Screener

Appendix A: Focus Group Recruitment Screening Questionnaire

Participants will be recruited by telephone for the focus groups, per the criteria in Appendix B. The contractor will screen potential participants to meet the desired audience composition for each focus group.

Introduction

/* DISPLAY */ Hello, my name is ______ and I’m calling from XXXXX, a focus group facility working on behalf of the U.S. Census Bureau to help improve communications to communities across the country. We are conducting focus groups in XXXX, and you have previously indicated a desire to participate in focus groups.

The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of XX/XX/XX, I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about five to 10 minutes.

May we proceed? /*If yes, proceed*/ If no, thank and end call*/

If you are eligible, are you available on [DATE] [TIME] to participate in a focus group? The focus group will be held in [PLACE].

1. Yes

2. No (if unable to make any of the times, explain that they do not qualify for the focus group, and they can pass the information along if they know someone else who might qualify)

/* TERMINATE */

Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you and the focus group itself have been authorized for collection by U.S. Office of Management and Budget, approval number XXX, expiring on XXX.

Are you willing to participate? [If yes] Great, I have a few questions to see if you qualify for this study.

Screening Questions

Background

1b. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion? DO NOT READ LIST

1. Within the past three months [ ] > INELIGIBLE

2. Over three months ago [ ] > CONTINUE

3. Never [ ] > CONTINUE

1c. Do you or an immediate family member work in any of the following fields? READ LIST IN RANDOM ORDER AND RECORD BELOW

1. Advertising or public relations? [ ] INELIGIBLE

2. Marketing or market research? [ ] INELIGIBLE

3. Federal government? [ ] INELIGIBLE

4. Journalism? [ ] INELIGIBLE

5. Education? [ ] Continue

6. Medicine? [ ] Continue

7. Engineering? [ ] Continue

How old are you? (DO NOT READ ANSWER CHOICES)

1. 17 or younger ## ASK FOR ANOTHER PERSON, THEN END CALL ##

2. 18–24

3. 25-34

4. 35-54

5. 55+

/*QAGE_CODE*/ Code Age

1. ##If Q2=C2 ## 18-24

2. ##If Q2=C2-C3 ## 18-34

3. ##If Q2=C4 ## 35-54

4. ##If Q2=C5## 55+

Are you…

1. Male

2. Female

3. Prefer to self-describe /* SPECIFY */

/* QRace */ What is your race or ethnicity? You may provide more than one group. /* MULTIPLE RESPONSES PERMITTED */

1. White

2. Hispanic, Latino, or Spanish

3. Black or African American

4. Asian

5. American Indian or Alaska Native

6. Middle Eastern or North African

7. Native Hawaiian or Pacific Islander

8. Some other race or ethnicity /* SPECIFY */

[[ Thank you. Next, we will collect details for each group reported. ]]

/* QRace_White */## IF QRACE = C1 ## Earlier, you reported you were WHITE. What are your detailed WHITE ethnicities? For example, German, Irish, English, Italian, Polish, French, etc? /* MULTIPLE RESPONSES PERMITTED */

1. German

2. Irish

3. English

4. Italian

5. Polish

6. French

7. Other /* SPECIFY */

/* QRace_Hispanic */ ## IF QRACE = C2 ## Earlier, you reported you were HISPANIC OR LATINO. What are your detailed HISPANIC OR LATINO ethnicities? For example, Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc? /* MULTIPLE RESPONSES PERMITTED */

1. Mexican or Mexican American

2. Puerto Rican

3. Cuban

4. Salvadoran

5. Dominican

6. Colombian

7. Other /* SPECIFY */

/* QRace_Black */ ## IF QRACE = C3 Earlier, you reported you were BLACK OR AFRICAN AMERICAN. What are your detailed BLACK ethnicities? For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. /* MULTIPLE RESPONSES PERMITTED */

1. African American

2. Jamaican

3. Haitian

4. Nigerian

5. Ethiopian

6. Somali

7. Other /* SPECIFY */

/* QRace_Asian */ ## IF QRACE = C4 ## Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. /* MULTIPLE RESPONSES PERMITTED */

1. Chinese

2. Filipino

3. Asian Indian

4. Vietnamese

5. Korean

6. Japanese

7. Other /* SPECIFY */

/* QRace_AIAN */## IF QRACE = C5 ## Earlier, you reported you were AMERICAN INDIAN OR ALASKA NATIVE. What are your American Indian or Alaska Native ethnicities? For example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Tlingit, etc /* RECORD RESPONSE*/

/* QRace_MENA */## IF QRACE = C6 ## Earlier, you reported you were MIDDLE EASTERN OR NORTH AFRICAN. What are your detailed MIDDLE EASTERN OR NORTH AFRICAN ethnicities? For example, Lebanese, Iranian, Egyptian, Syrian, Moroccan, Israeli, etc. /* MULTIPLE RESPONSES PERMITTED */

1. Lebanese

2. Iranian

3. Egyptian

4. Syrian

5. Moroccan

6. Israeli

7. Other /* SPECIFY

/* QRace_NHPI */*/## IF QRACE = C7 ## Earlier, you reported you were NATIVE HAWAIIAN OR PACIFIC ISLANDER. What are your detailed PACIFIC ISLANDER ethnicities? For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc. /* MULTIPLE RESPONSES PERMITTED */

1. Native Hawaiian

2. Samoan

3. Chamorro

4. Tongan

5. Fijian

6. Marshallese

7. Other /* SPECIFY */

QRace_OTHER */*/## IF QRACE = C8 ## Earlier, you reported you were some other race or ethnicity. Can you provide me with more details?/* RECORD RESPONSE*/

/* QNativity*/ In what country or territory were you born? [DON’T READ CHOICES, CIRCLE RESPONSE.]

1. In the United States

2. Other /* SPECIFY */

/* QAge_At_Immigration */ ## IF QNATIVITY=C2 ## How old were you when you first came to the United States? (IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.)

1. 17 or older ## 1^st Generation ##

2. 16 or younger ## 1.5 Generation, meaning more acculturation ##

/* QLanguage*/ What is your native language or languages?

1. [target language]

2. English

3. Other /* SPECIFY */

/* QLanguage_Followup*/ ## IF TARGET LANGUAGE = NOT ENGLISH ## How well do you speak [target language]?

1. Very well

2. Well

3. Not well

4. Not at all

/* QRead*/ ## IF TARGET LANGUAGE = NOT ENGLISH ## How well do you read [target language]?

1. Very well

2. Well

3. Not well

4. Not at all

/* QSpeakEnglish*/ ## IF TARGET LANGUAGE = NOT ENGLISH ## How well do you speak English?

1. Very well

2. Well

3. Not well

4. Not at all

/* QLanguage Preference*/ ## IF TARGET LANGUAGE = NOT ENGLISH ## When both are available, do you prefer to complete forms in English or [target language]? (EXAMPLES IF CONFUSED: GOVERNMENT FORMS, QUESTIONNAIRES, SCHOOL FORMS, MEDICAL FORMS)

1. [Target language]

2. English

3. Either way

/*QEDU */ What is the highest grade or year of schooling you have completed?

1. High school or Less

2. Some college

3. College graduate or postgraduate degree

Low Self-Response Characteristics

What is your marital status?

1. Married

2. Widowed

3. Divorced

4. Separated

5. Never married

Besides yourself, how many adults live in your home?

1. None, just myself

2. One other person

3. Two other people

4. Three other people

5. Four or more other people

6a. For “Young and Mobile” Groups ONLY: ## IF Q2 == 2 [18-24] AND AT LEAST ONE OTHER ADULT IN Q6 ## Do your parents or grandparents live in your home?

1) Yes [INELIGIBLE]

2) No

How many children, including babies, live in your home?

1. None [Skip Q8]

2. All other, record and proceed

## IF HAS CHILDREN ## What is the age of the youngest child in your home?

1. Less than 6 years old

2. 6–9 years old

3. 10–17 years old

/*QCHILDREN*/ Code household with children

1. ## IF Q7=C1## HH with no children

2. ## IF Q8=C1## HH with small children

3. ## IF Q8=C2 OR C3## HH with older children

/* QCELL */ Do you own a cell phone?

1. Yes

2. No

/* QCELL_A */ ## IF QCell = C1 ## Is your cell phone a smartphone, such as an iPhone or Android, or are you not sure?

1. Yes

2. No

3. Not sure /* DO NOT read this answer choice select if respondent says they aren’t sure */

Do you own a tablet computer such as an iPad, Samsung Galaxy Tab, Google Nexus, or Kindle Fire?

1. Yes

2. No

3. Not sure

/* QINTERNET */ Do you have at least one year of internet experience?

1. Yes

2. No

/* QINTERNET_A */ ## IF QINTERNET = C1 ## How often do you use the internet, either on a computer or on a mobile device like a smartphone or tablet? (DO NOT READ ANSWER CHOICES)

1. Several times a day

2. About once a day

3. A few times a week

4. A few times a month

5. A few times a year

6. Not at all

/*QINTERNET_PROFICIENCY*/ Code Internet proficiency

1. ##IF QINTERNET=C2 OR INTERNET_A=C3-C5 ## Low Internet proficiency

2. ##IF QINTERNET=C1 AND INTERNET_A=C1-C2 ## Moderate to High Internet proficiency

Do you rent or own your own house or apartment?

1. Rent

2. Own

3. Other /*SPECIFY*/

What is your total annual household income?

1. Less than $14,999

2. $15,000 to $29,999

3. $30,000 to $34,999

4. $35,000 to $74,999

5. $75,000 to $149,999

6. More than $150,000

/*QINCOME_Code*/ Code Income

1. ## If QINCOME=C1-C2 ## Income less than $30,000

2. ## If QINCOME=C3-C4 ## Income between $30,000 and $74,999

3. ## If QINCOME = C5 ## Income between $75,000 and $149,000

4. ## If QINCOME = C6 ## Income more than $150,000
   
   

12. What is your ZIP code? [RECORD RESPONSE]

13. When did you move into your current house, apartment, or mobile home? [RECORD RESPONSE as 2 digit month and 4 digit year]

/*Q13_Code*/ Code Q13

1. ##If Response is more recent than Month: 01 and Year: 2014## Moved in last 4 years

2. ## If Response is Month: 01 and Year: 2014 and older ## Moved more than 4 years ago

/* QPOINT */ Assign points to Hard-To-Count traits

1. ##IF Q10=C1## Renters: 2 points

2. ##IF QCHILDREN=C2## HH with children five or younger: 1 point

3. ##IF QINCOME CODE = C1## Less than $35,000 income: 1 point

4. ##IF Q6=C5## HH with more than 4 people: 1 point

5. ##IF Q3=2, Q5 does not equal 1, and Q6 does not equal 1## Female head of house, no husband: 1 point

6. ## IF Q13­_Code=1## Moved in last 4 years: 1 point

/* QPOINT */ Assign points to inclusivity traits

7. ##IF QRACE !=C1## Hispanic, Black, Asian, AIAN, MENA, NHPI: 1 point

8. ##IF QEdu_Code=C1## High School or less: 1 point

TOTAL POINTS: ______

/* QHTC */ Code Priority population

1. ##IF QPOINT >=3 ## Priority [QUALIFIES]

2. ##IF QPOINT <3 ## Non-priority [DOES NOT QUALIFY]

/* DISPLAY */ ## IF QUALIFIES ## Thank you. You are eligible to participate in the focus group on XX/XX. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?

[Coordinate scheduling details.]

/* DISPLAY */ ## IF DOES NOT QUALIFY ## Thank you. It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals that match your characteristics so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to [email protected].