Attachment E 3 Focus Group Confirmation Form - English 6 5 15

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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 at 5 minutes including the time for reviewing instructions and completing the information.

Attachment E 3: Focus Group Confirmation Form – English

CNPP Focus Group Activity Confirmation Form - English

OMB CONTROL NO.: 0584-0523

EXPIRATION DATE: XX/XX/20XX

<DATE>

Dear <NAME>,

Thank you for agreeing to participate in this voluntary focus group research. EurekaFacts is conducting this research on behalf of the United States Department of Agriculture (USDA) to inform them about how Americans make food choices and think about health-related issues. All of the information you provide will be used only for research purposes and will not be disclosed or used, in identifiable form, for any other purpose except as required by Federal guidelines.

You have been scheduled to participate in a focus group study at <TIME> on <DATE>. The discussion will last no more than 90 minutes. To thank you for your time, you will receive S 75 for participating.

The focus group discussion will take place at <LOCATION>.

<ADDRESS>

<DIRECTIONS>

In preparation for the discussion, please collect 7-10 images that represent your thoughts, feelings, impressions, and concerns about living a healthy life. These can be photographs, pictures torn out of magazines, newspaper clippings, images you print from the web, hand drawings – images in any medium. This should be based on what you already think and feel about this topic (please do not do any new research). Please bring the images with you and be prepared to talk about what you see in them.

The images should reflect your thoughts and emotions about living a healthy life. We are looking for analogies or metaphors for your feelings. We know this can be a different way of thinking so I’d like to share some examples from unrelated projects. This is just to jump start your thinking based on images other people have picked to represent feelings or thoughts.

• A fuzzy sock to represent comfort, softness

• A picture of an iceberg to show there are some things hidden that you can’t see

• A picture of a river stone to illustrate time, smoothness

Look for images that show all aspects of how you feel about living a healthy life.

You will receive a gift of $25 to show our appreciation for completing this pre-discussion assignment

If you have any further questions, please contact

NAME

CONTACT EMAIL CONTACT TELEPHONE