Tips from Former Smokers Campaign
Tips 2 Formative Research
Rough Cut Testing
Main Questionnaire
November 28, 2012
Form Approved
OMB No. 0920-0910
Exp. Date 01/31/2015
Public reporting burden of this collection of information is estimated to average 13 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 CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0910).
[21
ADS WILL BE TESTED, BUT EACH RESPONDENT WILL ONLY VIEW TWO OF THE
ADS. Respondent will not see this list.]
Ad Name For Selection |
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|
TV Ads |
Print Ads |
Radio Ads |
Nathan Dance |
Jamason |
Nathan |
Michael Thinking |
Ellie |
Michael |
Terrie Voice |
Nathan |
Bill |
Bill List |
Terrie |
Tiffany |
Tiffany Missed |
Bill |
Terrie |
Jessica (Spanish) |
Beatrice (Spanish) |
Mariano (Spanish) |
|
Mariano (Spanish) |
Jessica (Spanish) |
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Jessica (Spanish) |
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Main Questionnaire: Message Evaluations
We would now like to share with you a few ads and then gather your reactions to those ads. Your opinions are very important to us! Please be assured that the purpose of this survey is to gather feedback regarding specific health-related advertising and we appreciate your candid responses.
[IF SELECTED TO EVALUATE TV AD, INSERT THE FOLLOWING: Please make sure the volume on your computer is turned up, so that you may both see and hear the video.] [IF SELECTED TO EVALUATE RADIO AD, INSERT THE FOLLOWING: Please make sure the volume on your computer is turned up, so that you may hear the audio.]
Please click the forward arrow at the bottom of the screen to continue.
Main Questionnaire SECTION 1: Questions for each ad, to be shown right after each ad
What do you think [or would you say] is the main message of this advertisement?
People
sometimes have different emotional reactions when they see or hear
advertisements. On a scale from 1 to 5, where 1 indicates not
at all,
and 5 indicates very,
please indicate how much this advertisement made you feel:
Not Very
At All
1 2 3 4 5
[RANDOMIZE LIST]
Angry
Afraid
Ashamed
Sad
Hopeful
Understood
Surprised
Trusting
Motivated
Regretful
On a scale from 1 to 5, where 1 indicates that you strongly disagree, and 5 indicates that you strongly agree, please tell me the number which indicates how much you disagree or agree with the following statements.
Strongly Strongly
Disagree Agree
1 2 3 4 5
[RANDOMIZE LIST]
This ad is convincing
This ad grabbed my attention
This ad was easy to understand
I learned something new by viewing or hearing this ad
I trust the information in this ad
This ad is believable
I would talk to someone else about this ad
This ad is annoying
The people in this ad are believable
This ad is worth remembering
This ad is powerful
This ad is informative
This ad is meaningful
I can identify with what the ad says
[Please note that A,B,J,K,L,M will be used to calculate the PE score]
What do you like about this advertisement? Please be as specific as possible.
What do you dislike about this advertisement? Please be as specific as possible.
Is there anything confusing, unclear, or hard to understand?
Yes
No
What was confusing, unclear or hard to understand? Please be as specific as possible.
ONLY ASK THIS QUESTION OF RESPONDENTS SELECTED TO VIEW PRINT ADS
How much of the ad would you read?
A. I would only read the headline.
B. I would only look at the image.
C. I would only read the headline and look at the image/s.
D. I would read the whole thing.
E. I wouldn’t read any of it.
THE FOLLOWING QUESTIONS ARE FOR ALL RESPONDENTS
IF RESPONDENT IS A SMOKER, ASK THE FOLLOWING QUESTIONS
This question is about the possibility of you quitting smoking, based on the message you just saw or heard in the advertisement.
Does the ad make you want to quit smoking?
Yes
No
ASK IF PRIOR QUESTIONS RESPONSE IS NO
Why not? Please be as specific as possible.
ASK IF PRIOR QUESTIONS RESPONSE IS YES
What about the ad made you want to quit smoking? Please be as specific as possible.
IF
RESPONDENT IS A NON-SMOKER, ASK THE FOLLOWING QUESTION
This question is about the possibility of encouraging someone you care about to quit smoking, based on the message you just saw or heard in the advertisement.
Does the ad make you want to encourage someone you care about to quit smoking?
Yes
No
ASK IF PRIOR QUESTIONS RESPONSE IS NO
Why not? Please be as specific as possible.
ASK IF PRIOR QUESTIONS RESPONSE IS YES
What about the ad made you want to encourage someone you care about to quit smoking? Please be as specific as possible.
ASK ALL ENGLISH-LANGUAGE RESPONDENTS
If you saw or heard this advertisement, on a scale from 1 to 5, where 1 is not at all likely and 5 is extremely likely, how likely would you be to take the following actions in the next 6 months?
Not At All Extremely
Likely Likely
1 2 3 4 5
SHOW RESPONSES 1-8, TO ENGLISH-LANGUAGE SMOKERS
1 Call 1-800-QUIT-NOW for assistance in quitting smoking
2 Visit an informational government website, such as www.cdc.gov/tips for information on quitting
3 Talk with your doctor about quitting smoking
4 Not smoke around others
5 Visit the Twitter site for the campaign.
6 Try to quit on your own
7 Support smoke-free laws in your community
8 Do nothing
SHOW RESPONSES 10-17 TO ENGLISH-LANGUAGE NON-SMOKERS
10 Call 1-800-QUIT-NOW for information to help someone you care about quit smoking
11 Visit an informational government website, such as www.cdc.gov/tips for information to help someone you care about quit smoking
12 Talk to your doctor about helping someone you care about quit smoking
13 Ask someone to not smoke around you or others
14 Visit the Twitter site for the campaign.
15 Support smoke-free laws in your community
16 Encourage someone you care about to quit smoking
17 Do nothing
ASK ALL SPANISH-LANGUAGE RESPONDENTS
If you saw or heard this advertisement, on a scale from 1 to 5, where 1 is not at all likely and 5 is extremely likely, how likely would you be to take the following actions in the next 6 months?
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|
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Not At All Extremely
Likely Likely
1 2 3 4 5
SHOW RESPONSES 1-8, TO SPANISH-LANGUAGE SMOKERS
1a Call an English-language 1-800-QUIT-NOW number for assistance in quitting smoking
1b Call a Spanish-language 1-855-DEJELO-YA number for assistance in quitting smoking
2a Visit an English-language informational government website, such as www.cdc.gov/tips for Information on quitting
2b Visit a Spanish-language informational government website, such as www.cdc.gov/consejos for information on quitting
3 Talk with your doctor about quitting smoking
4 Not smoke around others
5 Visit the an English-language Twitter site for the campaign
6 Try to quit on your own
7 Support smoke-free laws in your community
8 Do nothing
SHOW RESPONSES 9-16, TO SPANISH-LANGUAGE NON-SMOKERS
9a Call an English-language 1-800-QUIT-NOW for information to help someone you care about quit smoking
9b. Call a Spanish-language 1-855-DEJELO-YA for information to help someone you care about quit smoking
10a Visit an English-language informational government website, such as www.smokefree.gov or www.cdc.gov/tips for information to help someone you care about quit smoking
10b. Visit an Spanish-language informational government website, such as www.cdc.gov/consejos for information to help someone you care about quit smoking
11 Talk to your doctor about helping someone you care about quit smoking
12 Ask someone to not smoke around you or others
13 Visit an English-language Twitter for the campaign
14 Support smoke-free laws in your community
15 Encourage someone you care about to quit smoking
16 Do nothing
ONLY ASK THIS QUESTION OF RESPONDENTS WHO ARE EVALUATING THE NATHAN DANCE TV AD, ALL OTHERS SKIP TO NEXT QUESTION.
Thinking about the ad that you just saw, on a scale from 1 to 5, where 1 indicates that you strongly disagree, and 5 indicates that you strongly agree, please select the number which indicates how much you disagree or agree with the following statements.
This ad makes me more concerned about…
Strongly Strongly
Disagree Agree
1 2 3 4 5
[RANDOMIZE IN GROUPS ALWAYS KEEPING 1&2 AND 3&4 TOGETHER IN THAT ORDER]
1 My exposure to secondhand smoke in casinos
2 Other people’s exposure to secondhand smoke in casinos
3 My exposure to secondhand smoke in enclosed environments (restaurants, bars, factories, etc.)
4 Other people’s exposure to secondhand smoke in enclosed environments (restaurants, bars, factories, etc.)
LOOP BACK AND REPEAT QUESTIONS FOR THE 2ND AD SELECTED TO EVALUATE. INSERT SCREEN WITH THE FOLLOWING TEXT:
“To follow is the second ad we would like you to review. Your opinions are very important to us! Please be assured that the purpose of this survey is to gather feedback regarding specific health-related advertising and we appreciate your candid responses.
Please click the forward arrow at the bottom of the screen to continue.”
AFTER 2ND AD EVALUATION, PLEASE PROCEED TO NEXT QUESTION.
Now we have a few additional questions for demographic purposes only.
How many children (under age 18) currently live in your household?
None
1-2 children
3-4 children
5 or more children
What is the highest level of education you have completed?
Grade school
Less than high school graduate/some high school
High school graduate or completed GED
Some college or technical school
Received four-year college degree
Some post graduate studies
Received advanced degree
Other
What is your current occupational status?
Employed full time
Employed part time
Unemployed
Homemaker
Student
Retired
Disabled
Other
What is your marital status?
Married
Unmarried living with a partner
Divorced
Widowed
Separated
Single, never been married
Which of the following categories best describe your total, annual household income?
Under $20,000/year
$20,001 - $30,000/year
$30,001 - $40,000/year
$40,001 - $50,000/year
$50,001 - $60,000/year
$60,001 - $80,000/year
$80,001 - $100,000/year
Over
$100,000/year
Of the following, which do you consider yourself to be?
[RANDOMIZE 2-4.]
01 Heterosexual (Straight) ANCHOR
02 Lesbian
03 Gay
04 Bisexual
96 Other ANCHOR
99 Decline to answer ANCHOR
Thank you for your participation in this survey. We appreciate your responses and hope you will join us on future surveys!
| File Type | application/msword |
| File Title | OSH Media Rough Cut Survey |
| Author | Carol Haney |
| Last Modified By | Jennifer Cantrell |
| File Modified | 2012-11-28 |
| File Created | 2012-11-28 |