NHTSA Form 1270 NHTSA UDDP Screener

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

NHTSA UDDP Screener_FINAL_KH sm (3)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 2127-0682

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OMB Control No. 2127-0682

Expiration Date 04/30/2018

Recruitment Screener

Teen Focus Groups to Develop

Underage Drinking and Driving Prevention Public Service Advertising Campaign

OMB Control No: 2127-0682: Focus Groups for Traffic and Motor Vehicle

Safety Programs and Activities

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. A federal agency may 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 Control Number for this information collection is 2127-0682. Public reporting for this collection of information is estimated to be approximately 10 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., W51-316, Washington, DC, 20590

PHONE SCREENING INTERVIEW GUIDE

NOTE TO RECRUITER: If a child answers the phone say, “May I speak with a parent or adult who lives in the household?”

INTRODUCTION: Hello, my name is _________ from [NAME OF FOCUS GROUP COMPANY] calling on behalf of the U.S. Department of Transportation. We are conducting a survey today among households in your area and would like to hear your opinions. This is not an attempt to sell you anything.

(INTERVIEWER NOTE: If necessary, read:)

[GO TO Q1]

REFERRED PROSPECT INTRODUCTION: Hello, my name is _________ from ______________, a market research firm. I’m calling today because ____________ has agreed to participate in a market research interview. The discussion would take place with __________ and five of his/her peers. He/she provided your child’s name as peer who might like to participate. This is not an attempt to sell anything. We are interested in your child’s opinions. If your child qualifies, is this something you might allow them to participate in? [IF YES, CONTINUE; OTHERWISE TERMINATE]

(INTERVIEWER NOTE: If necessary, read:)

All your answers will be kept confidential. Could we begin now?

( ) Yes

( ) No TERMINATE OR SCHEDULE CALLBACK

IF REFERRED PEER, SKIP TO Q3 TO VERIFY CHILD AGE.

Do you have any high school age children living in your home?

( ) Yes

( ) No TERMINATE

What are the age and gender of each of the high school-age children that are currently living in your home? [RECORD AGE OF EACH CHILD IN APPROPRIATE BOX]

	15 years or less	16 years	17 years	18 years or more
Male
Female
	TERMINATE	CONTINUE		TERMINATE

RESPONDENT MUST BE 16 OR 17 YEARS OLD TO CONTINUE.

What is your 16 or 17 year old child’s (children’s) grade level?

( ) Junior Year (11^th grade)

( ) Senior Year (12^th grade)

( ) Neither Junior or Senior Year TERMINATE

Are you the parent or guardian of the XX year old male/female that lives in your household?

( ) Yes CONTINUE

( ) No

IF NO, ASK TO SPEAK TO PARENT/GUARDIAN. IF NOT AVAILABLE, SCHEDULE CALL BACK OR THANK AND TERMINATE.

Now I am going to read a list of brief statements and I’d like you to tell me how well each statement describes your XX year old son/daughter. After I read each one, would you please tell me whether or not it describes you completely, somewhat, or not at all? [RECORD RESPONSE WITH “X” IN APPROPRIATE BOX]

	Describes completely	Describes somewhat	Describes not at all
My child enjoys meeting and talking to new people
My child is open about expressing his/her opinions in a group setting.
My child generally likes to spend his/her free time alone.

TERMINATE IF RESPONDENT SELECTS ANY SHADED BOXES.

Which of the following ranges includes your annual household income? (READ)

( ) Under $20,000 TERMINATE

( ) $20,000 - $29,999

( ) $30,000 - 49,999

( ) $50,000 – 79,999

( ) $80,000 - 99,999

( ) $100,000 and over

( ) unsure/prefer not to answer

AIM TO RECRUIT A MIX ACROSS GROUPS

Which of the following best describes your child’s race or ethnic origin?

( ) Hispanic or Latino

( ) American Indian or Alaska Native

( ) Asian

( ) Black or African American

( ) Native Hawaiian or Other Pacific Islander

( ) White

AIM FOR A MIX WITH SOME NON-CAUCASIANS ACROSS ALL RESPONDENTS. ENSURE AT LEAST 1-2 HISPANIC PARTICIPANTS PER MARKET

Do you or does anyone in your immediate family work for any of the following companies or industries? [READ LIST. MARK ALL THAT APPLY.]

A ( ) A market research, advertising, marketing, or public relations firm or department within a company TERMINATE

B ( ) A media company such as radio, newspaper, television, etc TERMINATE

C ( ) A company that sells, manufactures, or distributes any alcoholic beverages, excluding grocery and convenience stores TERMINATE

D ( ) Law enforcement TERMINATE

E ( ) Banking or Financial Services CONTINUE

F ( ) An energy, oil or fuel provider CONTINUE

TERMINATE IF YES TO A-D. CONTINUE IF ANSWER E-F.

PARENT INTRO TO INVITE FOR INITIAL RESPONDENT:

We are planning to hold a discussion with high school students to discuss decisions they make and hear their opinions.

PARENT INTRO TO INVITE FOR PEER REFERRAL

As mentioned, we are planning to hold a discussion with ________and some of his/her other high school peers. We want to discuss decisions they make and hear their opinions.

TOPIC DISCLOSURE – ALL PARENTS OF UNDERAGE PARTICIPANTS

This research project is being conducted by the National Highway Traffic Safety Administration (NHTSA). They are trying to understand teens’ opinions about public service advertising concepts that are designed to discourage underage drinking and driving. The research will not attempt to impact your child’s decisions or opinions; rather the agency wants to hear feedback from teens that will help them to refine the messaging. We will not be telling this to any of the teens participating in the research prior to the discussion because we do not want to influence their opinions. However, the organization felt it was important that parents know the topic ahead of time. The discussion would last 90 minutes, would take place on (DATE) and your child would be paid $75 for their time.

Now, I’d like to ask your XX age son/daughter a few questions and see if he/she is interested in participating. Would that be okay? Remember, we’d rather not have your child know the nature or purpose of the discussion until they find out during the discussion.

Could I speak with him/her? [IF PARENT WANTS TO LISTEN, INDICATE THAT WE’D RATHER THEY NOT SO THAT CHILD WILL FEEL COMFORTABLE BEING COMPLETELY HONEST. IF PARENT INSISTS, PLEASE MAKE NOTE OF THAT ON THE SCREENER AND REQUEST THAT CHILD BE ALLOWED TO ANSWER ON HIS/HER OWN.]

TO ALL 16-17 TEENS:

Hi my name is __________ . I was just speaking with your [mom/dad] about market research discussions that we’re putting together with teens your age about lifestyle influences and decisions. If you might be interested in participating in this kind of discussion, I’d like to ask you a few quick questions about yourself. Can I ask you a few questions? [UNLESS PARENT HAS OPTED TO LISTEN:] Please be assured that we will not be sharing your answers to these questions with your parents and everything you say is confidential.

Have you ever participated in a market research study such as a focus group or interview?

( ) Yes CONTINUE TO Q11

( ) No SKIP TO Q12

Approximately when was the last time you participated in a market research study?
[DO NOT READ LIST]

( ) Within the past six months TERMINATE

( ) Longer than six months ago CONTINUE

Do you currently have a valid driver’s license?

( ) Yes CONTINUE

( ) No TERMINATE

MUST HAVE A VALID DRIVER’S LICENSE TO CONTINUE

Do you currently own or have access to a vehicle that you are allowed to drive?

( ) Yes CONTINUE

( ) No TERMINATE

Which of the following statements describes your driving habits in a typical week? (READ)

A ( ) I’m a “weekday driver.” I drive mostly on weekdays, like when I commute to/from school. CONTINUE

B ( ) I’m a “weekend driver.” I spend the most time behind the wheel on weekends (Friday- Sunday). CONTINUE

C ( ) I’m a “road warrior.” I drive more than 100 miles in a typical week, whether for school, work or leisure. CONTINUE

D ( ) I’m a “moderate driver.” I drive most days, but I log fewer than 100 miles in a typical week. CONTINUE

E ( ) I’m a “driveway dweller.” I drive very little. TERMINATE

F ( ) None of these statements describe my driving behavior. TERMINATE

MUST ANSWER A-D TO CONTINUE; TERMINATE IF ANSWER E-F.

Where you live, do you have easy access to public transport such as buses or a subway system?

( ) Yes CONTINUE TO Q 16

( ) No SKIP TO Q17

[ASK IF YES IN Q15]

How often do you take public transport?

( ) Daily TERMINATE

( ) On the weekends TERMINATE

( ) During the week but not on the weekends

( ) Occasionally

( ) Hardly ever

How much TV or video content do you watch on a typical day (this can be on any platform – television, laptop/desktop, tablet, smartphone)?

( ) Under 1 hour TERMINATE

( ) 1-2 hours CONTINUE

( ) More than 2 hours CONTINUE

Which of the following social activities, if any, have you engaged in over the past month? (READ)

( ) Dining out with friends

( ) Attending concerts or theater productions

( ) Attending house parties

( ) Hanging out with groups of friends in my home or theirs

( ) Going bowling

MUST ANSWER YES TO AT LEAST 2 OF THE ABOVE LIST TO CONTINUE

Now I am going to read a list of brief statements and I’d like you to tell me how much you agree or disagree with each statement. Please use a 1-7 scale where 1 means you ‘disagree completely’ and 7 means you ‘agree completely.’ Choose any number between 1 and 7 for each statement I read. Please remember as you answer these questions, that your answers are confidential and will not be shared beyond this survey. We’d like you to be as honest as possible. (READ FIRST QUESTION). How much do you agree or disagree with that statement on that scale from 1 to 7. Again, 1 is disagree completely and 7 is agree completely. [RECORD RESPONSE WITH “X” IN APPROPRIATE BOX & CONTINUE UNTIL ALL STATEMENTS ARE RATED]

	1	2	3	4	5	6	7
a. Some of my friends have experimented with beer/wine/liquor
b. Several of my peers smoke cigarettes when we’re in social situations
c. No one should drink alcohol until they are of legal drinking age.
d. I think texting and driving is wrong under all circumstances
e. I would get a ride home with a friend who has had an alcoholic drink as long as they aren’t buzzed or drunk.
f. Several of my peers smoke marijuana when we’re in social situations
g. Drinking sometimes is fine if it’s in a safe setting

TERMINATE IF RESPONDENT SELECTS ANY SHADED BOXES.

During the last 12 months, how often did you usually have any kind of alcoholic drink? (Examples: a 12 ounce can or glass of beer or cooler, a 5 ounce glass of wine, or a drink containing 1 shot of liquor). Choose only one.

( ) Every day

( ) At least once a week

( ) 2 to 3 times a month

( ) once a month

( ) 3 to 11 times in the past year

( ) 1 or 2 times in the past year

( ) I did not drink any alcohol in the past year, but I did drink in the past TERMINATE

( ) I never drank any alcohol in my life TERMINATE

TRY TO RECRUIT RANGE OF FREQUENCY

During the last 12 months, how many alcoholic drinks did you have on a typical day when you drank alcohol?

( ) 7 or more drinks TERMINATE
( ) 5 to 6 drinks SEE INSTRUCTIONS
( ) 3 to 4 drinks CONTINUE
( ) 2 drinks CONTINUE
( ) 1 drink CONTINUE

ALLOW 1-2 RESPONDENTS PER GROUP THAT DRINK 5-6 DRINKS OR MORE.

During the last 12 months, how often did you have 5 or more (males) or 4 or more (females) drinks containing any kind of alcohol in within a two-hour period? [That would be the equivalent of at least 5 (4) 12-ounce cans or bottles of beer, 5 (4) five ounce glasses of wine, 5 (4) drinks each containing one shot of liquor or spirits - to be provided by interviewer if asked.] Choose only one:

( ) Every day TERMINATE

( ) At least once a week TERMINATE

( ) 2 to 3 days a month SEE INSTRUCTIONS

( ) One day a month CONTINUE

( ) 3 to 11 days in the past year CONTINUE

( ) 1 or 2 days in the past year CONTINUE

ALLOW 1-2 RESPONDENTS PER GROUP THAT DRINK 2 TO 3 DAYS A MONTH

I am going to read a few statements. After I read each one, would you please tell me whether or not it describes you completely, somewhat, or not at all? [RECORD RESPONSE WITH “X” IN APPROPRIATE BOX]

	Describes completely	Describes somewhat	Describes not at all
I enjoy meeting and talking to new people
I am open about expressing my opinion, even when it is different than my friends
I usually spend all of my free time by myself

TERMINATE IF RESPONDENT SELECTS ANY SHADED BOXES

THE NEXT QUESTION IS AN ARTICULATION QUESTION. WHAT THE RESPONDENT SAYS IS NOT IMPORTANT; RATHER, JUDGE HIS ABILITY AND WILLINGNESS TO COMMENT WITH A SPECIFIC POINT-OF-VIEW.

I’d like to finish by asking you a question that is a complete departure from the type of questions I’ve been asking you to this point. There are no right or wrong answers and it’s an opportunity to use your imagination:

If you had the opportunity to spend one hour with a famous person – either from the past or present – who would that person be?

Why did you pick this person? Please be as specific as possible.

____ Articulate

____ Not articulate (TERMINATE)

INVITATION TO RECRUIT PEERS (FOR INITIAL RESPONDENT IN EACH FRIENDSHIP PAIR)

Thank you for helping with this survey. I would like to invite you to a research discussion. We are interested in holding a discussion to speak with you and a friend who is 16 or 17 years old and also in your grade. In addition to you and your friend, there will be four other people your age who will take part in the discussion. If you agree to participate, we would like you to give us the name and contact details of one friend who we would call and ask to attend. The discussion would be held on MM/DD/YY at XX:XX, and the session will last approximately 90 minutes. You and you friend will each receive $75 cash incentive for your participation. Your participation is strictly voluntary. I will also talk to your mom/dad about the date/time, but would you be interested in joining us?

( ) Yes CONTINUE & ASK TO SPEAK WITH PARENT/ GUARDIAN; SKIP TO PARENT INVITATION

( ) No TERMINATE

REFERRED INVITATION

Thank you for helping with this survey. I would like to invite you to a research discussion to be held on MM/DD/YY at XX:XX. __________ (referrer) and 4 other participants close to your age are also invited to participate. The session will last approximately 90 minutes. You will receive $75 cash incentive for your participation. Your participation is strictly voluntary. I will talk to your mom/dad about the date/time, but would you be interested in joining us?

( ) Yes CONTINUE & ASK TO SPEAK WITH PARENT/ GUARDIAN; SKIP TO PARENT INVITATION

( ) No TERMINATE & TRY ANOTHER PEER IDENTIFIED BY ORIGINAL RESPONDENT

NOTE TO INTERVIEWER: Do not schedule anyone who is reluctant about the time, hesitant about participating in a discussion, talks too low or speaks unclearly.

PARENT INVITATION FOR RESPONDENTS

Your child has indicated that HE/SHE is interested in participating in our discussion. The discussion would take place on MM/DD/YY at XX:XX and will last approximately 90 minutes. To show our appreciation, we would offer your child $75 to participate. This would be paid after participating in the discussion. Would you allow your child to participate?

( ) Yes

( ) No TERMINATE

NOTE TO INTERVIEWER: Do not schedule anyone who is reluctant about the time, hesitant about participating in a discussion, talks too low or speaks unclearly.

FINAL INSTRUCTION: Thank you very much for allowing your child to participate. Please ask [him/her] to arrive to the facility a few minutes early. If you should need to cancel for any reason, please contact X at XXX-XXX-XXXX.

END OF SCREENER GUIDE

NHTSA Form 1270

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