2 Screener focusgroup

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

Attachment4_Screener_focusgroup

HRSA Division of Transplantation Qualitative Assessment of Outreach Materials

OMB: 0915-0212

Document [doc]
Download: doc | pdf

Screener

HRSA Focus Groups Related to Organ Donation


Summary of recruiting specifications

Mix of men and women

Support organ donation

Are not registered organ donors (exception is professional audiences, who should be registered)

Mix of educational levels

Do not work in the field of market research or related to organ donation

Have not been in a focus group in the past six months

Meet specific demographic criteria for each group type (see table at end of screener)



(RECRUIT NUMBER NEEDED FOR 10 TO SHOW)


1. Thank you for your interest in this project. We are recruiting people to attend a focus group that will take place in [place] from [time] on [date]. All participants will be paid $75 for their time. If you are eligible for the study, would you be interested in participating?

  1. Yes (CONTINUE)

  2. No (THANK AND END)


Note whether respondent is male or female and recruit a mix.

  1. Male

  2. Female


2. To begin, thinking about organ donation, do you do you strongly support, support, oppose, or strongly oppose organ donation?

  1. Strongly support (CONTINUE)

  2. Support (CONTINUE)

  3. Oppose (THANK AND END)

  4. Strongly Oppose (THANK AND END)


3. Are you a registered organ donor, either by registering on your driver’s license, a donor card, or an organ donor registry?

  1. Yes (THANK AND END) [REVERSE FOR PROF AUD—ALL SHOULD BE REGISTERED]

  2. No (CONTINUE)


4. Now, I need to ask you some basic information. Which category best describes your age?

  1. Under 21 (THANK AND END)

  2. 21–35 (CONTINUE) [QUALIFIES FOR YOUNG ADULT GROUP; max of 2 for most groups, see chart]

  3. 36–49 (CONTINUE)

  4. 50–65 (CONTINUE) [QUALIFIES FOR 50+; max of 2 for most groups, see chart]

  5. 66 or older (CONTINUE) [QUALIFIES FOR 50+; max of 2 for 50+group]

Recruit a mix of ages.


5. What is the highest grade you have completed in school? [READ LIST IF NECESSARY]

  1. 8th grade or less (CONTINUE)

  2. Some high school (grades 9, 10, or 11) (CONTINUE)

  3. High school graduate or GED (High school equivalency) (CONTINUE)

  4. Some college/2-year college/technical school/associate degree (CONTINUE)

  5. College graduate (CONTINUE)

  6. Some graduate school/post-graduate degree (CONTINUE)

Recruit a mix of education levels.


6. We want to make sure we represent different ethnic and racial groups in our study. Would you describe yourself as… ?

  1. Hispanic or Latino/Latina (CONTINUE)

  2. Not Hispanic or Latino/Latina (CONTINUE)


(If Hispanic)

At home do you primarily speak:

  1. English (CONTINUE) [QUALIFIES FOR ENGLISH HISPANIC GROUP]

  2. Spanish (CONTINUE) [QUALIFIES FOR SPANISH HISPANIC GROUP]


7. Next, would you describe yourself as…?

  1. White (CONTINUE)

  2. Black or African American (CONTINUE) [QUALIFIES FOR AFRICAN AMERICAN GROUP]

  3. American Indian or Alaskan Native (CONTINUE) [QUALIFIES FOR ANHOPI GROUP]

  4. Asian (CONTINUE) [QUALIFIES FOR ANHOPI GROUP]

  5. Native Hawaiian or Other Pacific Islander (CONTINUE) [QUALIFIES FOR ANHOPI GROUP]


Recruit a mix of ethnic and racial backgrounds.


8. What is your present occupation? ___________________

  1. Related to organ donation (THANK AND END)

  2. Market research (THANK AND END)

  3. Medical professional [QUALIFIES FOR PROFESSIONAL GROUP ONLY]

  4. Teacher [QUALIFIES FOR PROFESSIONAL GROUP ONLY]

  5. Clergy/religious leader [QUALIFIES FOR PROFESSIONAL GROUP ONLY]

  6. All others (CONTINUE)


9. Have you ever participated in a focus group or been paid to be part of a discussion group?

  1. Yes (CONTINUE)

  2. No (SKIP TO Q12)


10. How recently did you participate in this focus group or discussion group?

  1. Within the past six months (THANK AND END)

  2. More than six months ago (CONTINUE)


11. Thank you. We are conducting an informal group discussion on issues related to organ donation, and your views would be valuable in helping us better understand this issue. The discussion will take place in [place] on [date] at [time]. The discussion will last two hours, and there will be no attempt to sell you anything or convince you to register as a donor. We are simply interested in your opinions. We will pay you $75 as a way of thanking you for participating. Would you be interested in attending?

  1. No (THANK AND END)

  2. Yes (CONTINUE)


12. Great! We would like to send you a message to confirm your participation in this study, and we will also call you the day before to remind you. Can you please provide me with your …?

NAME:

E-MAIL ADDRESS:

PHONE NO:

** Double check spelling of name and read back phone and e-mail to confirm ***


13. It is very important that you let us know right away if you will not be able to attend this discussion so that we may have time to find a replacement. Will you call us at [phone] if for some reason you cannot attend? [WAIT FOR AN ANSWER]


14. Finally, can you please let me know where you heard about this project? _________________________________________________________________________


Thank you for your time and for agreeing to participate. We look forward to seeing you!

Recruiting table: Group type x Screening Criteria


Gender

Reg Donor

Age

Race

Occupation

General Public

Mix

No

Mix, but limit 2 50+ and limit 2 21-35 (at least half qualify only this group)

Mix

No organ or mrkt research

Hispanic English

Mix

No

Mix, but limit 2 50+ and limit 2 21-35

Hispanic

No organ or mrkt research

Hispanic Spanish

Mix

No

Mix, but limit 2 50+ and limit 2 21-35

Hispanic

No organ or mrkt research

African American

Mix

No

Mix, but limit 2 50+ and limit 2 21-35

AA

No organ or mrkt research

ANHOPI

Mix

No

Mix, but limit 2 50+ and limit 2 21-35

ANHOPI

No organ or mrkt research

Young adult

Mix

No

21-35

Mix

No organ or mrkt research

50+

Mix

No

50+, but limit 2 65+

Mix

No organ or mrkt research

Prof. audience

Mix

Yes

Mix

Mix

Health, teacher, clergy


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File Typeapplication/msword
File TitleFocus Group Screener
AuthorChristine Brittle
Last Modified ByRMaldonado
File Modified2012-01-26
File Created2011-11-07

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