NSUBS Appendices

THE NATIONAL SURVEY OF THE USE OF BOOSTER SEATS

OMB Clearance Number: 2127-0644

Appendices

1. References

Glassbrenner, D. (2002, September). Safety Belt and Helmet Use in 2002 – Overall Results. DOT HS 809 500. Washington, DC: National Highway Traffic Safety Administration.

Glassbrenner, D. (2009, April). NCSA Technical Report: The 2006 National Survey of the Use of Booster Seats—Methodology Report. DOT HS 811 111. Washington, DC: National Highway Traffic Safety Administration.

Office of Management and Budget, Update of Statistical Area Definitions and Guidance on Their Uses, OMB BULLETIN NO. 05-02, February 2005.

Public Law 107-318, 107^th Congress, Anton’s Law, 114 STAT. 1800, December 4, 2002.

2. Data Collection Forms

The following forms were used by the data collectors to record the survey data. Each data collector was given one “booklet” of forms for each site visit, plus additional booklets that they could use at a given site if necessary (this will occur if they record data on more than 20 vehicles at a given site).

A “booklet” consisted of the form “Booster Seat Survey Recording Form” (displayed below, modified so as to keep anonymous the names of the five fast food chains that participated in the survey) as a cover page, followed by 20 copies of the untitled form displayed below following the Booster Seat Survey recording form (i.e., the form that displays the survey’s OMB number).

The pages of the booklet were numbered. The displayed second form below, which has also been modified to keep anonymous the participating fast food chains, shows Page 1.

Hi, My name is _ from Westat, a national research organization. We are conducting a Booster Seat Survey for the National Highw ay Traffic Safety Administration. We w ould simply like to record the restraint use of everyone in your vehicle and ask some simple questions. All your responses and any observations I

make are completely confidential.

Can you tell me the Age of this child? Height? Weight?

Survey Questions

1. In the past w eek, how many minutes did this child spend in a vehicle driven by you?

2. In the past w eek how ma ny times did you visit a gas station w hen this child was in a vehicle with you?

3. In the past w eek how many times did you go to a (Chain 1) w ith this child in a vehicle

with you?

(Chain 2)? (Chain 3)? (Chain 4)? (Chain 5)?

4. In the past week how m any tim es did y ou go to a recreatio n center wh e n th is c hild was in a vehicle with y ou?

Which one(s )?

5. In the past w eek, how many times did you go to a day care center w ith this child in a vehicle with you?

Whic h o ne(s )?

Booster Seat Survey Recording Form

Date: _	PSU #:	Site # : _
Start Time for Booklet AM PM		End Time for Booklet AM PM

Site Type: Gas Station Fast Food Day Care Recreation Center Site Name Street Address _

Weather : Light Precipitation Light Fog Clear

Area : Urban Suburban Rural

_{Total Misses:}

B oo k let # o f

Total Refusals:

Observer Name:

PSU # Site #

MM / DD / YY

Car Pickup Van/SUV

Booklet # of

Page 1

₁^st _Row

₂^nd _{Row 3}^rd _Row

_{Driver Middle Right} ^{Question Key}

Driver Side

Middle

_Right ^{Driver Side Middle Right}

ADULT AGE ADULT AGE ADULT AGE

Adult Age Group

ADULT AGE

ADULT AGE ADULT AGE ADULT AGE ADULT AGE ADULT AGE

BELT RACE

GENDER

BELT RACE

GENDER

BELT RACE

GENDER

Restraint use

Race [ B W O ] Gender [ M F ]

BELT RACE

GENDER

BELT RACE

GENDER

BELT RACE

GENDER

BELT RACE

GENDER

BELT RACE

GENDER

BELT RACE

GENDER

Teen (T)

(13 -15)

Young (Y)

(16 -24)

Adult (A)

(25 -69)

Senior (S)

(70+)

YY / MM FT / IN

^LBS.

HH : MM

YY / MM FT / IN

^LBS.

HH : MM

Childre n O NLY( < 12 yrs)

Age Height Weight

1. Time in Vehicle

YY / MM FT / IN

^LBS.

HH : MM

YY / MM FT / IN

^LBS.

HH : MM

YY / MM FT / IN

^LBS.

HH : MM

YY / MM FT / IN

^LBS.

HH : MM

YY / MM FT / IN

^LBS.

HH : MM

YY / MM FT / IN

^LBS.

HH : MM

Confidential Survey Information WESTAT, Rockville, MD 20850 (301) 251-1500

OMB Permit No.: 2127 -0644

GAS McD Taco BK Wendy

KFC

GAS McD Taco BK Wendy

KFC

2. Gas station

3. Fast Food

Times in the Past Week:

(Chain 1) (Chain 2) (Chain 3)

(Chain 4)

(Chain 5)

GAS McD Taco BK Wendy

KFC

GAS McD Taco BK Wendy

KFC

GAS McD Taco BK Wendy

KFC

GAS McD Taco BK Wendy

KFC

GAS McD Taco BK Wendy

KFC

GAS McD Taco BK Wendy

KFC

# / NAME

# /

NAME

# / NAME

# /

NAME

4. Rec. Ctr. (Name)

5. Day Care (Name)

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

# / NAME

3. Card for Race/Ethnicity Questions

The following information was provided to data collectors on a laminated card to show to interviewees to aid in answering the race and ethnicity questions.

Are you of Hispanic or Latino origin?

1) Yes

2) No

What is your race? Please select one or more.

1) White

2) Black or African-American

3) Asian

4) Native Hawaiian or other Pacific Islander

5) American Indian or Alaskan Native

National Survey of the Use of Booster Seats

OMB Control No. 2127-0644

4. Letter of Authorization

The following letter of authorization on the following page was provided to the data collectors to show to people questioning their authority to conduct the survey.

U.S. Department of Transportation National Highway Traffic Safety Administration

400 Seventh Street, S.W. Washington, D.C. 20590

_{March 22, 2011}

To Whom It May Concern:

Westat is under contract to the National Highway Traffic Safety Administration, U.S. Department of Transportation, to conduct a survey on child passenger transportation characteristics. The data collection phase consists of indentifying vehicles with child passengers and conducting brief interviews with those drivers at selected sites across the country. The survey will be conducted from July 14 through 31, 2011.

This county has been selected as one of the 16 areas across the United States that will be surveyed. Information from this survey will be used to help design programs that improve the safety of child passengers in motor vehicles.

Please direct any questions you may have to Westat Project Director, Ms. Fran Bents, at 1-800-937-8281 extension 7557. Thank you very much for your support of this important research program.

Sincerely,

Timothy M. Pickrell

NHTSA Program Manager

5. Frequently Asked Questions

The following list of questions and answers was provided to data collectors to help answer any questions that potential respondents or others might have about the survey.

How was I selected for the survey?

As you drove on to the property I noticed that there were children in the vehicle.

How many people are you interviewing?

We are interviewing approximately 4,800 drivers of vehicles with child passengers throughout the

United States.

What is the purpose of this study? What is this survey about?

This survey will allow the government to compute national estimates of child safety seat use.

How long will this take?

The survey takes 2-3 minutes to complete.

How will the study results be used? / What will you do with this information?

The survey will identify how children of different age groups are restrained when riding in a vehicle.

How do I know you will keep this information confidential?

We are not collecting any personal identifying information. We will not be asking for names or recording license plate information.

Why do you need to know the height and weight of my child(ren)?

The selection of appropriate child safety seats is dependent on age, height, and weight.

Why do you need to know how often my child goes to a gas station, fast food restaurant, daycare center, or recreation center?

Department of Transportation will use this information to generate national estimates.

How will the results be published? Will the results be made available?

The Department of Transportation will publish the results of the study. However, that can take up to a year or more. I can take your name and address and we can send you the study results when they are available.

Do I have to do this? / Do I have to answer this survey? / I don’t want to do this.

You do not have to respond, but your help is very important to us. The information will provide better national estimates on child safety seat use. You may refuse to answer any question at any time.

Why don’t you ask someone else?

We are attempting to stop every adult who is driving with children in the vehicle to better understand child safety seat use.

I had a bad experience recently with someone taking a survey, so I don’t think I want to participate.

I’m sorry that your experience was unpleasant. We hope to make your contact with us a pleasant

and interesting experience. This is a legitimate research effort, in which your responses will help us to learn about the use of child safety seats in passenger vehicles.

I think this whole business is stupid. The federal government could better spend my money. The money for this study could be spent more wisely, etc.

[Occasionally you will encounter an argumentative respondent. In spite of their statements, this is

usually a person who is interested in the study, but wants to talk about what he feels before consenting to complete the survey. Bear with him and hear him out! As long as he keeps talking, he has not refused to do the survey. Do not argue: simply make short, neutral comments to let him know you are listening.]

What is the authority/sponsor for this study?

The Department of Transportation is sponsoring this study. This survey is authorized by the

United States Code, Title 49, Section 111(c)(2).

Who do you work for?

I work for Westat, a survey research firm in the Washington, DC, area, and we have been contracted by the Department of Transportation to conduct this study.

Who can I call at the Department of Transportation?

If you have questions about your rights as a person who is part of this study, please call the DOT

at: [redacted]. Please leave a short message with your name, phone number, and mention that you are calling about the Booster Seat Survey. Someone will return your call as soon as possible.

How do I know the survey is legitimate? / How do I know that you are really an interviewer for this study?

If you would like, you can speak to my supervisor, or I can give you a toll-free number to call at

your convenience. The toll free number is: [redacted] and ask to speak with [redacted]. I also have an authorization letter with the toll-free number on it.

Does this survey have approval from the Office of Management and Budget (OMB)? / What is the

OMB number?

Yes, the study has been approved by the Office of Management and Budget (OMB). The approval number assigned to the study is 2127-0644 (it is listed on the side of the recording forms).

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