Appendix II
Healthy Icon Focus Groups – Phase II
Screener
OMB No: 0910-0497 Expiration Date: 10/31/2020
Paperwork Reduction Act 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 0910-0497. The time required to complete this portion of the information collection is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to [email protected].
Recruiting Goals:
Recruit 12 participants for each group.
Participants need to be a mix of age groups.
Participants will be a mix of men and women with no more than 4 men per group.
Participants will have a mix of race/ethnicity reflective of the population in the region.
Groups will be segmented by Nutrition Motivation (see screener questions)
Groups will also be segmented by education level (high, low)
Participants must be one of the primary food shoppers in the household.
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Screener:
My name is ( ) and I'm calling about a market research study we are conducting on behalf of the U.S. Food and Drug Administration in your area. We are recruiting for an upcoming focus group. We are holding a group discussion on [DATE] with approximately 9 people. The group will start at [TIME] and will last no longer than 90 minutes. Groups will be audio and video recorded. You will be provided with an incentive as a token of our appreciation for participating in this study for your time, effort, and travel expenses. Would it be OK if I ask you a few questions now to see if you’re eligible to be in one of the groups? (if yes, continue; if no, thank and terminate).
1. Are you the person who usually goes grocery shopping for your family?
Yes continue
No eliminate
2. Do you or does anyone from your immediate family work for:
a. Market Research Firm eliminate
b. Food Product Manufacturing Company eliminate
3. I am going to read some age categories --- could you please tell me which category your age falls in. [RECRUIT A MIX OF 3 AGE SEGMENTS]
a. Under 18 years old eliminate
b. 18-22 continue
c. 23-45 continue
d. 46+ continue
4. Determine gender.
a. Male [Do not recruit more than 4 men per group of 12.]
b. Female
5. What is the highest level of education that you have completed?
Less than high school graduate lower education group
High school graduate or GED lower education group
Attended or graduated technical/vocational school lower education group
Some community college lower education group
Some college or community college graduate higher education group
College graduate higher education group
Attended or graduated with advanced degree higher education group
6. Are you of Hispanic or Latino origin?
Yes continue – recruit a mix of race/ethnicity
No continue – recruit a mix of race/ethnicity
7. What is your race? I am going to read several categories of race. You may choose one or more categories. Are you…? [RECRUIT A MIX PER GROUP]
White
Black or African American
Asian
Native Hawaiian or other Pacific Islander
American Indian or Alaska Native
8. During the focus group discussion, you will be asked to review written materials and offer your opinions, so I need to ask whether you have a medical or nonmedical condition that affects your ability to read and/or understand written materials in English?
Yes eliminate
No continue
9. Do you ever look at the Nutrition Facts label on food packages? It lists the amounts of calories, fat, cholesterol, vitamins and minerals in the food product.
___ Yes Continue to 10b
___ No or don’t know recruit to low motivation group
10. When buying a food product for the first time, how often do you use the Nutrition Facts label?
___ Always or Most of the time Recruit to high motivation group
___ Sometimes, Rarely, or Never Recruit to low motivation group
You qualify for our study. The discussion group will be held on [DATE] at [TIME] and will last about 90 minutes. For your time and opinions, you will receive $75 as a token of our appreciation at the end of the session.
11. Would you like to participate in the group discussion at [TIME] on [DATE]?
Yes continue
No eliminate
Great! May I please have your mailing and/or e-mail address to send you a confirmation letter with directions? [Verify address and phone number.]
Thank you. That’s all the questions I have today. Please try to arrive at least 15 minutes before the starting time. If you have any questions or find that you are unable to attend, please call [facility’s phone number] as soon as possible. Thank you again for your time. We look forward to seeing you at [TIME] on [DATE].
Read if necessary:
If you have any questions about the study, you may contact _________ of _______ at _______. If you have concerns about how participants are being treated in the study, you may contact _______ toll-free at _______.
OMB No. 0910-0497 Expiration Date: 10/31/2020
**NOTE** THIS PAGE MUST BE STORED SEPARATELY FROM THE SCREENER AND FOCUS GROUP DATA. PLEASE DESTROY UPON COMPLETION OF FOCUS GROUP.
We are asking for your contact information only for sending you a reminder letter and giving you a call to remind you of the discussion group. We will destroy all contact information at the end of the groups.
NAME: ____________________________________________________________
ADDRESS: ________________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
E-MAIL_______________________________________________________
What is the best time to reach you? What is the best telephone number to reach you at that time?
BEST TIME TO BE REACHED: ________________________________________
BEST PHONE NUMBER: __________________
Is there another time and number we can try if we miss you?
ALTERNATE TIME:
ALTERNATE PHONE NUMBER:
Thank you. That’s all the questions I have today. Please try to arrive at least 15 minutes before the starting time. If you have any questions or find that you are unable to attend, please call [facility’s phone number] as soon as possible. Thank you again for your time. We look forward to seeing you at [TIME] on [DATE].
File Type | application/msword |
File Title | DRAFT 12/16/02 |
Author | ALando |
Last Modified By | SYSTEM |
File Modified | 2019-09-06 |
File Created | 2019-09-06 |