Form Appendix A and B Appendix A and B Extended recall survey protocol

Cognitive and Psychological Research

Survey Protocol - Extended recall periods with updated demographics v2

Research on extended recall periods to collect outlet information in the CE

OMB: 1220-0141

Document [docx]
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Appendix A: Items for testing



Module 1

Good or Service

Item category name

S

Adult day care

S

Catered events or board such as weddings or college meal plans

G

Elementary or high school textbooks

G

Unpowered Boats or trailers

G

Outboard motors or powered sports vehicles

G

Leased cars, trucks or vans

S

Day care providers including nursery schools

G

Infants’ furniture

S

Tuition or fixed fees for elementary or high schools

S

Tuition or fixed fees for technical or vocational schools

G

Calculators, typewriters, or other information processing equipment

G

Women’s suits or suit components

S

Reupholstery of household furniture

G

Fuel oil for household heating

G

Audio Equipment for automobiles or home

S

Funeral services

G

Washers or dryers

G

Refrigerators or home freezers

G

Entertainment centers, bookcases or desks

S

Taxi or cab fares


Module 2

Good or Service

Item category name

S

Photographer’s fees

G

DVD players, camcorders or other video equipment

S

Shoe repair or other shoe services

G

Hunting, fishing, or camping equipment

G

Outdoor furniture

G

Stoves, ovens, or microwave ovens

S

Moving, storage or freight services

G

Heating or cooling equipment or home safety devices

G

Musical instruments or musical accessories

S

Legal services

S

Recreational lessons, classes or instruction

G

Men’s suits or blazers

G

Infants’ equipment such as strollers, car seats, bottles or dishes

S

Ship travel or passenger cruises

S

Services by medical professionals other than MDs

S

Tuition or fixed fees for a college or university

S

Housekeeping services

S

Appliance repair

G

College or university level textbooks

G

General sports equipment


Module 3

Good or Service

Item category name

G

Video game hardware, games or accessories

S

Motor vehicle body work

G

Propane, firewood, coal or charcoal used for household heating or cooking

G

Bedroom furniture including mattresses or springs

G

Jewelry

G

Cameras or other photographic equipment excluding film

S

Clothing rental, alterations or repairs

S

Watch or jewelry repair

S

Pet services such as grooming, boarding, or training

G

Vacuums or other electric floor cleaning equipment

G

Watches

S

Admissions to sporting events

G

Men’s coats, jackets, or snow wear

G

Sewing machines, fabric or sewing supplies

G

Living room, dining room, or kitchen furniture

G

Computer software and blank media

G

Televisions

G

Bicycles or bicycling accessories

G

Power tools

G

Luggage, briefcases, or other carrying cases


Module 4

Good or Service

Item category name

G

Men’s accessories including hats, ties, belts or wallets

G

Barbeque grills, powered lawn and garden equipment or other outdoor items excluding outdoor furniture

G

Window coverings such as curtains, drapes or blinds

G

Hard liquor for home use

G

Household decorative items including clocks or lamps

G

Vehicle parts or accessories

G

Boys’ or girls’ clothing or accessories

G

Women’s dresses

G

Floor coverings such as hard surface tiling, carpets or scatter rugs

G

Paint, wallpaper tools, or related supplies

G

Nonpowered tools or miscellaneous hardware

S

Motor vehicle repair

S

Car, truck or van rentals


Module 5

Good or Service

Item category name

G

Small kitchen electric appliances or clothing irons

S

Inside home maintenance and repair

G

Electric personal care appliances such as shavers or hair dryers

S

Veterinarian services

G

Dishes, glassware or flatware

G

Motor oil, coolants, or fluids

S

Club Membership Dues for Shopping Clubs, Fraternal, or Other Organizations or Fees for Participant Sports

G

Toys, Games, Hobby Supplies, or Playground Equipment

G

Boys' or Girls' Footwear

G

Gardening or Lawncare Services

S

Automobile Service Clubs

G

Women’s Coats, Jackets, or Snow Wear

G

Tires



Module 6

Good or Service

Item category name

G

Lawn and Garden Supplies or Insecticides

G

Personal Computers or Peripheral equipment

G

Wine for Home Use

G

Men's Footwear

G

Men's Pants or Shorts

G

Eyeglasses or Eye Care

G

Men's Shirts, Sweaters, or Vests

G

Household Linens, such as Kitchen or Bathroom Towels, Bedding, or Tablecloths

S

Lodging Away From Home such as Hotels, Motels, or Vacation Rentals

S

Garbage or Trash Collection Service

S

Tax Return Preparation or Other Accounting Services

G

Women's Footwear

S

Dental Services







Appendix B: Protocol Template



[This is the first screen they see after they sign up for the study]


Thank you for your interest in our research study.


The Consumer Price Index (CPI) is an important economic indicator that measures how prices change. To calculate the CPI, we collect data on what US households purchase, how much they spend, and what stores and businesses they purchase them from. Your participation in this study will help us to design our surveys to ensure we get the best data possible.


The goal of this study is to understand what people can remember about their past expenses. This survey will ask you whether you had a particular expense and what you can remember about it.


Please be honest about what you remember. We know that some expenses are easier to remember than others and you may or may not remember the details about all of them. There are no penalties for saying that you can’t remember something.


Please do not use your browser's back button.

This voluntary study is being collected by the Bureau of Labor Statistics under OMB No. 1220-0141. This survey will take approximately 10 minutes to complete. Your participation is voluntary, and you have the right to stop at any time. This survey is being administered by SurveyMonkey and resides on a server outside of the BLS Domain. The BLS cannot guarantee the protection of survey responses and advises against the inclusion of sensitive personal information in any response. By proceeding with this study, you give your consent to participate in this study.


[Next screen]


You will be asked questions about household expenses. When answering the survey, please include expenses made by:

  • You

  • Anyone you currently live with

  • Anyone you lived with at the time the item was purchased


And please remember:

  • It is OK to give estimates

  • It is OK to say that you don’t remember something


Thank you for your help! Let’s get started.


[Next screen]


[Fill for a service: e.g., Adult day care]


  1. Have you or anyone in your household had expenses for [fill: adult day care]?

    1. Yes

    2. No (skip to next target category)

    3. Yes, but I don’t remember many details


[Next screen]


(If Yes or Yes, but I don’t remember many details)

[Fill for a service: e.g., Adult day care]


The following questions are about the most recent time you or someone in your household had an expense for [fill: service title].


  1. Briefly describe the expense. (open text entry)


  1. When did you have this expense?

    1. (dropdown for month)

    2. (dropdown for year)

    3. I don’t remember


  1. How much did you pay? $ _______


  1. How accurate is that amount?

    1. Exactly accurate

    2. Very close

    3. Somewhat close

    4. I don’t remember how much was paid


  1. What was the name of the [fill: adult day care] provider?

    1. Enter the name of provider ______________________

    2. I don’t remember


  1. In what city and state was this provider located?

    1. Name of city ______________________

    2. Two character state __

    3. Online

    4. I don’t remember


[Next screen]



[Fill for a commodity: e.g., Film, film development supplies or disposable cameras]


  1. Have you or anyone in your household EVER had expenses for [fill: film, film development or disposable cameras]?

    1. Yes

    2. Yes, but I don’t remember many details

    3. No (skip to next target category)


[Next screen]


(If Yes or Yes, but I don’t remember many details)

[Fill for a commodity: e.g., Film, film development supplies or disposable cameras]


The following questions are about the most recent time you or someone in your household had an expense for [fill commodity name].


  1. Briefly describe the expense. (open text entry)


  1. When did you have this expense?

    1. Enter the two digit month __

    2. Enter the four digit year ____

    3. I don’t remember


  1. How much did you pay? $ _______


  1. How accurate is that amount?

    1. Exactly accurate

    2. Very close

    3. Somewhat close

    4. I don’t remember how much was paid


  1. What was the name of the business?

    1. Enter the name of business ______________________

    2. I don’t remember


  1. In what city and state was this business located?

    1. Name of city ______________________

    2. Two character state __

    3. Online

    4. I don’t remember


[Next screen]


And now a few final questions about you, to help us better understand your answers.


        1. How old are you?


        1. What is your gender?

  • Male

  • Female



        1. Are you Hispanic, Latino or Spanish?

  • Yes

  • No



        1. What is your race? (Enter all that apply.)

  • White

  • Black or African American

  • American Indian or Alaska Native

  • Asian

  • Native Hawaiian

  • Guamanian or Chamorro

  • Samoan

  • Other Pacific Islander

  • Other (Specify) __________________

  • Don’t know



        1. What is the highest level of school you have completed or the highest degree you have received?

  • No schooling completed, or less than 1 year

  • Nursery, kindergarten, and elementary (grades 1-8)

  • High School (grades 9-12, no degree)

  • High school graduate – high school diploma or the equivalent (GED)

  • Some College, but no degree

  • Associate’s Degree in College

  • Bachelor’s Degree (BA, AB, BS, etc.)

  • Master’s Professional, or Doctorate Degree (MA, MS, MBA, MD, JD, PHD, etc.)


        1. Are you currently enrolled in a college or university either –

  • Full-time?

  • Part-time?

  • Not at all?



        1. How many people live in your household, including yourself?

  • 1

  • 2

  • 3

  • 4

  • 5 or more


        1. [if HHSize > 1] How many of those people are under the age of 18?

  • 1

  • 2

  • 3

  • 4

  • 5 or more


[Next screen]


Thank you for participating in our research study!


If you have any feedback about the survey, please leave your comments here; otherwise, leave this space blank.


Please proceed to next page for your completion code.


[Next screen]


Your completion code is: [fill code]


Please copy and paste this code into the HIT page on mTurk.





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