Youth Pre-Test Outcome Survey

OMB No. 0910-0788
Exp. Date 05/31/2018

Attachment 17: Telephone Verification Survey

Telephone Verification Survey for the Evaluation of the Fresh Empire Campaign on Tobacco (EFECT)

ID:

Hello, my name is _______________________. I am calling from RTI International regarding a study sponsored by the Food and Drug Administration.

Our records indicate that a (AGE, GENDER) by the name of (YOUTH NAME) in your household was recently interviewed and that a parent or guardian granted permission for this youth to complete the interview.

This call is to verify the quality of our interviewer’s performance, and will take just a few minutes.

May I please speak to an adult in the household?

IF UNAVAILABLE -When would be a better time to speak with an adult or can (he/she) be reached at another number? (RECORD INFORMATION IN SPREADSHEET.)

IF AVAILABLE - (IF SPEAKING TO THE SAME PERSON - As I just mentioned) I am calling to verify the work of one of our field representatives, (REPRESENTATIVE NAME), who reported conducting an interview with a youth in the household on (DATE OF INTERVIEW) for the Evaluation of the Fresh Empire Campaign on Tobacco. Are you familiar with this interview?

YES  GO TO QUESTION 1

NO  IF RESPONDENT DOES NOT REMEMBER THE INTERVIEW, REMIND HIM/HER THAT THE FI ASKED QUESTIONS ABOUT HOUSEHOLD CHARACTERISTICS, MEDIA USE, ATTITUDES TOWARDS TOBACCO. IF RESPONDENT STILL DOES NOT REMEMBER CONFIRM THAT YOU HAVE THE CORRECT ADDRESS AND DIALED THE CORRECT PHONE NUMBER. IF THESE ARE CORRECT, ASK IF THERE IS ANOTHER PARENT/GUARDIAN IN THE HH IF NO SKIP TO CONCLUSION.

1. Our records show that we interviewed a (AGE, GENDER) by the name of (YOUTH’S NAME) for this study. I would like to speak with (YOUTH’S NAME) to verify the work of the field interviewer that interviewed him/her. Is (YOUTH’S NAME) available?

IF UNAVAILABLE -When would be a better time to speak with him/her or can (he/she) be reached at another number? (RECORD INFORMATION IN SPREADSHEET.)

IF AVAILABLE - I am calling to verify the work of one of our field interviewers, (FI NAME), who reported conducting an interview with you on (DATE OF INTERVIEW) for the Evaluation of the Fresh Empire Campaign on Tobacco. Do you remember this interview?

YES  GO TO QUESTION 2

NO  IF RESPONDENT DOES NOT REMEMBER THE INTERVIEW, REMIND HIM/HER THAT THE FI ASKED QUESTIONS ABOUT HOUSEHOLD CHARACTERISTICS, MEDIA USE, ATTITUDES TOWARDS TOBACCO. IF RESPONDENT STILL DOES NOT REMEMBER, SKIP TO CONCLUSION.

2. Were you interviewed in person?

1 = YES

2 = NO  PROBE

3. Was the interview conducted in your home or somewhere else?

1 = IN RESPONDENT’S HOME

2 = SOMEWHERE ELSE (SPECIFY) ________________________________________

4. About how long was the interviewer present in your home?

1 = <30 MINUTES

2 = 30-44 MINUTES

3 = 45-59 MINUTES

4 = 60-90 MINUTES

5 = OVER 90 MINUTES

5. Did you enter answers into the computer yourself?

1 = YES

2 = NO  PROBE

6. Were you given money as a thank you for completing the survey?

1 = YES

2 = NO  SKIP TO Q9

8. In what form were you paid? For example: cash, check, money order.

________________

IF NOT “CASH”, PROBE

7. How much did you receive?

$ _______________

IF RESPONDENT STATES DOESN’T REMEMBER OR A DIFFERENT AMOUNT OTHER THAN $25, AND ANSWER TO Q8 WAS “CASH”

PROBE: Did you receive one bill or two bills? ____________

9. Did the interviewer behave in a professional manner?

1 = YES

2 = NO (EXPLAIN) __________________________________________________

10. Those are all the questions I have. Do you have any additional comments you’d like to make about the interview(s)?

1 = YES (SPECIFY) ____________________________________________________

2 = NO

CONCLUSION: Thank you very much for your time. Have a nice day/evening.

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