Focus Group Screener for Adult Women

Evaluation of health communication messages for

Infertility Prevention Campaign

Attachment 3E

Focus Group Screener for Adult Women

2/2/2021

Form approved

OMB no. 0920-XXXX

Expiration date xx/xx/20xx

Focus Group Screener for Adult Women

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)

Recruitment Objectives
Group 1	18-25 year old students	72*
Group 2	18-25 year old non-students	72*

*These figure allow for an over-recruit of ~30%

I’m _______________ with _____________________, an independent consumer research firm. I am conducting a research study on behalf of the Centers for Disease Control and Prevention (CDC) to help prepare information for women your age. The CDC is conducting focus groups to understand how to communicate with teens and young women about measures they can take now to protect their health and prevent infertility in the future. The focus groups will ask young women to give their opinions on how information is presented in materials like posters and public service announcements 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?

I’m going to ask you several health-related questions. Some of these questions may sound personal but this information will help me to ensure that the groups will include a lot of different people.

Note for Recruiters: Please use the following language for termination of screening:

“I’d like to thank you very much for your time today. We are looking to recruit a mix of young women from across the country to help with this study. Right now we are still in the process of recruitment, and if we need your help, we will call you back.”

1. What is your age? ____ Record Age

( ) under 18 Thank and terminate

( ) 18-25 Continue

( ) over 25 Thank and terminate

2. Have you participated in a market research study in the past 6 months, in which you were paid to provide your opinions regarding a product, a service, or advertising on the topic of STDs or sexual/reproductive health?

( ) Yes Thank and terminate

( ) No Continue

3. Have you ever, or do you currently work or volunteer in the field of sexual or reproductive

health?

( ) Yes Terminate

( ) No Continue

4. Do you feel comfortable responding to materials that require a 7^th grade reading level?

( ) Yes Continue

( ) No Terminate

Question	Yes	No
1. Have you ever had a pelvic exam or Pap test?
2. Have you ever asked to be tested for a sexually transmitted disease (STD)?
3. Have you ever had sexual intercourse?

Thank and terminate only if “no” to all.

[*ONLY if asked for a definition: “Sexual intercourse” refers to sexual activity when a penis is put inside a vagina.]

6. Are you Hispanic/Latina?

( ) Yes Continue

( ) No Continue

( ) Don’t Know Terminate

7. Are you . . . ?

( ) African American/Black Continue

( ) Caucasian/White Continue

( ) Asian Ask #8, then Thank and terminate

( ) Native American Ask #8, then Thank and terminate

( ) Refused to answer Terminate

Recruit one-third each of Hispanic, African American, and Caucasian.

8. Tell me a little bit about a good movie or TV show that you’ve seen recently—what was the movie or TV show, and what did you like about it?

[Note: This question is intended to establish whether the respondent is reasonably articulate, fluent in English, and willing to converse. If respondent has a strong accent, difficulty speaking English, serious speech impediment or has trouble communicating (e.g., “shuts down”), thank and terminate.]

9. When was the last time you visited a doctor or nurse (this does not include visits to the dentist, optometrist, or psychologist)?

( ) Within last six months Continue

( ) Within last year Continue

( ) Between one and two years ago Continue

( ) More than two years ago Continue

Recruit a mix.

10. What type of health care provider did you see?

( ) General practitioner/Internist Continue

( ) OB/GYN Continue

( ) Medical specialist other than GYN Continue

( ) Nurse practitioner Continue

( ) Nurse Continue

( ) Other [Record]: ____________________

So that we can be sure that all backgrounds are represented in our study, please help me by answering the following questions.

11. Are you currently enrolled in college or trade school?

( ) Yes Skip to Q #13

( ) No Continue to #12

Recruit “Yes” for Group 1.

Recruit “No” for Group 2.

12. [Only if not enrolled in school] Do you currently work full or part time?

( ) Work full time Continue

( ) Work part time Continue

( ) Do not work Continue

For Group 2: Recruit a mix.

13. Do you currently live with your parents or guardians?

( ) Yes Continue

( ) No Continue

Recruit a mix.

14. [If living with parents] Think of the person who is the main source of income in your household. What is that person’s occupation?

[If not living with parents] Think of the person who was the main source of income when you were growing up. What is that person’s occupation?

[Check category corresponding to occupation given. Read list below if respondent is unsure or asks for clarification]

Occupation	Examples	(Check Box)
Management, professional, or related	Manager, doctor, lawyer, accountant, human resources staff
Service	Waiter, hair dresser, flight attendant, child care, chef, hotel staff
Sales or office	Cashier, realtor, administrative assistant, data entry clerk, mail carrier/post office
Farming, fishing or forestry	Farmer, park ranger, logger
Construction, extraction, or maintenance	Carpenter, electrician, janitor, housekeeper, pest control
Production, transportation, or moving	Pilot, bus or truck driver, deliveryman, EMT, cab driver
Manufacturing	Assembly worker, food inspectors
Other

Recruit participants from at least three categories.

15. At this point, I am going to read you a short description of the project, and I will need you to confirm that you want to participate.

[Read and complete “Adult Informed Consent”]

6

Focus Group Screeners