Core Nutrition Messages - Revised

Generic Clearance to Conduct Formative Research

A - FNS screener_mothers form 8-11-10

Core Nutrition Messages - Revised

OMB: 0584-0524

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OMB BURDEN STATEMENT: 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 0584-0524. The time to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information and signing confidentiality agreements.

USDA/FNS

Triad Screening Questionnaire – Low-Income Mothers

October 2010

Birmingham, AL; Dallas, TX; Chicago, IL

RESEARCH CONTACT: Radha Rajan at 202-973-3617 or [email protected]


SPECS:

  • Six, 90-minute triads with low-income mothers per location:

    • Child feeding practices group: “Amenable” moms of non-school aged children (i.e., 2-5 years of age and not yet in kindergarten) that strongly disagree with the statement “It is important for preschool children to eat at every meal, even if they say they are not hungry” – (1 group per location)

    • Child feeding practices group: “Less assured” moms of non-school aged children (i.e., 2-5 years of age and not yet in kindergarten) that somewhat disagree, neither agree not disagree or somewhat agree with the child feeding practices statement “It is important for preschool children to eat at every meal, even if they say they are not hungry” – (1 group per location)

    • Milk and whole grains groups: Moms of non-school aged children (i.e., 2-5 years of age and not yet in kindergarten) – (2 groups per location)

    • Milk and whole grains groups: Moms with at least one child in elementary school, up to 10 years of age – (2 groups per location)

  • Recruit 5 for 3 to show (seat) at each group.

  • Each woman must be in a low income household (see Q14 and Q15); at least half must participate in one or more nutrition programs, such as WIC, SNAP, etc. (Q24).

  • All respondents must speak English.

  • All respondents must be outgoing, responsive, articulate, willing and able to read and react to written materials, and must be willing to speak openly in a group.


PLEASE SCHEDULE/RECRUIT RESPONDENTS AS FOLLOWS:


GROUP

DATE*

TIME

LOCATION

[ ]

Group A: “Amenable” low-income mothers (Room TBD)

TBD

TBD

Birmingham, AL

[ ]

Group 1: low-income mothers of non-school aged children (Room TBD)

TBD

TBD

Birmingham, AL

[ ]

Group B: “Less assured” low-income mothers (Room TBD)

TBD

TBD

Birmingham, AL

[ ]

Group 2: low-income mothers of non-school aged children (Room TBD)

TBD

TBD

Birmingham, AL

[ ]

Group 3: low-income mothers of elementary school aged children (Room TBD)

TBD

TBD

Birmingham, AL

[ ]

Group 4: low-income mothers of elementary school aged children (Room TBD)

TBD

TBD

Birmingham, AL

[ ]

Group C: Amenable” low-income mothers (Room TBD)

TBD

TBD

Dallas, TX

[ ]

Group 5: low-income mothers of non-school aged children (Room TBD)

TBD

TBD

Dallas, TX

[ ]

Group D: “Less assured” low-income mothers (Room TBD)

TBD

TBD

Dallas, TX

[ ]

Group 6: low-income mothers of non-school aged children (Room TBD)

TBD

TBD

Dallas, TX

[ ]

Group 7: low-income mothers of elementary school aged children (Room TBD)

TBD

TBD

Dallas, TX

[ ]

Group 8: low-income mothers of elementary school aged children (Room TBD)

TBD

TBD

Dallas, TX

[ ]

Group E: Amenable” low-income mothers (Room TBD)

TBD

TBD

Chicago, IL

[ ]

Group 9: low-income mothers of non-school aged children (Room TBD)

TBD

TBD

Chicago, IL

[ ]

Group F: “Less assured” low-income mothers (Room TBD)

TBD

TBD

Chicago, IL

[ ]

Group 10: low-income mothers of non-school aged children (Room TBD)

TBD

TBD

Chicago, IL

[ ]

Group 11: low-income mothers of elementary school aged children (Room TBD)

TBD

TBD

Chicago, IL

[ ]

Group 12: low-income mothers of elementary school aged children (Room TBD)

TBD

TBD

Chicago, IL


[LETTERED GROUPS = CHILD FEEDING PRACTICES SESSIONS]

Hello, my name is _____with______. We are conducting a study about nutrition on behalf of the United States Department of Agriculture’s, Food and Nutrition Service, which is part of the federal government, and I would like to ask you a few questions. I’m not trying to sell you anything. We would like to invite a number of women in your area to participate in a focus group to help us understand more about what they think about nutrition and health. May I speak to the female head of household? This should only take a few minutes. ONCE HEAD OF HOUSEHOLD ON PHONE, REPEAT INTRODUCTION AND READ OMB STATEMENT (see top of screener).

  1. Record Gender—DO NOT ASK UNLESS UNABLE TO TELL.


Female……

[ ]

Continue

Male ……..

[ ]

Terminate


  1. Do you, or does anyone in your household, work for a radio station, television station, newspaper, market research company, advertising or public relations company?


Yes……

[ ]

Terminate

No……..

[ ]

Continue


  1. Do you have any children under age 19 living at home?


Yes…………

[ ]

Continue

No …….…..

[ ]

Terminate


  1. How old are your children? [check all that apply]


Under 2…………

[ ]


2-5 years old.…..

[ ]

If one of these is checked, continue. If not, terminate.

6-10 years old.….

[ ]

11 and up…...…..

[ ]



  1. [If child is between the ages of 2-5, ASK] Is your child in Kindergarten?


Yes……………….

[ ]

Recruit for older group

No.………………

[ ]

Recruit for younger group


  1. [If child is between the ages of 6-10, ASK] What grade is your child in?


____________ [Record answer] Recruit for older group


  1. Do you or does anyone in your household work in any of the following industries? [Record each “yes” response.]



Yes


Healthcare/Medical………………………………

[ ]

Terminate if “YES” to any

Nutrition/Food Service……..……………………

[ ]

Fitness……..……………………………………..

[ ]

Dairy farm/Dairy Council/Food manufacturing…

[ ]

School Food Service…………….…………….…

[ ]

Food/Nutrition Assistance Programs…………….

[ ]


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


Yes……..………………

[ ]

Continue

No………………………

[ ]

Skip to Q10



  1. How recently did you participate in a focus group?

Less than 6 months ago

[ ]

Terminate

6 months ago or longer

[ ]

Continue



  1. Generally speaking, do you consider yourself to be an “expert” in nutrition?


No………………….

[ ]

Continue

Yes …….…….……

[ ]

Terminate

Don’t know/Refused...

[ ]

Terminate


  1. Do you or your child(ren) have any health condition where you have to eat a special diet, cannot eat certain foods or have a diet prescribed by your doctor?


No………………….

[ ]

Continue

Yes …….…….……

[ ]

Terminate


  1. Are you a vegetarian or vegan?


No………………….

[ ]

Continue

Yes …….…….……

[ ]

Terminate


  1. Who does most of the grocery shopping or makes the shopping lists in your household? [DO NOT READ RESPONSES]


You…………………………

[ ]

Continue

Someone else…….…….……

[ ]

Terminate

  1. Including yourself, how many people currently live in your household?


__________ [Record answer]


  1. What is your total annual household income? [Do not read list]


Less than $20,000…………

1

Record number below

$20,000 - $27,000…………

2

Record number below

$27,001 - $34,000…………

3

Record number below

$34,001 - $40,000…………

4

Record number below

$40,001 - $47,000…………

5

Record number below

$47,001 - $54,000…………

6

Record number below

$54,001 - $61,000…………

7

Record number below

$61,001 - $68,000…………

8

Record number below

More than $68,000………..

[ ]

Terminate

Don’t know/Refused ……...

[ ]

Terminate


Answer to question 14: ____________ Answer to question 15: _______________


Accept respondent if he/she falls into one of the following categories:


___ Has 1 person in household (Q14), and answer to Q15 is 1.

___ Has 2 people in household (Q14), and answer to Q15 is 1 or 2.

___ Has 3 people in household (Q14), and answer to Q15 is 1, 2, or 3

___ Has 4 people in household (Q14), and answer to Q15 is 1, 2, 3, or 4

___ Has 5 people in household (Q14), and answer to Q15 is 1, 2, 3, 4, or 5.

___ Has 6 people in household (Q14), and answer to Q15 is 1, 2, 3, 4, 5, or 6.

___ Has 7 people in household (Q14), and answer to Q15 is 1, 2, 3, 4, 5, 6, or 7.

___ Has 8+ people in household (Q14), and answer to Q15 is 1, 2, 3, 4, 5, 6, 7, or 8.


[INTERVIEWER, RECORD WHICH CATEGORY RESPONDENT FALLS INTO]


[ASK ONLY OF MOMS OF KIDS AGES 2-5, WHO ARE NOT IN SCHOOL]

  1. Now I’m going to read four statements and I would like you to tell me how much you disagree or agree with each one. Please use a scale from 1 to 5 where 1 means strongly disagree, 2 means disagree, 3 is neutral, 4 means agree and 5 means strongly agree. [Record one answer for each statement. Repeat scale if necessary]



Strongly disagree

Disagree

Neutral

Agree

Strongly agree

a.) Healthy eating is very important to me.

1

2

3

4

5

b.) It is important for preschool children to eat at every meal, even if they say they are not hungry

1

2

3

4

5

c.) I prefer food that I can eat “on the go”

1

2

3

4

5


Amenable” mom if Q16b = 1 AND responded “Yes” to Q5 (non-school aged child, 2-5 years old)

Less assured” mom if Q16b = 2 or 3 or 4 AND responded “Yes” to Q5 (non-school aged child, 2-5 years old)


_____ Check here if respondent qualifies as “Amenable” mom

_____ Check here if respondent qualifies as “Less assured” mom


**POTENTIALLY RECRUIT for lettered groups if check for at least one of the above.**


[ASK EVERYONE]

  1. What is your current age? [Do not read list]


Under 18…………

[ ]

Terminate

18-34 …….……...

[ ]

Record

35-50…….………

[ ]

50+ ……...............

[ ]

Terminate


  1. Are you of Hispanic or Latino origin?


No………………….

[ ]

Continue

Yes …….…….……

[ ]

Continue


  1. What is your race? (READ LIST. ACCEPT MULTIPLE ANSWERS.)


American Indian or Alaska Native………...

[ ]


Asian ….…….…………………………….

[ ]


Black or African American …….………

[ ]


Native Hawaiian or Other Pacific Islander..

[ ]


White………………………………………

[ ]

Recruit no more than 2*

*Using questions 18 and 19, recruit no more than 2 white, non-Hispanic respondents for each group. The remaining 3 recruits can be any mix of other races, but should not all be of one racial or ethnic group.



  1. What is the highest level of education you have completed? [Do not read list]


High school graduate or less.…….……...

[ ]

Recruit a mix

Some college, vocational or technical school………………………………........


[ ]

College graduate………………………...

[ ]

Recruit no more than 2

Post graduate education (e.g., Master’s degree, MBA, law degree, PhD)………...

[ ]

Terminate



  1. How comfortable would you be reading an information pamphlet that is written in English and telling someone what you think about it?

Very comfortable.…….……………..

[ ]

Continue

Somewhat comfortable………………


[ ]

Continue

Somewhat uncomfortable……………

[ ]

Terminate

Very uncomfortable………………….

[ ]

Terminate


  1. Are you currently employed?


Yes, full-time……………...

[ ]


Recruit a mix of employed and not employed

Yes, part-time………………

[ ]

No…………………………

[ ]


  1. Are you ……….


Married………………………...

[ ]


Recruit a mix

Single, never married …………

[ ]

Separated/divorced/widowed

[ ]


  1. Are you or your child participating in any one of the following nutrition programs? [select all that apply]


SNAP or other Food Stamp Programs……….....

[ ]

Record. Half of recruits must participate in at least one of these programs.

Free- or Reduced-price School Lunch …………

[ ]

Women, Infants, and Children Program (WIC)

[ ]



  1. Take a moment and think about your health. What is the biggest concern you have about your health and why?






Recruiter: After recording respondent’s answer, determine whether or not you feel this respondent would be useful in the group. Did she:

Give full and complete answer?

Speak clearly, and without long pauses?

Answer enthusiastically?

Speaks understandable English/is comfortable with the English language


It is most important that respondent be articulate!! If not, terminate.


I would like to invite you to participate in a group discussion that will be held at our facility on (DATE) at (TIME). The group will last approximately 90 minutes. To help cover costs such as transportation to the focus group site and child care, you will receive $(XXX) in cash at the end of the group session. Would you be willing to participate?


Yes……………( ) SCHEDULE No……………..( ) TERMINATE

I will call you to remind you of this appointment. However, if for some reason you are unable to attend, please call me at (TELEPHONE NUMBER) so that I can find a replacement for you. Thank You.



Respondent’s name: ___________________________________________


Address: ____________________________________________________


Telephone # (Home): __________________ (Work) _________________


Recruited by: _________________________________________________





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