CNPP Segmentation Study

OMB CONTROL NO.: 0584-0523

EXPIRATION DATE: XX/XX/20XX

OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0523. The time to complete this information collection is estimated at 5 minutes, including the time for reviewing instructions and completing the information.

APPENDIX B-1 – USDA SEGMENTATION SURVEY SCREENER - ENGLISH

[After reading and signing consent form as well as reading the Privacy Act Statement, respondents will automatically be directed to the screener]

1. Please indicate your gender.

1. Male

2. Female

2. In what state do you currently reside?

[drop down list to select state] [WILL PROVIDE QUOTAS BY STATE, BASED ON ZIP CODE]

2. Please enter your zip code.

[GROUP BY STATE]

2. Just to make sure we have a representative sample, in what year were you born?

____ [enter 4-digit year] [WILL SET AGE QUOTAS FOR SAMPLE TO BE REP]

TERMINATE IF AFTER 1994 (under age 22)

2. In which of the following fields do you work? Please select all that apply.

1. Healthcare TERMINATE

2. Fitness TERMINATE

3. Nutrition TERMINATE

4. Marketing and Advertising TERMINATE

5. Federal government TERMINATE

6. None of the above

6. Including yourself, how many household members are there in your home? Exclude any roommates/boarders/etc.

1. 1 (yourself only)

2. 2

3. 3

4. 4

5. 5

6. 6

7. 7

8. 8 or more

6. Thinking of everyone in your household who receives income, what was your approximate annual household income for 2015, before taxes, from all sources?

1. $15,000 and under

2. $16,000 to just below $25,000

3. $25,000 to just below $30,000

4. $31,000 to just below $35,000

5. $36,000 to just below $40,000

6. $40,000 to just below $45,000

7. $45,000 to just below $50,000

8. $50,000 to just below $55,000

9. $55,000 to just below $60,000

10. $60,000 to just below $65,000

11. $65,000 to just below $70,000

12. $70,000 to just below $75,000

13. $75,000 to just below $80,000

14. $80,000 to just below $85,000

15. $85,000 to just below $90,000

16. $90,000 to just below $95,000

17. $95,000 to just below $100,000

18. $100,000 or more

[WILL SET QUOTA ON LOW INCOME. Programmer Note: The following combinations will qualify as low income:

If Q6=1 and Q7=1

If Q6=2 and Q7=1,2

If Q6=3 and Q7=1,2,3

If Q6=4 and Q7=1,2,3,4

If Q6=5 and Q7=1,2,3,4,5

If Q6=6 and Q7=1,2,3,4,5,6

If Q6=7 and Q7=1,2,3,4,5,6,7

If Q6=8 and Q7=1,2,3,4,5,6,7,8]

[PUT RACE AND ETHNICITY (q8 and q9) ON SAME PAGE]

8. Are you Hispanic or Latino?

1. Yes, I am Hispanic or Latino

2. No, I am not Hispanic or Latino

8. To be sure we have a representative sample, what is your race? Select all that apply. [WILL SET RACE QUOTAS FOR PANEL SAMPLE TO BE REP]

1. American Indian or Alaskan Native

2. Asian

3. Black or African American

4. Hawaii Native or Other Pacific Islander

5. White

[If Q8=Yes then ask Q10 else Proceed to survey]

8. In general, what language(s) do you read and speak?

1. Only Spanish

2. Spanish better than English

3. Both equally

4. English better than Spanish

5. Only English

8. In general, what language(s) do you usually speak at home?

1. Only Spanish

2. Spanish better than English

3. Both equally

4. English better than Spanish

5. Only English

8. In which language(s) do you usually think?

1 Only Spanish

2 Spanish better than English

3 Both equally

4 English better than Spanish

5 Only English

8. What language(s) do you usually speak with your friends?

1 Only Spanish

2 Spanish better than English

3 Both equally

4 English better than Spanish

5 Only English

[If Average of Q10 to Q13 <2.99 then Spanish language sample; Otherwise English Language sample]

8. What language would you prefer to use for this survey?

1 Spanish

2 English

[If Q14=1, direct to Spanish survey. If Q14=2 direct to English survey]

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