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ASPA_CET Weekly Survey_3_19_21_FINAL
ICR 202112-0990-005 · OMB 0990-0476 · Object 117278501.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | ASPA_CET Weekly Survey_3_19_21_FINAL |
| Author | Lindsey Strausser |
| Last Modified By | Writer |
| File Modified | 2021-03-16 |
| File Created | 2026-08-24 |
| Conversion State | complete |
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CET – Annotated Questionnaire (Wave 8) Note: The questions below are the proposed questions for the eighth wave of the Weekly Current Events Tracker (CET). Questions highlighted in yellow will be asked every week; questions highlighted in blue will be rotated into the survey on a monthly basis; and questions highlighted in green are meant to be asked in Wave 8 only or are being asked again to update data on a variable of interest. This wave’s module is Vaccine Knowledge and Preferences. This week’s new question set examines vaccine access, registration, and eligibility. ASPA will provide OMB with updates to the questionnaire for subsequent Waves. Standard Questions Modular Questions One-Time or Repeat Questions Being Asked Again to Update Data For the next section we would like to talk about current events. // Page Break // //PROGRAMMING NOTE: RANDOMIZE ORDER OF Q1/Q2 and Q3/Q4 (I.E., 50% SEE Q1/Q2 FIRST, 50% SEE Q3/Q4 FIRST)// //BASE: All respondents// Item #: Q1 Question type: Single punch // Soft Prompt: “We would like your response to this question.” // hhs_fam: How familiar are you with the U.S. Department of Health and Human Services (HHS)? Variable Label: hhs_fam: Familiarity with HHS Value Value Label 1 Not at all familiar 2 Slightly familiar 3 Moderately familiar 4 Very familiar -99 Refused // Page Break // //BASE: hhs_fam= 2, 3, 4, OR -99// Item #: Q2 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // hhs_trust. How much trust do you have in the U.S. Department of Health and Human Services (HHS) to provide you with accurate information about the coronavirus or COVID-19? Variable Label: hhs_trust: Trust in HHS Value Value Label 1 None at all 2 Not very much 3 A fair amount 4 A great deal -99 Refused -100 Valid skip // Page Break // //BASE: All respondents// Item #: Q3 Question type: Single punch // Soft Prompt: “We would like your response to this question.” // cdc_fam: How familiar are you with the Centers for Disease Control and Prevention (CDC)? Variable Label: cdc_fam: Familiarity with HHS Value Value Label 1 Not at all familiar 2 Slightly familiar 3 Moderately familiar 4 Very familiar -99 Refused // Page Break // //BASE: cdc_fam= 2, 3, 4, OR -99// Item #: Q4 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // cdc_trust. How much trust do you have in the Centers for Disease Control and Prevention (CDC) to provide you with accurate information about the coronavirus or COVID-19? Variable Label: cdc_trust: Trust in CDC Value Value Label 1 None at all 2 Not very much 3 A fair amount 4 A great deal -99 Refused -100 Valid skip // Page Break // //BASE: All respondents// Item #: Q5 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // vacc_off. How much do you trust U.S. federal public health officials to provide reliable information on COVID-19? Variable Label: vacc_off: Confidence in U.S. public health officials Value Value Label 1 None at all 2 Not very much 3 A fair amount 4 A great deal -99 Refused // Page Break // //BASE: All respondents// Item #: Q6 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // vacc_trust. How much trust do you have that an FDA-authorized COVID-19 vaccine may be safe and effective for you to get? Variable Label: vacc_trust: Trust in Safety of Vaccine Value Value Label 1 None at all 2 Not very much 3 A fair amount 4 A great deal -99 Refused // Page Break // //BASE: All respondents// Item #: Q7 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // beh1_cet. Food and Drug Administration (FDA)-authorized vaccines to prevent COVID-19 are now available at no cost. Have you received a COVID-19 vaccine? Variable Label: beh1: Vaccination behavior Value Value Label 0 No, I have not received a COVID-19 vaccine 1 Yes, but I have only received one shot out of the two required shots 2 Yes, I have received all of the required shots -99 Refused // Page Break // //BASE: beh1_cet =0 OR -99// Item #: Q8 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // beh2a_cet. What is the likelihood that you will get a COVID-19 vaccine? Variable Label: beh2a: Intention to get vaccinated Value Value Label 1 Very unlikely 2 Somewhat unlikely 3 Neither likely nor unlikely 4 Somewhat likely 5 Very likely -99 Refused -100 Valid Skip // Page Break // //BASE: beh1_cet=1// Item #: Q9 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // beh2b_cet. What is the likelihood that you will complete COVID-19 vaccination? Variable Label: BEH2b_CET: Intention to complete vaccination Value Value Label 1 Very unlikely 2 Somewhat unlikely 3 Neither likely nor unlikely 4 Somewhat likely 5 Very likely -99 Refused -100 Valid Skip // Page Break // //BASE: beh1_cet =0 OR -99// Item #: Q10 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // beh3a_cet. Food and Drug Administration (FDA)-authorized vaccines to prevent COVID-19 are now available at no cost. How soon will you get vaccinated? For this question, assume there is enough vaccine so that everyone who wants it can get it. Variable Label: BEH3a_CET: Wait to get vaccinated Value Value Label 1 I will get a vaccine as soon as I can 2 I will wait to get a vaccine for one or more reasons 3 I will never get a COVID-19 vaccine -99 Refused -100 Valid Skip // Page Break // //BASE: beh1_cet =1// Item #: Q11 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // beh3b_cet. Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 are now available at no cost. How soon will you get the second required dose? For this question, assume there is enough vaccine so that everyone who wants it can get it. Variable Label: BEH3b_CET: Wait to complete vaccination Value Value Label 1 I will get the second required dose as soon as I can 2 I will wait to get the second required dose for one or more reasons 3 I will never get the second required COVID-19 dose -99 Refused -100 Valid Skip // Page Break // //BASE beh3a_cet =2// Item #: Q12-Q14 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // beh4_cet. You responded that you will wait to get a COVID-19 vaccine. For each of the following statements, is this a reason why you would wait to get a COVID-19 vaccine? Select yes or no for each item. Variable Label: BEH4_CET: Reasons: Waiting to get vaccinated //PROGRAMMING NOTE: RANDOMIZE BEH3_1_CET-BEH3_10_CET Variable Name Variable Text Variable Label beh4_1_cet I will wait because of my age. beh4_1_cet: Age beh4_2_cet I will wait because of my health status, allergies, or medical history. beh4_2_cet: Health beh4_3_cet I want to know if the vaccine is effective first. beh4_3_cet: Confirm effectiveness beh4_4_cet I am pregnant or expect to become pregnant. beh4_4_cet: Pregnant beh4_5_cet I want to talk to my doctor first. beh4_5_cet: Talk to doctor first beh4_6_cet I want to compare the effectiveness of the different vaccines. beh4_6_cet: Compare vaccines beh4_7_cet I want to see if my friends and family get the vaccine. beh4_7_cet: Friends/family beh4_8_cet I want to see if others who get the vaccine first develop any problems. beh4_8_cet: Side effects beh4_9_cet I want to make sure it is safe for people like me first. beh4_9_cet: Confirm safety beh4_10_cet I want to hear from leaders in my community about the vaccine first. beh4_10_cet: Hear from leaders beh4_11_cet Other beh4_11_cet: Other Value Value Label 0 No 1 Yes -99 Refused -100 Valid skip // Page Break // //BASE: All respondents// Item #: Q15-Q16 Question Type: Multi-Punch Grid // Soft Prompt: “We would like your response to this question.” // vacc_type_know. There are three COVID-19 vaccines currently authorized by the FDA, and more will likely be authorized soon. Please tell us what you know about the different COVID-19 vaccines. Variable Label: vacc_type_know: Knowledge of vaccine types //PROGRAMMING NOTE: RANDOMIZE vacc_type_know_1-vacc_type_know_7// //PROGRAMMING NOTE: RESPONDENTS CAN SELECT MULTIPLE OPTIONS FOR 1-4. OPTION 5 (DON’T KNOW) SHOULD BE EXCLUSIVE.// Variable Name Variable Text Variable Label vacc_type_know_1 Is a one-dose vaccine vacc_type_know_1: Vaccine knowledge: One dose vacc_ type_know_2 Side effects are milder than with other vaccines vacc_ type_know_2: Vaccine knowledge: Milder side effect vacc_ type_know_3 Is effective at preventing COVID-19 vacc_ type_know_3: Vaccine knowledge: Effective at prevention vacc_ type_know_4 Is effective at reducing the symptoms of COVID-19 vacc_ type_know_4: Vaccine knowledge: Effective at reducing symptoms vacc_ type_know_5 Has been authorized by the FDA vacc_ type_know_5: Vaccine knowledge: Authorized vacc_ type_know_6 Is now being used to vaccinate people in the United States vacc_ type_know_6: Vaccine knowledge: Now in use vacc_ type_know_7 Is effective at reducing the symptoms of all COVID-19 variants vacc_ type_know_7: Vaccine knowledge: Effective against variants Value Value Label 1 Pfizer-BioNTech 2 Moderna 3 Johnson & Johnson 4 AstraZeneca 5 Don’t know -99 Refused Value Value Label 0 Not selected 1 Selected // Page Break // //PROGRAMMING NOTE: DISPLAY IF beh1_cet=0 or -99// Item #: Q17 Question Type: Grid (exclusive options) // Soft Prompt: “We would like your response to this question.” // vacc_choice. Please rank the following in your decision to get a COVID-19 vaccine. Variable Label: vacc_choice: Factors on vaccine choice //PROGRAMMING NOTE: RANDOMIZE vacc_choice_1-vacc_choice5// //PROGRAMMING NOTE: MAKE EACH COLUMN EXCLUSIVE, SO EACH RESPONSE OPTION CAN ONLY BE SELECTED ONCE.// Variable Name Variable Text Variable Label vacc_choice_1 Only having to take one dose vacc_choice_1: One dose vacc_choice_2 Side effects are milder than with other vaccines vacc_choice_2: Side effects vacc_choice_3 Effectiveness at preventing COVID-19 vacc_choice_3: General effectiveness vacc_choice_4 Effectiveness at reducing the symptoms of all COVID-19 variants vacc_choice_4: Variant effectiveness vacc_choice_5 Getting the vaccine as soon as possible vacc_choice_5: Getting soon Value Value Label 1 1 – Least important 2 2 3 3 4 4 5 5 – Most important -99 Refused -100 Valid skip // Page Break // //BASE: All respondents// Item #: Q18 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // vacc_type_diff. How much do you agree or disagree with the following statement: There are major differences between the vaccines (e.g., Pfizer-BioNTech, Moderna, Johnson & Johnson). Variable Label: vacc_type_diff: Perceived differences in vaccines Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused // Page Break // //PROGRAMMING NOTE: DISPLAY IF beh1_cet =0 or -99// Item #: Q19 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // vacc_pref. If you were able to get any COVID-19 vaccine, which vaccine would you prefer to get? Variable Label: vacc_pref: Vaccine preference Value Value Label 1 Pfizer-BioNTech 2 Moderna 3 Johnson & Johnson 4 AstraZeneca 5 Other 6 I do not have a vaccine preference -99 Refused -100 Valid skip //PROGRAMMING NOTE: DISPLAY wait_vacc IF beh1_cet =0 or -99.// Item #: Q20 Question Type: Grid // Soft Prompt: “We would like your response to this question.” // wait_vacc. How much do you agree or disagree with the following statements? Variable Label: wait_vacc: Wait for Vaccine Type or Doses //PROGRAMMING NOTE: RANDOMIZE wait_vacc_type & wait vacc_dose Variable Name Variable Text Variable Label wait_vacc_type I would wait longer to get vaccinated if it meant getting my preferred vaccine type. wait_vacc_type: Wait for Preferred Type wait_vacc_dose I would wait longer to get vaccinated if it meant getting a vaccine with only one dose. wait_vacc_dose: Wait for Preferred Doses Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused -100 Valid skip // Page Break // //BASE: All respondents// Item #: Q21 Question Type: Grid // Soft Prompt: “We would like your response to this question.” // fair_access. How much do you agree or disagree with the following statements? Variable Label: fair_access: Fair Access to COVID-19 Vaccine //PROGRAMMING NOTE: RANDOMIZE fair_access_1 to fair_access_3// Variable Name Variable Text Variable Label fair_access_1 I believe that everyone has fair access to getting a COVID-19 vaccine. fair_access_1: Everyone fair_access_2 I believe that my family has fair access to getting a COVID-19 vaccine. fair_access_2: My Family fair_access_3 I believe that I have fair access to getting the COVID-19 vaccine. fair_access_3: Myself fair_access_4 I believe that the COVID-19 vaccination rollout has been in the best interest of people in my race/ethnicity group. fair_access_4: Race/eth best interest fair_access_5 I believe that people in my race/ethnicity group have been treated fairly during the COVID-19 vaccination rollout. fair_access_5: Race/eth fairness Value Value Label 1 Strongly disagree 2 Disagree 3 Neither agree nor disagree 4 Agree 5 Strongly agree -99 Refused // Page Break // //Base: beh1_cet =0 OR -99// Item #: Q22 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // vacc_eligible_now. Are you currently eligible to get a COVID-19 vaccine? Variable Label: vacc_eligible_now: Vaccine eligibility now Value Value Label 1 Yes 2 No 3 I don’t know -99 Refused // Page Break // //PROGRAMMING NOTE: DISPLAY IF vacc_eligible_now=1 OR beh1_cet=1 or 2// Item #: Q23-Q24 Question Type: Grid // Soft Prompt: “We would like your response to this question.” // vacc_signup_source. How much [PIPE: “have” if vacc_eligible_now=1, “did” if beh1_cet=1 or 2] each of the following people helped you with the COVID-19 vaccine registration and appointment processes (e.g., provided information or tips, helped you to register, took you to or from an appointment)? //PROGRAMMING NOTE: RANDOMIZE vacc_signup_source1- vacc_signup_source9.// Variable Name Variable Text Variable Label vacc_signup_source1 Myself vacc_signup_source1: Myself vacc_signup_source2 Friends vacc_signup_source2: Friends vacc_signup_source3 Immediate family members vacc_signup_source3: Immediate family members vacc_signup_source4 Extended family members vacc_signup_source4: Extended family members vacc_signup_source5 Neighbors in my community vacc_signup_source5: Neighbors in my community vacc_signup_source6 My employer vacc_signup_source6: My employer vacc_signup_source7 My place of worship vacc_signup_source7: My place of worship vacc_signup_source8 My pharmacist/pharmacy vacc_signup_source8: My pharmacist/pharmacy vacc_signup_source9 My family physician vacc_signup_source9: My family physician vacc_signup_source10 Other vacc_signup_source10: Other Value Value Label 1 Not at all 2 Not very much 3 A fair amount 4 A great deal 99 Not applicable -99 Refused -100 Valid skip // Page Break // //PROGRAMMING NOTE: DISPLAY IF vacc_eligible_now=1 OR beh1_cet=1 or 2// Item #: Q25 Question Type: Grid // Soft Prompt: “We would like your response to this question.” // vacc_reg_difficulty. When it comes to getting a COVID-19 vaccine, how difficult has it been for you to register for or schedule a vaccine appointment? Variable Label: vacc_reg_difficulty: Vaccine registration difficulty Value Value Label 1 Not at all difficult 2 Slightly difficult 3 Moderately difficult 4 Very difficult -99 Refused -100 Valid skip