0920-0910 Survey Questionnaire

Form Approved

OMB No. 0920-0910

Exp. Date 01/31/2024

Emerging Tobacco Products Communication Initiative

Survey Questionnaire

Public reporting burden of this collection of information is estimated to average 18 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0910).

[Introduction]

Thank you for agreeing to participate in this study today. This study is about health topics that educators and coaches might discuss with middle and high school students (aged 11 to 17 years old).

This study will have two parts. First, we will ask you some questions about youth-related health topics. Next, we will show you several advertisements and ask for your feedback on them. The survey will take about 20 minutes to complete.

Make sure you are comfortable and can read the screen clearly. The survey will include a video, so please make sure the sound on your device is active and the volume is turned up.

Section 1. Educator Attitudes and Perceptions about E-cigarettes (3 Minutes)

[Perceived Student Challenges]

1. In your opinion, what are the most important non-academic challenges facing students in your school (e.g., substance use, social pressure, family instability)? Please list the top three challenges.

Challenge #1: _____________________

Challenge #2: _____________________

Challenge #3: _____________________

[Perceived Priority of E-cigarettes – Relative Importance]

2. Middle and high school students can face many challenges outside of the classroom. Which of the following challenges do you consider most important for educators or coaches like you to address?

Please rank the challenges listed below from most important (1) to least important (7).

[Randomize order] Challenge	Rank
E-cigarette use / vaping
Alcohol, marijuana, and other drug use
Sex / pregnancy
Mental health (e.g., depression, anxiety)
Bullying
Family matters (e.g., abuse, violence, divorce)
Poverty

[Perceived Priority of E-cigarettes – Absolute Importance]

3. How important do you think it is for educators or coaches like you to address student use of e-cigarettes?

1 Not at all important

2

3

4

5 Extremely important

[Perceived Knowledge – General]

4. How much do you know about e-cigarettes?

1 Very little

2

3

4

5 A great deal

[Perceived Knowledge – Health Effects]

5. How much do you know about the health effects of e-cigarettes on youth?

1 Very little

2

3

4

5 A great deal

[Behavioral Intention – Talk with Students]

6. How likely are you to speak with students about the potential health effects and other harms of e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[School Policies – Presence]

7. Does your school have a formal policy against student use of e-cigarettes?

• Yes

• No

• Don’t know

[School Policies – Referral to Treatment]

8. [If Q7 = Yes] To your knowledge, if a student is caught using e-cigarettes at school, are they referred to counseling or treatment?

• Yes

• No

• Don’t know

[Trusted Sources of Information] 

9. Which of the following sources do you trust to provide accurate information about e-cigarette use among youth? Check all that apply:

[Randomize order of response options, except “Other”]

• Healthcare providers 

• My school district 

• Family and friends 

• Religious leader(s) 

• State or local health departments

• Centers for Disease Control and Prevention (CDC) 

• News sources (e.g., online or print newspapers, radio, television, apps) 

• Social media (e.g., Facebook, Twitter, Instagram, LinkedIn, TikTok) 

• Other (please specify): 

Section 2. Advertisement Testing (12 Minutes)

Now we’d like to show you some advertisements about youth-related health topics. We’ll show you an ad on screen and then ask you several questions about it.

Section 2A. Ad #1

[DISPLAY AD. RANDOMIZE PRESENTATION ORDER. CONTINUE DISPLAYING STILL IMAGE OF AD AT TOP OF SCREEN DURING Q10-20.]

Now, we would like you to answer the following questions based on the ad you saw.

[Perceived Ad Effectiveness]

10. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
This ad was worth remembering.
This ad grabbed my attention.
This ad was powerful.
This ad was informative.
This ad was meaningful.
This ad was convincing.

[Main Message Comprehension]

11. Imagine that you were describing this ad to someone else (like a friend or colleague). In your own words, how would you describe the main message of this ad?

[Open-ended text format]

[Confusion]

12. Is there anything about the ad that is confusing, unclear, or hard to understand? Please select all that apply.

• Yes

• No

[Confusion – Open-Ended]

13. [If Q12 = Yes] What part of the ad was confusing, unclear, or hard to understand?

[Open-ended text format]

[Self-Efficacy]

14. After viewing this ad, how confident are you that you can speak with your students about the potential health effects and other harms of e-cigarette use in a way that will resonate with them?

1 Not at all confident

2

3

4

5 Extremely confident

[Outcome Expectation]

15. After viewing this ad, how confident are you that you can personally influence whether your students use e-cigarettes?

1 Not at all confident

2

3

4

5 Extremely confident

[Behavioral Intention – Talk with Students]

16. After viewing this ad, how likely are you to speak with your students about the potential health effects and other harms of e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Behavioral Intention – Learn More]

17. After viewing this ad, how likely are you to seek out more information about the potential health effects and other harms of youth e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Ad Credibility and Relevance]

18. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I believe the information in this ad.
This ad was created for people like me.

[Ad Visual Design]

19. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I like the way this ad looks.
The visuals in this ad are distracting.
The people in this ad look like the students or educators in my school.

[Recommended Ad Changes]

20. If you could change one thing about this ad, what would it be? Please be as specific as possible.

[Open-ended text format]

Section 2B. Material #2

[DISPLAY AD/MATERIAL. RANDOMIZE PRESENTATION ORDER. CONTINUE DISPLAYING STILL IMAGE OF AD/MATERIAL AT TOP OF SCREEN DURING Q21-31.]

Now, we would like you to answer the following questions based on the ad or material you saw.

[Perceived Ad Effectiveness]

21. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
This ad was worth remembering.
This ad grabbed my attention.
This ad was powerful.
This ad was informative.
This ad was meaningful.
This ad was convincing.

[Main Message Comprehension]

22. Imagine that you were describing this ad to someone else (like a friend or colleague). In your own words, how would you describe the main message of this ad?

[Open-ended text format]

[Confusion]

23. Is there anything about the ad that is confusing, unclear, or hard to understand? Please select all that apply.

• Yes

• No

[Confusion – Open-Ended]

24. [If Q23 = Yes] What part of the ad was confusing, unclear, or hard to understand?

[Open-ended text format]

[Self-Efficacy]

25. After viewing this ad, how confident are you that you can speak with your students about the potential health effects and other harms of e-cigarette use in a way that will resonate with them?

1 Not at all confident

2

3

4

5 Extremely confident

[Outcome Expectation]

26. After viewing this ad, how confident are you that you can personally influence whether your students use e-cigarettes?

1 Not at all confident

2

3

4

5 Extremely confident

[Behavioral Intention – Talk with Students]

27. After viewing this ad, how likely are you to speak with your students about the potential health effects and other harms of e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Behavioral Intention – Learn More]

28. After viewing this ad, how likely are you to seek out more information about the potential health effects and other harms of youth e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Ad Credibility and Relevance]

29. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I believe the information in this ad.
This ad was created for people like me.

[Ad Visual Design]

30. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I like the way this ad looks.
The visuals in this ad are distracting.
The people in this ad look like the students or educators in my school.

[Recommended Ad Changes]

31. If you could change one thing about this ad, what would it be? Please be as specific as possible.

[Open-ended text format]

Section 2C. Material #3

[DISPLAY AD/MATERIAL. RANDOMIZE PRESENTATION ORDER. CONTINUE DISPLAYING STILL IMAGE OF AD/MATERIAL AT TOP OF SCREEN DURING Q32-42.]

Now, we would like you to answer the following questions based on the ad or material you saw.

[Perceived Ad Effectiveness]

32. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
This ad was worth remembering.
This ad grabbed my attention.
This ad was powerful.
This ad was informative.
This ad was meaningful.
This ad was convincing.

[Main Message Comprehension]

33. Imagine that you were describing this ad to someone else (like a friend or colleague). In your own words, how would you describe the main message of this ad?

[Open-ended text format]

[Confusion]

34. Is there anything about the ad that is confusing, unclear, or hard to understand? Please select all that apply.

• Yes

• No

[Confusion – Open-Ended]

35. [If Q34 = Yes] What part of the ad was confusing, unclear, or hard to understand?

[Open-ended text format]

[Self-Efficacy]

36. After viewing this ad, how confident are you that you can speak with your students about the potential health effects and other harms of e-cigarette use in a way that will resonate with them?

1 Not at all confident

2

3

4

5 Extremely confident

[Outcome Expectation]

37. After viewing this ad, how confident are you that you can personally influence whether your students use e-cigarettes?

1 Not at all confident

2

3

4

5 Extremely confident

[Behavioral Intention – Talk with Students]

38. After viewing this ad, how likely are you to speak with your students about the potential health effects and other harms of e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Behavioral Intention – Learn More]

39. After viewing this ad, how likely are you to seek out more information about the potential health effects and other harms of youth e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Ad Credibility and Relevance]

40. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I believe the information in this ad.
This ad was created for people like me.

[Ad Visual Design]

41. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I like the way this ad looks.
The visuals in this ad are distracting.
The people in this ad look like the students or educators in my school.

[Recommended Ad Changes]

42. If you could change one thing about this ad, what would it be? Please be as specific as possible.

[Open-ended text format]

Section 2D. Material #4

[DISPLAY AD/MATERIAL. RANDOMIZE PRESENTATION ORDER. CONTINUE DISPLAYING STILL IMAGE OF AD/MATERIAL AT TOP OF SCREEN DURING Q43-53.]

Now, we would like you to answer the following questions based on the ad or material you saw.

[Perceived Ad Effectiveness]

43. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
This ad was worth remembering.
This ad grabbed my attention.
This ad was powerful.
This ad was informative.
This ad was meaningful.
This ad was convincing.

[Main Message Comprehension]

44. Imagine that you were describing this ad to someone else (like a friend or colleague). In your own words, how would you describe the main message of this ad?

[Open-ended text format]

[Confusion]

45. Is there anything about the ad that is confusing, unclear, or hard to understand? Please select all that apply.

• Yes

• No

[Confusion – Open-Ended]

46. [If Q45 = Yes] What part of the ad was confusing, unclear, or hard to understand?

[Open-ended text format]

[Self-Efficacy]

47. After viewing this ad, how confident are you that you can speak with your students about the potential health effects and other harms of e-cigarette use in a way that will resonate with them?

1 Not at all confident

2

3

4

5 Extremely confident

[Outcome Expectation]

48. After viewing this ad, how confident are you that you can personally influence whether your students use e-cigarettes?

1 Not at all confident

2

3

4

5 Extremely confident

[Behavioral Intention – Talk with Students]

49. After viewing this ad, how likely are you to speak with your students about the potential health effects and other harms of e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Behavioral Intention – Learn More]

50. After viewing this ad, how likely are you to seek out more information about the potential health effects and other harms of youth e-cigarette use?

1 Not at all likely

2

3

4

5 Extremely likely

[Ad Credibility and Relevance]

51. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I believe the information in this ad.
This ad was created for people like me.

[Ad Visual Design]

52. Please select how much you disagree or agree with each of the following statements.

[Randomize order]	1 Strongly disagree	2	3	4	5 Strongly agree
I like the way this ad looks.
The visuals in this ad are distracting.
The people in this ad look like the students or educators in my school.

[Recommended Ad Changes]

53. If you could change one thing about this ad, what would it be? Please be as specific as possible.

[Open-ended text format]

Section 3. Participant Characteristics (3 minutes)

[Subjects Taught]

54. [If teacher] Which of the following subjects do you currently teach? Select all that apply.

• Art

• Computer arts / Technology

• English / Language arts

• Foreign language (e.g., Spanish, French)

• Math

• Music / Band

• Physical education

• Science

• Social studies

• Special education

• Trade studies (e.g., mechanics)

• Other (please specify)

[Administrator or Staff Role]

55. [If administrator or staff] What is your role as an administrator or staff? Select the best response.

• Principal

• Assistant or vice principal

• Guidance counselor

• Other (please specify)

[Coaching Role]

56. [If coach] What sports or extracurricular activities do you coach at your school? Select all that apply.

• Basketball

• Baseball / Softball

• Football

• Lacrosse

• Soccer

• Swimming

• Tennis

• Chess

• Debate / Drama

• Engineering / Robotics

• Math or science competitions

• United Nations or student counsel

• Other sport (please specify)

• Other extracurricular (please specify)

[School Type]

57. In what type of school do you currently work?

• Public

• Private

• Other (please specify)

[School ZIP Code]

58. What is the ZIP code of the school where you work? We use this information to make sure that we include educators from many different geographic areas.

[Open-ended numeric]

[Education]

59. What is the highest level of school you completed or the highest degree you received?

• Associate’s degree

• Bachelor’s degree

• Master’s degree

• Doctoral degree

• Other (please specify)

[Previous Tobacco Use]

60. In the past, have you ever been a regular user of e-cigarettes or other tobacco products? Select all that apply.

• Yes, e-cigarettes (e.g., e-cigs, vapes)

• Yes, regular cigarettes (any form of tobacco wrapped in paper)

• Yes, other tobacco products (e.g., chewing tobacco)

• No

[Current Tobacco Use]

61. Do you currently use e-cigarettes or other tobacco products? Select all that apply.

• Yes, e-cigarettes (e.g., e-cigs, vapes)

• Yes, regular cigarettes (any form of tobacco wrapped in paper)

• Yes, other tobacco products (e.g., chewing tobacco)

• No

Debriefing

Thank you for completing this survey. You have been very helpful, and we appreciate your participation.

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