Form NHTSA Form 1308 NHTSA Form 1308 Survey for Underage Drinking and Driving Prevention Publ

OMB No. 2127-0682
Expiration Date: xx/xx/xxxx

Survey for Underage Drinking and Driving Prevention Public Service Advertising Campaign

[INTRODUCTION] Thank you for agreeing to participate in this online study. The survey will take about 10 minutes to complete. All responses are anonymous and will only be viewed in aggregate.

This study is being conducted on behalf of the National Highway Traffic Safety Administration (NHTSA). Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB control number. The OMB control number for this study is 2127-0682. This survey is voluntary. We will not collect any personal information that would allow anyone to identify you. Any information you do provide will be kept private to the fullest extent of the law.

Your opinions are important to us! Please be honest when answering the survey. Your answers are anonymous and confidential.

[PN: For all respondents who terminate, please use the following terminate text: Thank you for your interest. However, at this point in time we are looking for survey respondents who fit a different profile. Please do not be discouraged, as there may be future studies to which you will be invited to participate.]

PS1. What is your exact age? [DROP DOWN MENU]

Under 13

13

14

15

16

17

18

19

20

…..

Over 62

[PN: Terminate if respondent is under 13, 13-15, 19-33, Over 62)

[PN: If respondent is 16, 17, 18 then skip to S1.]

[PN: If respondent is 34-61, continue]

PS2. 3. Are you the parent or guardian of any teenage children age 16-18 living in your household?

1. Yes

2. No [TERMINATE]

PS3. Please indicate the age (or ages) of your child (or children): [ALLOW MULTIPLE SELECTIONS]

16

17

18

None of the above [TERMINATE]

What grade level is your child age 16-18 currently in?

1 Below 9th grade [TERMINATE]

2 9th grade

3 10th grade

4 11th grade

5 12th grade

6 College or Technical school [TERMINATE]

7 Not enrolled in school right now [TERMINATE]

8 Prefer not to state [TERMINATE]

MUST BE IN GRADES 9^TH-12^TH TO CONTINUE.

PS4. Is your high school student, age 16-18, available to participate in this study?

1. Yes

2. No [TERMINATE]

[INSTRUCTION] We are interested in hearing from teens in high school. Please invite your child to take this survey and allow them to answer on their own from their perspective.

S1. What is your gender?

1. Male

2. Female

For S2:

If PS1= 16 autopunch S2=16

If PS1= 17 autopunch S2=17

If PS1= 15 autopunch S2=18

S2. What is your exact age? _____ [MUST BE 16-18 TO CONTINUE; OTHERWISE TERMINATE]

S3. What grade level are you currently in? [IF FIELDED IN SUMMER, ADD NOTE: “Please indicate the grade level that you will be entering if your school is currently out of session.”]

1. Below 9^th grade [TERMINATE]

2. 9^TH grade

3. 10^th grade

4. 11^th grade

5. 12^th grade

6. College/technical school [TERMINATE]

7. Not enrolled in school right now [TERMINATE]

8. Prefer not to state [TERMINATE]

MUST BE IN GRADES 9^TH-12^TH TO CONTINUE.

S4. Are you of Hispanic or Latino descent?

1. Yes

2. No

S5. Select one or more of the following that best describes your race?

(ACCEPT MULTIPLE RESPONSES)

1. American Indian or Alaska Native

2. Asian

3. Black or African American

4. Native Hawaiian or Other Pacific Islander

5. White

S6. What state do you live in?

[DROP-DOWN BOX]

CODE FOR REGION

S7. Do you currently have an unrestricted US driver’s license?

Note: An unrestricted license means that there are not restrictions on your driving privileges, such as curfew or the number of passengers allowed in the vehicle.

1. Yes

2. No [TERMINATE]

S8. In general, how many times per week do you personally drive a car or other motor vehicle?

1. Three days a week or more

2. Less than three days a week [TERMINATE]

3. I do not drive [TERMINATE]

[INSTRUCTION ON ITS OWN PAGE] In the next section, the questions will ask you about your opinions and experience with drinking alcohol. Please remember that all answers are anonymous and will never be linked to individual respondents.

S9.During the past sixty days, on how many days did you have at least one drink of alcohol?

Examples of one drink include: a 12 ounce can or glass of beer, cooler, or flavored malt drink (e.g. Zima); a 5 ounce glass of wine; or a drink containing 1 shot of hard liquor.

1. 0 days [TERMINATE]

2. 1 or 2 days

3. 3 to 5 days

4. 6 to 9 days

5. 10 to 19 days

6. 20 to 29 days

7. 30 days or more

[IF ANSWER ANY RESPONSE EXCEPT A (0 DAYS) CONTINUE TO Q1; OTHERWISE TERMINATE]

1. If you have driven somewhere and you have consumed alcohol, which statement best describes you?

1. I’ll drive without worrying too much about it

2. I’ll drive even though I worry about it

3. I’ll always find an alternative to driving (i.e. get a ride from someone, get a taxi or car service, use public transportation, or stay overnight at current location)

4. Not applicable – I never drink any alcohol if I need to drive afterwards

2. Among the friends you socialize with, which statement generally best describes what they would do if they have driven somewhere and consumed alcohol?

1. My friends will generally drive without worrying too much about it

2. My friends will generally drive even though they would worry about it

3. My friends will generally find an alternative to driving (i.e. get a ride from someone, get a taxi or car service, use public transportation, or stay overnight at current location)

4. Not applicable – My friends generally never drink any alcohol if they need to drive afterwards

3. How much do you agree or disagree with the following statements?

[RANDOMIZE STATEMENTS]	1 Disagree strongly	2 Disagree somewhat	3 Agree somewhat	4 Agree strongly	5 Not sure
Drinking before driving is not a big deal as long as the driver is not too impaired to operate a vehicle.
Many of my friends will drive after drinking alcohol.

4. In general, at parties or social gatherings, how many drinks do you allow yourself if you’re planning to drive AFTER?

Examples of one drink include: a 12 ounce can or glass of beer, cooler, or flavored malt drink (e.g. Zima); a 5 ounce glass of wine; or a drink containing 1 shot of hard liquor.

1. None

2. 1 drink

3. 2 drinks

4. 3 drinks

5. 4 drinks

6. 5 drinks

7. 6 drinks

8. 7 drinks

9. 8 drinks

10. 9 drinks

11. 10+ drinks

5. In the past twelve months, have you ever driven a motor vehicle AFTER drinking any alcoholic beverages?

1. Yes

2. No

[IF YES IN Q5]

6. In the past sixty days, how many times have you driven a motor vehicle AFTER drinking any alcoholic beverages?

1. Never

2. One time

3. 2-3 times

4. More than 3 times

7. Have you recently had any discussion (online or in-person) with a friend or family member about drinking and driving?

1. Yes

2. No

8. Have you recently seen, heard, or read messages about underage drinking and driving in advertising, publicity, the media, the Web or other places?

1. Yes

2. No

3. Not sure

[IF YES TO Q8]

9. Where was that…? (Accept multiple responses.)

[PROGRAMMER: SET UP AS A GRID BUT IF THE USER SELECTS NO FOR “SOME OTHER PLACE” THEY SHOULDN’T HAVE TO PROVIDE AN OPEN END ANSWER]

TV program	Yes	No
TV ad	Yes	No
Radio program	Yes	No
Radio commercial	Yes	No
Magazine article	Yes	No
Magazine ad	Yes	No
Newspaper article	Yes	No
Newspaper ad	Yes	No
Social media	Yes	No
Website content	Yes	No
Web ad	Yes	No
Outdoor billboards or outdoor posters	Yes	No
From friends or family	Yes	No
Driver’s Ed Class	Yes	No
School (e.g. assembly, class lectures, etc.)	Yes	No
Some other place (Specify)__________	Yes	No

10. Have you ever heard of a website called XXXX?

1. Yes

2. No

3. Not sure

11. Are you aware of any public service ads with the slogan “XXXX”?

1. Yes

2. No

3. Not sure

[RANDOMIZE ORDER OF AD RECOGNITION QUESTIONS: KEEP MEDIA TYPE TOGETHER IN BLOCKS & RANDOMIZE ADS WITHIN BLOCKS]

Below is a video of a public service ad you might see on TV, online, or some other place. After you view the ad, please indicate if you have seen it before.

[INSERT VIDEO_1]

12. Have you seen this ad?

1. Yes

2. No

3. Not sure

Below is a video of a public service ad you might see on TV, online, or some other place. After you view the ad, please indicate if you have seen it before.

[INSERT VIDEO_2]

13. Have you seen this ad?

1. Yes

2. No

3. Not sure

Below is an audio file of a public service ad you might hear on the radio. After you listen to the ad, please indicate if you have heard it before.

[INSERT AUDIO FILE_1]

14. Have you seen this ad?

1. Yes

2. No

3. Not sure

[INSERT AUDIO FILE_2]

15. Have you seen this ad?

1. Yes

2. No

3. Not sure

16. Have you seen any of these ads online?

[INSERT BANNER AD MONTAGE]

1. Yes

2. No

3. Not sure

17. Have you seen any of these ads someplace, such as on a poster, billboard, or bus stop?

[INSERT OUTDOOR AD MONTAGE]

1. Yes

2. No

3. Not sure

The following background questions will help us divide the interviews into groups.

18. Which of the following best describes the area where you live?

1. City

2. Suburbs

3. Small town

4. Rural community

5. Some other area

NHTSA Form 1308 Page 15