Focus Group Screeners

Appendix B - Focus Group Screening Questionnaire by Audience_Revised.docx

Generic Clearance for Internet Nonprobability Panel Pretesting

Focus Group Screeners

OMB: 0607-0978

Document [docx]
Download: docx | pdf

Appendix C: Focus Group Audience Criteria with Quota Tables

Appendix C.1 American Indian/Alaska Native (AIAN)

Alaska Native: Fairbanks, AK


First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)


FAIRBANKS, AK


Alaska Native

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

10

10


Some college or an associate’s degree

6

6


College graduate +

0

0


Gender

Female

16

0


Male

0

16


Race/Ethnicity

Alaska Native

16

16


Other

0

0


Age

18-34

0

8


35-44

5

8


45-54

6

0


55 or older

5

0



RECRUIT 16 TO SEAT 6-8 PER GROUP



SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate





SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never


2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government (specify: )

> ask to specify

Bureau of Indian Affairs


Others

> terminate

Journalism

> terminate

Education


Medicine

Engineering

Other (specify: )



2c. How old are you?

17 or under

> ask for someone in household AgeS 18 or older

18 – 34


35 – 44


45 – 54


55+



2d. Are you…


Male


Female


Other (specify: )





SECTION 3: STUDY CRITERIA – Alaska Native


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No




3b. What is your race? You may provide more than one group. MUST RESPOND ALASKA NATIVE ONLY


White

> TERMINATE


Black or African American

> TERMINATE


Asian

> TERMINATE


American Indian

> TERMINATE


Alaska Native


Native Hawaiian or Other Pacific Islander

> TERMINATE


Some other race (specify: )

> TERMINATE




3c. What is the name of your Alaska Native Corporation? For example, Native Village of Barrow, Arctic Slope Corporation, Tlingit, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX IF POSSIBLE.


Native Village of Barrow


Arctic Slope Corporation


Tlingit


Other (specify: )


Not a member of an Alaska Native Corporation

> TERMINATE


3d-f. Please respond yes or no to the following. RANDOMIZE LIST:


3d.

Do you consider yourself to be knowledgeable about your native culture?

Yes

No

3e.

Do you participate in traditional native cultural events or ceremonies?

Yes

No

3f.

Do you live in or regularly communicate with people from your home village?

Yes

No

TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 3 TO QUALIFY





3g. What is your ZIP code?





SECTION 4: LANGUAGE


4a. What language do you primarily speak at home?


English

> skip to SECTION 5

Other (specify: )

> ask q4B



ONLY ASK IF OTHER @ Q4A:


4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate



SECTION 5: HTC DEMOGRAPHICS

NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


5a. What is the highest grade or year of schooling you have completed?


Less than High school

1 point


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate





5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married



5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e


5d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old




5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)


CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point

5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:______________________________ _)







5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point



5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within past year

1 point

Moved more than a year ago



5i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE






SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT

READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].



American Indian: Phoenix, AZ


First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)




PHOENIX, AZ


American Indian

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

10

8


Some college or an associate’s degree

6

6


College graduate +

0

0


Gender

Female

16

0


Male

0

16


Race/Ethnicity

American Indian

16

16


Other

0

0


Age

18-34

0

0


35-44

5

6


45-54

6

5


55 or older

5

5



RECRUIT 16 TO SEAT 6-8 PER GROUP




SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

2

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

2

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

2

> Terminate


SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.




2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never


2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government (specify: )

> ask to specify

Bureau of Indian Affairs


Others

> terminate

Journalism

> terminate

Education


Medicine

Engineering

Other (specify: )


2c. How old are you?

17 or under

> ask for someone in household ages 18 or older

18 – 34


35 – 44


45 – 54


55+


2d. Are you…


Male


Female


Other (specify: )




SECTION 3: STUDY CRITERIA – American Indian


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No




3b. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY


White

> TERMINATE


Black or African American

> TERMINATE


Asian

> TERMINATE


American Indian



Alaska Native

> TERMINATE

Native Hawaiian or Other Pacific Islander

> TERMINATE


Some other race (specify: )

> TERMINATE



3c. What is the name of your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath etc. MULTIPLE RESPONSES PERMITTED.


Navajo Nation


Blackfeet Tribe


Bay Mills


Klamath


Other (specify: )


Not a member of a tribe

> TERMINATE


3d-f. Please respond yes or no to the following. RANDOMIZE LIST:


3d.

Do you consider yourself to be knowledgeable about your native culture?

Yes

No

3e.

Do you participate in traditional native cultural events or ceremonies?

Yes

No

3f.

Do you live in or regularly communicate with people from your home tribe?

Yes

No

TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 3 TO QUALIFY



3g. What is your ZIP code?





SECTION 4: LANGUAGE


4a. What language do you primarily speak at home?


English

> skip to SECTION 5

Other (specify: )

> ask q4B

ONLY ASK IF OTHER @ Q4A:


4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate



SECTION 5: HTC DEMOGRAPHICS

NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


5a. What is the highest grade or year of schooling you have completed?


Less than High school

1 point Check quotas for group


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate



5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married



5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e



5d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old




5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)



CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point


5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:________________________________)




5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point





5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within past year

1 point

Moved more than a year ago



5i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE


SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT

READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].

American Indian: Sault Ste. Marie, MI


First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)





SAULT STE. MARIE, MI


American Indian

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

10

10


Some college or an associate’s degree

6

6


College graduate +

0

0


Gender

Female

16

0


Male

0

16


Race/Ethnicity

American Indian

16

16


Other

0

0


Age

18-34

5

5


35-44

6

6


45-54

5

5


55 or older

0

0



RECRUIT 16 TO SEAT 6-8 PER GROUP


SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate


SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never




2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government (specify: )

> ask to specify

Bureau of Indian Affairs


Others

> terminate

Journalism

> terminate

Education


Medicine

Engineering

Other (specify: )


2c. How old are you?

17 or under

> ask for someone in household AgeS 18 to 54 years old

18 – 34

> check quotas

35 – 44

> check quotas

45 – 54

> check quotas

55+

> ask for someone in household AgeS 18 to 54 years old


2d. Are you…


Male


Female


Other (specify: )






SECTION 3: STUDY CRITERIA – American Indian


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No




3b. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY


White

> TERMINATE


Black or African American

> TERMINATE


Asian

> TERMINATE


American Indian



Alaska Native

> TERMINATE

Native Hawaiian or Other Pacific Islander

> TERMINATE


Some other race (specify: )

> TERMINATE



3c. What is the name of your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX IF POSSIBLE


Navajo Nation


Blackfeet Tribe


Bay Mills


Klamath


Other (specify: )


Not a member of a tribe

> TERMINATE


3d-f. Please respond yes or no to the following. RANDOMIZE LIST:


3d.

Do you consider yourself to be knowledgeable about your native culture?

Yes

No

3e.

Do you participate in traditional native cultural events or ceremonies?

Yes

No

3f.

Do you live in or regularly communicate with people from your home tribe?

Yes

No

TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 3 TO QUALIFY


3g. What is your ZIP code?





SECTION 4: LANGUAGE


4a. What language do you primarily speak at home?


English

> skip to secton 5

Other (specify: )

> ask q4B


ONLY ASK IF OTHER @ Q4A:


4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate



SECTION 5: HTC DEMOGRAPHICS

NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


5a. What is the highest grade or year of schooling you have completed?


Less than High school

1 point Check quotas for group


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate



5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married


5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e


5d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old




5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)


CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point


5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:________________________ _)




5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point





5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within the past year

1 point

Moved more than 1 year ago



5i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE


SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT

READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].

American Indian: Portland, OR

First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)




PORTLAND, OR


American Indian

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

10

10


Some college or an associate’s degree

6

6


College graduate +

0

0


Gender

Female

16

0


Male

0

16


Race/Ethnicity

American Indian

16

16


Other

0

0


Age

18-34

0

10


35-44

0

6


45-54

0

0


55 or older

16

0



RECRUIT 16 TO SEAT 6-8 PER GROUP




SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

2

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate




SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never

2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government (specify: )

> ask to specify

Bureau of Indian Affairs


Others

> terminate

Journalism

> terminate

Education


Medicine

Engineering

Other (specify: )



2c. How old are you?

17 or under

> ask for someone in household AgeS 18-44 or 55+

18 – 34


35 – 44


45 – 54

> ask for someone in household AgeS 18-44 or 55+

55+



2d. Are you…


Male


Female


Other (specify: )





SECTION 3: STUDY CRITERIA – American Indian


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No





3b. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY


White

> TERMINATE


Black or African American

> TERMINATE


Asian

> TERMINATE


American Indian



Alaska Native

> TERMINATE

Native Hawaiian or Other Pacific Islander

> TERMINATE


Some other race (specify: )

> TERMINATE



3c. What is the name of your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX IF POSSIBLE


Navajo Nation


Blackfeet Tribe


Bay Mills


Klamath


Other (specify: )


Not a member of a tribe

> TERMINATE


3d-f. Please respond yes or no to the following. RANDOMIZE LIST:


3d.

Do you consider yourself to be knowledgeable about your native culture?

Yes

No

3e.

Do you participate in traditional native cultural events or ceremonies?

Yes

No

3f.

Do you live in or regularly communicate with people from your home tribe?

Yes

No


3g. What is your ZIP code?





SECTION 4: LANGUAGE


4a. What language do you primarily speak at home?


English

> skip to section 5

Other (specify: )

> ask q4B


ONLY ASK IF OTHER @ Q4A:


4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate


SECTION 5: HTC DEMOGRAPHICS

NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


5a. What is the highest grade or year of schooling you have completed?


Less than High school

1 point


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate



5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married



5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e


5d. What is the age of the youngest child in your home?


0–4 years old

YOUNGchildren

1 point

5–9 years old



10–17 years old




5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)



CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point


5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:______________________________)




5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point



5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within the past year

1 point

Moved more than 1 year ago



5i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE


SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT

READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].

Appendix C.2 Native Hawaiian and Pacific Islander (NHPI)

First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)




HONOLULU, HI & SEATTLE, WA


Native Hawaiian or Pacific Islander (NHPI)

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

10

10


Some college or an associate’s degree

6

6


College graduate or postgraduate degree

0

0


Gender

Female

8

8


Male

8

8


Race/Ethnicity

Native Hawaiian

6

6


Micronesian islands

5

5


Polynesian/Melanesian islands

5

5


Age

18-34

3

3


35-44

3

3


45-54

5

5


55 or older

5

5



RECRUIT 16 TO SEAT 6-8 PER GROUP



SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate


SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never

2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government

> terminate

Journalism

> terminate

Education


Medicine


Engineering


Service Industry


Other (specify: )



2c. How old are you?

17 or under

> ask for someone in household ages 18 or over

18 – 24


25 – 34


35 – 54


55+



2d. Are you…


Male


Female


Other gender (specify: )




SECTION 3: STUDY CRITERIA – NHPI


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No





3b. What is your race? You may provide more than one group. MUST RESPOND NHPI ONLY.


White

> TERMINATE


Black or African American

> TERMINATE


Asian

> TERMINATE


American Indian

> TERMINATE


Alaska Native

> TERMINATE


Native Hawaiian or Other Pacific Islander



Some other race (specify: )

> TERMINATE



3c. Earlier, you reported you were NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER. What are your NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER ethnicities? For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.


Native Hawaiian

> native hawaiian

Samoan

> Polynesian/ melanesian

Chamorro

> micronesian

Fijian

> Polynesian/ melanesian

Tongan

> Polynesian/ melanesian

Marshallese

> micronesian

Other (specify: )



3d. In what country or territory were you born?


In the continental United States, Alaska, or Hawaii

> skip to SECTION 4

Outside of the United States (specify: )

> ask q3E


ONLY ASK IF NOT BORN IN THE UNITEd STATES (CODE 2 @ Q3D)


3e. How old were you when you first came to the United States?

IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.


17 or older


16 or younger




SECTION 4: LANGUAGE


4a. Is there a language besides English that you are fluent in? RECRUIT A MIX.


Yes (specify: )

> ask q4b

Native Hawaiian


Micronesian


Polynesian/Melanesian


No

> IF Micronesian OR Polynesian/ MELANESIAN, TERMINATE.

> IF Native Hawaiian, skip to section 5

ONLY ASK IF OTHER @ Q4A:


4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate


SECTION 5: HTC DEMOGRAPHICS


NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000/year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


5a. What is the highest grade or year of schooling you have completed?


Less than High school

1 point


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate





5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married



5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e


5d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old




5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)



CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point


5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:___________________________)




5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point


5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within the past year

1 point

Moved more than 1 year ago



5i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE



SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT


READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].



Appendix C.3 Asian

First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)




San Gabriel Valley/Pasadena, CA


Asian

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]


Education

High school or less

9

9


Some college or an associate’s degree

5

5


College graduate or postgraduate degree

0

0


Gender

Female

7

7


Male

7

7


Ancestry

Chinese

3

2


Vietnamese

3

1


Korean

3

1


Filipino

0

3


Hmong or Thai

3

1


Cambodian

2

0


Asian Indian

0

3


Other South Asian (Pakistani, Bangladeshi)

0

3


Age

18-34

3

2


35-44

3

2


45-54

4

5


55 or older

4

5



RECRUIT 14 TO SEAT 6-8 PER GROUP



SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate


SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never


2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST MULTIPLE RESPONSES PERMITTED


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government

> terminate

Journalism

> terminate

Education


Medicine


Engineering


Service Industry


Other (specify: )




2c. Are you currently a full or part-time student?


Full time student

> TERMINATE

Part-time student

> HOLD

Not a student



2d. How old are you?

17 or under

> ask for someone in household ages 18 or over

18 – 24


25 – 34


35 – 54


55+



2e. Are you…


Male


Female


Other gender (specify: )



SECTION 3: STUDY CRITERIA – Asian


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No




3b. What is your race? You may provide more than one group. MUST RESPOND ASIAN ONLY


White

> TERMINATE


Black or African American

> TERMINATE


Asian



American Indian

> TERMINATE


Alaska Native

> TERMINATE


Native Hawaiian or Other Pacific Islander

> TERMINATE


Some other race (specify: )

> TERMINATE



3c. Earlier, you reported you were ASIAN. What best describe your nationality or ethnicity? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.


Chinese


Vietnamese


Korean


Filipino


Hmong or Thai


Cambodian


Asian Indian


Other South Asian (Pakistani, Bangladeshi)


Other (specify: )

> terminate


3d. In what country or territory were you born?


In the United States

> terminate

Outside of the United States (specify: )

> ask q3E


3e. How old were you when you first came to the United States?


IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.


17 or older


16 or younger

> terminate



SECTION 4: LANGUAGE


4a. What languages do you speak at home? TERMINATE IF NOT BILINGUAL


English


Other (specify: )



4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate



4c. How well do you read English?


Very well


Well

Not well

> Terminate

Not at all

> terminate


4d. How well do you speak [OTHER] language?


Very well


Well

Not well

> Terminate

Not at all

> terminate



4e. How many hours of media in [OTHER] language do you consume per week? This can include TV, print, radio, digital media, and social media.


HOURS: ________________________________________


must enter ROUND NUMBER




SECTION 5: HTC DEMOGRAPHICS

NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


5a. What is the highest grade or year of schooling you have completed?


Less than High School

1 point


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate



5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married




5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e


5d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old





5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)



CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point


5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:________________________________)




5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point



5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within the past year

1 point

Moved more than a year ago



5i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




5j. How many months of the year do you live outside of your primary residence?


Never live elsewhere


Less than two month


2 – 4 months

1 poinT

4 – 6 months

1 poinT

More than 6 months

1 poinT


record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE



SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT


READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].


Appendix C.4 Hispanic

First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)



Houston, TX


Hispanic

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

9

9


Some college or an associate’s degree

5

5


College graduate +

0

0


Gender

Female

7

7


Male

7

7


Race/Ethnicity

Hispanic

14

14


Not Hispanic

0

0


Ancestry

Mexican

9

9


Central American

5

5


Generation*

1st Generation

7

7


1.5 Generation

7

7


Age

24-34

7

7


35-50

7

7



*Definitions

1st Generation: Foreign born; both parents foreign born; immigrated to the U.S. when 17 or older

1.5 Generation: Foreign born; both parents foreign born; immigrated to the U.S. when 16 or younger


RECRUIT 14 TO SEAT 6-8 PER GROUP


SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate




SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never


2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government

> terminate

Journalism

> terminate

Education


Medicine

Engineering

Other (specify: )



2c. How old are you?

17 or under

> ask for someone in household AGED 24-50

> if none terminate

18 – 23

24 – 34

> check quota

35 – 50

> check quota

51+

> ask for someone in household AGED 24-50

> if none terminate


2d. Are you…


Male


Female


Other gender (specify: )





SECTION 3: STUDY CRITERIA – HISPANIC


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes



No

> TERMINATE



3b. What is your race? You may provide more than one group.


White



Black or African American



Asian



American Indian



Alaska Native



Native Hawaiian or Other Pacific Islander



Some other race (specify: _____)




3c. In what country or territory were you born?


United States

> Terminate

Other



3d. How old were you when you first came to the United States?

IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.


17 or older

> 1ST GENERATION

16 or younger

> 1.5 GENERATION


3e. In what country or territory were your parents born?


Both parents were born in the U.S.

> Terminate

One parent was born in the U.S.; the other was born outside of the U.S.

> Terminate

Both parents were born outside of the U.S.


Don’t know

> Terminate


FIRST GENERATION IF ALL OF FOLLOWING: 1.5 GENERATION IF ALL OF FOLLOWING:

> BORN OUTSIDE THE U.S. (Code 2 @ Q3C) > BORN OUTSIDE THE U.S. (Code 2 @ Q3C)

> ARRIVE IN THE U.S. AFTER AGE OF 16 (Code 1 @ Q3D) > ARRIVE IN THE U.S. AT OR BEFORE AGE OF 16

> FOREIGN-BORN PARENTS (Code 3 @ Q3E) (Code 2 @ Q3D)

> FOREIGN-BORN PARENTS (Code 3 @ Q3E)


3f. What is your country of origin? DO NOT READ ANSWER CHOICES. RECRUIT A MIX.


Mexico

> mexican check quotas

El Salvador, Guatemala, Honduras or other Central American country

> central american check quotas

Puerto Rico, Cuba, Dominican Republic

> Caribbean

Colombia, Venezuela, Argentina, or other South American country

> south american


SECTION 4: LANGUAGE


4a. What languages do you speak at home? TERMINATE IF NOT BILINGUAL


English


Spanish


Other (specify: )

> TERMINATE



4b. How well do you speak English?


Very well


Well

Not well

> Terminate

Not at all

> terminate


4c. How well do you read English?


Very well


Well

Not well

> Terminate

Not at all

> terminate


4d. How well do you speak Spanish?


Very well


Well

Not well


Not at all

> terminate



SECTION 5: HTC DEMOGRAPHICS

NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure



5a. What is the highest grade or year of schooling you have completed?


Less than High School

1 point


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> terminate



5b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married



5c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q5d

No

> skip to q5e


5d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old




5e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________




1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q5B)

LIVES WITH ANOTHER ADULT (Q5E > 0)



CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point


5f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:___________________________)



5g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point



5h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within the past year

1 point

Moved within the past 4 years


Moved more than 4 years ago

> TERMINATE




5i. How long have you been living in Houston, TX?


5 years or fewer


More than 5 years

> TERMINATE

Do not live in Houston, TX

> TERMINATE


5j. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE


SECTION 6: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT

READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].






Appendix C.5 Rural

First Name,
Last Initial


Unique ID


Address


City, State, Zip


Phone (H/C/W)



Reason for Termination
(IF TERMINATED)



POLK COUNTY / SPRINGFIELD, MO


Rural

 

Session 1
[DATE, TIME]

Session 2
[DATE, TIME]

Education

High school or less

9

9


Some college or an associate’s degree

5

5


College graduate +

0

0


Gender

Female

7

7


Male

7

7


Age

18-34

2

2


35-44

2

2


45-54

5

5


55 or older

5

5


Race/Ethnicity

White, not Hispanic

14

14


Other

0

0



RECRUIT 14 TO SEAT 6-8 PER GROUP














SECTION 1: WILLINGNESS


Hello, my name is ______ and I’m from ______, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country.


The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.


1a. May we proceed?


Yes


No

> Terminate



1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].


Yes


No

> Terminate


Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.


1c. Are you willing to participate?


Yes


No

> Terminate




SECTION 2: STUDY CRITERIA


Great, I have a few questions to see if you qualify for this study.


2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?


Within the past three months

> hold

Over three months ago


Never


2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST


Advertising or public relations

> terminate

Marketing or market research

> terminate

Federal government

> terminate

Journalism

> terminate

Education


Medicine


Engineering


Service Industry


Other (specify: )



2c. How old are you?

17 or under

> ask for someone in household ages 18 or over

18 – 24

> Check Age quotas for group

25 – 34


35 – 54


55+



2d. Are you…


Male


Female


Other (specify: )






SECTION 3: STUDY CRITERIA – Rural


3a. Do you consider yourself to be of Latino or Hispanic origin?


Yes

> TERMINATE


No




3b. What is your race? You may provide more than one group.


White



Black or African American

> Terminate

Asian

> Terminate

American Indian

> Terminate

Alaska Native

> Terminate

Native Hawaiian or Other Pacific Islander

> Terminate

Some other race (specify: )

> Terminate


3c. What is your ZIP code? RECRUIT FROM A LIST OF ZIP CODES PROVIDED BY TEAM Y&R




SECTION 4: HTC DEMOGRAPHICS


NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:


  • Renters

  • Living in a large household (with 6 or more people)

  • Less than high school diploma

  • Female householder, no husband present

  • Low income (less than $35,000 per year)

  • Move within the past year

  • Household with young children aged 4 years old or younger

  • Multi-unit or mobile home structure


4a. What is the highest grade or year of schooling you have completed?


Less than High school

1 point


High School graduate or equivalent



Some college or an associate’s degree



College graduate or postgraduate degree

> Terminate





4b. What is your marital status?


Married


Widowed


Divorced


Separated


Never married



4c. Are there any children currently living in your household?


Yes (specify number of children: )

> ask q4d

No

> skip to q4e


4d. What is the age of the youngest child in your home?


0–4 years old

YOUNG

children

1 point

5–9 years old



10–17 years old





4e. Besides yourself, how many adults live in your home?

RECORD NUMBER:______________________________________


1 point IF ALL OF FOLLOWING:

FEMALE (Code 2 @ Q2D)

UMARRIED (Code 2-5 @ Q4B)

LIVES WITH ANOTHER ADULT (Q4E > 0)



CODE NUMBER OF PEOPLE IN HOUSEHOLD (4C + 4E)


None, just myself


One other person


Two other people


Three other people


Four other people


Five or more other people

1 point




4f. Do you rent or own your own house or apartment?


Rent

1 point


Own



Other (specify:___________________________ _)




4g. Which describes the building of your primary residence?


A mobile home

1 point


A one-family house detached from any other house



A one-family house attached to any other house

1 point


A building with 2 or more apartments

1 point


Boat, RV, van, etc.

1 point



4h. What month and year did you move into your current house, apartment, or mobile home?


MONTH:______________________________________

YEAR: ________________________________________


must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005)


Moved within the past year

1 point

Moved more than a year ago




4i. In 2017, what was your total household income before taxes?


Less than $25,000

1 point


$25,000 - $34,999

1 poinT


$35,000 - $49,999



$50,000 - $74,999



$75,000 - $99,999



$100,000 - $149,999



More than $150,000




record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)


2 OR MORE POINTS


LESS THAN 2 POINTS

> TERMINATE




SECTION 5: INVITATION TO PARTICIPATE


READ TO ALL QUALIFYING PARTICIPANTS

Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?


Yes


No

> Terminate


CONFIRM DETAILS & SCHEDULE PARTICIPANT

READ TO ALL NON-QUALIFYING PARTICIPANTS

Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].


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