Healthy School Environment

Attachment D

OMB Control # 0584-0524

Expiration Date: 03/31/2013

O MB 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 as part of the 10 minutes for the screener, including the time for reviewing instructions and completing the information.

USDA/FNS

Telephone Focus Group Screening Questionnaire –

Middle School Principals

Formative Round (December 2010)

Evaluative Round (May 2011)

RESEARCH CONTACT: Kristy Grulikowski at 404-995-4552 or [email protected]

SPECS:

• Six, 90-minute telephone focus groups with middle school (grades 6-8) principals

  • Formative Round: 3 telephone focus groups

  • Evaluative Round: 3 telephone focus groups

• Recruit 9 for 6 to show (seat) at each group.

• All principals must work at a middle school that offers the National School Lunch Program (we will provide facility with a list of eligible schools for recruitment).

• All principals must not work at a middle school that has won a HUSSC (HealthierUS School Challenge) award (we will provide facility with a list of local schools not eligible for recruitment).

• 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 setting over the phone.

FORMATIVE: PLEASE RECRUIT RESPONDENTS AS FOLLOWS:

	GROUP	DATE*	TIME	LOCATION
[ ]	Group 1: middle school principals	TBD	TBD	Telephone
[ ]	Group 2: middle school principals	TBD	TBD	Telephone
[ ]	Group 3: middle school principals	TBD	TBD	Telephone

EVALUATIVE: PLEASE RECRUIT RESPONDENTS AS FOLLOWS:

	GROUP	DATE*	TIME	LOCATION
[ ]	Group 1: middle school principals	TBD	TBD	Telephone
[ ]	Group 2: middle school principals	TBD	TBD	Telephone
[ ]	Group 3: middle school principals	TBD	TBD	Telephone

Hello, my name is _____with______. We are conducting a study about nutrition on behalf of the United States Department of Agriculture, Food and Nutrition Service, 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 middle school principals across the country to participate in a telephone focus group to help us understand more about what they think about nutrition and health. May I speak to [NAME OF PRINCIPAL]? This should only take a few minutes. ONCE PRINCIPAL 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 ……..	[ ]	Continue

2. 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

3. Do you or 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……..……………………………………..	[ ]
Food manufacturing……………………………..	[ ]
School Food Service…………….…………….…	[ ]
Food/Nutrition Assistance Programs…………….	[ ]

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

Yes……..………………	[ ]	Continue
No………………………	[ ]	Skip to Q6

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

Less than 6 months ago	[ ]	Terminate
6 months ago or longer	[ ]	Continue

6. Generally speaking, do you consider yourself to be an “expert” in nutrition or physical activity?

No………………….	[ ]	Continue
Yes …….…….……	[ ]	Terminate
Don’t know/Refused...	[ ]	Terminate

7. Are you currently employed as a middle school principal?

No………………….	[ ]	Terminate
Yes …….…….……	[ ]	Continue

8. How long have you been a middle school principal?

Less than 6 months…………	[ ]	Terminate
More than 6 months …….…	[ ]	Continue

9. What state is your school is located? (RECORD and RECRUIT A MIX)

10. What is the best way to describe the area in which your school resides? (READ LIST and RECORD)

Urban ………........................................	[ ]	Recruit at least 2
Rural ….…….…………………………	[ ]	Recruit at least 2
Suburban……………………………….	[ ]	Recruit at least 2
Don’t Know/Refused……………………...	[ ]	TERMINATE

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

Under 18…………	[ ]	Terminate
18-34 …….……...	[ ]	Record
35-50…….………	[ ]
50+ ……...............	[ ]

12. Are you of Hispanic or Latino origin?

No………………….	[   ]	Continue
Yes …….…….……	[   ]	Continue

13. 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 6*

*TO THE EXTENT POSSIBLE, THE GROUPS SHOULD BE A MIX OF RACES/ETHNICITIES.

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

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

• Give full and complete answers?

• Speak clearly, and without long pauses?

• Answer enthusiastically?

• Speaks understandable English/is comfortable with the language

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

I would like to invite you to participate in a group discussion over the phone that will be held (DATE) at (TIME/EASTERN STANDARD TIME). The group will last approximately 90 minutes. To cover inconveniences such as child care we will mail you a check for $75 after the telephone discussion. Would you be willing to participate?

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

As I mentioned, the discussion group is (DATE) at (TIME) EST.

(Time zone respondent lives in ________)

[RECRUITER: ASK IF PARTICIPANT IS ON EASTERN STANDARD TIME. IF NOT ASK WHAT TIME ZONE THEY ARE IN, AND CONFIRM THAT THEY UNDERSTAND WHAT TIME THE GROUP WOULD BEGIN IN THEIR TIME ZONE.]

Someone from 20/20 Research will call you to begin the discussion. May I please have the phone number where we will be able to reach you on (DATE) at (TIME) EST?

Phone Number: __________________________________

You will also be mailed some materials in advance, which you will review as part of the discussion. Please do not open the packet before the discussion group. We will also call you a day or two before to remind you on this appointment, and to confirm that you have received these materials. On the day of the discussion, we will call you 30 minutes before the discussion to make sure you are near the phone. We will then call you at the designated time in order to begin the discussion.

If for some reason you realize in the next few days that you will be unable to participate in the discussion group, 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: _________________________________________________