CPS Recruitment Screener

2021 CPS Public Participation in the Arts Cognitive Testing – Additional Questions for Telephone Screener

FIRST PERSON SCREENED IN HOUSEHOLD

1. We are looking to interview two people living in the same household. Do you live with another person 18 or older who would be willing to participate in our study?

Yes Great. Please tell me that person’s name, phone number, and email address and I will follow up with them.

First and Last Name: ____________________

Phone number: _______________________

Email address: ________________________

No SKIP TO Q4

2. (if yes to Q1) How is [NAME] related to you? ____________________

3. How long have you lived in the same household as [NAME]? If less than two years, ask if needed: About how many months have you lived with them?

Years:______ Months:______ (report months only if less than two years)

4. In the past two years, have you attended a live musical performance, stage production, or any other artistic performance?

Yes
No

5. In the past two years, have you engaged in creative activities of any kind, such as making art or crafts, playing music, singing, dancing, etc., whether professionally or for your own pleasure?

Yes
No

CONCLUDE INTERVIEW.

SECOND PERSON SCREENED IN HOUSEHOLD

1. How is [NAME of 1^st person screened] related to you?

2. In the past two years, have you attended a live musical performance, stage production, or any other artistic performance?

Yes

No

3. In the past two years, have you engaged in creative activities of any kind, such as making art or crafts, playing music, singing, dancing, etc., whether professionally or for your own pleasure?

Yes

No

WRAP-UP

If they have an e-mail address:

Thanks for taking time to answer my questions today. If you qualify for the study, someone will be back in touch with you soon to schedule an interview. I am going to email you some more information about how we protect the privacy of your data and your rights.

If they do not have an e-mail address:

Thanks for taking some time to answer my questions today. If you qualify, someone will call you soon to schedule an interview.

Confidentiality information for inclusion in email:

The U.S. Census Bureau is required by law to protect your information. We are conducting this voluntary study under the authority of Title 13, United States Code, Sections 6(c), 141 and 193. All of the information you provide may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required by law (20 U.S.C. §9573 and 6 U.S.C. §151).

The Census Bureau is not permitted to publicly release your responses in a way that could identify you. We are conducting this voluntary study under the authority of Title 13, United States Code, Sections 6(c), 141 and 193. The results of this study will be used to inform future surveys.

Your privacy is also protected by the Privacy Act, Title 5 U.S. Code. Routine uses of these data are limited to those identified in the Privacy Act System of Record Notice titled, “SORN COMMERCE/Census-3, Demographic Survey Collection (Census Bureau Sampling Frame).”

We estimate that completing these screening questions will take 15 minutes on average. This information collection has been approved by the Office of Management and Budget (OMB). You can validate that this survey is a legitimate federally-approved information collection using the Office of Management and Budget's approval number 0607-0725, which expires December 31, 2022. We are required to tell you this number to conduct this survey. Send comments regarding this estimate or any other aspect of this survey, including suggestions for reducing the time it takes to complete this survey to [email protected].

SCHEDULING AN INTERVIEW

We would like to invite you to participate in a telephone interview. The interview will take about 75 minutes, and you will receive $40 as a thank-you for completing the interview. Are you available on [date] at [time]?

We will send you an email with a link to a form explaining your rights as a participant, and you will need to use your computer or smartphone to sign this before the interview. Is this okay?

Yes Great. A researcher will call you at [say interview date and time] and we will conduct the interview at that time. Please be sure to click on the link in the email and sign the form before the interview.

No I’m afraid we need you to sign the online consent form before we can conduct the interview. If that isn’t possible, we are not able to include you in our study. Thank you for your time today.