Form Approved
OMB No. 0990-0281
Exp. Date XX/XX/20XX
Childhood Obesity Prevention Communications Campaign Research
Children ages 8-12
Online Consumer Survey
SAMPLE:
n = 1000
Boys and girls – balanced across gender
8-12 years old- balanced across ages
QUOTAS:
Gender |
Age |
|
Sample Size |
||
Girls |
8 |
100 |
9 |
100 |
|
10 |
100 |
|
11 |
100 |
|
12 |
100 |
|
Boys |
8 |
100 |
9 |
100 |
|
10 |
100 |
|
11 |
100 |
|
12 |
100 |
Ethnicity |
Sample Size |
African- American |
200 |
Hispanic |
200 |
Caucasian or other |
600 |
Region |
Sample Size |
Northeast |
170 |
South |
369 |
Midwest |
220 |
West |
241 |
Income |
Sample Size |
< $35,000 |
303 |
$35,000-$74,999 |
330 |
$75,000 + |
367 |
Prefer not to answer |
1000 |
EXCLUDE SAMPLE THAT DOES NOT HAVE PARENT EDUCATION DATA OR INCOME DATA.
INTRO PAGE
Thanks for participating in this survey!
Once you complete this survey you will earn 50 KidzPoints!
Please click on CONTINUE to begin.
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TYPE: CHOICE
How important is it to you to eat healthy foods everyday? “Healthy foods” are foods like yogurt, milk, whole grains, fruits, and vegetables.
Very important
Somewhat important
Not very important
Not important at all
IF QUOTAS ARE FULL, TERM AFTER THEY ANSWER Q1, OTHERWISE THEY GO TO THE QUALIFICATION PAGE.
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QUALIFICATION PAGE
You have qualified to take the remainder of this survey. Once you complete it we will add an additional 100 KidzPoints for a total of 150 KidzPoints!
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TYPE: GRID
LOGIC: RANDOMIZE LIST
Does eating healthy foods help you. . .? Just a reminder, “healthy foods” are foods like yogurt, milk, whole grains, fruits, and vegetables.
|
Yes |
No |
Not Sure |
Do better in school |
|
|
|
Tell funnier jokes |
|
|
|
Have more energy to play |
|
|
|
Be healthier |
|
|
|
Have a stronger body |
|
|
|
Have more fun |
|
|
|
Be more like an action hero |
|
|
|
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TYPE: GRID
LOGIC: RANDOMIZE LIST. ALWAYS SHOW “OTHER VEGETABLES” LISTED UNDER “GREEN VEGETABLES”
In
a typical week, how often would you say you eat or drink the
following?
|
5-7 days a week |
3 or 4 days a week |
1 or 2 days a week |
1 or 2 days a month |
Hardly ever |
I never eat or drink this |
Soda |
|
|
|
|
|
|
Milk |
|
|
|
|
|
|
Water |
|
|
|
|
|
|
Sports Drinks (like Gatorade, Powerade, Vitamin Water, etc.) |
|
|
|
|
|
|
Fast Food (like Taco Bell, McDonalds or Burger King, etc.) |
|
|
|
|
|
|
Fruit (like apples, grapes, oranges, etc.) |
|
|
|
|
|
|
Whole Grains (like wheat bread, oatmeal, etc.) |
|
|
|
|
|
|
Salty Snacks (like potato chips, cheese puffs, etc.) |
|
|
|
|
|
|
Green Vegetables (like broccoli, spinach, green peppers, etc.) |
|
|
|
|
|
|
Other Vegetables (like carrots, corn, etc.) |
|
|
|
|
|
|
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TYPE: GRID
LOGIC: RANDOMIZE LIST.
And how many times a day would you say you ordinarily eat or drink the following?
|
0 Times a Day (none) |
1 time per day |
2 times per day |
3 times per day |
4 times per day |
5 or more times per day |
Fruit (like apples, grapes, oranges, etc.) |
|
|
|
|
|
|
Whole Grains (like Wheat Bread, oatmeal, etc.) |
|
|
|
|
|
|
Vegetables (like broccoli, carrots, corn, etc.) |
|
|
|
|
|
|
Milk |
|
|
|
|
|
|
Water |
|
|
|
|
|
|
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TYPE: CHOICE
How important is it to you to be physically active every day? “Being physically active” means doing things like walking, playing outside, dancing, playing sports, or other activities.
Very important
Somewhat important
Not very important
Not important at all
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LOGIC: RANDOMIZE LIST
How much do you agree or disagree with each statement below?
|
Really agree |
Sort of agree |
Sort of disagree |
Really disagree |
I’d rather watch TV or play video games than do physical activities |
|
|
|
|
I should probably do more physical activities than I do |
|
|
|
|
Being physically active is fun |
|
|
|
|
Eating healthy food helps bring out the best in me |
|
|
|
|
I should probably eat more healthy foods than I do |
|
|
|
|
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TYPE: CHOICE
None
Less than 30 minutes
30 minutes - 1 hour
1 – 2 hours
2 – 3 hours
More than 3 hours
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TYPE: CHOICE
None
Less than 30 minutes
30 minutes - 1 hour
1 – 2 hours
2 – 3 hours
More than 3 hours
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TYPE: CHOICE
To be healthy, how much time do you think you should spend running around and playing every day?
20 minutes
40 minutes
1 hour
2 hours
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Next, we’re going to show you some commercials, which you might see on television.
We’re going to show you 4 different commercials, and we’re going to ask you a question about each one.
PLEASE MAKE SURE THE VOLUME ON YOUR COMPUTER/SPEAKERS IS TURNED UP!
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RANDOMIZE
THE ORDER IN WHICH THE ADS ARE SHOWN. SHOW FULL-SCREEN SIZE. SHOW THE
AD AND ASK Q9 BEFORE SHOWING THE NEXT AD.
AD 1
AD 2
AD 3
AD 4
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Please look carefully at this [INSERT: FIRST/SECOND/THIRD/FOURTH] commercial. Then click continue.
SHOW AD HERE
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TYPE: CHOICE
Before today, have you ever seen the TV commercial we just showed you?
Yes
No
Don’t know
ONCE ALL 4 ADS ARE SHOWN, AND Q9 IS ASKED FOR EACH, THEN ASK Q9A (SO Q9A ONLY GETS ASKED ONCE).
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9a. TYPE: CHOICE
Were you able to hear and see ALL 4 commercials?
Yes
No
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Now we would like to play you some commercials, which you might hear on the radio.
We’re going to play 2 different commercials, and we’re going to ask you a question about each one.
PLEASE MAKE SURE THE VOLUME ON YOUR COMPUTER/SPEAKERS IS TURNED UP!
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RANDOMIZE THE ORDER IN WHICH THE ADS ARE PLAYED. PLAY THE AD AND ASK Q10 BEFORE PLAYING THE NEXT AD.
RADIO AD 1
RADIO AD 2
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Please listen carefully to this [INSERT FIRST/SECOND] commercial. Then click Continue.
[AD PLAYS ON THIS PAGE]
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TYPE: CHOICE
Before today, have you ever heard the radio commercial we just played for you?
Yes
No
Don’t know
ONCE BOTH ADS ARE PLAYED, AND Q10 IS ASKED FOR EACH, THEN ASK 10A (ONLY ASK 10A ONCE).
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10a. TYPE: CHOICE
Were you able to hear BOTH radio commercials?
Yes
No
Don’t know
TRACKING VARIABLE:
“HAD AUDIO OR VIDEO TROUBLES” = RESPONDENT SELECTS “NO” AT Q9A AND/OR Q10A
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Now we would like to show you some ads, which you might see on a website.
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RANDOMIZE THE ORDER IN WHICH THE ADS ARE SHOWN. SHOW THE AD AND ASK Q11 BEFORE SHOWING THE NEXT AD.
BANNER AD 1 =
BANNER AD 2 =
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[SHOW IMAGE ON THIS PAGE]
TYPE: CHOICE.
Before today, have you ever seen this ad on a website?
Yes
No
Don’t know
11A. TYPE: CHOICE.
NOTE – THIS QUESTION IS TO MEASURE AWARENESS OF A CAMPAIGN LOGO (e.g. GAME logo or the Presidential Active Lifestyle Award (PALA +)
Before today, have you seen anything like this image on TV, in school, in the store, in a magazine or anywhere else?
Yes
No
Don’t know
ONCE BOTH ADS ARE SHOWN, AND Q11 IS ASKED FOR EACH, THEN ASK Q12
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TYPE: CHOICE
“The Greatest Action Movie Ever” is a series of ads about eating healthy food and being physically active which may be seen on TV, at school, in a magazine, on a website or heard on the radio. The commercials you just saw are part of “The Greatest Action Movie Ever.”
Before this survey, have you ever seen or heard something about “The Greatest Action Movie Ever”?
Yes
No
Don’t know
IF ANSWERED “YES” AT Q12, ASK Q13.
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TYPE: MULTI-CHOICE
LOGIC: RANDOMIZE LIST. ANCHOR I DON’T REMEMBER
Please tell us how you have seen or heard about “The Greatest Action Movie Ever” (which includes the commercials). You can choose more than 1 answer.
On TV
At school
In a magazine
Website
On the Radio
At the store or supermarket
I don’t remember
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14a. TYPE: CHOICE
Before today, have you ever heard of the website ActionHeroAlliance.com?
Yes
No
Don’t know
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14b. TYPE: CHOICE
Before today, have you ever heard of the website PresidentsChallenge.org or Fitness.gov (determine appropriate website via HHS)?
Yes
No
Don’t know
15. TYPE: DROPDOWN LISTS- ONE FOR FEET AND ONE FOR INCHES BOTH ON ONE SCREEN
How tall are you? If you aren’t sure about your height, please feel free to ask an adult to help you.
Height in Feet ________
Height in Inches ________
Prefer not to answer
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TYPE: DROPDOWN LIST
How much do you weigh? If you aren’t sure about your weight, please feel free to ask an adult to help you or give your best estimate.
Lbs_______
Prefer not to answer
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THAT’S ALL! Thanks for taking our survey! We hope you enjoyed it! Please click on the button below to receive 150 KidzPoints for helping us on this survey. Be sure to check your email often to look for new surveys where you can earn more KidzPoints and get more ca$h!!
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THAT’S ALL! Thanks for taking our survey! We hope you enjoyed it! Please click on the button below to receive 50 KidzPoints for helping us on this survey. Be sure to check your email often to look for new surveys where you can earn more KidzPoints and get more ca$h!!
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According to the Paperwork Reduction Act of 1995, no persons are 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 0990-0379 . The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | JaneM |
| File Modified | 0000-00-00 |
| File Created | 2021-02-04 |