NHTSA Form 1394 Parents of Teen Drivers Screener

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

Parents of Teens FG Screener 032117

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 04/31/2018



Recruitment Screener for Focus Groups


OMB Control No: 2127-0682: Focus Groups for Exploratory Research Among Parents of New Teenage Drivers Regarding Teaching Knowledge, Resources and Techniques


PHONE SCREENING GUIDE FOR PARENTS OF YOUNG DRIVERS


NOTE TO RECRUITER: Ask to speak to a head of the household. Then confirm that this person is a parent to one or more children still residing in the household.



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 driving safety. I would like to ask you a few questions to determine if you are eligible for the study. (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 six 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



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


  1. Are you a licensed driver?


( ) Yes

( ) No (TERMINATE)






  1. You mentioned that you have one or more children. For this question, please consider just the oldest if there is more than one. What is her or his age?


NOTE TO RECRUITER: If parent’s situation is twins, triplets, etc., OK to adapt this and the subsequent question number 3 to fit either one or more than one of those siblings.


( ) 15, 16, 17 or 18

( ) 14 or younger (TERMINATE)

( ) 19 or older (TERMINATE)



NOTE TO RECRUITER: If not already revealed, OK to clarify if the child is female or male to simplify appropriate pronoun use for subsequent question.



  1. For her/him, which of the following matches her/his situation, relative to driving?


( ) She/he is planning to get a driver’s learner’s permit within the next six months

( ) She/he currently has a learner’s permit

( ) She/he has had a driver’s license for six months or less

( ) None of these match (TERMINATE)



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


( ) Marketing, advertising, public relations or marketing research

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

( ) Law enforcement

( ) Legal

( ) Driving instruction or training

( ) Local, state or federal government, including teaching positions

( ) Teaching in a private school or learning center

( ) Professional driver and/or paid ride-sharing driver (such as Uber)




NOTE TO RECRUITER: question 5 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.


  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. Do you consider yourself to be Hispanic or Latino?


( ) Yes (NOTE TO RECRUITER: Quota: at least 1, but no more than 2 per group)

( ) No




  1. Which of the following racial categories describes you? You may select more than one. Please select all that apply. (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 1, but

no more than 2 per group)

( ) 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 assisting new teenaged drivers. The group discussion, including your arrival and check-in time, will be about an hour and a half. For your participation, you will receive $75 cash. As many as four 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).


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

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NHTSA Form 1394



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