Form NHTSA Form 1536 NHTSA Form 1536 CIOT Screener

OMB Control No. 2127-0682

Expiration Date 08/31/2021

FOCUS GROUPS FOR ASSESSMENT OF CREATIVE CONCEPTS SUPPORTING A NATIONAL COMMUNICATIONS CAMPAIGN TO INCREASE SEAT BELT USE AMONG PICKUP TRUCK DRIVERS

FOCUS GROUP RECRUITING SCREENER

DRAFT – Dec. 31, 2019

Focus Group Times: 6pm and 8pm local time

Recruit Criteria – Recruit 11 for 9 per group

• Male

• 18-34 years old

• Doesn’t work in a sensitive industry

• Hasn’t participated in a focus group in last 6 months

• Has driver’s license

• Lives in rural area (self-reported)

• Owns/drives a pickup truck

• Doesn’t wear seat belt 100% of the time as a passenger or a driver

• Ethnicity – targets for African Americans and Hispanics

• Employment – recruit a good mix

• Marital status – recruit a good mix

• Education – recruit a good mix

• Income – recruit a good mix

• Articulation – Good

INTRODUCTION

Thank you for taking this survey. Your opinions are important to us! Please be honest when answering the survey. Your answers are anonymous and confidential, and none of your individual information will be shared with any third parties.

[INCLUDE ON ITS OWN SEPARATE SCREEN AFTER THE INTRODUCTION SCREEN] This collection of information is voluntary and will be used for formative purposes only so that we may develop communications programs designed to reduce the number of traffic-related injuries and deaths. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0682. Public reporting for this collection of information is estimated to be approximately 3.5 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Avenue, S.E., Washington, DC, 20590.

Hello, may I please speak with ______________________? This is _________ from a national opinion research company.

If on the phone, continue.

If not on the phone/voicemail/no answer, arrange for callback.

If someone other than participant is on the phone, continue with screen.

Good morning/afternoon/evening. I am calling to see if you would be interested participating in a research discussion about seat belt usage. I have just a few questions to ask you to be sure that we have a good balance of qualified participants. All answers to these questions remain confidential.

S1. To which gender do you most closely identify?

1. Male

2. Female THANK & TERMINATE

S2. What is your age? [RECRUIT A MIX]

______________

1. <18 THANK & TERMINATE

2. 18-34

3. 35-54 THANK & TERMINATE

4. 55+ THANK & TERMINATE

S3. Do you or does any member of your household currently work for…?

[THANK & TERMINATE 1-9]

1. Marketing, advertising, public relations or marketing research firm or division of a company

2. Graphic design

3. News media or journalism organization, including newspaper, television, radio or publishing

4. Law enforcement

5. Legal

6. Auto insurance

7. Local, state or federal government

8. Part-time or full-time ride sharing such as Uber or Lyft

9. Commercial or professional driving (NOTE TO RECRUITER: If necessary, to clarify, “commercial driving” means driving as a primary part of one’s occupation or job)

10. None of the above

S4. Have you participated in a focus group in the past six months?

1. Yes THANK & TERMINATE

2. No

3. Don’t Know/refused THANK & TERMINATE
   
   
   
   

S5. Do you currently have a valid driver’s license?

1. Yes

2. No THANK & TERMINATE

____________________________________________________________________________

S6. Which of the following best describes the area of your current primary residence?

1. An urban or city area THANK & TERMINATE

2. A suburban area next to a city THANK & TERMINATE

3. A small town/rural area

4. Don’t know/not sure THANK & TERMINATE

5. Refused/decline to answer THANK & TERMINATE

S7. Which of the following types of vehicles do you own or drive on a regular basis? Please select all that apply.

1. Car (coupe, sedan, hatchback, wagon, etc.)

2. Utility vehicle (SUV, crossover)

3. Pickup Truck

4. Van/Minivan

5. Don’t know/not sure

6. Refused/decline to answer

THANK & TERMINATE if respondent doesn’t select S7=3 (Pickup Truck)

S8a. While most people wear seat belts, some don’t wear them 100% of the time they are driving or as a passenger in vehicle. When you are driving a pickup truck, how often do you wear your seatbelt, regardless of how far you might be driving?

1. 0%

2. 1% - 9%

3. 10% - 19%

4. 20% - 29%

5. 30% - 39%

6. 40% - 49%

7. 50% - 59%

8. 60% - 69%

9. 70% - 79%

10. 80% - 89%

11. 90% - 99%

12. 100%

S8b. When you are the passenger in a pickup truck, how often do you wear your seatbelt regardless of how far the trip might be?

1. 0%

2. 1% - 9%

3. 10% - 19%

4. 20% - 29%

5. 30% - 39%

6. 40% - 49%

7. 50% - 59%

8. 60% - 69%

9. 70% - 79%

10. 80% - 89%

11. 90% - 99%

12. 100%

S8c. HIDDEN QUESTION – SEAT BELT USAGE QUALIFICATION

1. Qualified (S8a/1-11 & S8b/1-11)

2. Not Qualified (ELSE) THANK & TERMINATE

S9. What is the last grade of formal education you completed? [RECRUIT A MIX]

1. Less than high school

2. High school graduate

3. Vocational/technical

4. Some college

5. College graduate

6. Post graduate

7. [DO NOT READ] Decline to answer

S10. Are you of Hispanic or Latino origin?

1. Yes [BEST EFFORT TO TARGET 2 per group]

2. No

S11. What is your race? Select all that apply.

1. White

2. Black or African American [BEST EFFORT TO TARGET 2 per group]

3. Asian

4. Native Hawaiian or other Pacific Islander

5. American Indian or Alaska Native

S12. Which of the following best describes your employment status? [RECRUIT A MIX]

1. Employed full-time

2. Employed part-time

3. Retired

4. Unemployed

5. Student

6. Homemaker

7. Other: _________________ [IF MILITARY RECODE TO 1 ‘Employed full-time’]

S13. What was the total combined annual income before taxes, of all the members of your household including yourself in 2018? [RECRUIT A MIX]

1. Less than $25,000

2. $25,000-$49,999

3. $50,000-$74,999

4. $75,000-$99,999

5. $100,000-$149,999

6. $150,000 or more

7. [DO NOT READ] Decline to answer

S14. Which of the following best describes your current marital status? [RECRUIT A MIX]

1. Single, never married

2. Married/Living with partner/Civil Union

3. Divorced/Separated/Widowed

4. [DO NOT READ] Decline to answer

S15. Now I’d like you to use your imagination a bit. If you could plan your perfect trip to any location in America where would you go and whom would you take with you? Why? What would you do while you’re there?

[RECORD RESPONSE IN RECRUIT GRID]

[THANK & TERMINATE IF PARTICIPANT IS UNABLE TO FORMULATE A THOUGHTFUL AND COHERENT RESPONSE]

INVITATION

Thank you for answering my questions. We are inviting a select number of residents from your area to participate in a discussion session (session location to be determined) regarding seat belt usage.

All your responses will be kept strictly confidential and we think you’ll find the session interesting and engaging. In appreciation for your feedback, we are offering $75 for your participation.

Would you be available to join us for this session?

1. YES GIVE LOCATION DETAILS

2. NO TERMINATE

Just so I can confirm what we just talked about, what is your name and email address?

NAME: ______________________________________________

EMAIL ADDRESS: [CONFIRM FROM ABOVE]

[THANK, TELL THEM THEY WILL RECEIVE A “REMINDER” CALL AND A VERIFICATION EMAIL AS THE DATE GETS NEARER AND POLITELY END THE CALL.]

12

NHTSA Form 1536