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

Appendix C-5: Household Screener Questions for Pretest 2

FoodAPS Pilot Instrument

Screener

[Obtain permission]

Hello. My name is [FILL NAME]. I work for Westat and we’re conducting the National Food Study for the U.S. Department of Agriculture. We recently sent a letter to this address.

[SHOW ID CARD]

The National Food Study will help the USDA improve its programs by answering questions about where households get food and how much they pay for food.

[OFFER THE STUDY BROCHURE/FACT SHEET]

I am here to conduct a 12 minute questionnaire to see if your household is eligible to participate in the study. If you are eligible and you complete the study you will receive $125 or more. All of your responses to this information collection are voluntary. The information that you provide will be kept completely confidential. We will use your information only for statistical purposes and your responses will not have any effect on services you currently receive or may apply for in the future.

1. Are you a member of this household and at least 18 years of age?

If yes, continue. If no, ask to speak with an adult household member.

2. May I begin the ten minute questionnaire?

1. YES GO TO Q.3

0. NO GO TO Screener Nonresponse follow-up SECTION

[Verify Address]

3. I have this address as [READ ADDRESS ON CONTACT SHEET]. Is that your exact address?

1 YES, EXACTLY AS LISTED GO TO Q.6

2 MOSTLY CORRECT, BUT NEEDS MINOR CORRECTING ADDRESS IN CAPI, GO TO Q.6

3 INCORRECT ADDRESS TERMINATE INTERVIEW, CODE CASE STATUS AS WRONG ADDRESS AND FIND CORRECT ADDRESS

6. Do you or at least one member of your household live or stay at this address year round?

1 YES GO TO Q.7

0 NO

d DON’T KNOW

r REFUSED

6a. How many months of the year do members of this household stay at this address?

1. 6 MONTHS OR MORE GO TO Q.7

0. LESS THAN 6 MONTHS TERMINATE. READ IF NECESSARY: This study only includes people at their permanent residence. Based on your responses, you are not eligible for the study at this time. RECORD CASE STATUS AS SCREENER COMPLETE INELIGIBLE FOR MAIN STUDY.

[HH entity (# people share food)]

7. Including yourself, how many people live in your household? Don’t forget to include babies, small children, and non-relatives who live here. Also include persons who usually live here but are temporarily away for reasons such as: vacation, traveling for work, or in the hospital. Do not include people living away at school or incarcerated.

_______________ NUMBER

d DON’T KNOW READ: This information is critical for determining your household’s eligibility to participate in the main study. IF R STILL GIVES DON’T KNOW, TERMINATE. RECORD CASE STATUS AS SCREENER REFUSAL AND GO TO “Screener Nonresponse follow-up” SECTION.

r REFUSED READ: This information is critical for determining your household’s eligibility to participate in the main study. IF R STILL GIVES DON’T KNOW, TERMINATE. RECORD CASE STATUS AS SCREENER REFUSAL AND GO TO “Screener Nonresponse follow-up” SECTION.

8. Do all the people in your household live together and share food?

[IF NEEDED: By sharing food, we mean people purchase and prepare meals together?]

1 YES CAPI RECORD Q7 RESPONSE AS HH SIZE, THEN SKIP TO Q.8B

0 NO

8a. How many people live together and share food?

____________ NUMBER CAPI RECORD AS HH SIZE

d DON’T KNOW CAPI RECORD ANSWER TO Q7 AS HH SIZE

r REFUSEDCAPI RECORD ANSWER TO Q7 AS HH SIZE

[HH member pregnant or with infant but not on WIC?]

8b. Is anyone in your household currently pregnant?

1. YES

2. NO

8c. How many of the [FILL IN HH SIZE] people is under the age of 5?

__________NUMBER

[Total HH income—PLACEHOLDE SUBJECT TO CHANGE]

9. From now on when we refer to your household we mean the [FILL HH SIZE] people that live together and share food.

Next are questions about your household’s income in the last 12 months, that is since (month) 1st of 2015. When we say “income” we mean earnings from work, unemployment, welfare, child support, retirement income, disability income, investment income, and any type of income even if you do not get it regularly. Please look at this card [SHOW INCOME SOURCES HAND CARD] and tell me which types of income were received by people in your household in the last 12 months.

1 EARNINGS FROM WORK 2 UNEMPLOYMENT COMPENSATION 3 WORKERS COMPENSATION 4 DISABILITY OR SSI 5 SOCIAL SECURITY 6 PENSIONS AND RETIREMENT INCOME

7 CHILD SUPPORT 8 ALIMONY 9 CASH WELFARE (LIKE TANF OR GENERAL ASSISTANCE) 10 INVESTMENT INCOME 11 OTHER d DON’T KNOW r REFUSED

10. Thinking about your household’s income from [LIST INCOME SOURCES IN Q.9] in the last 12 months, which group (A, B or C) corresponds to your household total income in the 12 months, before taxes? [IF MORE THAN ONE PERSON IN HOUSEHOLD: Please include income from all people in your household.]

SHOW HAND CARD FOR THE HOUSEHOLD SIZE.

1. GROUP ACAPI RECODE INCOME CATEGORY AND GO TO Q11

2. GROUP B CAPI RECODE INCOME CATEGORY AND GO TO Q11

3. GROUP C CAPI RECODE INCOME CATEGORY AND GO TO Q11

d DON’T KNOW GO TO Q10A

r REFUSED GO TO Q10A

10a. Was it [FILL-Q10a] or more last year?

1. YES GO TO Q.10b

0 NO  CAPI RECORD “A” AS INCOME CATEGORY AND GO TO Q.11

d DON’T KNOW GO TO Q.10b

r REFUSED GO TO Q.10b

10b. Was it [FILL-Q10b] or more last year?

1. YES CAPI RECORD “C” AS INCOME CATEGORY

0. NO CAPI RECORD “B” AS INCOME CATEGORY

d DON’T KNOW CAPI RECORD “DK” AS INCOME CATEGORY

r REFUSED CAPI RECORD “REF” AS INCOME CATEGORY

[Receive SNAP benefits]

11. Do you or any member of your household currently receive [FILL STATE SNAP NAME]? This program puts money on an EBT card that you can use to buy food.

1 YES

0 NO

d DON’T KNOW

r REFUSED

[Currently on WIC?]

12. 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?

1 YES

0 NO

d DON’T KNOW

r REFUSED

[SMARTPHONE AND COMPUTER USE IN HH]

Q15. Do you have a working cell phone?

1 YES GO TO Q16

0 NOGO TO Q17

d DON’T KNOW GO TO Q17

r REFUSED GO TO Q17

Q16. Some cell phones are called 'smartphones' because of certain features they have. Is your cell phone a smartphone or not, or are you not sure?

1 Yes, is a smartphone

0 No, is not a smartphone

d NOT SURE/DON’T KNOW

r REFUSED

Q17. [IF Q16=1 READ: ]Who else in this household has a smartphone?

[IF Q16 =0, d, r READ: ] Who in this household has a smartphone?

[IF Q15=0, d, r READ: ] Some cell phones are called 'smartphones' because of certain features they have. Who in this household has a smartphone?

INTERVIEWERS: CHECK ALL THAT APPLY

1. R’S SPOUSE/PARTNER

2. R’S CHILDREN

3. R’S PARENTS

4. OTHER RELATIVES IN HH

5. OTHER NON-RELATIVES IN HH

6. NO ONE ELSEGO TO Q20

[IF Q16=1 OR Q17^=6 THEN ASK Q18 AND Q19; ELSE GO TO Q20]

Q18. Do the smartphones/does the smartphone in your household have a data plan?

1 YESGO TO Q19

0 NOGO TO Q20

d DON’T KNOW GO TO Q20

r REFUSED GO TO Q20

Q19. What is the maximum amount of data allowed to use as part of the cell phone plan?

1. Below 1GB per month

2. Above 1 GB per month but below 2 GB per month

3. Above 2 GB per month but below 4 GB per month

4. Unlimited data plan

d DON’T KNOW

r REFUSED

Q20. Do you or anyone in your household own a desktop or laptop computer?

1 YES

0 NO

d DON’T KNOW

r REFUSED

Q21. Do you or anyone in your household own a tablet computer (e.g., IPad, Kindle, Microsoft Surface, Samsung Galaxy Tab, Nook, etc.)?

1 YES

0 NO

d DON’T KNOW

r REFUSED

Q22. (IF Q18=1, READ: Other than the data plan on your cell phone,) do you have high-speed internet service at home (such as cable internet, DSL, FIOS, or satellite internet service)?

1 YES

0 NO

d DON’T KNOW

r REFUSED

[DETERMINE ELGIBILITY]

[IF Q11=1 GO TO INTERVIEWER CHECK 1; ELSE GO TO INSTRUCTION BEFORE INTERVIEWER CHECK 2]

INTERVIEWER CHECK 1 (OR CAPI CHECK?): IS SAMPLING DOMAIN “SNAP HOUSEHOLDS” OPEN?

1. YES GO TO ELIGIBLE SECTION

2. NO GO TO INELIGIBLE SECTION

[IF Q12=1 THEN GO TO INTERVIEWER CHECK 2; ELSE GO TO INSTRUCTION BEFORE INTERVIEWER CHECK 3]

INTERVIEWER CHECK 2 (OR CAPI CHECK?): IS SAMPLING DOMAIN “NON-SNAP WIC HOUSEHOLDS” OPEN?

1. YESGO TO ELIGIBLE SECTION

2. NOGO TO INELIGIBLE SECTION

[IF INCOME CATEGORY IS A, B, OR C, THEN GO TO INTERVIEWER CHECK 3; ELSE INTERVIEWER CHECK 4]

INTERVIEWER CHECK 3: IS INCOME SAMPLING DOMAIN OPEN?

1. YES  GO TO ELIGIBLE SECTION

2. NO GO TO INELIGIBLE SECTION

[IF INCOME CATEGORY IS DK OR REF, GO TO INTERVIEWER CHECK 4]

INTERVIEWER CHECK 4: IS SAMPLING DOMAIN “INCOME CATEGORY C” OPEN?

1. YES  GO TO ELIGIBLE SECTION

2. NO GO TO INELIGIBLE SECTION

[INELGIBLE SECTION]

Thank you for your time. I’m sorry your household is not eligible for the study.

READ IF NECESSARY: In order to produce a representative sample we only take households with certain characteristics. Based on your responses you are not eligible at this time.

IE1. May I have your name and telephone number in case my supervisor wants to confirm that I spoke with you?

FIRST NAME:

LAST NAME:

TELEPHONE: (______) -______ - ________

0 →NO TELEPHONE

d →DON’T KNOW

r →REFUSED

IE2. (INTERVIEWER CHECK: ) WHAT LANGUAGE WAS USED FOR THIS INTERVIEW?

1 →ENGLISH

2 →SPANISH

3 →KOREAN

4 →VIETNAMESE

5 →CHINESE

6 →TRANSLATED BY OTHER HH MEMBER

THANK AGAIN AND TERMINATE. RECORD CASE STATUS AS SCREENER COMPLETE- INELIGIBLE FOR MAIN STUDY.

[Screener Nonresponse follow-up]

Can you help us by answering just 4 quick questions? We want to know if people who participate in our study are a good representation of all households in the United States.

R1. How many people are in your household?

______________________PEOPLE

d DON’T KNOW

r REFUSED TERMINATE AND THANK. RECORD CASE STATUS AS SCREENER REFUSAL

R2. Is your total household income greater than $30,000 a year?

1 YES

0 NO

d DON’T KNOW

r REFUSED

R3. Last week, how much did your household spend on groceries? Your best guess is fine.

$____________

d DON’T KNOW

r REFUSED

R4. Last week, how much did your household spend while eating out? Your best guess is fine.

$____________ d DON’T KNOW r REFUSED

Those are all the questions I have. Thank you for your time. If you change your mind about taking part in the study, please call us at the toll-free number on the brochure/fact sheet. Have a nice day!

RECORD CASE STATUS AS SCREENER REFUSAL

[ELIGIBLES: IDENTIFY MAIN FOOD SHOPPER]

E1. Are you the person who does most of the shopping for food in your household?

1 YES

0 NO

d DON’T KNOW

r REFUSED

E2. Are you the person who does most of the planning or preparing of meals in your household?

IF RESPONDENT ANSWERS “SOMETIMES” OR “50/50,” ENTER YES.

1 YES GO TO INTERVIEWER CHECK #5

0 NO GO TO INTERVIEWER CHECK #5

D DON’T KNOW GO TO INTERVIEWER CHECK #5

R REFUSED GO TO INTERVIEWER CHECK #5

INTERVIEWER CHECK #5: IS RESPONDENT THE FOOD SHOPPER (QE1=YES) OR MEAL PLANNER (QE2=YES)?

1 YES GO TO CONTACT INFORMATION

0 NO GO TO Q.E3

E3. Your household is eligible to take part in the study, but I need to speak with the person who does most of the shopping for food in your household. What is the name of the person who does most of the shopping for food?

FIRST NAME _____________________

E4. Can I speak with [FILL Q.E3 NAME]?

1 YES  GO TO NEW RESPONDENT INTRO

0 NO

d DON’T KNOW

r REFUSED

E5. What is the best telephone number to reach [FILL Q.E3 NAME]?

(______) - ______ - _______________

Area Code

0 NO TELEPHONE

d DON’T KNOW

r REFUSED

As I mentioned, your household is eligible for the study, but I need to speak with the Food Shopper or Meal Planner. I’d like to schedule a time to come back.

IF PHONE NUMBER PROVIDED: I will call [FILL Q.E3 NAME] at the phone number you provided to schedule a time to come back. When is a good time to call?

IF PHONE NUMBER NOTPROVIDED: When is a good time to come back and speak with [FILL Q.E3 NAME]?

WHEN YOU RETURN TO TALK TO THE NEW RESPONDENT START AT THE NEW RESPONDENT INTRO.

[NEW RESPONDENT INFORMATION]

Hello. My name is [FILL NAME]. I work for Westat and we’re conducting the National Food Purchase Study for the U.S. Department of Agriculture. We recently sent a letter to this address. SHOW ID CARD

The National Food Purchase Study will help the USDA improve its programs by answering questions about where households get food and how much they pay for food. The addresses we visit are scientifically selected to represent all households in the country. Taking part is completely voluntary and any information that you provide will be kept completely confidential. We will use your information only for statistical purposes and your responses will not have any effect on services you currently receive or may apply for in the future.

GO TO CONTACT INFORMATION

[CONTACT INFORMATION]

Your household is eligible for this study! In this study, you will be asked to complete one 30-minute interview now, keep track of foods you get during the week, and one final 35-minute interview at the end. You will receive a $50 today and $50 or more in incentives at the end of the week. You will also receive up to$21 for each member of your household if they report the foods they get during the week.

I’d like to get your contact information before we continue.

C1. What is your name?

FIRST NAME ___________________________

LAST NAME ____________________________

C2. What is the best telephone number to reach you?

(______) - ______ - _______________

Area Code

0 NO TELEPHONE

d DON’T KNOW

r REFUSED

[IF Q16=1 OR Q17^=6 THEN ASK C2A. ELSE GO TO C3]

C2a. Is this your cell phone number?

1 YES

0 NO

C3. Is there another number where you can be reached?

(______) - ______ - _______________

Area Code

0 NO TELEPHONE GO TO C4

d DON’T KNOW GO TO C4

r REFUSED GO TO C4

C3a. Is this a cell phone number?

1 YES

0 NO

C4. INTERVIEWER OBSERVATION: IN WHAT LANGUAGE IS THIS INTERVIEW ADMINISTERED?

1 ENGLISH

2 SPANISH

C4A. INTERVIEWER OBSERVATION: IN YOUR OPINION, IS RESPONDENT’S ENGLISH EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR?

1 EXCELLENT

2 VERY GOOD

3 GOOD

4 FAIR

5 POOR

6 DIDN’T HEAR RESPONDENT SPEAK ENGLISH

C5. Do you have time now to discuss the study and learn about what you’ll be doing for the week? This will take a little over an hour.

1 YES  CONTINUE TO INITIAL INTERVIEW AND TRAINING. RECORD CASE STATUS AS SCREENER COMPLETE ELIGIBLE FOR MAIN STUDY.

2 NO, NO TIME NOW  SCHEDULE A TIME FOR THE INITIAL INTERVIEW AND TRAINING. RECORD CASE STATUS AS SCREENER COMPLETE ELIGIBLE FOR MAIN STUDY.

3 NO, REFUSED TO PARTICIPATE.  GO TO NONRESPONSE TO MAIN STUDY SECTION. RECORD CASE STATUS AS SCREENER COMPLETE ELIGIBLE FOR MAIN STUDY.

[NONRESPONSE TO MAIN STUDY]

IF RESPONDENT IS ELIGIBLE AND REFUSES TO PARTICIPATE IN THE STUDY

I would like to ask a few questions so that we know if people who participate in our study are a good representation of all households in the United States.

[NONRESPONSE FOLLOWUP: Basic demographics]

MNR1. (ASK IF NECESSARY: )Are you…?

1. MALE

2. FEMALE

MNR2. Are you…

1. 18-29

2. 30-49

3. 50-69

4. Over 70

MNR3. Are you Spanish, Hispanic, or Latino?

1. YES

2. NO

MNR4. Please choose one or more races that you consider yourself to be…

1. WHITE

2. BLACK OR AFRICAN AMERICAN

3. HISPANIC

4. AMERICAN INDIAN

5. ASIAN

6. OTHER

MNR5A. How many people in your household are aged 5 to 9?

#______________

d DON’T KNOW

r REFUSED

MNR5B. How many people in your household are aged 10 to 13?

#______________

d DON’T KNOW

r REFUSED

MNR5C. How many people in your household are aged 14 to 18?

#______________

d DON’T KNOW

r REFUSED

MNR5D. How many people in your household are over 18 years old?

#______________

d DON’T KNOW

r REFUSED

[NONRESPONSE FOLLOWUP: Usual food acquisition patterns]

MNR6. Last week, how much did your household spend on groceries? Your best guess is fine.

$___|,___|___|___|.00

d DON’T KNOW

r REFUSED

MNR7. Last week, how much did your household spend while eating out? Your best guess is fine.

$ ___|,___|___|___|.00

d DON’T KNOW

r REFUSED

Those are all the questions I have. Thank you for your time. If you change your mind about taking part in the study, please call us at the toll-free number on the brochure/fact sheet. Have a nice day! RECORD CASE STATUS AS REFUSAL TO MAIN STUDY.

Categories for Q10a and Q10b
HH Size	FILL-Q10a	FILL-Q10b
1	$ 11,000	$ 21,000
2	$ 15,000	$ 29,000
3	$ 20,000	$ 37,000
4	$ 24,000	$ 44,000
5	$ 28,000	$ 52,000
6	$ 32,000	$ 60,000
7	$ 36,000	$ 67,000
8+	$ 40,000	$ 75,000