Focus group screener - Family and Cultural Impact

“Family and Cultural Impact on STD and HIV Risk among Latino and African-American Youth”

Attachment 1a. Focus Group Screener

Form Approved

OMB No. 0920-0840

Expiration Date 01/31/2013

“Family and Cultural Impact on STD and HIV Risk among Latino and African-American Youth”

Focus Group Screener

Public reporting burden of this collection of information is estimated to average 7 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. An 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: OMB-PRA (0920-0840)

PHONE SCRIPT for PROJECT FACTS

Research Staff: If receiving a call, read:

Hello, this is _________. How can I help you?

If caller is calling about FACTS, start reading at the asterisks**

Research staff: If returning a call, read:

Hello, can I speak to [insert name of mom].

My name is _______ I received your message that you are interested in RECEIVING INFORMATION ABOUT the FACTS Project.

**Project FACTS is a Family Health research project at Cal State University Dominguez Hills. Is now a good time to ask you a few questions to see if you are eligible to participate in the study? It will only take about 5-10 minutes.

IF NO: Thank caller and ask for a good time to call back and obtain a call back number: (_____) _________________.

IF YES: Proceed with screening questions

What is your race/ethnic background? _________________________________

Are you a parent of a child or children between the ages of 12 to 15 years old that goes to Boys and Girls Club Activities?

IF NO: [Read] Thank you for your time. Unfortunately, you are not eligible to participate in the study. But we appreciate you taking the time to talk to us. Have a good day!

IF YES: [Read] What is/are the name/s of the child/ren between 12-15 years old? What is/are the gender/s and has she or he lived with you for half of the time in the past 2 years? [Write answers in box below]

Name of Child	___________	___________	___________	___________
Age of Child	______Years	______Years	______Years	______Years
Gender of Child	Male/Female	Male/Female	Male/Female	Male/Female
Has child lived with you half the time in the past 2 years?	Yes / No	Yes / No	Yes / No	Yes / No

Research Staff:

Proceed ONLY if there the caller has lived with child/ren half the time in the past 2 years AND if there are spaces left for the child’s gender.

If caller is ELIGIBLE read at *! below.

If caller NOT ELIGLE read:

Thank you for your time. Unfortunately, you are not eligible to participate in the study. But we appreciate you taking the time to talk to us. Have a good day!

*!. You are eligible to take part in this study, let me tell you a little more about what we are doing. Project FACTS is a Family Health study at Cal State University, Dominguez Hills. In this project we are talking to parents to learn about how they communicate with their children about sex. If you choose to participate in this study, you will be asked to be part of a 60 to 90 minute focus group with up to 11 other moms (a focus group is small meeting in a room). The questions for discussion will focus on how family and culture influences you on how you talk to your child/ren about sex. Information that you provide this study will be kept secure by the research staff. Participation in this study is completely voluntary. The focus groups will be tape recorded. All of the focus groups will take place on the campus of California State University, Dominguez Hills on a Saturday morning. Each participant will receive a token of appreciation of $50 in cash.

Are you interested in participating?

IF NO: [Read] Thank you for your time. If you change your mind, please feel free to call us back anytime. Have a good day!

IF YES: [Read] Thank you! We have a few more questions to ask in order to place you in a focus group.

1. What's your name? ___________________________________________

2. Have you called the study before? Y N

3. How did you hear about our study?

_______________________________________________________

4. These are some dates and times for taking part in the focus group.

Date 1: Date 2: Date 3: Date 4:

Time 1: Time 2: Time 3: Time 4:

Are any of these good for you?

IF NO: [Read]

Thank you for your time. Unfortunately, DUE TO YOUR AVAILABILITY, YOU WILL NOT BE ABLE TO TAKE PART IN THIS STUDY. But we appreciate you taking the time to talk to us. Have a good day!

IF YES: Circle the dates and times that works for them.

5. As soon as we place you in a focus group we will call you to make sure that this date still works for you. Please give me a good number to reach you at. (_____)____________________.

6. Now I need to give you directions on how to get to the study. Please grab a pen and a piece of paper.

7. Are there any questions you have for me?

IF NO: [Read] Thank you for agreeing to participate in this study. We will be calling you soon!

IF YES: [Answer questions]

[Read] Thank you for agreeing to participate in this study. We will be calling you soon!