Pretest screener

Health and Diet Survey

Health and Diet Survey pretest screener

Pretest screener

OMB: 0910-0545

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FDA HEALTH AND DIET SURVEY


Pretest Screener




Hello, I'm ________________ with (contractor). I am calling on behalf of the United States Food and Drug Administration, the FDA. We’re not selling anything. We’re doing a study about people’s opinions about foods and health. Have I reached you on a landline phone or a cell phone?



[IF LANDLINE]


SCR1. May I speak to the member of your household who is aged 18 or over and has had the most RECENT birthday? Would that be you?


[IF SCR2:1, REINTRODUCE; IF SCR2:2, ASK FOR THE FIRST NAME OF THE ELIGIBLE RESPONDENT FOR CALL-BACK PURPOSE. REINTRODUCE AS NECESSARY.]


SCR2. May I speak with a member of the household who is at least 18 years old and has the most recent birthday?


Yes

No/Not available


(IF NOT AVAILABLE, ASK FOR THE FIRST NAME OF THE ELIGIBLE RESPONDENT FOR CALL-BACK PURPOSE. REINTRODUCE AS NECESSARY.)



[ONLY respondents reached via a cell number]


SCR4. Are you at least 18 years old or under 18?


Yes, 18+ years old

No, under 18


[IF SCR4:1; CONTINUE, OTHERWISE TERMINATE]



FIRST QUESTION SCRIPTED


[ASK SCR0 OF ALL RESPONDENTS]


SCR0. INTERVIEWER DO NOT READ. Is respondent on cell phone or landline?


Landline phone

Cell phone


INTERVIEWER WARNING: YOU HAVE SELECTED [INSERT SCR0 RESPONSE]. IS THIS CORRECT?


YES

NO


[IF NO GO BACK TO SCR0 AND ENTER CORRECT RESPONSE]


SCR3. This call may be monitored for quality control purposes. Your answers to this survey are voluntary and will be kept secure to the extent provided by law. The survey will take about 15 minutes.


[ONLY respondents reached via a landline number]



SCR3a. For personal calls, do you only use a landline phone at your household, or do you also have cell phone service on which I could have reached you?


Landline only

Cell phone also


[SCR5 ON ONLY RESPONDENTS REACHED VIA A CELL NUMBER]


SCR5. For personal calls, do you only use a cell phone, or do you also have regular landline phone at your household on which I could have reached you?


Cell phone only

Landline also


This call may be monitored for quality control purposes. Your answers to this survey are voluntary and will be kept secure to the extent permitted by law. The survey will take about 15 minutes.



(INTERVIEWER: CODE SEX WITHOUT ASKING)


Male

Female

Not Sure


[ALL RESPONDENTS] GO TO SURVEY.


File Typeapplication/msword
AuthorLin, Chung-Tung
Last Modified ByLin, Chung-Tung
File Modified2014-12-03
File Created2014-12-03

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