CMV Focus Group Screener

ATTACHMENT 3A

CMV Focus Group Screener

CMV Focus Group Screener

1. How old are you?

• IF 18-40 → CONTINUE

• IF <18 OR >41 →THANK AND END

2. Do you have a child who is 5 years old or less?

• IF YES → CONTINUE

• IF NO → THANK AND END

3. Are you currently pregnant?

TO BE ELIGIBLE, PARTICIPANTS MUST SAY YES TO EITHER Q3 OR Q4

• IF YES → SKIP TO Q5

• IF NO → CONTINUE

4. Do you plan to get pregnant within the next
   12 months?

• YES → CONTINUE

• NO → THANK AND END

5. Do you have a child with a disability?

• IF YES → THANK AND END

• IF NO → CONTINUE

6. Are you currently or have you ever been a health care provider (e.g., as a nurse, physician or medical assistant)?

• IF YES → THANK AND END

• IF NO → CONTINUE

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

• Less than high school

• High school diploma or GED

• Technical college/Associates degree

• Some college

• College degree

• Graduate degree

8. Are you of Hispanic or Latino origin?

( ) Yes → THANK AND END

( ) No

8. How would you describe your race/ethnicity?

• American Indian or Alaska Native → THANK AND END

• Asian → THANK AND END

• Black or African American

• Native Hawaiian or Other Pacific Islander → THANK AND END

• White

• Refused → THANK AND END

QUOTAS
	ATLANTA	SAN DIEGO
	Recruit 11 per group, for 6-9 participants each (n=44)	Recruit 11 per group, for 6-9 participants each (n=44)
Caucasian	(n=22)	(n=22)
African American	(n=22)	(n=22)
Education	Mix of education levels for each group	Mix of education levels for each group
Pregnancy status	Mix of pregnant and planning pregnancy (within next 12 months) for each group	Mix of pregnant and planning pregnancy (within next 12 months) for each group