OMB No. 0910-xxxx
Expiration Date: xx/xx/20xx
PUBLIC Disclosure Burden Statement
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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:
Department
of Health and Human Services
Food and Drug
Administration
CFSAN/PRB Comments/HFS-24
5100 Paint Branch
Parkway
College Park, MD 20740-3835.
[“Real Time” Survey of Consumer Knowledge, Perception,
and Reported Behavior Concerning
“All Clear” E-coli Outbreak and Spinach Recall]
[Screener and Questionnaire]
Thank you for responding to the invitation to participate in this survey on a recent E-coli outbreak and spinach recall.
Please answer a few questions to see if you are eligible to participate in the study. Please be assured that all of your answers are kept confidential and no personal identifying information is retained with your answers. If any part of the survey makes you uncomfortable, please feel free to stop at any time.
S1. Are you at least 18 years old?
YES
NO [“You must be at least 18 years old to participate in this study. Thank you very much for your interest in our research.”] [eliminate]
S2. Have you shopped for groceries for yourself or others in the last month?
Yes
No [“We are looking for participants who have shopped for groceries in the past month. Thank you very much for your interest in our research.”] [eliminate]
S3. Do you or does someone from your immediate family work for any of the following:
Market Research Firm [“We are recruiting individuals with certain characteristics. Thank you very much for your interest in our research.”] [eliminate]
The Food and Drug Administration,
U.S. Department of Agriculture,
or State or local food agency [“We are recruiting individuals with certain characteristics. Thank you very much for your interest in our research.”]
[eliminate]
Food Industry or Food Retailer [“We are recruiting individuals with certain characteristics. Thank you very much for your interest in our research.”] [eliminate]
We are interested in what you have heard about the current E-coli problem in spinach. We are interested in spinach that you would buy at a store or have at a food establishment away from home. This survey will take about 10 minutes to complete. Please allow enough time to complete the entire survey in one sitting. All responses will be kept confidential.
[Knowledge/Information Seeking]
1. Have you heard or read anything in the last week about health risks related to eating raw spinach?
0. No
1. Yes
98. DON’T KNOW
1a. Have you heard or read anything in the last week about a raw spinach recall? That is, have you heard or read anything in the last week about returning raw spinach to the store, or that some raw spinach is potentially contaminated with disease-causing organisms?
0. No
1. Yes
98. DON’T KNOW
2. Have you seen anything on television in the last week about a spinach recall?
0. No
1. Yes
98. DON’T KNOW
3. Have you seen anything in the newspaper in the last week about a spinach recall?
0. No
1. Yes
98. DON’T KNOW
4. Have you seen anything on the internet in the last week about a spinach recall?
0. No
1. Yes
98. DON’T KNOW
4a. Have you heard anything on the radio in the last week about a spinach recall?
0. No
1. Yes
98. DON’T KNOW
[If Q1 thru Q4a =0, Skip to Q12]
5. Do you remember what you heard or read recently about raw spinach?
Did you hear . . .?
5a. Do not eat any spinach
5b. Do not eat certain types of spinach
5c. Do not eat certain brands of spinach
5d. Cook spinach well before eating
5e. Return spinach to the food store
5f. Discard spinach
5h. It is ok to eat all types of raw spinach
5g. Other ___________ [specify]
0. No
1. Yes
98. DON’T KNOW
7. Did you go to any of the following sources for further information about the spinach recall? [y/n for each source]
7a. The Centers for Disease Control, or CDC, website
7b. The Food and Drug Administration, or FDA, website
7c. The U.S. Department of Agriculture, or USDA, website
7d. The Foodsafety.gov website
7e. News websites
7f. Food company websites
7g. The Centers for Disease Control, or CDC, 1-800 number
7h. The Food and Drug Administration, or FDA, 1-800 number
7i. Your State department of health
7j. Newspapers or television
7k. Blog articles, podcasts, or other social media sources
0. No
1. Yes
98. DON’T KNOW
11. Using a 10-point scale, how safe do you think it is currently to eat raw spinach associated with the recent[food product] recall?
1. Not at all safe
10. Very safe
98. DON’T KNOW
[Behavior]
12. In the past year, have you eaten raw spinach?
0. No
1. Yes
98. DON’T KNOW
13. In the past month, did you eat any raw spinach?
0. No
1. Yes
98. DON’T KNOW
14. Have you eaten any raw spinach this week?
0. No
1. Yes
98. DON’T KNOW
15. Do you currently have any raw spinach in your home?
0. No
1. Yes
98. DON’T KNOW
16. Would you say that raw spinach are a regular part of your daily food intake?
0. No
1. Yes
98. DON’T KNOW
17. Weekly food intake?
0. No
1. Yes
98. DON’T KNOW
18. Monthly food intake?
0. No
1. Yes
98. DON’T KNOW
19a. If you have not recently eaten raw spinach, which of the following is true?
I have not recently eaten raw spinach because . . .
19.a.1. no particular reason
19.a.2. I have not had a taste for spinach
19.a.3. I have not had the opportunity
19.a.4. I wanted to avoid becoming ill
19.a.5. I wanted to follow the food recall health advisory
19.a.6. spinach were unavailable for purchase
[If Q19=4, skip to Q20]
19b. Since hearing about the recall, have you changed how often you eat raw spinach?
Have you eaten raw spinach [select one best answer]
1. more often.
2. as often as usual.
3. less often.
8. DON’T KNOW
[If Q1 thru Q4a =0, Skip to Q24]
20. Once you hear that the raw spinach available in stores and restaurants are no longer part of the problem that caused the E-coli outbreak, how soon will you resume eating spinach?
1. I have not stopped eating raw spinach
2. Immediately or as soon as I have an occasion to eat it
3. I plan to wait awhile.
4. I do not intend to eat raw spinach again.
21. If you were unable to eat raw spinach for three months, do you have other foods to choose from that could easily take its place?
0. No
1. Yes
98. DON’T KNOW
[Perception]
24. On a scale from strongly disagree to strongly agree, please indicate your response about the following
24a. I want to prevent foodborne illnesses (or getting sick from food)
1. Strongly disagree
10. Strongly agree
98. DON’T KNOW
24b. I want the ability to protect myself from foodborne illnesses (or getting sick from food)
1. Strongly disagree
10. Strongly agree
98. DON’T KNOW
24c. I really don’t care about foodborne illnesses (getting sick from food)
1. Strongly disagree
10. Strongly agree
98. DON’T KNOW
26. Do you believe you had the information you need to keep yourself and your family safe from foodborne E-coli during the recent spinach recall?
0. No
1. Yes
98. DON’T KNOW
32. Would you now like to have more information about the recent spinach recall advisory?
0. No
1. Yes (provide link to advisory)
98. DON’T KNOW
[Demographics.]
33. How many total people, including yourself, live in your household? (Range = 1-97)
(Include foster children, roommates or housemates, and people staying with you last night who have no permanent place to stay. This includes people living with you most of the time while working, even if they have another place to live. Do not include college students living away while attending college, people in a correctional facility, nursing home or psychiatric hospital last night, armed forces personnel living somewhere else, people who live or stay at another place most of the time.
_____NUMBER
98. DON’T KNOW
[If Q33 <2, skip to Q37]
How many of these people in your household are . . .
34. Children younger than five years old?
_____ (Range = 0 to 20)
98. DON’T KNOW
35. Children between 5 and 18 years?
______ (Range = 0 to 20)
98. DON’T KNOW
36. Adults 60 years of age or older?
_______ (Range = 0 to 20)
98. DON’T KNOW
37. Are you or is anyone in your household pregnant?
1. YES, I am pregnant.
2. Yes, someone in my household is pregnant
3. NO
8. DON’T KNOW
38. Please read the following list of health conditions and indicate if you have been told by a doctor that you have any of them: liver disease, currently receiving chemotherapy or radiation therapy, HIV, AIDS, organ transplant, or weakened immune system.
Yes, I have at least one of the conditions listed.
No, I do not have any of the conditions listed.
DON’T KNOW
39. Please select one of the following. Are you:
0. Male
1. Female
40. What is your age in years? [Open ended]
_______
41. What is the highest level of education that you have completed?
1. Less than high school
2. High school graduate or GED
3. Technical/vocational school
4. Community college
5. Some college (1-3 years
towards Bachelor’s degree)
6. College (Bachelor’s degree)
7. Advanced degree (post graduate degree)
42. Are you of Hispanic or Latino origin?
0. No
1. Yes
43. What is your race? You may choose one or more categories. Are you?
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or other Pacific Islander
5. American Indian or Alaska Native
6. Other
44. Please provide any comments you wish. [Open-ended]
File Type | application/msword |
File Title | 10-9-08 |
Author | tempuser |
Last Modified By | DPresley |
File Modified | 2011-06-17 |
File Created | 2011-06-17 |