NHTSA Form 1361 Recruitment Screener for Focus Groups: Night Shift Worke

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

FINAL Drowsy Driving Screener ShiftWorkers

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

OMB: 2127-0682

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Focus Group Studies Under Generic Clearance - Recruitment Screener



OMB Control No. 2127-0682

Expiration Date 04/31/2018


Recruitment Screener for Focus Groups: Night Shift Workers

(one of two screeners for this project)



OMB Control No: 2127-0682: Focus Groups for Assessments of Messaging Taglines and Concepts Supporting a National Awareness Campaign to Reduce Drowsy Driving



PHONE SCREENING INTERVIEW GUIDE


NOTE TO RECRUITER: Ask to speak to any person in the household between

the ages of 25 and 54.


Hello, this is __________________, from (NAME OF FOCUS GROUP COMPANY), calling on behalf of the U.S. Department of Transportation. We are conducting a study of American’s opinions about communications campaigns that emphasize motor vehicle safety. I would like to ask you a few questions to determine if you are eligible for the study which will be in the form of a focus group. (NOTE TO RECRUITER: If necessary, read:)


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 6 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., Washington, DC, 20590



(NOTE TO RECRUITER: If already known – or if not already known, judge by person’s name and/or voice – determine gender. Ask respondent for gender if necessary. Recruit 6 or 7 males and 6 or 7 females.)


( ) Male (QUOTA: 6 or 7)

( ) Female (QUOTA: 6 or 7)


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


  1. Within the past month, have there been ten nights or more during which you worked during the late-night and/or early-morning hours – for example, reporting to work at approximately 10 p.m. or later, and then working for six hours or longer?


( ) Yes

( ) No (TERMINATE)



  1. Are you a licensed driver?


( ) Yes

( ) No (TERMINATE)



  1. Do you, or does anyone living in your household, work in any of the following industries or professions? (TERMINATE if “yes” to any)


( ) Marketing, advertising, public relations or marketing research

( ) Graphic design

( ) News media, including newspaper, television, radio or publishing

( ) Law enforcement

( ) Legal

( ) Local, state or federal government



(NOTE TO RECRUITER: At this stage, disclose the following information, then ask question 4)


Again, I remind you that all your answers are confidential. Likewise, the focus group discussion and people’s participation will also be confidential. For these focus groups, the research sponsor wants to hear the opinions and comments from people who have a tendency to not get adequate sleep on a regular basis. So let me ask…


  1. During most weeks, are there 24-hour periods of time when you get less than seven hours of sleep during the 24-hour period?


( ) Yes

( ) No (TERMINATE)

( ) Refused or not sure (TERMINATE)



  1. On average, how many of the typical week’s seven 24-hour periods do you get less than seven hours of sleep?


( ) 1, 2, 3, or 4 (TERMINATE)

( ) 5, 6 or 7

( ) Refused or not sure (TERMINATE)



  1. Which one of the following types of vehicles do you drive most often for personal, non-business travel? (NOTE TO RECRUITER: Read list; accept only the one driven most often):


( ) Automobile

( ) Mini-van

( ) Full-size van

( ) Sport utility vehicle

( ) Pick-up truck

( ) None of these or something different (TERMINATE)


(NOTE TO RECRUITER: “none of these/something different” includes motorcycles)



(NOTE TO RECRUITER: question 7 is an articulation question. What the respondent says is not important; rather, judge her/his ability and willingness to comment with a specific point-of-view and ideally with more than just a few words.)


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


( ) Articulate

( ) Not articulate (TERMINATE)




  1. Are you of Hispanic or Latino descent?


( ) Yes (NOTE TO RECRUITER: Quota: at least 1, but no more than 3 per group)

( ) No







  1. Which one or more of these best describes your race? (NOTE TO RECRUITER: Read list. OK to accept multiple responses.)


( ) American Indian or Alaska Native

( ) Asian

( ) Black or African American (NOTE TO RECRUITER: Quota: at least 2, but no

more than 4 per group up)

( ) Native Hawaiian or Other Pacific Islander

( ) White



Based on your responses, we would like to invite you to participate in a focus group research study about advertising ideas. The group discussion will be about an hour-and-a-half in length, and that time includes your early arrival time approximately fifteen minutes before the group discussion begins. 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 a.m./p.m.) It will be at our focus group research facility at (FOCUS GROUP FACILITY ADDRESS/LOCATIONAL INFORMATION).


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






END OF SCREENER GUIDE



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NHTSA Form 1361

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AuthorLiana Morgado
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File Created2021-01-25

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