Form NHTSA Form 1431 NHTSA Form 1431 Recruitment Screener - Parent and Caretaker

OMB Control Number: 2127-0682

Expiration Date: 04/30/2018

Focus Group Studies Under Generic Clearance - Recruitment Screener

Recruitment Screener

Parent & Caretaker Focus Groups to Develop

New Seat Belt Safety Public Service Advertising Campaign

Generic Clearance OMB Control No: 2127-0682: Focus Groups for Traffic and Motor Vehicle Safety Programs and Activities

PHONE SCREENING INTERVIEW GUIDE

The Spanish language interviews will be conducted in Spanish by a fluent Spanish-speaking moderator who specializes in research with the Hispanic audience

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

Hello, this is __________________, from [Fieldwork Phoenix/Fieldwork O’Hare], calling on behalf of the U.S. Department of Transportation. We are conducting a study of Americans’ opinions about motor vehicle safety. I would like to ask you a few questions to determine if you are eligible for the study. (INTERVIEWER NOTE: If necessary, read) 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 generic clearance control number for this collection is 2127-0682.

Public Burden Statement:

This collection of information is voluntary and will be used to recruit individuals to participate in this study.  Public reporting burden for this survey is estimated to average 75 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 number 2127-0682.

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

1. NOTE TO RECRUITER: RECORD SEX. (RECRUIT MIX, OK TO SKEW FEMALE)

( ) Female

( ) Male

2. Do you, or does anyone in your immediate family, work in any of the following industries or professions? NOTE TO RECRUITER: IF YES TO ANY ANSWER, TERMINATE

( ) Marketing or marketing research (TERMINATE)

( ) Advertising or public relations (TERMINATE)

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

( ) Any company that manufactures, distributes, or sells automobiles or automobile

Parts (TERMINATE)

( ) Any company that manufactures, distributes, or sells car seats (TERMINATE)

(_) Any Child Passenger Safety technician or child safety advocacy group

(TERMINATE)

3. In the past 6 months, have you participated in a group discussion or interview regarding a product or service?

( ) Yes (TERMINATE)

( ) No (CONTINUE)

4. Which of the following groups does your age fall into? (READ LIST)

( ) Under 18 (TERMINATE)

( ) 18 – 24 (TERMINATE)

( ) 25 – 34 (CONTINUE)

( ) 35 – 44 (CONTINUE)

( ) 45 – 54 (CONTINUE)

( ) 55 – 64 (CONTINUE)

( ) 65+ (CONTINUE)

( ) Refused (TERMINATE)

5. Are you the parent or guardian of any children age 14 or younger living in your household?

( ) Yes (CONTINUE)

( ) No (SKIP TO Q7)

6. What are the ages of your children age 14 or younger who currently live with you?

NOTE TO RECRUITER: WRITE IN AGES

	Age
Child 1	_____
Child 2	_____
Child 3	_____
Child 4	_____
Child 5	_____

NOTE TO RECRUITER: VERIFY ONE CHILD IS BETWEEN AGES 0-14. IF YES, SKIP TO Q9. IF NO, CONTINUE TO Q7.

NOTE TO RECRUITER: PER MARKET, RECRUIT 32 GEN POP AND 16 HISPANIC PARENTS/ CARETAKERS, AS FOLLOWS:

8 GENERAL MARKET (GM) PARENTS/ CARETAKERS OF CHILDREN AGES 0-3

8 GM PARENTS/CARETAKERS OF CHILDREN AGES 4-6

8 GM PARENTS/CARETAKERS AGES 7-10

8 GM PARENTS/ CARETAKERS AGES 11-14

8 HISPANIC UNACCULTURATED PARENTS/CAREGIVERS WITH CHILDREN AGE 0-3 AND 4-6

8 HISPANIC UNACCULTURATED PARENTS/CAREGIVERS WITH CHILDREN AGES 7-10 AND 11-14

7. Do you look after children for family or friends for three or more days per week regularly?

( ) Yes

( ) No (TERMINATE)

8. How old is this child/children that you look after?

	Age
Child 1	_____
Child 2	_____
Child 3	_____
Child 4	_____
Child 5	_____

NOTE TO RECRUITER: ONE CHILD MUST BE BETWEEN AGES 0-14 TO CONTINUE; IF 15 OR OLDER, TERMINATE. IF MULTIPLE CHILDREN AGE 0-14 IN HOUSEHOLD, CHOOSE CHILD BASED ON WHICH AGE GROUP YOU NEED TO FILL.

9. Are you Hispanic or Latino?

No

Yes, Mexican, Mexican-American, Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, other Hispanic/Latino

10. Which of the following best describes your race? You can select more than one.

(ACCEPT MULTIPLE RESPONSES)

( ) American Indian or Alaska Native

( ) Asian

( ) Black or African American

( ) Native Hawaiian or Other Pacific Islander

( ) White

NOTE TO RECRUITER: RECRUIT FAIR REPRESENTATION OF RACE/ETHNICITY; FOR SPANISH-SPEAKING GROUPS, RECRUIT HISPANIC ONLY.

11. What was the last grade of school that you’ve completed? NOTE TO RECRUITER: READ LIST

( ) Lower than Grade 8* (TERMINATE FOR GM GROUPS ONLY)

( ) Grades 9-11

( ) Completed high school

( ) Some college/Trade School/Associate’s Degree

( ) Completed college

( ) Post Graduate

( ) Refused (TERMINATE)

GENERAL MARKET PARTICIPANTS MUST HAVE COMPLETED THE 9TH GRADE TO PARTICIPATE OTHERWISE THANK AND TERMINATE. UNACCULTURATED HISPANIC PARENTS CAN QUALIFY WITH LESS THAN 8TH GRADE EDUCATION.

RECRUIT FAIR REPRESENTATION AND SKEW TOWARD AT LEAST SOME HIGH SCHOOL OR HIGHER FOR GENERAL MARKET GROUPS

NOTE TO RECRUITER: ASK Q10-11C FOR HISPANIC RESPONDENTS ONLY.

12. In what country were you born? (DO NOT READ LIST. RECORD ANSWER.)

( ) Argentina

( ) Bolivia

( ) Chile

( ) Columbia

( ) Costa Rica

( ) Cuba

( ) Ecuador

( ) El Salvador

( ) Guatemala

( ) Honduras

( ) Mexico

( ) Nicaragua

( ) Panama

( ) Paraguay

( ) Peru

( ) Puerto Rico

( ) Dominican Republic

( ) Uruguay

( ) Venezuela

( ) United States (TERMINATE)

( ) Other/Refusal (TERMINATE)

NOTE TO RECRUITER: RECRUIT A MIX OF COUNTRIES TO MATCH THE MARKET

13. How many years have you lived in the United States? Your response is confidential and will not be shared. (RECORD ANSWER)

( ) Less than 1 year (TERMINATE)

( ) 1 to 4 years CONTINUE

( ) 5 to 10 years CONTINUE

( ) 11 to 15 years CONTINUE

( ) 16 to 20 years CONTINUE

( ) More than 20 years (TERMINATE)

13a. Of the first 18 years of your life, how many years did you live in the United States?

Points

( ) Less than 3 years……………………………………..…….0

( ) 4-6 years ……………………...2

( ) 7-9 years ……………………...4

( ) 10-12 years ……………………...6

( ) 13-15 years ……………………...8

( ) 16-18 years …………………….10

13b. Which language are you most comfortable speaking?

Points

( ) English always 8

( ) English mostly 6

( ) Both English & Spanish equally 4

( ) Spanish mostly 2

( ) Spanish always 0

13c. In what language do you prefer to watch, read, and listen to media?

Points

( ) English always 4

( ) English mostly 3

( ) Both English and Spanish equally 2

( ) Spanish mostly 1

( ) Spanish always 0

13d. How many hours of TV and radio do you consume in Spanish per week?

( ) 10 or more hours CONTINUE

( ) Less than 10 hours (TERMINATE)

( ) Don’t know/Refused (TERMINATE)

13e. Thinking about your interpersonal relationships including friends and relatives, would you say they are…?

Points

( ) All outside of your culture/ethnicity 4

( ) Mostly outside of your culture/ethnicity 3

( ) Even split 2

( ) Mostly within your culture/ethnicity 1

( ) All within your culture/ethnicity 0

13f. Thinking about your neighborhood, would you describe it as…? (READ LIST)

Points

( ) 0 to 20% Hispanic …………………………………..….4

( ) 21 to 40%. Hispanic…………………………………….3

( ) 41 to 60% Hispanic……………………………………..2

( ) 61 to 80% Hispanic……………………………………..1

( ) 81 to 100% Hispanic……………………………………0

Acculturation Model Scoring Key

INTERVIEWER: ADD THE POINTS FROM QUESTIONS 12a THRU 12e AS INDICATED BELOW AND CLASSIFY THE RESPONDENT.

	Q. 12ª	Q. 12b	Q. 12c	Q. 12d	Q.12e	Total
TOTAL POINTS

INTERVIEWER: MARK THE RESPONDENT’S ACCULTURATION LEVEL BELOW:

TOTAL POINTS	LEVEL OF ACCULTURATION	MARK HERE
From 0 to 5	Not acculturated	CONTINUE FOR SPANISH-SPEAKING GROUPS
From 6 to 11	Low/Partially not acculturated	CONTINUE FOR SPANISH-SPEAKING GROUPS
From 12 to 17	Bicultural	CONTINUE FOR GENERAL MARKET GROUPS
From 18-23	Partially Acculturated	CONTINUE FOR GENERAL MARKET GROUPS
From 24-30	Acculturated	CONTINUE FOR GENERAL MARKET GROUPS
Max 30 points

NOTE TO RECRUITER: READ THE FOLLOWING:

We would like to know how well you speak Spanish.

13g. would you say you speak Spanish...? (READ LIST)

13h. would you say you speak English...? (READ LIST)

13i. in what language do you prefer to communicate? (READ LIST)

Q.13a Q.13b Q.13c

SPANISH ENGLISH LANGUAGE

Very well ( ) ( ) English ( )

Well ( ) ( ) Spanish ( )

A little ( ) ( )

Either one/ ( )

No preference

Very little ( ) ( )

Not at all ( ) ( )

NOTE TO RECRUITER: FOR SPANISH-SPEAKING HISPANIC GROUPS, RECRUIT RESPONDENTS WHO ANSWERS FALL IN BOXES

14. Do you drive a car, truck, SUV, or van on a regular basis?

( ) Yes (CONTINUE)

( ) No (TERMINATE)

NOTE TO RECRUITER: READ THE FOLLOWING:

For the rest of the survey, I will use the term car. When I use this term, please also think about vans, trucks, and SUVs.

14. On average, how often does [your child/the child you care for] AGE 0-14 travel with you when you are driving?

( ) 3 days per week or more (CONTINUE)

( ) Less than 3 days per week (TERMINATE)

14. Thinking about the car that you drive when you are with [your child/the child you care for], how often do you do each of the following? (READ LIST, CHECK ALL THAT APPLY)

	Never	Sometimes	Most of the time	Always
Lock your doors when you leave the car
Wear your seat belt
Ask others riding in the car to buckle their seat belt
Take the car in for tune-ups
Use a safety restraint like a car seat or a seat belt [for your child/the children) you care for]		**	**	**

NOTE TO RECRUITER: MUST ANSWER “SOMETIMES,” or “MOST OF THE TIME” OR “ALWAYS” TO “E” IN Q16 TO CONTINUE. RECRUIT AS MANY ‘SOMETIMES’ AND ‘MOST OF THE TIME’ RESPONDENTS AS POSSIBLE. OTHERWISE, TERMINATE.

14. As I reference the age of each child AGE 0-14, please tell me which of the following type of car safety restraint like a car seat or a seat belt you use for that child when they ride in the car with you when you’re driving.

NOTE TO RECRUITER: REFERENCE CHILD’S AGE, READ LIST OF SAFETY RESTRAINTS, CHECK ONE.

	Child 1 Age ___	Child 2 Age ___	Child 3 Age ___	Child 4 Age ___	Child 5 Age ___
Rear-facing car seat	( )	( )	( )	( )	( )
Forward-facing car seat	( )	( )	( )	( )	( )
Booster seat	( )	( )	( )	( )	( )
Adult seat belt	( )	( )	( )	( )	( )
Don’t know	( )	( )	( )	( )	( )

NOTE TO RECRUITER: TERMINATE IF RESPOND “DON’T KNOW” FOR ALL CHILDREN. 

FOR ALL 0-3 YR OLD GROUPS: MUST HAVE AT LEAST 1-2 PARENTS IN EACH GROUP WHO SELECT ‘BOOSTER SEAT’ OR ‘ADULT SEAT BELT’ FOR AT LEAST ONE 0-3 CHILD

FOR ALL 4-7  YR OLD GROUPS: MUST HAVE AT LEAST 1-2 PARENTS IN EACH GROUP WHO SELECT ‘ADULT SEAT BELT’ FOR AT LEAST ONE 4-7 CHILD

FOR ALL 8-14 YR OLD GROUPS: MUST HAVE AT LEAST 1-2 PARENTS IN EACH GROUP WHO SELECT ‘ADULT SEAT BELT’ FOR AT LEAST ONE 8-14 CHILD

14. [ASK IF HAVE A CHILD AGE 8-14]: When riding in the car, where do your children ages 8-14 sit in the car?

NOTE TO RECRUITER: ALLOW MULTIPLE RESPONSE IF MULTIPLE CHILDREN 8-14

( ) Front Passenger Seat

( ) Back Seat

( ) Other (Please describe)

NOTE TO RECRUITER: RECRUIT A FAIR REPRESENTATION OF FRONT AND BACK SEAT

14. What is your marital status?

( ) Single (never married)

( ) Living together but not married

( ) Married

( ) Separated

( ) Divorced

( ) Widowed

( ) Prefer not to state

NOTE TO RECRUITER: RECRUIT FAIR REPRESENTATION OF MARITAL STATUS

14. Please tell me which of the following bests describes your annual household income before taxes? NOTE TO RECRUITER: READ LIST

( ) Less than $30,000

( ) Between $30,000 and $49,999

( ) Between $50,000 and $74,999

( ) Between $75,000 and $99,999

( ) More than $100,000

( ) Refused

NOTE TO RECRUITER: RECRUIT A MIX OF HH INCOME LEVELS

NOTE TO RECRUITER: The next question is an articulation question. What the respondent says is not important; rather, judge his/her ability and willingness to comment with a specific point-of-view.

14. What is a movie you’ve seen recently that you liked? What did you like about it?

( ) Articulate

( ) Not articulate (TERMINATE)

INVITATION

Thank you for helping us with this survey. We have been asked to conduct interviews with people like you to give us ideas related to child safety in the car. We would like to invite you to a research interview to be held on MM/DD/YY at XXXX. The session will last approximately 90 minutes. We understand the demand on your schedule; therefore, you will receive $75 for your participation. Your participation is strictly voluntary.

May we count on you to join us?

( ) Yes (CONTINUE)

( ) No (TERMINATE)

We will be giving you a reminder call the day before the session. Is this the best number to reach you? Is there a preferred time for us to call you?

ALTERNATIVE PHONE, IF NECESSARY: ____________________________

PREFFERED TIME, IF APPLICABLE: _________________________________

If you wear glasses to read or watch TV please bring them with you.

Make sure to arrive at least 15 minutes before your session.

If, for any reason, you are unable to attend, please call us at XXX-XXX-XXXX.

Thank you, and we look forward to seeing you soon.

END OF SCREENER GUIDE

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NHTSA Form 1431