Evaluation of health communication messages for
Infertility Prevention Campaign
Attachment 3C
Focus Group Screener for Parents of Minors
Form approved
OMB no. 0920-XXXX
Expiration date xx/xx/20xx
Focus Group Screener for Parents of Minors
Infertility Prevention Campaign
Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time to respond to these questions. 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: PRA (0920-XXXX)
Group |
Description |
Number |
A |
15–17 year-olds, in school |
36* |
B |
15–17 year-olds, not in school |
36* |
*These figure allow for an over-recruit of ~30%
Notes for recruiters:
1) If at any point a parent requests specific information about the questions that will be asked of their daughter, read the following:
“CDC is exploring ways to communicate with young women about measures they can take now to protect their health and prevent infertility in the future, including STD prevention and testing. The purpose of this study is to help CDC understand how to communicate with young women about these measures.”
2) If the parent requests further details about selection criteria, etc., read the following:
“For this study we are recruiting a mix of young women between the ages of 15 and 25 with different backgrounds and a range of experience. As is standard practice in research, we must protect their confidentiality, so we will not be sharing why they were or were not selected, nor will we be sharing what they tell us.”
3) If the parent will not give permission with this information, thank them and terminate the interview. Should they request more information on the campaign or this research, they can contact the Principal Investigator at CDC:
Ms. Allison Friedman, Health Scientist
CDC
Building CPSQ, Mail Stop E44
Atlanta GA 30329-1902
Phone: 404-639-8537
Fax: 404-639-8622
Email: [email protected]
Hello, I’m ___________ with ____________, an independent consumer research firm. We are not selling or promoting any product or service. We are conducting a research study on behalf of the Centers for Disease Control and Prevention (CDC) about health issues for female teens.
Are you the parent or guardian of a 15–17 year-old girl?
( ) Yes Continue
[If yes] How old is your daughter? [Record response]________
( ) No Thank and terminate
The CDC is conducting focus groups to help prepare information for 15–17 year-old girls about measures they can take now to protect their health and prevent infertility in the future. The purpose of this study is to help CDC develop materials like posters and public service announcements towards this purpose. The focus groups will ask teens to give their opinions on how information is presented and whether it is easy to understand. The groups will be held at 5:30 p.m. or 7:30 p.m. on [Date] in [City] and will last about 2 hours. Refreshments will be served and all teens who participate will receive $75 when the group ends. These questions will only take a few moments to answer. Do you have time now to answer a few questions?
Would
you allow your daughter to participate in a maximum 2 hour focus
group discussion with up to 8 other young women and a researcher on
behalf of the CDC?
( ) Yes Continue
( ) No Thank and terminate
I will need to ask your teen a few questions before scheduling her to ensure that the CDC has a wide range of teens represented. But first, I would like to ask you a few questions.
Which of the following categories best describes your total annual household income?
( ) Less than $15,000 Continue
( ) $15,001 to $30,000 Continue
( ) $30,001 to $45,000 Continue
( ) $45,001 to $60,000 Continue
( ) $60,001 to $75,000 Continue
( ) More than $75,000 Continue
Recruit half above $45,000 and half below $45,000.
What is the highest level of education completed by the primary wage earner in your household?
( ) Less than high school Continue
( ) High school diploma or GED Continue
( ) Some college or trade school (including Associate’s degree) Continue
( ) Bachelor’s degree Continue
( ) Graduate degree Continue
Recruit a mix.
[Only ask during school year] Does your daughter currently attend high school or home school? [Note, GED program counts as “no”]
( ) Yes Continue
( ) No Continue
Recruit “Yes” for Group A.
Recruit “No” for Group B.
At this point, I would like to confirm that you give permission for your teen to participate in this research.
[Read “Parental Permission Form” and complete “Parental Permission”, then ask Q7.]
I will need to speak privately with your teen in order to ask her a few questions to determine whether she is eligible to participate in the focus group. If she is eligible, I will then schedule a time for her interview. Is your 15–17 year-old daughter available now for me to ask a few questions?
( ) Yes
[If Yes] May I speak with her now? Go to “Minor Screener”
( ) No
[If No] When would be a good time (or better phone number) for me to call back and speak with your daughter?
Record time to return call:__________________________
File Type | application/msword |
File Title | Mall Intercept Screener & Interview Guide (15-25) |
Author | aviskin |
Last Modified By | vbs6 |
File Modified | 2009-07-15 |
File Created | 2009-06-23 |