Fish Consumption Advisories

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Fish Consumption Advisories - Screener Guide

Fish Consumption Advisories

OMB: 2010-0042

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Pretesting Outreach and Web Materials for Fish Consumption Advisories



Draft Screener



Revised July 25, 2019































Public reporting burden of this collection of information is estimated to average 5 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to XXXXX Reports Clearance Officer; [INSERT ADDRESS]; Attn: OMB-PRA (XXXX-XXXX).

Draft Screener

Introduction

Hello, my name is ____________________. I am working with RTI International, a nonprofit research organization. We are not selling anything. The Environmental Protection Agency or EPA, a federal government agency, has hired us to get feedback on pictures that are being developed about eating fish.

For individual interviews: If you are interested in participating, we would ask you to sit down, look at the pictures, and answer some questions about what you think of the pictures. The purpose of the interviews is to gather feedback to improve the pictures before a lot of people see them. The interviews will take no more than 20 minutes and we will give you $20 as a token of our appreciation.

For group interviews: If you are interested in participating, we would ask you to participate in a group interview. During the group discussion, we will look at the pictures and discuss them as a group. The purpose of the interviews is to gather feedback to improve the pictures before a lot of people see them. The interviews will take no more than 60 minutes and we will give you $50 as a token of our appreciation.

Before we go any further, I need to ask you a few questions to see if you are eligible to participate. May I ask you the questions now?

  1. Interviewer records gender (without asking)

    1. Male

    2. Female

    3. Transgender Female/Transwoman/male-to-female transgender

    4. Transgender Male/Transmale/female-to-male transgender

    5. Genderqueer

    6. Other







  1. What is your age?

    1. ______________ [Interviewer records age]

    2. Prefer not to answer.

[Must be age 18 years or older to participate. If prefer not to answer or under age 18, skip to Closing for ineligible participants]

  1. Do you eat fish?

    1. Yes

    2. No

    3. Prefer not to answer

  2. Do you ever catch fish to eat or share with others?

    1. Yes

    2. No

    3. Prefer not to answer

  3. Do you ever buy or receive locally caught fish to eat?

    1. Yes

    2. No

    3. Prefer not to answer

  4. Do you ever prepare (clean, gut, skin or fillet) fish to eat?

    1. Yes

    2. No

    3. Prefer not to answer

[Must answer “Yes” to Q 4, 5 or 6 to be eligible. Otherwise, skip to Closing for ineligible participants]



  1. What is your primary language? This would be the language that you use when talking with your family or friends.

    1. English

    2. Spanish

    3. Tagalog

    4. Hmong

    5. Vietnamese

    6. Chinese

    7. Korean

    8. Arabic

    9. French

    10. Cambodian

    11. Portuguese

    12. Russian

    13. German

    14. Haitian Creole

    15. Hindi

    16. Italian

    17. Polish

    18. Other [specify] _____________________ [Interviewer records language]

    19. Prefer not to answer

  2. Are you the parent, guardian or primary caretaker of a child under age 11?

    1. Yes

    2. No

    3. Prefer not to answer

[Question 9 and 10 for women only; Skip to Invitation for male participants]

  1. Are you currently pregnant?

    1. Yes [Skip to Invitation]

    2. No

    3. Don’t know

    4. Prefer not to answer

  2. Are you planning or hoping to get pregnant within the next year?

    1. Yes

    2. No

    3. Prefer not to answer

Invitation for Eligible Individuals

Thank you for answering my questions. I would like to invite you to participate in [an individual interview OR group interview].

Closing for Ineligible Individuals

Thank you for answering my questions. I’m sorry, you are not eligible to participate. The eligibility criteria were determined in advance by the study team. Thank you for being willing to help us.





File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorUhrig, Jennifer
File Modified0000-00-00
File Created2021-01-13

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