SNAP-Eligible Qualitative Research (Individuals/Households 18-75 years) Respondents + non-respondents

OMB CONTROL NO.: 0584-0523

EXPIRATION DATE: 09/30/2019

Attachment C-1 Screener (English)

• Audience 1: SNAP-eligible (Q8-Q8a), Non-married/no children (Q2), 18-29 years old (Q5), English-speaking (Q9-Q10)

• Audience 1-S: SNAP-eligible (Q8-Q8a), Non-married/no children (Q2), 18-29 years old (Q5), Spanish-speaking (Q9-Q10)

• Audience 2: SNAP-eligible (Q8-Q8a), 18-44 years old (Q5), with children (Q2), English-speaking (Q9-Q10)

• Audience 2-S: SNAP-eligible (Q8-Q8a), 18-44 years old (Q5), with children (Q2), Spanish-speaking (Q9-Q10)

• Audience 3: SNAP-eligible (Q8-Q8a), 45-75 years old (Q5), empty-nester/no children (Q2), English-speaking (Q9-Q10)

• Audience 3-S: SNAP-eligible (Q8-Q8a), 45-75 years old (Q5), empty-nester/no children (Q2), Spanish-speaking (Q9-Q10)

All groups recruit 10 to seat six.

Hello, My name is_______________________, and I am calling from Edge Research, a research company in CITY/LOCATION. We are calling on behalf of the United States Department of Agriculture (USDA FNS) Food and Nutrition Service (FNS) to ask for your participation in a discussion about how USDA can best communicate about food and nutrition programs to people like you. Your participation is voluntary and as a token of our appreciation, we will provide $75 as an incentive for your participation in a 2-hour discussion on this subject. There are no penalties if you chose not to participate. This feedback session will be private, which means that nothing that you say will be seen by anyone other than qualified researchers working on this project, except as otherwise required by law. Your responses will be combined with others and you will never be personally identified.

Are you interested in participating?

IF NO: Thank you and have a great day/evening.

IF YES: Great! First, I need to ask you a few questions to find out if your background meets the needs of this study.

Before the questions, I need to inform you about the process.

It will take approximately 15 minutes to complete the questions. In accordance with the Paperwork Reduction Act of 1995, the valid OMB control number for this information collection is 0584-0524. If you have comments on any aspect of this information collection, there is a mailing address to send comment to USDA. Would you like that address? [IF YES: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302, ATTN: PRA (0584-0524).]

1. DO NOT READ: RECORD GENDER [RECRUIT A MIX FOR EACH GROUP, OK TO SKEW FEMALE]

1. Male

2. Female

2. Are you the parent of a child 17 or younger who lives with you, even part-time?

1. Yes [MUST SELECT TO CONTINUE SCREEN FOR AUDIENCE 2, 2-S]

2. No [MUST SELECT TO CONTINUE SCREEN FOR AUDIENCE 1, 1-S, 3, 3-S]

3. Are you Hispanic, Latino or of Spanish descent?

1. Yes, Hispanic or Latino [CONTINUE SCREEN FOR ALL GROUPS; MUST SELECT FOR AUDIENCE 1-S, 2-S, 3-S]

2. No, not Hispanic or Latino

1. Prefer not to answer

4. Which of the following best describes your race? [ACCEPT MULTIPLE RESPONSES; RECRUIT A MIX FOR AUDIENCES 1,2,3 INCLUDING HISPANIC AND NATIVE AMERICAN]

1. American Indian or Alaska Native

2. Asian

3. Black or African American

4. Native Hawaiian or Other Pacific Islander

5. White [MAX 4 PER GROUP THAT SELECT WHITE ONLY]

6. Other

7. Prefer not to answer

5. Please stop me when I come to the category that includes your age.

1. Under 18 [TERMINATE AND THANK: Based on the requirements of the study, it looks like we can’t include you at this time. It is possible we will be calling you in the future for other studies.]

2. 18 – 29 [CONTINUE SCREEN FOR AUDIENCE 1, 1-S, 2, 2-S]

3. 30 – 44 [CONTINUE SCREEN FOR AUDIENCE 2, 2-S]

4. 45 – 59 [CONTINUE SCREEN FOR AUDIENCE 3, 3S]

5. 60 – 74 [CONTINUE SCREEN FOR AUDIENCE 3, 3-S]

6. 75 or older [TERMINATE AND THANK]

FOR AUDIENCE 2, 2-S: RECRUIT A MIX OF AGE 18-44

FOR AUDIENCE 3, 3-S: RECRUIT A MIX OF AGE 45-75

6. Please select the category that best represents your living situation:

1. Live in parent/guardian’s home

2. Live in dorm/group home

3. Live with spouse/significant other [MAX 3 FOR AUDIENCE 1, 1-S]

4. Live with children/other family members [CHECK AGAINST PARENT Q2 FOR AUDIENCE 2, 2-S]

7. In your household, who is responsible for making choices regarding the food you and your household eats?

1. I am primary responsible for making choices regarding the food I/my household eats

2. I share responsibility for making choices regarding the food I/my household eats

3. Someone else is primarily responsible for making choices regarding the food I/my household eats [TERMINATE]

8. How many people live with you regularly and make up your “household” including yourself? Please exclude any roommates/boarders/etc. __ __ [NUMERIC 1-99; REQUIRED]

8a. What was your approximate annual household income for 2017, before taxes, from all sources? This includes salaries, Social Security, pension, interest, and investment earnings.

1. Under $30,000

2. $30,000 to just below $35,000

3. $35,000 to just below $40,000

4. $40,000 to just below $45,000

5. $45,000 to just below $55,000

6. $55,000 to just below $65,000

7. $65,000 to just below $75,000

8. $75,000 to just below $85,000

9. More than $85,000 TERMINATE AND THANK

[DEFINITION OF SNAP-ELIGIBLE:

If Q8=1 and Q8a=1

If Q8=2 and Q8a =1,2

If Q8=3 and Q8a =1,2,3

If Q8=4 and Q8a =1,2,3,4

If Q8=5 and Q8a =1,2,3,4,5

If Q8=6 and Q8a =1,2,3,4,5,6

If Q8=7 and Q8a =1,2,3,4,5,6,7

If Q8=8 and Q8a =1,2,3,4,5,6,7,8

MUST BE SNAP-ELIGIBLE TO QUALIFY

IF NOT SNAP-ELIGIBLE, IN ANY CATEGORY, TERMINATE

[ADDITIONAL SCREEN FOR HISPANIC PARTICIPANTS]

9. What language do you usually speak at home?

1. Only Spanish

2. Mostly Spanish

3. Spanish and English equally

4. Mostly English

5. Only English [SKIP TO RESUME ALL QUESTION]

10. Thinking of your media habits, including television, the internet, social media, radio, and print newspapers and magazines, would you say you use …

1. Only Spanish language media

2. Mostly Spanish language media

3. Spanish and English language media equally

4. Mostly English language media

5. Only English language media

MUST BE MOSTLY-SPANISH IN MEDIA OR AT HOME TO QUALIFY FOR SPANISH-SPEAKING GROUPS (Q9 or Q10 = 1,2). IF EQUAL OR MOSTLY ENGLISH ON BOTH (Q9 and Q10=3-5), MAY QUALIFY FOR AUDIENCE 1,2,3.

[RESUME ASKING ALL]

11. For each statement, please tell me whether you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with that statement.

1. Strongly agree

2. Somewhat agree

3. Somewhat disagree

4. Strongly disagree

5. Don’t know/Not sure

[RANDOMIZE]

1. I am confident in my ability to make nutritious eating choices

2. The people closest to me have nutritious eating habits

3. I know where to find/purchase nutritious foods near me

4. Eating food you know is not good for you is fine as long as you have a balanced diet

5. Nutritious food is expensive

6. I eat whatever I want, whenever I want

7. I eat whatever I know my kids/family will eat

RECRUIT FOR A MIX OF ATTITUDES/LIFESTYLE.

12. How familiar are you with each of the following programs from USDA?

1. Very familiar

2. Somewhat familiar

3. Not too familiar

4. Never heard of/don’t know

[ROTATE]

1. “SNAP” or the Supplemental Nutritional Assistance Program. It is sometimes referred to and formerly known as “Food Stamps”

2. “WIC” or the Special Supplemental Nutrition Program for Women, Infants, and Children 

3. “MyPlate”

MAX 2 PER GROUP “NEVER HEARD OF” SNAP (Q12 A=4)

MIN 2 PER GROUP “VERY FAMILIAR” WITH SNAP (Q12 A=1)

13. What is your zipcode? __ __ __ __ __ __ __ [NUMERIC, RECORD]

14. In what type of community do you live? [CONFIRM AGAINST ZIP CODE. RECRUIT A MIX REFLECTIVE OF THE CITY/LOCATION.]

1. Urban, which is inside a city

2. Suburban, which is just outside of a city

3. Rural, which is farther outside of a city, like in the country [MIN. 4 PER GROUP IN “RURAL” CITY/LOCATIONS.]

Thank you for completing the screening questions. As I mentioned previously, you have been invited to participate in a small discussion group regarding how USDA can best communicate about nutrition information to people like you via digital channels like social media. Your participation means that you would participate in the 2-hour discussion that will be held on DATE/TIME/LOCATION. As a token of our appreciation, you will receive $75 upon completion of the group.

Would you still like to participate?

[If Respondent seems uncomfortable, explain, “This information will be used only to send you a confirmation and details for the group.”]

Respondent’s name _____________________________________

Address ______________________________________________

Email Address__________________________________________

Telephone Number: ________________

Alternate Number: ___________________________

Privacy Act Statement

Authority: Section 9 of the Food and Nutrition Act of 2008, as amended, (7 U.S.C. 2018); section 205(c)(2)(C) of the Social Security Act (42 U.S.C. 405(c)(2)(C)); and section 6109(f) of the Internal Revenue Code of 1986 (26 U.S.C. 6109(f)), authorizes collection of the information on this application.

Purpose: Information is collected primarily for use by the Food and Nutrition Service in the administration of the Supplemental Nutrition Assistance Program.

Routine Use: Information may be disclosed for any of the routine uses listed in the published System of Record notice https://www.federalregister.gov/documents/2010/12/27/2010-32457/privacy-act-revision-of-privacy-act-systems-of-records#p-30

Disclosure: Furnishing the information on this form is voluntary.

OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0584-0524. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302, ATTN: PRA (0584-0523). Do not return the completed form to this address.