APPENDIX D1
Recruitment Screener for
Parent-Child Groups
Recruitment Screener D1
Instructions for the use of form D1:
This form will be used in Phase 1 to recruit parents of children ages 9-12 and their children, and Phase 2 for ages 5-8, to participate in focus groups. Each parent will be in a focus group with other parents, and the children will be in groups according to their ages.
This form serves three purposes:
To assess the parent’s interest and eligibility to participate in the parent-only focus group.
Receive permission from the parent to talk to their tween.
Assess the tweens’ interest and eligibility to participate in the tween-only focus group.
Form Approved
OMB No. 0920-XXXX
Exp. Date: _______________
Screener D1 for Parent and Children Focus Groups
Project: “Formative Research of Adults’ and Childrens’ Views Related to Promotion of Health Food Choices”
PHASES 1 & 2: Focus Groups with Parents of Children ages 5-8 (early elementary ages) and ages 9-12 (later elementary, or “tweens”)
AED – Obesity Focus Groups – Pr # 666-65
CITIES/DATES/TIMES – TBD
Section 1: For Parents
ASK TO SPEAK TO PARENT OF CHILD WHO IS OF APPROPRIATE GRADE & AGE
[CONFIRM THAT YOU ARE SPEAKING TO A PARENT IN THE HOUSEHOLD. EXPLAIN THAT WE ARE RESEARCHERS LOOKING FOR SCHOOL-AGED CHILDREN AND THEIR PARENTS WHO WOULD BE INTERESTED IN PARTICIPATING IN A FUTURE RESEARCH PROJECT.
EXPLAIN THAT THE PROJECT INVOLVES FOCUS GROUPS. THE DISCUSSION TOPIC WILL BE ABOUT FOOD.
EXPLAIN THAT WE WOULD LIKE TO ASK THE PARENT A FEW QUESTIONS TO DETERMINE THEIR LEVEL OF INTEREST AND WHETHER THE PARENT AND THE CHILD ARE ELIGIBLE AND INTERESTED. EXPLAIN THAT YOUR QUESTIONS WILL NOT TAKE LONGER THAN 3-7 MINUTES PER RESPONDENT.
EXPLAIN THAT YOU WANT TO ASK THE PARENT A FEW QUESTIONS FIRST, AND THEN WITH THE PARENT’S PERMISSION, YOU’D LIKE TO SPEAK WITH THE CHILD, AND THEN SPEAK TO THE PARENT AGAIN TO DISCUSS THE PARENT’S AND CHILD’S INTEREST AND ELIGIBILITY.
RECRUIT 8 PER GROUP (FOR 6 TO 8 TO SHOW)
NOTE: WE WILL BE CONDUCTING 2 GROUPS SIMULTANEOUSLY FOR EACH TIME SLOT. ONE GROUP WITH THE PARENT (OR CAREGIVER WHO IS THE PRIMARY MEAL PLANNER AND GROCERY SHOPPER) AND THE OTHER WITH THEIR CHILD.
Hello, I’m __________ with Alan Newman Research, an independent consumer research firm. We are not selling or promoting any product or service. We are conducting a research study on food among preschool and school-age children and their parents on behalf of the Centers for Disease Control and Prevention. (CDC). We would like to ask you a few brief questions now over the phone. We’d like to determine if you are interested in and available to participate in a focus group study in a few weeks. We want to determine if the ages of children in your family fit the ages we need for our project. There are a few qualifiers for our particular study we’d like to ask you about to determine if you and possibly a family member fit the needs of our study. Our questions will only take a couple of minutes. May I start with the first question?
Public reporting burden of this collection of information is estimated to average 3-7 minutes per respondent, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, ad completing and reviewing the collection of information. As agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX)
1. First, do you, or any member of your household, work:
For a market research company _____
For an advertising agency or public relations firm _____
As a healthcare professional (a doctor, nurse, nutritionist, pharmacist, etc.) _____
[IF YES TO ANY >> TERMINATE]
NOTE: Use the following language to “terminate” throughout the screening process:
“We want to thank you for taking the time to answer our questions.” Unfortunately, the category that you (and your child) fall into is currently full. If it should open back up, may we call you back?”
Do you have any children in your household who are between 5 and 12 years old?
IF NO, THANKS AND TERMINATE
2A. Please tell me the first name of your child/children who is ___ (between 5-12) years old? [RECORD BELOW]
2B.
3. Please tell me the first name of your child/children who are __ or __ years old. [RECORD BELOW]
3A. . I’d like to ask you three other questions about _________________. Is ____________ a boy or girl?
3B. So that we can be sure that all backgrounds are represented in our study please tell me your child’s ethnicity and race. Would you describe him/her as;
Hispanic or Latino _____
Not Hispanic or Latino _____
Prefer not to answer _____
AND
Do you consider him/her to be (select one ore more):
American Indian or Alaska Native _____
Asian _____
Native Hawaiian or Other Pacific Islander _____
Black or African American _____
White _____
(Specify) ________________________ Other _____
Prefer not to answer _____
[RECORD BELOW]
Name |
Gender |
Age |
Ethnicity |
Race |
Child 1 |
|
|
|
|
Child 2 |
|
|
|
|
QUOTAS: MUST BE __ OR __ YEARS OLD TO QUALIFY
GROUPS ARE GENDER AND RACE SPECIFIC:
RECRUIT PARENTS OF BOYS AND BOYS ONLY FOR GROUPS _____
RECRUIT PARENTS OF GIRLS AND GIRLS ONLY FOR GROUPS _____
RECRUIT WHITES, NOT HISPANIC ONLY FOR GROUPS _____
RECRUIT AFRICAN-AMERICAN, NOT HISPANIC, ONLY FOR GROUPS ____
RECRUIT ONLY BLACK OR WHITE HISPANIC, FOR GROUPS ____
Note: If child does not identify with any of the grouping needed (White, African-American, or Black or White Hispanic) then thank and terminate.
4. Who in your household is most responsible for the menu planning, food preparation, and grocery shopping for your household?
Self _____
GET REFERRAL & ASK Q.4A >> Spouse or someone else _____
ASK Q.4A >> Shared equally with spouse or someone else _____
4A. How much input (or influence) would you say that you have in deciding what kinds of food your preschool and school-age children eat at home? Would you say that you…?
[READ ALL OPTIONS BEFORE RECORDING ONLY ONE]
Are the primary decision-maker _____
Share the decisions equally with your spouse _____
Share the decisions equally with your child _____
TERMINATE or GET REFERRAL > see box below > Those decisions are most often made by your spouse, child, or to someone else _____
If not qualified, read ….
“Thank you so much for answering our questions.
Unfortunately, the category you fall into is currently full. May I
speak with your (spouse or another adult
decision-maker) to see if he/she is interested in taking part in our
study?”
[If
“Yes”, speak with decision-maker & begin again].
[If
“No”, read…] “Thank
you again for taking the time to speak with us today. If the
category you fall into should open up, would you like us to call you
back?” (Yes) (No) circle one
5. Which of the following categories best describes your total, annual, household income before taxes? [NEED GOOD MIX OF LOWER TO MIDDLE CLASS INCOMES]
[ACTUAL INCOME AMOUNTS WILL VARY BY CITY]
Under $25,000 _____
$25,000 - $34,999 _____
$35,000 - $39,999 _____
$40,000 - $49,999 _____
$50,000 - $74,999 _____
$75,000 - $99,999 _____
$100,000 or greater _____
6. So that we can be sure that diverse backgrounds of parents are represented in our study, please tell me your ethnic origin and race. Would you say that you are… ?
[GROUPS ARE RACE SPECIFIC. CHECK QUOTAS]
Hispanic or Latino _____
Not Hispanic or Latino _____
Prefer not to answer _____
AND
Do you consider yourself to be (select one ore more):
American Indian or Alaska Native _____
Asian _____
Native Hawaiian or Other Pacific Islander _____
Black or African American _____
White _____
(Specify) ________________________ Other _____
Prefer not to answer _____
[Note: Since these groups are race specific, we cannot accept a parent and a child who are different races for these sessions. Check Q.2C & Q.3C against Q.6 to see that the child’s and the parent’s races agree]
Note: If parent does not identify any of the groupings neededi n the study, thank them for their time and terminate.
What school does your child attend?
___________________________ >> NEED GOOD MIX OF SCHOOLS IN EACH SESSION TO MINIMIZE PREVIOUS RELATIONSHIPS AMONG PARTICIPANTS
We want to be sensitive to children with special needs. Do you feel that your child has a special need that would make him or her uncomfortable participating in a small group discussion for 2 hours with kids his or her age?
TERMINATE >> Yes _____
CONTINUE >> No _____
Note: If yes, reply: We appreciate your time and interest, but given the setting and how this particular research is being conducted, it would probably be more appropriate if we do not ask you or your child to take time to do this. Thanks.
9. What is the highest level of education you personally have completed? [NEED GOOD MIX]
TERMINATE >> Less than high school graduate/some high school _____
High school graduate _____
Some college _____
College graduate _____
MAX. 1-2 PER GROUP >> Post graduate studies or degree _____
10. Have you ever attended a focus group discussion? By that we mean an informal, round-table discussion, conducted by a professional moderator, in which you were asked your opinions regarding a product, a service, or advertising?
ATTEMPT MAX. ½ GROUP >> ASK A-C >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 2 EVER]
What was/were the topics discussed?
______________________________
[IF NUTRITION-RELATED, GET SPECIFICS & HOLD FOR APPROVAL]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
As I mentioned earlier, we are conducting a study among preschool and school-age children and their parents regarding topics related to food and nutrition. If your child qualifies, would you (and your child) be interested in participating in this study? Please be assured that your (and child’s) opinions will be treated in a confidential manner. You will receive $50 and your child will receive $25 if you choose to participate. The discussion will last about 2 hours and will be both interesting and enjoyable. You will be in a group of adults while your child takes part in another discussion with other children his/her age. Would you be interested in participating with your child? If so, may I have your permission to ask your child a few questions now to determine his or her level of interest? If it works out, may I have permission to invite him or her to participate in the research?
Section 2: Child Screener
May I speak to your child for a minute to ask him/her a couple of questions?
[ASK CHILD Q.11 - 15]
Explain to the child that you have spoken to his parent and that the parent has given permission for him or her to talk to you. Explain that you are looking for people who might be interested in participating in a focus group in a few weeks. Next, ask if you may ask him or her a few questions.
11. How old are you? ______________ >> MUST BE _____
12. What school do you go to? __________________________ >> NEED MIX
[NOTE: CHILD’S ANSWERS SHOULD AGREE WITH PARENT’S IN Q.2, 2A & 2B, OR 3, 3A & 3B & Q.7] [IF NOT, ASK TO SPEAK TO PARENT AND THANK AND TERMINATE] (See box below)
13. This question is one you can have some fun with. There are no right or wrong answers. Please use your imagination and tell me… If you could be any character from TV, the movies, or from a book, who would it be and why do you feel that way?
________________________________________________________________________________________________________________________________________________________________________________________________________________________
[CHILD MUST BE FORTHCOMING, CONVERSATIONAL, AND RELATIVELY ARTICULATE TO BE INVITED. REGARDLESS OF ANSWER, CONTINUE ON AT THIS POINT.]
14. Have you ever attended a focus group discussion? By that, we mean a group discussion with several other young people your age when you were asked your opinions regarding a particular product (or some advertising) and were paid something for your time and opinions?
ATTEMPT MAX. ½ GROUP >> ASK A-C >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 2 EVER]
What was/were the topics discussed?
______________________________
[IF NUTRITION-RELATED, GET SPECIFICS & HOLD FOR APPROVAL]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
If child does not qualify,
read … “ Thank you for answering
our questions. Can I speak to your (mother/father) again for a
moment please?”
When parent comes to
phone, read, …..
“Thank you so much for taking the time today to
answer our questions and for letting us speak with your child.
Unfortunately, the category that you and your child fall into is
currently full. Should it open back up, would you like us to call
you back? (Yes) (No) circle one
CHECK QUOTAS CAREFULLY AND INVITE TO APPROPRIATE GROUP
[Child’s Invitation]
Thank you for answering our questions. We are conducting a project with young people and their parents about the foods we eat and would like to include your opinions. We would like to invite you to come to a group discussion with other youth your age on [date] and [time]. The group will last about two hours and will be a lot of fun. You will receive $25 if you choose to participate. No one will try to sell you anything. We only want to hear your opinions. We can only invite about 8 kids to come. Would you like to join us? (Yes) (No) circle one
IF “YES”, ASK TO SPEAK TO PARENT AND PROCEED TO INVITATION
IF “NO”, ASK TO SPEAK TO PARENT AND READ TEXT IN BOX BELOW
S
“Thank you for
taking the time to speak with us today and for answering our
questions. Unfortunately, your [son/daughter] has indicated that
he/she is not interested in attending. We do not want to make your
child feel uncomfortable, so we will not be able to include your
family in our research. Thanks you so much for your initial
interest. If you like, we will call you again for a future study.”
[Invitation for Parent/child]
We just spoke with your son/daughter and would like to invite you both to attend a group discussion on [date] at [time]. You will participate in a discussion with other adults and your child will take part in a discussion with other children his/her age. The discussions will last about 2 hours and will be conducted simultaneously. Just to remind you, you will receive $50 and your child will receive $25. No one will call on either you or your child as a result of your participation. We are not selling or promoting anything and your (and your child’s) responses will remain anonymous and will be treated in a confidential manner. Can we schedule your participation? If yes, …..
Remember both you and your child will need to attend on [date] to take part.
If parent accepts invitation, read ….
“When you arrive, you will receive 3 forms to be completed and signed. They are:
1. An adult consent form for you to sign.
2. A parent permission form for you to sign for your child’s participation
3. A youth assent form for your child to sign. You may want to read and explain this form to your child.
Please be sure that you and your child have signed the appropriate forms and remember to bring the completed form(s) with you to the group(s).
[Record Group] Parent: Group X _____ Child: Group X _____
CHILD’S NAME: _________________________________________________
PARENT’S NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) _____________________________________
(EVE) _____________________________________
(FAX) _____________________________________
(EMAIL) _____________________________________
----------------END OF PARENT-CHILD SCREENER ------------------------
File Type | application/msword |
File Title | APPENDIX D |
Author | rkg4 |
Last Modified By | Reba Prince Griffith |
File Modified | 2008-02-06 |
File Created | 2008-02-06 |