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USDA/FNS
Focus Group Screening Questionnaire – Low-Income Mothers
RESEARCH CONTACT: Radha Rajan at 202-973-3617 or [email protected]
SPECS:
Six, 90-minute focus groups 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 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 group: Moms of non-school aged children (i.e., 2-5 years of age and not yet in kindergarten) – (1 group per location)
Milk and whole grains group: Moms with at least one child in elementary school, up to 10 years of age – (1 group per location)
Communications tools group: Moms of non-school aged children (i.e., 2-5 years of age and not yet in kindergarten) – (1 group per location)
Communications tools group: Moms with at least one child in elementary school, up to 10 years of age – (1 group per location)
Recruit 12 for 8 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 |
Baltimore, MD |
[ ] |
Group 1: low-income mothers of non-school aged children – milk/whole grain discussion (Room TBD) |
TBD |
TBD |
Baltimore, MD |
[ ] |
Group B: “Less assured” low-income mothers (Room TBD) |
TBD |
TBD |
Baltimore, MD |
[ ] |
Group 2: low-income mothers of non-school aged children – communications tools discussion (Room TBD) |
TBD |
TBD |
Baltimore, MD |
[ ] |
Group 3: low-income mothers of elementary school aged children – milk/whole grains discussion (Room TBD) |
TBD |
TBD |
Baltimore, MD |
[ ] |
Group 4: low-income mothers of elementary school aged children – communications tools discussion (Room TBD) |
TBD |
TBD |
Baltimore, MD |
[ ] |
Group C: “Amenable” low-income mothers (Room TBD) |
TBD |
TBD |
Raleigh, NC |
[ ] |
Group 5: low-income mothers of non-school aged children - milk/whole grain discussion (Room TBD) |
TBD |
TBD |
Raleigh, NC |
[ ] |
Group D: “Less assured” low-income mothers (Room TBD) |
TBD |
TBD |
Raleigh, NC |
[ ] |
Group 6: low-income mothers of non-school aged children – communications tools discussion (Room TBD) |
TBD |
TBD |
Raleigh, NC |
[ ] |
Group 7: low-income mothers of elementary school aged children - milk/whole grain discussion (Room TBD) |
TBD |
TBD |
Raleigh, NC |
[ ] |
Group 8: low-income mothers of elementary school aged children – communications tools discussion (Room TBD) |
TBD |
TBD |
Raleigh, NC |
[ ] |
Group E: “Amenable” low-income mothers (Room TBD) |
TBD |
TBD |
Phoenix, AZ |
[ ] |
Group 9: low-income mothers of non-school aged children – milk/whole grains discussion (Room TBD) |
TBD |
TBD |
Phoenix, AZ |
[ ] |
Group F: “Less assured” low-income mothers (Room TBD) |
TBD |
TBD |
Phoenix, AZ |
[ ] |
Group 10: low-income mothers of non-school aged children – communications tools discussion (Room TBD) |
TBD |
TBD |
Phoenix, AZ |
[ ] |
Group 11: low-income mothers of elementary school aged children – milk/whole grains discussion (Room TBD) |
TBD |
TBD |
Phoenix, AZ |
[ ] |
Group 12: low-income mothers of elementary school aged children – communications tools discussion (Room TBD) |
TBD |
TBD |
Phoenix, AZ |
[LETTERED GROUPS = CHILD FEEDING PRACTICES SESSIONS]
Hello, my name is _____with______. We are conducting a study about nutrition on behalf 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).
Record Gender—DO NOT ASK UNLESS UNABLE TO TELL.
Female…… |
[ ] |
Continue |
Male …….. |
[ ] |
Terminate |
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 |
Do you have any children under age 19 living at home?
Yes………… |
[ ] |
Continue |
No …….….. |
[ ] |
Terminate |
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…...….. |
[ ] |
|
[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 |
[If child is between the ages of 6-10, ASK] What grade is your child in?
____________ [Record answer] Recruit for older group
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……………. |
[ ] |
Have you ever participated in a focus group or been paid to be part of a discussion group?
Yes……..……………… |
[ ] |
Continue |
No……………………… |
[ ] |
Skip to Q10 |
How recently did you
participate in a focus group?
Less than 6 months ago |
[ ] |
Terminate |
6 months ago or longer |
[ ] |
Continue |
Generally speaking, do you consider yourself to be an “expert” in nutrition?
No…………………. |
[ ] |
Continue |
Yes …….…….…… |
[ ] |
Terminate |
Don’t know/Refused... |
[ ] |
Terminate |
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 |
Are you a vegetarian or vegan?
No…………………. |
[ ] |
Continue |
Yes …….…….…… |
[ ] |
Terminate |
Who does most of the grocery shopping or makes the shopping lists in your household? [DO NOT READ RESPONSES]
You………………………… |
[ ] |
Continue |
Someone else…….…….…… |
[ ] |
Terminate |
Including yourself, how many people currently live in your household?
__________ [Record answer]
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]
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]
What is your current age? [Do not read list]
Under 18………… |
[ ] |
Terminate |
18-34 …….……... |
[ ] |
Record |
35-50…….……… |
[ ] |
|
50+ ……............... |
[ ] |
Terminate |
Are you of Hispanic or Latino origin?
No…………………. |
[ ] |
Continue |
Yes …….…….…… |
[ ] |
Continue |
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 5* |
*Using questions 18 and 19, recruit no more than 4 white, non-Hispanic respondents for each group. The remaining 7 recruits can be any mix of other races, but should not all be of one racial or ethnic group.
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 5 |
Post graduate education (e.g., Master’s degree, MBA, law degree, PhD)………... |
[ ] |
Terminate |
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 |
Are you currently employed?
Yes, full-time……………... |
[ ] |
Recruit a mix of employed and not employed |
Yes, part-time……………… |
[ ] |
|
No………………………… |
[ ] |
Are you ……….
Married………………………... |
[ ] |
Recruit a mix |
Single, never married ………… |
[ ] |
|
Separated/divorced/widowed… |
[ ] |
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)… |
[ ] |
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?
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: _________________________________________________
File Type | application/msword |
File Title | USDA |
Author | taryn antigone |
Last Modified By | jwilson |
File Modified | 2010-08-10 |
File Created | 2010-08-10 |