Request Approval to Perform Research for Team Nutrition Posters-Phase 2

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 0584-0524. The time required to complete this information collection is estimated to average 15 minutes per response (10 minutes for parents and 5 minutes for students), including time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.

USDA/FNS

Screening Questionnaire – Elementary & Middle School Students

Formative Round Phase 2 (Fall 2013)

RESEARCH CONTACT: Jason McGrath at 202.326.1810 or [email protected]

SPECS:

• Eight, 60-minute mini focus groups with elementary school students (grades 3-4), per location.

• Eight, 60-minute mini focus groups with elementary school students (grades 5-6), per location.

• Eight, 60-minute mini focus groups with middle school students (grades 7-8), per location.

• Recruit 10 for 6 to show (seat) at each group.

• All students must be actively involved in school clubs, sports teams, student government or other school activities.

• All students should attend an elementary or middle school that offers the National School Lunch Program (we will provide facility with a list of eligible local schools for recruitment).

• Each child must be able to speak English.

• All respondents must be outgoing, responsive, articulate, willing and able to read and react to written materials, and must be willing to speak openly in a group.

FORMATIVE: PLEASE RECRUIT RESPONDENTS AS FOLLOWS:

	GROUP	DATE	TIME
[ ]	Group 1: 3rd & 4th grade boys	TBD	TBD
[ ]	Group 2: 3rd & 4th grade girls	TBD	TBD
[ ]	Group 3: 5th & 6th grade boys	TBD	TBD
[ ]	Group 4: 5th & 6th grade girls	TBD	TBD
[ ]	Group 5: 7th & 8th grade boys	TBD	TBD
[ ]	Group 6: 7th & 8th grade girls	TBD	TBD

INTRODUCTION: Hello, my name is __________ from __________. We are conducting a study about nutrition in schools on behalf of the federal government and I’d like to ask you a few questions. I’m not trying to sell you anything. We would like to invite a number of elementary and middle school students in your area to participate in a focus group to help us understand more about what they think about nutrition and health.

May I speak to the male or female head of household? This should only take a few minutes. [ONCE ADULT ON PHONE, REPEAT INTRODUCTION]

1. Do you or does anyone in your household work in any of the following industries?

1. Healthcare/Medical

2. Nutrition/Food Service

3. Fitness

4. Food Manufacturing

5. School Food Service

6. Food/Nutrition Assistance Programs

7. Media

8. Marketing, PR, Advertising

9. Market Research

1. Yes

2. No

2. How many elementary or middle school-aged children currently live in your household?

   1. [ENTER NUMBER]

[IF Q2=0, TERMINATE]

3. What is/are the age(s), grade(s) and gender(s) of the elementary and middle school child(ren) currently living at home with you?

[RECORD INFORMATION IN COLUMNS OF TABLE BELOW]

	Gender	Age	Grade	Name of School	Lunch (Y/N)
1
2
3
4

RECRUIT MIX OF AGE/GRADES

DO NOT RECRUIT MORE THAN ONE CHILD PER FAMILY

4. Which, if any, of your children participate in their school lunch program, that is they purchase lunch or receive a free lunch at school?

[RECORD IN ABOVE TABLE]

[TERMINATE IF NO KIDS PARTICIPATE IN SCHOOL LUNCH]

5. [IDENTIFY CHILD TO RECRUIT AND ASK THE FOLLOWING]

Do you think your child in X grade would like to participate in a focus group discussion?

1. Yes

2. No [ASK IF OTHER CHILD WOULD BE INTERESTED, IF NO,

THANK & TERMINATE]

6. Has this child ever participated in a focus group or been paid to be part of a discussion group?

   1. Yes

   2. No [SKIP to Q8]
      
      

7. How recently did he/she/they participate in a focus group?

   1. Less than 6 months ago [TERMINATE]

   2. 6 months ago or longer
      
      

8. Does this child participate in any of the following activities:

1. School clubs, like science, chess, community service or foreign language clubs

2. Sports teams

3. Dance, cheerleading or gymnastics

4. Student government

5. Theater or drama

6. School band, orchestra or chorus

1. Yes

2. No

[CONTINUE IF YES TO ANY ITEM; TERMINATE IF CHILD DOES NOT PARTICIPATE IN ANY EXTRA-CURRICULARS]

9. Including yourself, how many people currently live in your household?

   1. [ENTER NUMBER]

10. Which of the following categories best represents your total household income for the past year?

    1. Less than $19,000

    2. $19,000 to less than $25,000

    3. $25,000 to less than $32,000

    4. $32,000 to less than $38,000

    5. $38,000 to less than $45,000

    6. $45,000 to less than $51,000

    7. $51,000 to less than $58,000

    8. $58,000 to less than $64,000

    9. $64,000 or more

    10. Don’t know/Refused

11. MODERATOR ENTER CATEGORY BASED ON RESPONSES FROM Q9 & Q10

    1. At or below 185% of Federal poverty line [RECRUIT MIN 5 PER GROUP]

    2. Above 185 % of Federal poverty line

[CODE AS Q11=01 IF THE FOLLOWING APPLIES]

• 2 people in household (Q9), and answer to Q10 is 1 or 2.

• 3 people in household (Q9), and answer to Q10 is 1, 2, or 3

• 4 people in household (Q9), and answer to Q10 is 1, 2, 3, or 4

• 5 people in household (Q9), and answer to Q10 is 1, 2, 3, 4, or 5.

• 6 people in household (Q9), and answer to Q10 is 1, 2, 3, 4, 5, or 6.

• 7 people in household (Q9), and answer to Q10 is 1, 2, 3, 4, 5, 6, or 7.

• 8+ people in household (Q9), and answer to Q10 is 1, 2, 3, 4, 5, 6, 7, or 8.

[ALL OTHER RESPONDENTS CODE AS Q11=02]

12. Which of the following best describes your child’s race?*   (READ LIST. ACCEPT MULTIPLE ANSWERS.)

    1. American Indian or Alaska Native

    2. Asian

    3. Black or African American

    4. Native Hawaiian or Other Pacific Islander

    5. White

13. Which of the following best describes your child’s ethnicity?*

    1. Hispanic or Latino

    2. Not Hispanic or Latino

* TO THE EXTENT POSSIBLE, THE GROUP SHOULD BE A MIX OF RACES/ETHNICITIES.

AFTER THE PARENT HAS QUALIFIED THE CHILD ACCORDING TO ALL OF THE PRECEDING QUESTIONS, ASK TO SPEAK TO THE BOY OR GIRL WHO FITS THE SPECS. INFORM THE PARENT THAT HE/SHE MAY STAY ON THE LINE.

AFTER CHILD HAS COME TO THE PHONE, THE RECRUITER MUST PERSONALLY ASK THE CHILD THESE QUESTIONS.

Hello, my name is ______ and I’m glad to talk to you. I’d like to ask you a few questions. There are no right or wrong answers, just tell me what you think.

14. What is your name? RECORD FULL NAME ____________________________

15. What grade are you in?

1. 1 [TERMINATE]

2. 2 [TERMINATE]

3. 3

4. 4

5. 5

6. 6

7. 7

8. 8

9. 9 or higher [TERMINATE]

CHILD MUST BE IN GRADE 3, 4, 5, 6, 7 OR 8. IF NOT, TERMINATE.

The following question will be asked to ascertain if the respondent is articulate, outgoing and comfortable conversing. Outgoing and articulate respondents are critical to the success of the groups.

16. What is your favorite food? What are some of the reasons that you enjoy this (food item)?

RECORD FAVORITE FOOD: ________________________________________________

REASONS:

EACH CHILD MUST BE ABLE TO GIVE ANSWERS IN COMPLETE SENTENCES AND FULLY DESCRIBE WHY THE FOOD IS HIS/HER FAVORITE; OTHERWISE, TERMINATE.

17. Now, I’m going to read you some sentences. Please tell me if you think it is True, Not True, or You Don’t Know… READ ALL ANSWERS FOR EACH

	True	Not true	Don’t know
I like to tell other people what I think, even it is different from what other people think		TERMINATE	TERMINATE
I like meeting and talking to new people		TERMINATE	TERMINATE
I like being in groups of people		TERMINATE	TERMINATE

RESPONDENT MUST ANSWER “TRUE” FOR ALL THREE STATEMENTS.

18. I would like to invite you to come to a group and talk with other kids your age. I think you’ll have fun helping us with this project. Would you like to participate?

    1. Yes [CONTINUE]

    2. No [TERMINATE]

IF THE CHILD QUALIFIES ON ALL OF THE SCREENING QUESTIONS, TELL HIM/HER THAT HE/SHE HAS BEEN INVITED TO ATTEND A FOCUS GROUP DISCUSSION WITH OTHER KIDS HIS/HER AGE.

AGAIN…DO NOT RECRUIT A CHILD WHO DOES NOT WANT TO PARTICIPATE EVEN IF PARENT SAYS, “YES, HE/SHE WOULD LIKE TO.”

ASK THE CHILD TO GIVE THE PHONE BACK TO THE PARENT AND TELL THE PARENT THAT THEIR CHILD HAS QUALIFIED TO ATTEND A FOCUS GROUP SESSION WITH OTHER CHILDREN HIS/HER AGE.

We would like to invite your child to participate in a group discussion that will be held at our facility on (DATE) at (TIME). The group will last approximately 60 minutes. You will be given $50 at the end of the group session as a token of appreciation. Would you be willing to have your child participate?

Yes……………( ) SCHEDULE No……………..( ) TERMINATE

I will call you to remind you of this appointment. However, if for some reason your child is unable to attend, please call me at (TELEPHONE NUMBER) so that I can find a replacement for him/her.

Please note that we require at least one parent to be present on the day of the focus groups as you will be required to sign an agreement on the security of comments and a parental consent form prior to your child participating in the group. Thank you for agreeing to be part of our study.

Respondent’s name: ___________________________________________

Address: ____________________________________________________

Telephone # (Home): __________________ (Work) _________________

Recruited by: _________________________________________________

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