Public reporting burden of this collection of information is estimated to average seven minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx)
/ask of all//
from brfss
GENHLTH Would you say that in general your health is—? (73)
1 Excellent
2 Very good
3 Good
4 Fair Or
5 Poor
97 Don’t know / Not sure
99 Refused
//ask of all//
from brfss
SMOKE100 Have you smoked at least 100 cigarettes in your entire life?
NOTE: 5 packs = 100 cigarettes
1 Yes
2 No
97 Don’t know / Not sure
99 Refused
//ask if SMOKE100=1//
from brfss
SMOKDAY2 Do you now smoke cigarettes every day, some days, or not at all?
1 Every day
2 Some days, or
3 Not at all
97 Don’t know / Not sure
99 Refused
//ask if SMOKDAY2=1 or 2//
BUYCIG When you buy cigarettes, about how often do you take advantage of promotional offers such as coupons, rebates, buy 1 get 1 free, “dollar-off,” and 2 for 1?
1 Never
2 Rarely
3 Sometimes
4 Often
5 All the time
97 Don’t know / Not sure
99 Refused
//ask if SMOKDAY2=1 or 2//
TRYQUIT During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?
1 yes
2 no
97 Don’t know / Not sure
99 Refused
//ASK OF ALL//
QUESTION FROM NHIS, BUT THE BASE HERE IS ALL. ON NHIS, IT’S PEOPLE WHO HAVE HAD AT LEAST 12 DRINKS. sLIGHT MODIFICATION to the QUESTION TO INCLUDE THE ALCOHOL DESCRIPTION.
ALC12MNO. Alcoholic beverages include beer, wine, wine coolers, liquor such as whiskey or gin, and any other type of alcoholic beverage. In the past year, how often did you drink any type of alcoholic beverage?
Read if necessary: "How many days per week, per month or per year did you drink?"
FOR “NONE”, ENTER 0
ENTER NUMBER /RANGE 000-365/
ENTER UNIT
1=DAYS IN THE YEAR
2=DAYS PER WEEK
3=DAYS PER MONTH
//ask all//
SMRTPHN. Is the phone you’re using an iPhone, Android phone, Blackberry, or any other kind of smartphone?
if necessarY: A smartphone is a cell phone you can use to browse the internet.
1 yes
2 no
97 Don’t know / Not sure
99 Refused
ask if smrtphon=1
RECRUIT. CDC is conducting a special survey just with smartphone users. Would you be willing to complete two very short online surveys using your smartphone? We’re offering survey participants up to $10 for their time.
if necessary: Each survey will be about //five// questions long
if necessary: we will text you links to the surveys.
if necessary: for each survey you complete, including this one, you get three or four points. At the end of all the surveys, we’ll send you an amazon gift code or a paypal email with a dollar for every point you earned.
1 yes
2 no
ask if recruit=1
DETAIL. Great! Here’s how it will work. Once a week, we will send you a text message to this number with a link for you to follow to take the survey. There will be two total surveys. They’re all about five questions long, so they only take about two minutes to complete.
All the surveys are voluntary. You don’t have to answer any question you don’t want to. You can stop receiving messages from us by replying with the word “STOP” at any time.
You have already received four points for the survey you just completed. For each additional survey you complete, you will get three points. As you complete each of the weekly surveys, you will get more points, up to ten in total. At the end of the study, we’ll give you a dollar for each point you earned.
Are you willing to participate in the surveys?
1 yes
2 no
97 dk
99 ref
ask if detail=1
DETLSP. We can either text an Amazon gift code in the right amount straight to your phone, or we can send you a PayPal email with the amount. If you want the PayPal e-mail, we’ll need to collect your email address now, and you’ll need a free PayPal account to collect the money.
Would you prefer the Amazon gift code or the PayPal email?
1 Amazon
2 paypal
97 dk
99 ref
ask if smrtphon=2 and txt recruits<200
RECRTTX. CDC is conducting a special survey just with cell phone users. Would you be willing to complete two very short surveys via text message? We’re offering survey participants an Amazon.com gift code of up to $10 for their time.
if necessary: Each survey will be about //five// questions long
if necessary: we will text you the questions,
if necessary: for each survey you complete, including this one, you get three or four points. At the end of all the surveys, we’ll send you an amazon gift code with a dollar for every point you earned.
1 yes
2 no
ask if recruittx=1
DETLTX. Great! Here’s how this will work. Sometime in the next day, you’ll get a text message asking you to confirm that you have agreed to participate. Text “yes” in response to that message to sign up.
There will be two total surveys. They’re all about five questions long, so they only take about two minutes to complete.
All the surveys are voluntary. You don’t have to answer any question you don’t want to. You can stop receiving messages from us by replying with the word “STOP” at any time.
You have already received four points for the survey you just completed. For each additional survey you complete, you will get three points. As you complete each of the weekly surveys, you will get more points, up to ten in total. At the end of the study, we’ll give you an Amazon.com gift code worth a dollar for every survey point you earned.
Are you willing to participate in the surveys?
1 yes
2 no
97 dk
99 ref
ask if DETLSP =97
The Amazon gift code is easier, so we’ll just do that.
ask if DETLSP in (1, 97)
OK, I just need to know your cell phone carrier so that we can send you text messages. Who is your carrier?
list carriers
ask if DETLSP =2
EMAIL To send you the PayPal email, I’ll need your email address. What is that?
enter the first part of the email
@
Enter the second part of the email
.
Enter the last part of the email /.gov .com .edu .net are the only legal values/
97 dk
99 ref
ask if DETLSP =2
ECONF OK, I have that your email is FIRST.SECOND.LAST. Is that right?
1 yes
2 no
if econf=2 then ask email again.
if email in 97, 99, assign to amazon condition
ask if detail in (1) or DETLTX in (1)
CLOSE Great, you can expect your first invitation in about a week. Thanks so much for your participation!
ask if recruit=2 or detail in (2, 97,99) or recrttx=2 or DETLTX in (2,97,99)
CLOSE1. Thanks! Those are all the questions I have today. Thank you so much again for your time.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | 21280 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-29 |