CNPP Journaling (Revised)

OMB CONTROL NO.: 0584-0523

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 15 minutes, including the time for reviewing instructions and completing the information.

Attachment A 1: CNPP Journal Screener Guide - English

CNPP Journaling Activity

Screener Guide - 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 to ask for your participation in a journaling project regarding your life priorities. This information will be use to expand the understanding of food choice behaviors.

Your participation means that you would record what happens in a typical day via an online portal. You can use any internet connected device. You will be asked to keep an on-line journal for 14 days. It will take you no longer than 30 minutes a day. We will give you $250 as a token of our appreciation. 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. There are no penalties if you chose not to participate. No advanced preparation is needed for this exercise.

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 Hispanic or Latino?

1. □ Yes  GO TO Q4

2. □ No

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. □ Native Hawaiian 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:

(3) Generation X and Low Income, Overweight/obese

(3) Generation X and Low Income, Healthy weight

(3) Generation X and High Income, Overweight/obese

(3) Generation X and High Income, Healthy weight

(3) Generation Y and Low Income, Overweight/obese

(3) Generation Y and Low Income, Healthy weight

(3) Generation Y and High Income, Overweight/obese

(3) Generation Y and High Income, Healthy weight

Thank you for completing the screening questions. As I mentioned previously, you have been invited to participate in a journaling project regarding your life priorities. Your participation means that you would record your work-life balance, everyday stresses and achievements via an online portal. You will receive $250 as a token of our appreciation after the completion of the journaling project.

Would you still like to participate?

If YES: Thank you for your cooperation. We can send you a link with instructions to your e-mail or text the link to your phone? Which one would you prefer?

Text

E-mail

[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:

(3) Bicultural and Low Income, Overweight/obese

(3) Bicultural and Low Income, Healthy weight

(3) Bicultural and High Income, Overweight/obese

(3) Bicultural and High Income, Healthy weight

Thank you for completing the screening questions. As I mentioned previously, you have been invited to participate in a journaling project regarding your life priorities. Your participation means that you would record your work-life balance, everyday stresses and achievements via an online portal. You will receive $__ as a token of our appreciation after the completion of the journaling project.

Would you still like to participate?

If YES: Thank you for your cooperation. We can send you a link with instructions to your e-mail or text the link to your phone? Which one would you prefer?

Text

E-mail

[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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