First Text Message

Use of Smartphones to Collect Information about Health Behaviors: Feasibility Study

Appendix G. First Text Msg Follow-up for non-SP Users_4 08 2013

First Text Message Survey Follow-up for Non-Smartphone Users

OMB: 0920-0972

Document [docx]
Download: docx | pdf

Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/xxxx

First Text Message Survey Follow-up for non-Smartphone Users

Public reporting burden of this collection of information is estimated to average three 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)



  • within 24 hours of phone opt in

  • ask of all

OPTIN

TXT Survey: Thanks for participating in the ICF text surveys. Do you remember agreeing to participate? Reply “Yes”. Reply “STOP” to end survey messages.

  • monday morning

  • Display if optin=yes

You have [POP IN] survey points.

  • ask if optin=yes

ALC1

TXT Survey: Last week, did you drink any type of alcoholic beverage? Reply “Yes” or “No”. Reply “STOP” to end survey messages.

  • ask if alc1=1

ALC2

TXT Survey: Last week, how many alcoholic beverages did you drink? Reply with the number of drinks. Reply “STOP” to end survey messages.

  • ask if optin=yes

SMK1

TXT Survey: Last week, did you smoke any cigarettes at all? Reply “Yes” or “No”. Reply “STOP” to end survey messages.

  • ask if SMK1 =1

SMK2

TXT Survey: Last week, how many cigarettes did you smoke? Reply with the number of cigarettes. Reply “STOP” to end survey messages.

  • ask if optin=yes

  • from nats



  • Ask if smk1=1

CIGWARN

TXT Survey: During the past 7 days, have warning labels on cigarette packages led you to think about quitting? Reply “Yes”, “No”, or “I did not see warning labels”. Reply “STOP” to end survey messages.



  • ASK OF ALL

OTHTOB In the past 7 days, have you used any of the following products at least once:

  • ASK OF ALL



OTHTOB_A

TXT Survey: Cigars, cigarillos, or little cigars? Reply “Yes” or “No”. Reply “STOP” to end survey messages.

1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_B

TXT Survey: Chewing tobacco, snuff, or dip? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_C

TXT Survey: Snus, such as Camel or Marlboro snus? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_D

TXT Survey: Dissolvable tobacco products like Ariva, Stonewall, Camel orbs, Camel sticks, or Camel strips? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL



OTHTOB_E

TXT Survey: Electronic Cigarettes or E-cigarettes, such as Ruyan or NJOY? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL



OTHTOB_F

TXT Survey: Flavored little cigars? Reply “Yes” or “No”. Reply “STOP” to end survey messages.

1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_G

TXT Survey: Water pipes, also known as hookahs? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_H

TXT Survey: Clove cigarettes or clove cigars? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_I

TXT Survey: Roll your own cigarettes? Reply “Yes” or “No”. Reply “STOP” to end survey messages.

1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED



  • ASK OF ALL

OTHTOB_J

TXT Survey: Flavored cigarettes like Camel Crush? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



1. YES

2. NO

97. DON’T KNOW/NOT SURE

99. REFUSED













  • ASK OF ALL

HISP

TXT Survey: Are you Hispanic or Latino? Reply “Yes” or “No”. Reply “STOP” to end survey messages.



  • ASK OF ALL

RACE

TXT Survey: Which one or more of the following do you consider yourself to be? White, Black/African American, Asian, Native Hawaiian/Pacific Islander, or American Indian/Alaska Native? Reply with the race(s) you consider yourself to be. Reply “STOP” to end survey messages.



  • read to all

CLOSE1

TXT Survey: Thanks, this week’s survey is complete! You received a total of [POP IN] survey points.

  • read if STOP received at any time

CLOSE2

TXT Survey: All the surveys are complete. You received a total of [POP IN] survey points. Your Amazon.com gift code in the amount of $[POP IN] is: XXXX. Thanks!



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
Author21280
File Modified0000-00-00
File Created2021-01-29

© 2024 OMB.report | Privacy Policy