Form NHTSA Form 1241 NHTSA Form 1241 Impaired Driving Online Survey

OMB Control No. 2127-0682

Expiration Date 02/28/2015

Online Survey Questionnaire

Impaired Driving Public Service Advertising Campaign

[INTRODUCTION] Thank you for taking this survey. Your opinions are important to us! Please be honest when answering the survey. Your answers are anonymous and confidential, and none of your information will be shared with any third parties.

This collection of information is voluntary and will be used for formative purposes only so that we may develop communications programs designed to reduce the number of traffic-related injuries and deaths. Public reporting burden is estimated to average 15 minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. We will not collect any personal information that would allow anyone to identify you. Please note that a federal agency many not conduct or sponsor and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB control number. The OMB generic control number for this collection is 2127-0682.

1. Today, we are looking for people who work in certain industries or fields. Are you, or is any member of your immediate family or close friends employed in any of the following sectors?

1 TV/Radio/Press/Newspaper/ Magazine

2 Travel agency

3 Ad agency/Public Relations

4 Banking

5 Market Research/Marketing Consulting

6 Agriculture

7 Production or distributor of alcoholic beverages

8 Drug and Health Related Products Distributor

9 Insurance

10 Medical Field

11 None of the above

PROGRAMMING NOTE: If 1, 3, 5, or 7 checked Terminate

2. What is your gender?

1 Male

2 Female

3. What is your exact age? _________

(PROGRAMMER NOTE: MUST BE 21 OR OLDER; else Terminate)

4. Are you of Hispanic or Latino origin?

1 Yes

2 No

5. What is your race? Please select one or more. [^*Add popup option: “Why do we ask this question?”]

1 White

2 Black or African-American

3 Asian

4 Native Hawaiian or other Pacific Islander

5 American Indian or Alaska Native

6. What is the highest level of education that you have completed?

1 8^th grade or below

2 9th grade to 11th grade

3 High school graduate

4 Some college

5 Associate's degree

6 Bachelor's degree

7 Some postgraduate study

8 Graduate-school degree

9 Trade school

10 None of the above/Prefer not to state

7. Which classification best describes your total pre-tax household income? [^*Add popup option: “Why do we ask this question?”]

Under $10,000 [0]

$10,000-$19,999 [1]

$20,000-$29,999 [2]

$30,000-$39,999 [3]

$40,000-$49,999 [4]

$50,000-$74,999 [5]

$75,000-$99,999 [6]

$100,000-$124,999 [7]

$125,000-$149,999 [8]

$150,000-$174,999 [9]

$175,000-$199,999 [10]

More than $200,000 [11]

Prefer not to state [12]

8. What is your current employment status?

1 Employed full-time

2 Employed part-time

3 Temporarily unemployed

4 Full-time student

5 Part-time student

6 Retired

[PROGRAMMER NOTE: ASK Q9 IF 1 OR 2 IS CHECKED IN Q8]

9. What is your occupation? (Read list and record one answer below.)

1 Professional (such as a doctor, lawyer, accountant, consultant)

2 Executive/Manager

3 Technical (such as a computer programmer, medical technician)

4 Services

5 Clerical

6 Sales/Advertising/Marketing

7 A trade, such as plumber or electrician

8 Laborer

9 Other

10 Prefer not to answer

[PROGRAMMER NOTE: ASK Q10 IF 1 OR 2 IS CHECKED IN Q8]

10. Is the type of work you do compensated on:

1 A salary, that is exempt from overtime

2 An hourly basis, that is non-exempt from overtime

11. Which of the following activities do you do frequently, meaning at least three or four times a week?

Working out	Yes	No
Driving an automobile	Yes	No
Reading a book	Yes	No
Watching the news on TV	Yes	No

[PROGRAMMER NOTE: Must select “yes” for ‘driving an automobile’ to continue]

12. Which of the following types of foods and beverages do you consume at least occasionally, meaning at least once a month?

Juice	Yes	No
Soy Milk	Yes	No
Alcoholic beverage	Yes	No
Soda	Yes	No
Coffee	Yes	No

[PROGRAMMER NOTE: Must select “yes” for ‘Alcoholic beverage’ to continue]

13. Different people make different decisions about the amount of alcohol that they will drink if they know they will be driving afterwards. If you are at a social occasion lasting a few hours, about how many drinks do you typically allow yourself if you are planning to drive home afterwards?

1 1 drink

2 2 drinks

3 3 drinks

4 4 drinks

5 5 drinks

6 6 drinks

7 7 drinks

8 8 drinks

9 9 drinks

10 10+ drinks

11 I never drink any alcohol if I need to drive afterwards

14. When people are out socializing and having a few drinks, there may be times when they feel “buzzed” or somewhat impaired, even though they do not feel drunk or out of control. If you have driven somewhere to socialize and you are feeling “buzzed” or somewhat impaired, how likely is it that you will drive yourself home?

1 Extremely likely

2 Very likely

3 Somewhat likely

4 Not too likely

5 Not at all likely

6 Not applicable – I never drink any alcohol if I need to drive afterwards

15. If you are out socializing and feeling “buzzed” or somewhat impaired, which statement best describes you?

1 I’ll drive without worrying too much about it

2 I’ll drive even though I worry about it

3 I’ll always get a ride from a friend, get a taxi or use public transportation

4 Not applicable – I never drink any alcohol if I need to drive afterwards

16. Among the friends you socialize with, which statement generally best describes what they would do if they were feeling “buzzed” or somewhat impaired?

1 My friends will generally drive without worrying too much about it

2 My friends will generally drive even though they would worry about it

3 My friends will generally get a ride from a friend, get a taxi or use public transportation

4 Not applicable – My friends generally never drink any alcohol if they need to drive afterwards

17. As an issue in your community, how personally concerned are you about drunk driving prevention?

1 Extremely concerned

2 Very concerned

3 Somewhat concerned

4 Not too concerned

5 Not at all concerned

18. In your community, if somebody drives drunk, how likely do you think it is that he or she will get caught by law enforcement?

1 Extremely likely

2 Very likely

3 Somewhat likely

4 Not too likely

5 Not at all likely

19. How much do you agree or disagree with the following statements?

[RANDOMIZE STATEMENTS]	1 Disagree strongly	2 Disagree somewhat	3 Agree somewhat	4 Agree strongly	5 Not sure
A. There was a time recently when I probably had too much to drink before getting behind the wheel
B. There was a time recently when I decided to NOT drive after drinking
C. I’m confident in my ability to tell when I am too impaired to drive
D. I know when I am over the legal blood alcohol limit for driving
E. The legal blood alcohol limit for driving in my state is too strict
F. I don’t drink too much and drive, but many of my friends do

20. Have you recently done any of the following? (Please check all that apply.)

A. Discussed the risks of drinking and driving with a friend or family member	Yes	No
B. Stopped an impaired friend or family member from driving after drinking	Yes	No
C. Cut down on drinking alcoholic beverages while out socializing	Yes	No

21. In the past, have you ever been in a situation where you decided to

NOT drive after drinking, even though you had originally planned to drive?

1 Yes

2 No

[PROGRAMMER NOTE: IF YES to Q21 THEN ASK Q22]

22. When was the last time this happened?

1 About a week ago

2 A few weeks ago

3 A month ago

4 A few months ago

5 A year ago

6 A few years ago

7 Not sure

23. In the past, have you ever tried to stop someone who was about to drive after drinking?

1 Yes

2 No

[PROGRAMMER NOTE: IF YES TO Q23 THEN ASK Q24]

24. When was the last time you tried to stop someone who was about to drive after drinking?

1 About a week ago

2 A few weeks ago

3 A month ago

4 A few months ago

5 A year ago

6 A few years ago

7 Not sure

25. What are the potential consequences of driving while under the influence of alcohol? Please list as many consequences as you perceive. [Open-ended]

26. People have different reasons about why they become concerned about driving after they drink too much. For each risk described below, please indicate how important a role it plays in affecting your decision-making about drinking and driving. Please be honest.

[RANDOMIZE LIST]	Not at all important	Not too important	Somewhat important	Very important
I could get myself killed
I could get someone killed
I could get seriously injured
I could get someone seriously injured
I could get caught and sentenced to jail time
I could get caught and my license could be suspended
I could get caught and people I know could learn about it
I could get caught and lose a lot of money
I could mess up my car
I could mess up plans for my future
I could experience unintended consequences

27. Have you seen, heard or read anything about drunk driving prevention anywhere recently including all the different kinds of advertising, publicity and other activities that talk about it?

1 Yes

2 No

3 Not sure

[PROGRAMMER NOTE: IF “Yes” TO Q27 THEN ASK Q28]

28. (Where was that…? (Accept multiple responses.)

A. TV Program	Yes	No
B. TV Ad	Yes	No
C. Radio Program	Yes	No
D. Radio Ad	Yes	No
E. Magazine Article	Yes	No
F. Magazine Ad	Yes	No
G. Newspaper Article	Yes	No
H. Newspaper Ad	Yes	No
I. Internet or Web	Yes	No
J. Outdoor billboards or outdoor posters	Yes	No
K. From friends or family	Yes	No
L. Some other place (Specify)__________	Yes	No

[PROGRAMMER NOTE: IF “Yes” TO Q27 THEN ASK Q29]

29. Can you briefly describe any public service advertising about drunk driving that you remember seeing or hearing recently?

(Please be as specific as possible while entering your answer in the space provided below.) [Open-ended]

• Not applicable – I don’t remember any drunk driving prevention ads.

30. Please write down any drunk driving prevention slogans or taglines that you may have recently seen or heard in advertising or the media?

(Please be as specific as possible while entering your answer in the space provided below.) [Open-ended]

• Not applicable – I don’t remember any drunk driving prevention slogans or taglines.

31. Are you aware of any public service ads with the slogan “Buzzed Driving Is Drunk Driving”?

1 Yes

2 No

3 Not sure

[PROGRAMMER NOTE: IF “Yes” TO Q31 THEN ASK Q32] (Accept multiple responses.)

32. Where did you see or hear ads that said “Buzzed Driving Is Drunk Driving”?

A. TV Program	Yes	No
B. TV Commercial	Yes	No
C. Radio Program	Yes	No
D. Radio commercial	Yes	No
E. Magazine article	Yes	No
F. Magazine ad	Yes	No
G. Newspaper article	Yes	No
H. Newspaper ad	Yes	No
I. Internet or Web	Yes	No
G. Outdoor billboards or outdoor posters	Yes	No
H. From friends or family	Yes	No
I. Some other place (Specify)__________	Yes	No

33. In the past 30 days, have you seen any public service TV ads about drunk driving prevention sponsored by “Project Roadblock”?

[SHOW END FRAME OF PROJECT ROADBLOCK]

1 Yes

2 No

3 Not sure

34. Are you aware of any drunk driving prevention public service ads with the slogan “Drive Sober or Get Pulled Over”?

1 Yes

2 No

3 Not sure

35. Have you seen or heard any public service ads about drunk driving prevention with the slogan “Buzzed. Busted. Broke.”?

1 Yes

2 No

3 Not sure

36. Are you aware of any public service ads that talk about the monetary cost of buzzed driving?

1 Yes

2 No

3 Not sure

37. Please state the approximate total monetary amount that someone caught buzzed driving is subject to pay (including fines, legal fees, and increased insurance rates). [Open-ended]

[PROGRAMMER NOTE: Please provide a box to check for “I do not know.”]

[INTRO TO Q38]

On the next several screens you will see some TV public service ads. For each, please indicate whether or not you have seen it.

[RANDOMIZE ORDER OF AD RECOGNITION QUESTIONS Q38-53: KEEP MEDIA TYPE TOGETHER IN BLOCK.]

[SPLIT SAMPLE FOR Q38 & 39: RESPONDENT RANDOMLY ASSIGNED 1 OF 2.]

38. Below is a video file of a public service TV ad that you may have seen.

[PLAY “AMBULANCE VIDEO FILE]

Have you seen this public service ad?

1 Yes

2 No

3 Not sure

39. Here is a description of a public service TV ad that you may have seen.

[INSERT MONTAGE OF BUZZED :10 SPOTS PHOTOBOARD AND DESCRIPTION]

Have you seen any of these this public service ads? (Please select as many as apply.)

1 Yes, I saw an ad like this on TV

2. Yes, I saw an ad like this online

3 No, I’ve never seen any ads like this

4 Not sure

40. Below is a video file of a public service TV ad you might see.

(Please note that the ‘forward’ button will appear at the bottom of the screen, once the ad is almost completed)

PN: Play video “BAR MATH”

Have you seen this public service ad?

1. Yes, I have seen this

2. No, I have not seen this ad

3. Not sure

41. Below is a video file of a public service TV ad you might see.

(Please note that the ‘forward’ button will appear at the bottom of the screen, once the ad is almost completed)

PN: Play video “MONKEY IN THE MIDDLE”.

Have you seen this public service ad?

1. Yes, I have seen this

2. No, I have not seen this ad

3. Not sure

42. Below is a video file of a public service TV ad you might see.

(Please note that the ‘forward’ button will appear at the bottom of the screen, once the ad is almost completed)

PN: Play video “SOLITARY CONFINEMENT”.

Have you seen this public service ad?

1. Yes, I have seen this

2. No, I have not seen this ad

3. Not sure

43. Below is a video file of a public service TV ad you might see.

(Please note that the ‘forward’ button will appear at the bottom of the screen, once the ad is almost completed)

PN: Play video “BAD DATERS”.

Have you seen this public service ad?

1. Yes, I have seen this

2. No, I have not seen this ad

3. Not sure

44. Below is a video file of a public service TV ad you might see.

(Please note that the ‘forward’ button will appear at the bottom of the screen, once the ad is almost completed)

PN: Play video “NEON SIGNS”.

Have you seen this public service ad?

1. Yes, I have seen this

2. No, I have not seen this ad

3. Not sure

[SPLIT SAMPLE Q45 AND Q46: RESPONDENT RANDOMLY ASSIGNED 1 OF 2.]

45. Have you heard a public service ad on the radio that depicts a scene in the emergency room after a drunk driving crash? A doctor is treating a woman with a head injury and he tells her boyfriend to get out and stay in the waiting room. The boyfriend is upset and says, “I was just buzzed.” The doctor says, “Oh, in that case she is fine.” The boyfriend says, “Really??” And the doctor replies “Are you serious? Of course she’s not fine.” An announcer then says, “Buzzed driving. Maybe we should stop acting like it’s no big deal. Buzzed driving is drunk driving.”

Have you heard this public service ad on the radio?

1 Yes

2 No

3 Not sure

46. Have you heard a public service ad on the radio that depicts a scene where two women are talking in a car while driving home from a party? As they are talking, the driver crashes the car. In the aftermath, her friend is in pain and says she has broken her arm. The driver is upset and she says, “I was just buzzed.” Her friend says, “Oh, in that case I’m fine” and you hear her arm snap back into place. The driver says, “Really? Are you serious?” And her friend replies “No I’m not serious!” and she cries out in pain. An announcer then says, “Buzzed driving. Maybe we should stop acting like it’s no big deal. Buzzed driving is drunk driving.”

Have you heard this public service ad on the radio?

1 Yes

2 No

3 Not sure

[SPLIT SAMPLE Q47/Q48/Q49: RESPONDENTS RANDOMLY ASSIGNED 2 OF 3.]

47. [INSERT AUDIO FILE: EXPENSIVE NIGHT]

Have you heard this public service ad on the radio?

1 Yes

2 No

3 Not sure

48. [INSERT AUDIO FILE: GPS]

Have you heard this public service ad on the radio?

1 Yes

2 No

3 Not sure

49. [INSERT AUDIO FILE: DRIVE AROUND]

Have you heard this public service ad on the radio?

1 Yes

2 No

3 Not sure

50. Have you seen any of these ads in a newspaper, magazine, or some other place?

[INSERT PRINT MONTAGE: BREATHALYZER]

1 Yes

2 No

3 Not sure

51. Have you seen any of these ads on a billboard, poster, or some other place?

[INSERT OOH MONTAGE: BREATHALYZER/NEON SIGNS]

1 Yes

2 No

3 Not sure

52. Have you seen any of these ads online?

[INSERT WEB BANNER MONTAGE_PLEDGE/VIDEO/GAME/BAR MATH]

1 Yes

2 No

3 Not sure

53. Have you seen any of these ads online?

[INSERT WEB BANNER MONTAGE_NEON SIGNS]

1 Yes

2 No

3 Not sure

[ASK Q54 IF YES TO ANY QUESTION Q38-53]

54. In your opinion, how effective is the “Buzzed Driving Is Drunk Driving” advertising that you have seen or heard?

1. Extremely effective

2. Very effective

3. Somewhat effective

4. Not too effective

5. Not at all effective

[SEPARATE SCREEN] You are almost done. These last few questions will help us divide the interviews into groups.

55. In a typical week, how much time do you spend accessing the Internet?

SP (Drop down box)

Under 1 hour [0]

1 to 2 hours [1]

3 to 4 hours [2]

5 to 9 hours [3]

10 to 19 hours [4]

20 to 29 hours [5]

30 to 39 hours [6]

40 hours or more [7]

Not sure [-1]

56. On a typical day, how many hours of TV do you watch?

SP (Drop down box)

Under 1 hour [0]

1 to 2 hours [1]

2 to 3 hours [2]

3 to 4 hours [3]

4 to 5 hours [4]

5 to 8 hours [5]

8 to 10 hours [6]

10 hours + [7]

Not sure [-1]

57. On a typical day, how many hours do you spend listening to the radio?

SP (Drop down)

Under 1 hour [0]

1 to 2 hours [1]

2 to 3 hours [2]

3 to 4 hours [3]

4 to 5 hours [4]

5 to 8 hours [5]

8 to 10 hours [6]

10 hours + [7]

Not sure [-1]

58. Are you the parent or guardian of any children under the age of 18 living in your household?

1 Yes

2 No

[PROGRAMMER NOTE: ASK Q59 IF YES TO Q58]

59. Please check the appropriate box if you have a child in that age category living in your household:

1 5 years old or younger

2 6-12 years old

3 13-17 years old

`

60. What is your marital status?

1 Never married (Single)

2 Living together but not married

3 Married

4 Separated

5 Divorced

6 Widowed

7 Prefer not to state

61. Do you live in the city, suburbs, or some other area?

1 City

2 Suburbs

3 Some other area

62. What state do you live in?

[DROP DOWN BOX WHICH INCLUDES ALL 50 STATES AND DISTRICT OF COLUMBIA]

In which state do you currently reside?

1. AK West	14. ID West	27. MT West	40. RI Northeast
2. AL South	15. IL Midwest	28. NE Midwest	41. TN South
3. AR South	16. IN Midwest	29. NV West	42. TX South
4. AZ West	17. KS Midwest	30. NH Northeast	43. UT West
5. CA West	18. KY South	31. NJ Northeast	44. VA South
6. CO West	19. LA South	32. NM West	45. VT Northeast
7. CT Northeast	20. ME Northeast	33. ND Midwest	46. SD Midwest
8. DC South	21. MD South	34. NC South	47. SC South
9. DE South	22. MA Northeast	35. NY Northeast	48. WA West
10. FL South	23. MI Midwest	36. OH Midwest	49. WI Midwest
11. GA South	24. MN Midwest	37. OK South	50. WV South
12. IA Midwest	25. MO Midwest	38. OR West	51. WY West
13. HI West	26. MS South	39. PA Northeast

* These questions about [race/income] are important so that we make sure the voices of people in all different populations are represented. In this way, we can be fair and objective by adjusting our results based on the proportions of the various groups in the larger population.

Collecting data from all respondents on this question is important so that we can better and more reliably report differences and similarities between people of different backgrounds.

We understand that you might be concerned about sharing this information. Please be assured that the responses you provide are kept completely confidential. Any identifying information will be separated from your answers. Results are reported using the average, or pooled answers to the questions, instead of the responses of any one individual.

* These questions about [race/income] are important so that we make sure the voices of people in all different populations are represented. In this way, we can be fair and objective by adjusting our results based on the proportions of the various groups in the larger population.

Collecting data from all respondents on this question is important so that we can better and more reliably report differences and similarities between people of different backgrounds.

We understand that you might be concerned about sharing this information. Please be assured that the responses you provide are kept completely confidential. Any identifying information will be separated from your answers. Results are reported using the average, or pooled answers to the questions, instead of the responses of any one individual.

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NHTSA Form 1241