CNPP Message Concept Focus Groups

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EXPIRATION DATE: XX/XX/20XX

OMB 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 0584-0523. The time to complete this information collection is estimated as part of the 15 minutes, including the time for reviewing instructions and completing the information.

APPENDIX A-1 CNPP FOCUS GROUP SCREENER GUIDE - ENGLISH

CNPP Focus Group Activity

Screening Questionnaire - English

Hello, My name is_______________________, and I am calling from EurekaFacts, a research company in Maryland. We are calling on behalf of the United States Department of Agriculture (USDA) to ask for your participation in a discussion about how USDA should communicate information to people like you. Your participation is voluntary and as a token of our appreciation, we will provide $xx as an incentive for your participation in a 2-hour discussion on this subject. There are no penalties if you chose not to participate. This feedback session will be private, which means that nothing that you say will be seen by anyone other than qualified researchers working on this project. Your responses will be combined with others and you will never be personally identified.

Are you interested in participating?

IF NO: Thank you and have a great day/evening.

IF YES: Great! First, I need to ask you a few questions to find out if your background meets the needs of this study.

Q1. DO NOT READ: Record Gender

1. □ MALE

2. □ FEMALE

INTERVIEWER: recruit a mix on gender.

Q2.      Are you?

        1. □ Yes  Hispanic or Latino   GO TO Q4

        2. □ NoNot Hispanic or Latino

Q3. What is your race? Interviewer: accept multiple responses, if Black or African-American mentioned and not Hispanic/Latino assign to African American group

           1. □ American Indian or Alaskan Native

        2. □ Asian

        3. □ Black or African-American

           4. □ Hawaii Native or Other Pacific Islander

        5. □ White

Q4. Which of the following age categories are you in?

1. □ Under 18 [Terminate and thank: Based on the requirements of the study, it looks like we can’t include you at this time. It is possible we will be calling you in the future for other studies.]

Qualifies as Generation Y

2. □ 18-24

3. □ 25-32

Qualifies as Generation X

4. □ 33-39

5. □ 40-49

6. □ 50 or older – TERMINATE

Q5. Can you tell me how tall you are in feet and inches? INTERVIEWER: If respondent doesn’t know, ask them to give you their best guess. If they can’t guess, terminate.

_____ Feet _____Inches

Q6. Can you tell me how much you weigh in pounds? INTERVIEWER: If respondent doesn’t know, ask them to give you their best guess. If they can’t guess, terminate.

_____ Pounds

INTERVIEWER: Use NIH link (will be provided) and enter height and weight to calculate BMI

Q7. DO NOT READ: Interviewer, record BMI below

1. □ 18.5 or less  TERMINATE

2. □ 18.6 to 24.9

3. □ 25 to 34.9

4. □ 35 or over  TERMINATE

Q8. Please select the category that best represents your living situation:

1. □ Live in parent/guardian’s home  TERMINATE

2. □ Live in dorm/group home  TERMINATE

3. □ Live alone with roommates

4. □ Live alone without roommates

5. □ Live with spouse/significant other and/or children/other family members

Q9. In your household, who is responsible for making choices regarding the food you/your household eats?

1. □ I am primarily responsible for making choices regarding the food I/my household eats

2. □ I share the responsibility equally for making choices regarding the food I/my household eats

3. □ Someone else is primarily responsible for making choices regarding the food I/my household eats  TERMINATE

Q10. Including yourself, how many household members are there in your home? Exclude any roommates/boarders/etc.

1. □ 1 (yourself only)

2. □ 2

3. □ 3

4. □ 4

5. □ 5

6. □ 6

7. □ 7

8. □ 8 or more

Q11. Thinking of everyone in your household who receives income, what is the total yearly income for your household before taxes, including salaries, Social Security, pension, interest, and investment earnings.

1. □ Under $25,000

2. □ $25,000 to just below $30,000

3. □ $30,000 to just below $37,000

4. □ $37,000 to just below $45,000

5. □ $50,000 to just below $52,000

6. □ $52,000 to just below $60,000

7. □ $60,000 to just below $67,000

8. □ $67,000 to just below $75,000

9. □ $75,000 to just below $100,000

10. □ $100,000 or more

Programmer Note: The following combinations will qualify as low income

If Q10=1 and Q11=1

If Q10=2 and Q11=1,2

If Q10=3 and Q11=1,2,3

If Q10=4 and Q11=1,2,3,4

If Q10=5 and Q11=1,2,3,4,5

If Q10=6 and Q11=1,2,3,4,5,6

If Q10=7 and Q11=1,2,3,4,5,6,7

If Q10=8 and Q11=1,2,3,4,5,6,7,8

IF NON-HISPANIC GO TO INVITATION PAGE

Q12. In general, what language(s) do you read and speak?

1. □ Only Spanish

2. □ Spanish better than English

3. □ Both equally

4. □ English better than Spanish

5. □ Only English

Q13. In general, what language(s) do you usually speak at home?

1. □ Only Spanish

2. □ Spanish better than English

3. □ Both equally

4. □ English better than Spanish

5. □ Only English

Q14. In which language(s) do you usually think?

1. □ Only Spanish

2. □ Spanish better than English

3. □ Both equally

4. □ English better than Spanish

5. □ Only English

Q15. What language(s) do you usually speak with your friends?

1. □ Only Spanish

2. □ Spanish better than English

3. □ Both equally

4. □ English better than Spanish

5. □ Only English

Q16. Can you tell me the country or countries your family is originally from?

_____________________________ Record

NOTE: Add up and average for Q12-15. If average is less than 2.99 GO TO SPANISH BICULTURAL INVITATION PAGE. Otherwise GO TO ENGLISH INVITATION PAGE.

ENGLISH LANGUAGE INVITATION PAGE

NOTE – Recruit the following number per segment (will be split across locations):

(12) Generation X and Low Income, Overweight/obese, mix race

(12) Generation X and Low Income, Healthy weight, mix race

(12) Generation X and High Income, Overweight/obese, mix race

(12) Generation X and High Income, Healthy weight, mix race

(12) Generation Y and Low Income, Overweight/obese, mix race

(12) Generation Y and Low Income, Healthy weight, mix race

(12) Generation Y and High Income, Overweight/obese, mix race

(12) Generation Y and High Income, Healthy weight, mix race

(12) Generation X and Low Income, Healthy weight, African American

(12) Generation X and High Income, Overweight/obese, African American

(12) Generation Y and Low Income, Overweight/obese, African American

(12) Generation Y and High Income, Healthy weight, African American

Thank you for completing the screening questions. As I mentioned previously, you have been invited to participate in a small discussion group regarding your life priorities and food. Your participation means that you would participate in the 2-hour discussion that will be held on DATE/TIME/LOCATION. As a token of our appreciation, you will receive $__ upon completion of the group.

Would you still like to participate?

[If R seems uncomfortable, explain, “This information will be used only to send you instruction about the journaling task”]

Respondent’s name _____________________________________

Address ______________________________________________

Email Address__________________________________________

Telephone Number: ________________Alternate Number: ___________________________

SPANISH BICULTURAL LANGUAGE INVITATION PAGE

NOTE – Recruit the following number per segment (will be split across locations):

(12) Bicultural and Overweight/obese, Mexican

(12) Bicultural and Healthy weight, Mexican

(12) Bicultural and Overweight/obese, Caribbean and South American

(12) Bicultural and Healthy weight, Caribbean and South American

(12) Bicultural and Overweight/obese, Central American

(12) Bicultural and Healthy weight, Central American

Thank you for completing the screening questions. As I mentioned previously, you have been invited to participate in a discussion regarding your life priorities and food. As a token of our appreciation, you will receive $__ upon completion of the group.

Would you still like to participate?

[If R seems uncomfortable, explain, “This information will be used only to contact you about the journaling task.”]

Respondent’s name _____________________________________

Address ______________________________________________

Email Address__________________________________________

Telephone Number: _____________________________________

Alternate Number: ______________________________________

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