Form NHTSA Form 1213 NHTSA Form 1213 Recruitment Screener - Branding Positioning

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

NHTSA UDDP Screener _10212015_FINAL

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

Focus Groups to Assess NHTSA Perceptions and Brand Positioning/Identity


OMB Control No: 2127-0682: Focus Groups to Assess NHTSA Perceptions and Brand Positioning/Identity




NOTE TO RECRUITER: Three distinct groups of participants are sought:

  • Group 1: Shoppers for new and pre-owned vehicles

  • Group 2: Owners of vehicles for which recalls have been issued

  • Group 3: Parents-to-be whose children will be using child passenger seats




Screener to recruit group 1: shoppers for new and pre-owned vehicles


NOTE TO RECRUITER: Ask to speak to any member of the household age 25 or older. If none available, terminate.



Hello, I'm __________________ calling for (name of focus group company). In (metro name), a research project is being planned. It will consist of focus group discussions about personal cars and trucks. It is not being done for selling purposes; rather it is true research to gather information and opinions. Once the focus group discussion begins, it will last approximately one hour. Additionally, we ask that you check-in 15 minutes prior the discussion. For your time and participation, you would be paid $75.


(NOTE TO RECRUITER: Gauge interest; continue if positive. If he requests clarification about focus groups, briefly explain.)


This research requires that participants have particular characteristics. So to see if you match those characteristics, I need to ask you a few questions.


(NOTE TO RECRUITER: Continue if OK)



First, I need to read this statement. This collection of information is voluntary and will be used to recruit individuals to participate in a focus group meeting. Public reporting burden for this survey is estimated to average 5 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. We will not collect any personal information that would allow anyone to identify you. Please note that 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 currently valid OMB control number. The OMB control number for this collection is 2127-0682.


So let’s begin.


  1. For this research project, the research sponsor is especially interested in speaking with people who are considering the purchase or lease of a new or previously-owned car or truck in the next six months. Are you considering the purchase or lease of a new or pre-owned vehicle within the next six months?


____ Yes

____ No (NOTE TO RECRUITER: terminate)

____ Not sure or Refused (NOTE TO RECRUITER: terminate)



  1. Do you, or does anyone in your immediate family, work in any of the following industries or professions? (NOTE TO RECRUITER: terminate if “yes” to any)


____ Marketing, advertising, public relations or marketing research

____ Graphic design

____ News media, including newspaper, television, radio or publishing

____ Professional and/or commercial drivers

____ Law enforcement

____ Legal

____ Road/highway safety-oriented departments of local, state or federal

government



  1. Are you a licensed driver?


____ Yes ____ No (NOTE TO RECRUITER: terminate)




  1. NOTE TO RECRUITER: Judge by voice if respondent is male or female. If uncertain, ask.


____ Male (NOTE TO RECRUITER: quota per group: at least 5, but no more

than 7)

____ Female (NOTE TO RECRUITER: quota per group: at least 5, but no more

than 7)



  1. Do you consider yourself Hispanic or Latino?


____ Hispanic or Latino (NOTE TO RECRUITER: quota per group: need at

least 2, but no more than 3)

____ Not Hispanic or Latino

____ Refused (NOTE TO RECRUITER: terminate)



  1. Do you consider yourself ---- (NOTE TO RECRUITER: Read list and check all that apply; OK to repeat list if asked)


____ American Indian or Alaska Native

____ Asian

____ Black or African-American (NOTE TO RECRUITER: quota per group: need

at least 2, but no more than 3)


____ Native Hawaiian or Other Pacific Islander

____ White

____ Refused (NOTE TO RECRUITER: terminate)



NOTE TO RECRUITER: 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.


  1. In your opinion, what would be the best way to minimize traffic congestion on highways in the (name of metro) area?


____ Articulate

____ Not articulate (NOTE TO RECRUITER: terminate)




Based on your responses, we would like to invite you to participate in a focus group research study about vehicles and driving safety. Including check-in time and the actual group discussion, it will last about an hour and fifteen minutes. For your participation, you will receive $75 cash. As many as eight others will participate. The meeting will be on (SCHEDULED DATE) at (SCHEDULED START TIME) p.m. It will be at our focus group research facility at (FOCUS GROUP FACILITY ADDRESS/LOCATIONAL INFORMATION).


(Convey additional appropriate details if respondent is willing to participate)



Screener to recruit group 2: owners of vehicles for which recalls have been issued


NOTE TO RECRUITER: Ask to speak to any member of the household age 25 or older. If none available, terminate.



Hello, I'm __________________ calling for (name of focus group company). In (metro name), a research project is being planned. It will consist of focus group discussions about personal cars and trucks. It is not being done for selling purposes; rather it is true research to gather information and opinions. Once the focus group discussion begins, it will last approximately one hour. Additionally, we ask that you check-in 15 minutes prior the discussion. For your time and participation, you would be paid $75.


(NOTE TO RECRUITER: Gauge interest; continue if positive. If he requests clarification about focus groups, briefly explain.)


This research requires that participants have particular characteristics. So to see if you match those characteristics, I need to ask you a few questions.


(NOTE TO RECRUITER: Continue if OK)



First, I need to read this statement. This collection of information is voluntary and will be used to recruit individuals to participate in a focus group meeting. Public reporting burden for this survey is estimated to average 5 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. We will not collect any personal information that would allow anyone to identify you. Please note that 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 currently valid OMB control number. The OMB control number for this collection is 2127-0682.


So let’s begin.



  1. For this research project, the research sponsor is especially interested in speaking with people who own or lease vehicles that have been subject to a manufacturer’s recall within the past year. Do you remember having received within the past 12 months or so any recall notice from the manufacturer about a vehicle you own or lease?


____ Yes

____ No (NOTE TO RECRUITER: terminate)

____ Not sure or Refused (NOTE TO RECRUITER: terminate)




  1. Do you, or does anyone in your immediate family, work in any of the following industries or professions? (NOTE TO RECRUITER: terminate if “yes” to any)


____ Marketing, advertising, public relations or marketing research

____ Graphic design

____ News media, including newspaper, television, radio or publishing

____ Professional and/or commercial drivers

____ Law enforcement

____ Legal

____ Road/highway safety-oriented departments of local, state or federal

government



  1. Are you a licensed driver?


____ Yes ____ No (NOTE TO RECRUITER: terminate)




  1. NOTE TO RECRUITER: Judge by voice if respondent is male or female. If uncertain, ask.


____ Male (NOTE TO RECRUITER: quota per group: at least 5, but no more

than 7)

____ Female (NOTE TO RECRUITER: quota per group: at least 5, but no more

than 7)



  1. Do you consider yourself Hispanic or Latino?


____ Hispanic or Latino (NOTE TO RECRUITER: quota per group: need at

least 2, but no more than 3)

____ Not Hispanic or Latino

____ Refused (NOTE TO RECRUITER: terminate)



  1. Do you consider yourself ---- (NOTE TO RECRUITER: Read list and check all that apply; OK to repeat list if asked)


____ American Indian or Alaska Native

____ Asian

____ Black or African-American (NOTE TO RECRUITER: quota per group: need

at least 2, but no more than 3)


____ Native Hawaiian or Other Pacific Islander

____ White

____ Refused (NOTE TO RECRUITER: terminate)



NOTE TO RECRUITER: 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.


  1. In your opinion, what would be the best way to minimize traffic congestion on highways in the (name of metro) area?


____ Articulate

____ Not articulate (NOTE TO RECRUITER: terminate)




Based on your responses, we would like to invite you to participate in a focus group research study about vehicles and driving safety. Including check-in time and the actual group discussion, it will last about an hour and fifteen minutes. For your participation, you will receive $75 cash. As many as eight others will participate. The meeting will be on (SCHEDULED DATE) at (SCHEDULED START TIME) p.m. It will be at our focus group research facility at (FOCUS GROUP FACILITY ADDRESS/LOCATIONAL INFORMATION).


(Convey additional appropriate details if respondent is willing to participate)



Screener to recruit group 3: parents-to-be whose children will be using child passenger seats


NOTE TO RECRUITER: Ask to speak to any member of the household ages 21 to 35. If none available, terminate.



Hello, I'm __________________ calling for (name of focus group company). In (metro name), a research project is being planned. It will consist of focus group discussions about personal cars and trucks. It is not being done for selling purposes; rather it is true research to gather information and opinions. Once the focus group discussion begins, it will last approximately one hour. Additionally, we ask that you check-in 15 minutes prior the discussion. For your time and participation, you would be paid $75.


(NOTE TO RECRUITER: Gauge interest; continue if positive. If he requests clarification about focus groups, briefly explain.)


This research requires that participants have particular characteristics. So to see if you match those characteristics, I need to ask you a few questions.


(NOTE TO RECRUITER: Continue if OK)



First, I need to read this statement. This collection of information is voluntary and will be used to recruit individuals to participate in a focus group meeting. Public reporting burden for this survey is estimated to average 5 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. We will not collect any personal information that would allow anyone to identify you. Please note that 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 currently valid OMB control number. The OMB control number for this collection is 2127-0682


So let’s begin.


  1. For this research project, the research sponsor is especially interested in speaking with people who may soon need special seating in vehicles for young children or infants. Within the next six months, are you expecting birth or adoption of child for whom special child seating in your vehicle will be necessary?


____ Yes

____ No (NOTE TO RECRUITER: terminate)

____ Not sure or Refused (NOTE TO RECRUITER: terminate)



  1. Do you, or does anyone in your immediate family, work in any of the following industries or professions? (NOTE TO RECRUITER: terminate if “yes” to any)


____ Marketing, advertising, public relations or marketing research

____ Graphic design

____ News media, including newspaper, television, radio or publishing

____ Professional and/or commercial drivers

____ Law enforcement

____ Legal

____ Road/highway safety-oriented departments of local, state or federal

government



  1. Are you a licensed driver?


____ Yes ____ No (NOTE TO RECRUITER: terminate)




  1. NOTE TO RECRUITER: Judge by voice if respondent is male or female. If uncertain, ask.


____ Male (NOTE TO RECRUITER: quota per group: at least 5, but no more

than 7)

____ Female (NOTE TO RECRUITER: quota per group: at least 5, but no more

than 7)



  1. Do you consider yourself Hispanic or Latino?


____ Hispanic or Latino (NOTE TO RECRUITER: quota per group: need at

least 2, but no more than 3)

____ Not Hispanic or Latino

____ Refused (NOTE TO RECRUITER: terminate)



  1. Do you consider yourself ---- (NOTE TO RECRUITER: Read list and check all that apply; OK to repeat list if asked)


____ American Indian or Alaska Native

____ Asian

____ Black or African-American (NOTE TO RECRUITER: quota per group: need

at least 2, but no more than 3)


____ Native Hawaiian or Other Pacific Islander

____ White

____ Refused (NOTE TO RECRUITER: terminate)




NOTE TO RECRUITER: 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.


  1. In your opinion, what would be the best way to minimize traffic congestion on highways in the (name of metro) area?


____ Articulate

____ Not articulate (NOTE TO RECRUITER: terminate)




Based on your responses, we would like to invite you to participate in a focus group research study about vehicles and driving safety. Including check-in time and the actual group discussion, it will last about an hour and fifteen minutes. For your participation, you will receive $75 cash. As many as eight others will participate. The meeting will be on (SCHEDULED DATE) at (SCHEDULED START TIME) p.m. It will be at our focus group research facility at (FOCUS GROUP FACILITY ADDRESS/LOCATIONAL INFORMATION).


(Convey additional appropriate details if respondent is willing to participate)


9

NHTSA Form 1312

File Typeapplication/msword
File TitleScreener for “Risk Takers”
AuthorSteve Richardson
Last Modified ByCulbreath, Walter (NHTSA)
File Modified2015-10-27
File Created2015-10-27

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