First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
FAIRBANKS, AK
Alaska Native |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
10 |
10 |
|
||
Some college or an associate’s degree |
6 |
6 |
|
|||
College graduate + |
0 |
0 |
|
|||
Gender |
Female |
16 |
0 |
|
||
Male |
0 |
16 |
|
|||
Race/Ethnicity |
Alaska Native |
16 |
16 |
|
||
Other |
0 |
0 |
|
|||
Age |
18-34 |
0 |
8 |
|
||
35-44 |
5 |
8 |
|
|||
45-54 |
6 |
0 |
|
|||
55 or older |
5 |
0 |
|
RECRUIT 16 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government (specify: ) |
|
> ask to specify |
Bureau of Indian Affairs |
|
|
Others |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Other (specify: ) |
|
2c. How old are you?
17 or under |
|
> ask for someone in household AgeS 18 or older |
18 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
2d. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – Alaska Native
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group. MUST RESPOND ALASKA NATIVE ONLY
White |
|
> TERMINATE |
|
Black or African American |
|
> TERMINATE |
|
Asian |
|
> TERMINATE |
|
American Indian |
|
> TERMINATE |
|
Alaska Native |
|
|
|
Native Hawaiian or Other Pacific Islander |
|
> TERMINATE |
|
Some other race (specify: ) |
|
> TERMINATE |
|
3c. What is the name of your Alaska Native Corporation? For example, Native Village of Barrow, Arctic Slope Corporation, Tlingit, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX IF POSSIBLE.
Native Village of Barrow |
|
|
Arctic Slope Corporation |
|
|
Tlingit |
|
|
Other (specify: ) |
|
|
Not a member of an Alaska Native Corporation |
|
> TERMINATE |
3d-f. Please respond yes or no to the following. RANDOMIZE LIST:
3d. |
Do you consider yourself to be knowledgeable about your native culture? |
Yes |
No |
3e. |
Do you participate in traditional native cultural events or ceremonies? |
Yes |
No |
3f. |
Do you live in or regularly communicate with people from your home village? |
Yes |
No |
TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 3 TO QUALIFY
3g. What is your ZIP code?
|
SECTION 4: LANGUAGE
4a. What language do you primarily speak at home?
English |
|
> skip to SECTION 5 |
Other (specify: ) |
|
> ask q4B |
ONLY ASK IF OTHER @ Q4A:
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:______________________________ _) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within past year |
|
1 point |
Moved more than a year ago |
|
|
5i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM
DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
PHOENIX, AZ
American Indian |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
10 |
8 |
|
||
Some college or an associate’s degree |
6 |
6 |
|
|||
College graduate + |
0 |
0 |
|
|||
Gender |
Female |
16 |
0 |
|
||
Male |
0 |
16 |
|
|||
Race/Ethnicity |
American Indian |
16 |
16 |
|
||
Other |
0 |
0 |
|
|||
Age |
18-34 |
0 |
0 |
|
||
35-44 |
5 |
6 |
|
|||
45-54 |
6 |
5 |
|
|||
55 or older |
5 |
5 |
|
RECRUIT 16 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
2 |
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
2 |
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
2 |
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government (specify: ) |
|
> ask to specify |
Bureau of Indian Affairs |
|
|
Others |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Other (specify: ) |
|
2c. How old are you?
17 or under |
|
> ask for someone in household ages 18 or older |
18 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
2d. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – American Indian
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY
White |
|
> TERMINATE |
|
Black or African American |
|
> TERMINATE |
|
Asian |
|
> TERMINATE |
|
American Indian |
|
|
|
Alaska Native |
|
> TERMINATE |
|
Native Hawaiian or Other Pacific Islander |
|
> TERMINATE |
|
Some other race (specify: ) |
|
> TERMINATE |
|
3c. What is the name of your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath etc. MULTIPLE RESPONSES PERMITTED.
Navajo Nation |
|
|
Blackfeet Tribe |
|
|
Bay Mills |
|
|
Klamath |
|
|
Other (specify: ) |
|
|
Not a member of a tribe |
|
> TERMINATE |
3d-f. Please respond yes or no to the following. RANDOMIZE LIST:
3d. |
Do you consider yourself to be knowledgeable about your native culture? |
Yes |
No |
3e. |
Do you participate in traditional native cultural events or ceremonies? |
Yes |
No |
3f. |
Do you live in or regularly communicate with people from your home tribe? |
Yes |
No |
TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 3 TO QUALIFY
3g. What is your ZIP code?
|
SECTION 4: LANGUAGE
4a. What language do you primarily speak at home?
English |
|
> skip to SECTION 5 |
Other (specify: ) |
|
> ask q4B |
ONLY ASK IF OTHER @ Q4A:
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point Check quotas for group |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:________________________________) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within past year |
|
1 point |
Moved more than a year ago |
|
|
5i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM
DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
SAULT STE. MARIE, MI
American Indian |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
10 |
10 |
|
||
Some college or an associate’s degree |
6 |
6 |
|
|||
College graduate + |
0 |
0 |
|
|||
Gender |
Female |
16 |
0 |
|
||
Male |
0 |
16 |
|
|||
Race/Ethnicity |
American Indian |
16 |
16 |
|
||
Other |
0 |
0 |
|
|||
Age |
18-34 |
5 |
5 |
|
||
35-44 |
6 |
6 |
|
|||
45-54 |
5 |
5 |
|
|||
55 or older |
0 |
0 |
|
RECRUIT 16 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government (specify: ) |
|
> ask to specify |
Bureau of Indian Affairs |
|
|
Others |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Other (specify: ) |
|
2c. How old are you?
17 or under |
|
> ask for someone in household AgeS 18 to 54 years old |
18 – 34 |
|
> check quotas |
35 – 44 |
|
> check quotas |
45 – 54 |
|
> check quotas |
55+ |
|
> ask for someone in household AgeS 18 to 54 years old |
2d. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – American Indian
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY
White |
|
> TERMINATE |
|
Black or African American |
|
> TERMINATE |
|
Asian |
|
> TERMINATE |
|
American Indian |
|
|
|
Alaska Native |
|
> TERMINATE |
|
Native Hawaiian or Other Pacific Islander |
|
> TERMINATE |
|
Some other race (specify: ) |
|
> TERMINATE |
|
3c. What is the name of your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX IF POSSIBLE
Navajo Nation |
|
|
Blackfeet Tribe |
|
|
Bay Mills |
|
|
Klamath |
|
|
Other (specify: ) |
|
|
Not a member of a tribe |
|
> TERMINATE |
3d-f. Please respond yes or no to the following. RANDOMIZE LIST:
3d. |
Do you consider yourself to be knowledgeable about your native culture? |
Yes |
No |
3e. |
Do you participate in traditional native cultural events or ceremonies? |
Yes |
No |
3f. |
Do you live in or regularly communicate with people from your home tribe? |
Yes |
No |
TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 3 TO QUALIFY
3g. What is your ZIP code?
|
SECTION 4: LANGUAGE
4a. What language do you primarily speak at home?
English |
|
> skip to secton 5 |
Other (specify: ) |
|
> ask q4B |
ONLY ASK IF OTHER @ Q4A:
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point Check quotas for group |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
|
5–9 years old |
|
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:________________________ _) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within the past year |
|
1 point |
Moved more than 1 year ago |
|
|
5i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM
DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
PORTLAND, OR
American Indian |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
10 |
10 |
|
||
Some college or an associate’s degree |
6 |
6 |
|
|||
College graduate + |
0 |
0 |
|
|||
Gender |
Female |
16 |
0 |
|
||
Male |
0 |
16 |
|
|||
Race/Ethnicity |
American Indian |
16 |
16 |
|
||
Other |
0 |
0 |
|
|||
Age |
18-34 |
0 |
10 |
|
||
35-44 |
0 |
6 |
|
|||
45-54 |
0 |
0 |
|
|||
55 or older |
16 |
0 |
|
RECRUIT 16 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
2 |
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government (specify: ) |
|
> ask to specify |
Bureau of Indian Affairs |
|
|
Others |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Other (specify: ) |
|
2c. How old are you?
17 or under |
|
> ask for someone in household AgeS 18-44 or 55+ |
18 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
> ask for someone in household AgeS 18-44 or 55+ |
55+ |
|
|
2d. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – American Indian
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY
White |
|
> TERMINATE |
|
Black or African American |
|
> TERMINATE |
|
Asian |
|
> TERMINATE |
|
American Indian |
|
|
|
Alaska Native |
|
> TERMINATE |
|
Native Hawaiian or Other Pacific Islander |
|
> TERMINATE |
|
Some other race (specify: ) |
|
> TERMINATE |
|
3c. What is the name of your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX IF POSSIBLE
Navajo Nation |
|
|
Blackfeet Tribe |
|
|
Bay Mills |
|
|
Klamath |
|
|
Other (specify: ) |
|
|
Not a member of a tribe |
|
> TERMINATE |
3d-f. Please respond yes or no to the following. RANDOMIZE LIST:
3d. |
Do you consider yourself to be knowledgeable about your native culture? |
Yes |
No |
3e. |
Do you participate in traditional native cultural events or ceremonies? |
Yes |
No |
3f. |
Do you live in or regularly communicate with people from your home tribe? |
Yes |
No |
3g. What is your ZIP code?
|
SECTION 4: LANGUAGE
4a. What language do you primarily speak at home?
English |
|
> skip to section 5 |
Other (specify: ) |
|
> ask q4B |
ONLY ASK IF OTHER @ Q4A:
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNGchildren |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:______________________________) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within the past year |
|
1 point |
Moved more than 1 year ago |
|
|
5i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM
DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
HONOLULU, HI & SEATTLE, WA
Native Hawaiian or Pacific Islander (NHPI) |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
10 |
10 |
|
||
Some college or an associate’s degree |
6 |
6 |
|
|||
College graduate or postgraduate degree |
0 |
0 |
|
|||
Gender |
Female |
8 |
8 |
|
||
Male |
8 |
8 |
|
|||
Race/Ethnicity |
Native Hawaiian |
6 |
6 |
|
||
Micronesian islands |
5 |
5 |
|
|||
Polynesian/Melanesian islands |
5 |
5 |
|
|||
Age |
18-34 |
3 |
3 |
|
||
35-44 |
3 |
3 |
|
|||
45-54 |
5 |
5 |
|
|||
55 or older |
5 |
5 |
|
RECRUIT 16 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Service Industry |
|
|
Other (specify: ) |
|
|
2c. How old are you?
17 or under |
|
> ask for someone in household ages 18 or over |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 54 |
|
|
55+ |
|
|
2d. Are you…
Male |
|
|
Female |
|
|
Other gender (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – NHPI
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group. MUST RESPOND NHPI ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Native Hawaiian or Other Pacific Islander |
|
|
|
|
Some other race (specify: ) |
|
> TERMINATE |
|
3c. Earlier, you reported you were NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER. What are your NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER ethnicities? For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.
Native Hawaiian |
|
> native hawaiian |
Samoan |
|
> Polynesian/ melanesian |
Chamorro |
|
> micronesian |
Fijian |
|
> Polynesian/ melanesian |
Tongan |
|
> Polynesian/ melanesian |
Marshallese |
|
> micronesian |
Other (specify: ) |
|
|
3d. In what country or territory were you born?
In the continental United States, Alaska, or Hawaii |
|
> skip to SECTION 4 |
Outside of the United States (specify: ) |
|
> ask q3E |
ONLY ASK IF NOT BORN IN THE UNITEd STATES (CODE 2 @ Q3D)
3e. 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.
17 or older |
|
|
16 or younger |
|
|
SECTION 4: LANGUAGE
4a. Is there a language besides English that you are fluent in? RECRUIT A MIX.
Yes (specify: ) |
|
> ask q4b |
Native Hawaiian |
|
|
Micronesian |
|
|
Polynesian/Melanesian |
|
|
No |
|
> IF Micronesian OR Polynesian/ MELANESIAN, TERMINATE. > IF Native Hawaiian, skip to section 5 |
ONLY ASK IF OTHER @ Q4A:
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000/year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:___________________________) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within the past year |
|
1 point |
Moved more than 1 year ago |
|
|
5i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
San Gabriel Valley/Pasadena, CA
Asian |
||||
|
Session
1 |
Session
2 |
|
|
Education |
High school or less |
9 |
9 |
|
Some college or an associate’s degree |
5 |
5 |
|
|
College graduate or postgraduate degree |
0 |
0 |
|
|
Gender |
Female |
7 |
7 |
|
Male |
7 |
7 |
|
|
Ancestry |
Chinese |
3 |
2 |
|
Vietnamese |
3 |
1 |
|
|
Korean |
3 |
1 |
|
|
Filipino |
0 |
3 |
|
|
Hmong or Thai |
3 |
1 |
|
|
Cambodian |
2 |
0 |
|
|
Asian Indian |
0 |
3 |
|
|
Other South Asian (Pakistani, Bangladeshi) |
0 |
3 |
|
|
Age |
18-34 |
3 |
2 |
|
35-44 |
3 |
2 |
|
|
45-54 |
4 |
5 |
|
|
55 or older |
4 |
5 |
|
RECRUIT 14 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST MULTIPLE RESPONSES PERMITTED
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Service Industry |
|
|
Other (specify: ) |
|
|
2c. Are you currently a full or part-time student?
Full time student |
|
> TERMINATE |
Part-time student |
|
> HOLD |
Not a student |
|
|
2d. How old are you?
17 or under |
|
> ask for someone in household ages 18 or over |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 54 |
|
|
55+ |
|
|
2e. Are you…
Male |
|
|
Female |
|
|
Other gender (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – Asian
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group. MUST RESPOND ASIAN ONLY
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Native Hawaiian or Other Pacific Islander |
|
> TERMINATE |
|
|
Some other race (specify: ) |
|
> TERMINATE |
|
3c. Earlier, you reported you were ASIAN. What best describe your nationality or ethnicity? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.
Chinese |
|
|
Vietnamese |
|
|
Korean |
|
|
Filipino |
|
|
Hmong or Thai |
|
|
Cambodian |
|
|
Asian Indian |
|
|
Other South Asian (Pakistani, Bangladeshi) |
|
|
Other (specify: ) |
|
> terminate |
3d. In what country or territory were you born?
In the United States |
|
> terminate |
Outside of the United States (specify: ) |
|
> ask q3E |
3e. 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.
17 or older |
|
|
16 or younger |
|
> terminate |
SECTION 4: LANGUAGE
4a. What languages do you speak at home? TERMINATE IF NOT BILINGUAL
English |
|
|
Other (specify: ) |
|
|
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
4c. How well do you read English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
4d. How well do you speak [OTHER] language?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
4e. How many hours of media in [OTHER] language do you consume per week? This can include TV, print, radio, digital media, and social media.
HOURS: ________________________________________
must enter ROUND NUMBER |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High School |
|
1 point |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:________________________________) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within the past year |
|
1 point |
Moved more than a year ago |
|
|
5i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
5j. How many months of the year do you live outside of your primary residence?
Never live elsewhere |
|
|
Less than two month |
|
|
2 – 4 months |
|
1 poinT |
4 – 6 months |
|
1 poinT |
More than 6 months |
|
1 poinT |
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
Houston, TX
Hispanic |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
9 |
9 |
|
||
Some college or an associate’s degree |
5 |
5 |
|
|||
College graduate + |
0 |
0 |
|
|||
Gender |
Female |
7 |
7 |
|
||
Male |
7 |
7 |
|
|||
Race/Ethnicity |
Hispanic |
14 |
14 |
|
||
Not Hispanic |
0 |
0 |
|
|||
Ancestry |
Mexican |
9 |
9 |
|
||
Central American |
5 |
5 |
|
|||
Generation* |
1st Generation |
7 |
7 |
|
||
1.5 Generation |
7 |
7 |
|
|||
Age |
24-34 |
7 |
7 |
|
||
35-50 |
7 |
7 |
|
*Definitions
1st Generation: Foreign born; both parents foreign born; immigrated to the U.S. when 17 or older
1.5 Generation: Foreign born; both parents foreign born; immigrated to the U.S. when 16 or younger
RECRUIT 14 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Other (specify: ) |
|
2c. How old are you?
17 or under |
|
> ask for someone in household AGED 24-50 > if none terminate |
18 – 23 |
|
|
24 – 34 |
|
> check quota |
35 – 50 |
|
> check quota |
51+ |
|
> ask for someone in household AGED 24-50 > if none terminate |
2d. Are you…
Male |
|
|
Female |
|
|
Other gender (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – HISPANIC
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
|
|
No |
|
> TERMINATE |
|
3b. What is your race? You may provide more than one group.
White |
|
|
|
|
Black or African American |
|
|
|
|
Asian |
|
|
|
|
American Indian |
|
|
|
|
Alaska Native |
|
|
|
|
Native Hawaiian or Other Pacific Islander |
|
|
|
|
Some other race (specify: _____) |
|
|
|
3c. In what country or territory were you born?
United States |
|
> Terminate |
Other |
|
|
3d. 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.
17 or older |
|
> 1ST GENERATION |
16 or younger |
|
> 1.5 GENERATION |
3e. In what country or territory were your parents born?
Both parents were born in the U.S. |
|
> Terminate |
One parent was born in the U.S.; the other was born outside of the U.S. |
|
> Terminate |
Both parents were born outside of the U.S. |
|
|
Don’t know |
|
> Terminate |
FIRST GENERATION IF ALL OF FOLLOWING: 1.5 GENERATION IF ALL OF FOLLOWING:
> BORN OUTSIDE THE U.S. (Code 2 @ Q3C) > BORN OUTSIDE THE U.S. (Code 2 @ Q3C)
> ARRIVE IN THE U.S. AFTER AGE OF 16 (Code 1 @ Q3D) > ARRIVE IN THE U.S. AT OR BEFORE AGE OF 16
> FOREIGN-BORN PARENTS (Code 3 @ Q3E) (Code 2 @ Q3D)
> FOREIGN-BORN PARENTS (Code 3 @ Q3E)
3f. What is your country of origin? DO NOT READ ANSWER CHOICES. RECRUIT A MIX.
Mexico |
|
> mexican check quotas |
El Salvador, Guatemala, Honduras or other Central American country |
|
> central american check quotas |
Puerto Rico, Cuba, Dominican Republic |
|
> Caribbean |
Colombia, Venezuela, Argentina, or other South American country |
|
> south american |
SECTION 4: LANGUAGE
4a. What languages do you speak at home? TERMINATE IF NOT BILINGUAL
English |
|
|
Spanish |
|
|
Other (specify: ) |
|
> TERMINATE |
4b. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
4c. How well do you read English?
Very well |
|
|
Well |
|
|
Not well |
|
> Terminate |
Not at all |
|
> terminate |
4d. How well do you speak Spanish?
Very well |
|
|
Well |
|
|
Not well |
|
|
Not at all |
|
> terminate |
SECTION 5: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
5a. What is the highest grade or year of schooling you have completed?
Less than High School |
|
1 point |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> terminate |
|
5b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
5c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q5d |
No |
|
> skip to q5e |
5d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
5e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q5B)
LIVES WITH ANOTHER ADULT (Q5E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (5C + 5E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
5f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:___________________________) |
|
|
|
5g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
5h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within the past year |
|
1 point |
Moved within the past 4 years |
|
|
Moved more than 4 years ago |
|
> TERMINATE |
5i. How long have you been living in Houston, TX?
5 years or fewer |
|
|
More than 5 years |
|
> TERMINATE |
Do not live in Houston, TX |
|
> TERMINATE |
5j. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 6: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM
DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason
for Termination |
|
POLK COUNTY / SPRINGFIELD, MO
Rural |
||||||
|
Session
1 |
Session
2 |
||||
Education |
High school or less |
9 |
9 |
|
||
Some college or an associate’s degree |
5 |
5 |
|
|||
College graduate + |
0 |
0 |
|
|||
Gender |
Female |
7 |
7 |
|
||
Male |
7 |
7 |
|
|||
Age |
18-34 |
2 |
2 |
|
||
35-44 |
2 |
2 |
|
|||
45-54 |
5 |
5 |
|
|||
55 or older |
5 |
5 |
|
|||
Race/Ethnicity |
White, not Hispanic |
14 |
14 |
|
||
Other |
0 |
0 |
|
RECRUIT 14 TO SEAT 6-8 PER GROUP
SECTION 1: WILLINGNESS
Hello,
my name is ______ and I’m from ______, a focus group facility
working on behalf of the U.S. Census Bureau to help improve
communications to communities across the country.
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 [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> 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 those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: STUDY CRITERIA
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Service Industry |
|
|
Other (specify: ) |
|
|
2c. How old are you?
17 or under |
|
> ask for someone in household ages 18 or over |
18 – 24 |
|
> Check Age quotas for group |
25 – 34 |
|
|
35 – 54 |
|
|
55+ |
|
|
2d. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
SECTION 3: STUDY CRITERIA – Rural
3a. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3b. What is your race? You may provide more than one group.
White |
|
|
|
Black or African American |
|
> Terminate |
|
Asian |
|
> Terminate |
|
American Indian |
|
> Terminate |
|
Alaska Native |
|
> Terminate |
|
Native Hawaiian or Other Pacific Islander |
|
> Terminate |
|
Some other race (specify: ) |
|
> Terminate |
3c. What is your ZIP code? RECRUIT FROM A LIST OF ZIP CODES PROVIDED BY TEAM Y&R
|
SECTION 4: HTC DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children aged 4 years old or younger
Multi-unit or mobile home structure
4a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point |
|
High School graduate or equivalent |
|
|
|
Some college or an associate’s degree |
|
|
|
College graduate or postgraduate degree |
|
> Terminate |
|
4b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
4c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q4d |
No |
|
> skip to q4e |
4d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
4e. Besides yourself, how many adults live in your home?
RECORD NUMBER:______________________________________
1 point IF ALL OF FOLLOWING:
FEMALE (Code 2 @ Q2D)
UMARRIED (Code 2-5 @ Q4B)
LIVES WITH ANOTHER ADULT (Q4E > 0)
CODE NUMBER OF PEOPLE IN HOUSEHOLD (4C + 4E) |
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
4f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:___________________________ _) |
|
|
|
4g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached to any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
4h. What month and year did you move into your current house, apartment, or mobile home?
MONTH:______________________________________
YEAR: ________________________________________
must enter 2 digit month and 4 digit year (example: FEBRUARY 2005 = 02 / 2005) |
Moved within the past year |
|
1 point |
Moved more than a year ago |
|
|
4i. In 2017, what was your total household income before taxes?
Less than $25,000 |
|
1 point |
|
$25,000 - $34,999 |
|
1 poinT |
|
$35,000 - $49,999 |
|
|
|
$50,000 - $74,999 |
|
|
|
$75,000 - $99,999 |
|
|
|
$100,000 - $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 5: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to [email protected]. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM
DETAILS & SCHEDULE PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who 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].
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Valeria Ojeda-Avitia |
File Modified | 0000-00-00 |
File Created | 2021-01-20 |