUP]

WHAT: Two-Hour Online Focus Group

INCENTIVE: $75 if you qualify and fully participate

[CLICKABLE LINK INCLUDED:] Start Survey Here

[CLICKABLE LINK INCLUDED:] Visit Community

We are conducting a brief market research study about social service programs for the Federal government. We can assure you that your responses to this survey will in no way impact your eligibility for programs and services.

*START SURVEY BUTTON CAN ONLY BE CLICKED ONCE*

Many Thanks,
20|20 Research Panel
K2 Team

1. INSTRUCTION: SELECT ONE RESPONSE

2. INSTRUCTION: SELECT ONE RESPONSE

Faith-Based Organizations

3. INSTRUCTION: SELECT ALL THAT APPLY

4. INSTRUCTION: WRITE YOUR ANSWER BELOW

5. INSTRUCTION: SELECT ALL THAT APPLY

6. INSTRUCTION: WRITE YOUR ANSWER BELOW

7. INSTRUCTION: SELECT ALL THAT APPLY

8. INSTRUCTION: SELECT ALL THAT APPLY

Social Enterprise Questions

9. INSTRUCTION: SELECT ALL THAT APPLY

10. INSTRUCTION: SELECT ALL THAT APPLY

11. INSTRUCTION: WRITE YOUR ANSWER BELOW

12. INSTRUCTION: WRITE YOUR ANSWER BELOW

13. INSTRUCTION: SELECT ALL THAT APPLY

Government Organization/Human Service Practitioners Questions

14. INSTRUCTION: SELECT ALL THAT APPLY

15. INSTRUCTION: SELECT ALL THAT APPLY

16. INSTRUCTION: WRITE YOUR ANSWER BELOW

[Continued Questions for Participants Qualifying for Faith-Based Organizations, Social Enterprise Organizations, or Government Organizations)

17. INSTRUCTION: SELECT ONE RESPONSE

18. INSTRUCTION: SELECT ONE RESPONSE

19. INSTRUCTION: SELECT ONE RESPONSE

20. INSTRUCTION: SELECT ONE RESPONSE

21. INSTRUCTION: SELECT ONE RESPONSE

22. INSTRUCTION: WRITE YOUR ANSWER BELOW

INVITATION

SELECT ONE RESPONSE; CONFIRM CONTACT INFORMATION