Pretests for an alternate data collection method (ADCM) for FoodAPS2

Generic Clearance for Survey Research Studies

Pretest_generic_clearance_Appendix B_Recruitment Script

Pretests for an alternate data collection method (ADCM) for FoodAPS2

OMB: 0536-0073

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Appendix B: Participant Recruitment Script





Thank you for your interest in the food purchasing study. For this study, a Westat staff will visit your household and will ask you to report food or drinks obtained for one week using a web-based system or a smartphone APP. In order to make sure that you qualify for this study we need to ask a few brief questions about you and your household. This recruitment interview will take about 5 minutes and your answers will be kept confidential. The law prohibits us from giving anyone any information that may identify you or your family without your consent.





1. What is your age?

___________


IF UNDER 18 TELL PERSON THAT THEY ARE INELIGIBLE.



2. Do you have any difficulty reading in English?

Yes – TELL PERSON THAT THEY ARE INELIGIBLE

No

3. How many people live in your household?

__________

4. [IF MORE THAN 1 PERSON IN THE HOUSEHOLD] Are you the person who does most of the shopping for food in your household?

Yes

No

5 [IF MORE THAN 1 PERSON IN THE HOUSEHOLD] Are you the person who does most of the planning or preparing meals in your household?

Yes

No

6. Just to be sure we're interviewing a broad range of individuals for this study, what is your total annual household income?

(INTERVIEWER: If the participant indicates a preference to not disclose this information, say: “That’s fine” and move on to the next question.)

7. Do you or any member of your household currently receive Supplemental Nutritional Assistance Program or SNAP benefits? This program puts money on an EBT card that you use to buy food.

Yes


No


8. Are you male or female? (if needed)

Yes – go to question 9


No – go to question 10



9. The WIC program - the Women, Infants, and Children program. -- provides healthy foods and other services to low-income pregnant and breastfeeding women, infants, and children up to age 5. Is anyone in your household now receiving benefits from WIC?

Yes


No



10. At home, does anyone in the household have any of the following? Select one answer choice on each row.


Yes

No

Wi-Fi or some other Internet Connection



A desktop or laptop computer



A tablet, such as Apple iPad or Samsung Galaxy Tab



A smartphone





10a. [IF ANYONE HAS A SMARTPHONE] How many people in the household have smartphones?

____________

10b. What kind of smartphones are these?

Android

Iphone

Both

11. How often do you use each of the following? Select one answer choice on each row.


Never

Rarely

Sometimes

Very Often

Always

A desktop or laptop computer






A tablet, such as Apple iPad or Samsung Galaxy Tab






A smartphone






IF INELIGIBLE

Thank you very much for your interest and time, but you are not eligible for this study. We will destroy the information you have provided.

IF ELIGIBLE

Thank you for answering all my questions. We will contact you if you are selected to participate. Can I have your name, phone number and/or email so that we can get in touch with you?

COLLECT RESPONDENT NAME, ADDRESS, AND PHONE NUMBER.

Name: _____________________________________________________________

Address: _____________________________________________________________

City: _________________________________ State: ______ Zip Code: __________

Phone: _________________________________

IF NEEDED: If you have any questions about the legitimacy of the study or need more information, you can contact Janice Machado, at (301)-294-2801 or [email protected]



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