Screener

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Attachment 1 Screener

English Language Folic Acid Educational Materials: Message Testing and Materials Development

OMB: 0920-0919

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SCREENER- PROJECT 2


Introductory Statement:

Hello, my name is _________ and I am calling on behalf of the Battelle Centers for Public Health Research and Evaluation. This project is being sponsored by the Centers for Disease Control and Prevention, also called CDC. We are going to be conducting discussion groups to better understand women’s beliefs about women’s health and vitamins. We would like to speak with you about your thoughts and opinions about this topic. We are looking for women to participate in these discussions. The discussions will be with other women from your community. They will last one hour and a half. If you are eligible to participate, you will receive $60 at the end of the discussion as a thank-you for sharing your thoughts about women’s health and vitamins. Would you be interested in participating?


If she is NOT interested:

Thank you very much for taking the time to speak with me.


If she is interested:

May I ask you a few questions to see whether you are eligible to participate in the discussion group?


Eligibility Questions:

1. What is your age? _________ If under 18 years old or 45 or older [SKIP TO CLOSE]


2. Are you currently pregnant?

Yes (contemplator)................................................................................. [SKIP TO CLOSE]

No (pre-contemplator)............................................................................[CONTINUE]


3. Are you planning to become pregnant in the next 12 months?

Yes............................................................................... [CONTINUE]

No/Don’t know ........................................................... [CONTINUE]


4. Do you have any children?

Yes.............................................................................. [CONTINUE ]

No ................................................................................[CONTINUE]


5. Have you ever had a pregnancy that resulted in a child with a birth defect such as spina bifida or anencephaly?

Yes............................................................................. [READ STATEMENT BELOW]

No .............................................................................. [CONTINUE]


[If “Yes” to Q5, read this statement] Thank you for taking the time to answer my questions. I am sorry that I am not able to include you in a discussion group because you already have knowledge and experience with (spina bifida/anencephaly). The discussion group is more for women who do not have that first-hand experience.


6. How often do you take a multivitamin?

4 times per week, or more (user)................................................. [CONTINUE]

Fewer than 4 times per week (non-user)...................................... [CONTINUE]


7.   What is the highest level of education you have completed? (Read options below; only mark one response)


Less than High School...............................[CONTINUE]

High School Graduate/ GED.................... [CONTINUE]

Some college..............................................[CONTINUE]

College Graduate.......................................[CONTINUE]

More than Graduate School.......................[CONTINUE]


(ELIGIBLE)

Thank you for answering my questions. Based on your answers, you are eligible to participate in the study. I would like to invite you to participate in the discussion. This is not a sales meeting. No one will try to sell you anything. We are only interested in your opinions. Your opinions will help us better understand what women think about vitamins and health. This discussion will last one hour and a half and we will give you $75 taking the time to participate. Would you be interested in participating?


  • No [THANK YOU AND END CALL]

  • Yes [CONTINUE TO SCHEDULING]


(SCHEDULING)

Great! In the next few days, we will send you a packet of information with the details about where the discussion group will be held, as well as a reminder of the date and time of the group. I want to thank you again for your participation. We will call you the night before the group to remind you. It is very important that you arrive on time. Thank you for accepting our invitation. We look forward to hearing your opinions and comments. Have a nice day.


CLOSE (INELIGIBLE ONLY)

Thank you for answering my questions. I am sorry that I am not able to include you in a discussion group because you are not eligible. I appreciate your interest and taking the time to answer my questions.




File Typeapplication/msword
AuthorAlessandra M. Favoretto
Last Modified ByGrant, Dorthina G. (CDC/ONDIEH/NCBDDD)
File Modified2012-04-25
File Created2012-04-25

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