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Foundational Focus Groups

ICR 202306-0990-001 · OMB 0990-0476 · Object 132403601.

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application/vnd.openxmlformats-officedocument.wordprocessingml.document
Foundational Focus Groups
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2021-01-15
2026-10-05
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Foundational Focus Group Master Screener

NOTES TO RECRUITERS
    • Recruit 8 to “seat” 4-6 participants.
    • 9 focus groups among the “movable middle” (mixed gender, mixed race, divided by age/generation). 
    • 3 focus groups among Black/African American, non-Hispanic adults only (mixed gender, divided by age/generation). 
    • 3 focus groups among Hispanic/Latinx adults only (mixed gender). Of these, there should be:
        ◦ 1 English-speaking focus group = Only English (Q7) OR English (Q8)
        ◦ 1 bilingual focus group = More English than Spanish OR Both English and Spanish Equally OR More Spanish than English (all Q7) AND Spanish (Q8)
        ◦ 1 Spanish-speaking focus group = Only Spanish (Q7) OR Spanish (Q8)
    • 3 focus groups among AI/AN adults only (mixed age, divided by gender). 
    • All groups must include a range of education levels and cities/states.
    • “Movable middle” groups must also include a mix of race/ethnicity.
    • All groups aside from AI/AN groups must include a roughly equal mix of genders.
    • Age ranges for the generational breaks are:
        ◦ 18-34
        ◦ 35-54
        ◦ 55+ (two-thirds of this group should be 65+)

SCREENER
Hello, my name is	 from [INSERT FACILITY NAME], a market research firm. We are recruiting for an upcoming study to get your thoughts and opinions about COVID-19 and how it is affecting life in the country today. This is not a sales call of any kind. I am only calling to see if you or an eligible member of your household has an interest in participating in a 90-minute focus group that will be conducted virtually for which you would receive a $75 incentive. I have a few questions I need to ask to see if you are qualified for this study. You don’t have to answer any question that you don’t want to answer.

    1. Are you interested in seeing if you or anyone in your household qualifies to participate in this focus group? [ACCEPT ONLY 1 PER HOUSEHOLD]

Yes
[  ]
> CONTINUE 
No
[  ]
> TERMINATE

    2. In the past five years, have you or a member of your immediate family worked in any of the following fields, companies, or organizations?
Market or public opinion research
[  ]
> TERMINATE
An advertising, public relations, or marketing agency
[  ]
> TERMINATE
News, radio, TV, print, media
[  ]
> TERMINATE
As a health care provider or medical professional (e.g., physician, nurse)
[  ]
> CONTINUE 
At a health care company
[  ]
> CONTINUE 
Construction, repair and maintenance
[  ]
> CONTINUE 
Finance
[  ]
> CONTINUE 
None of these
[  ]
> CONTINUE 

    3. In order to participate, you need to have a desktop or laptop computer or a smartphone with an internet connection. You will also need to consent to be recorded during the interview. Will you be able to meet both of these requirements?
Yes
[  ]
> CONTINUE 
No
[  ]
> TERMINATE

    4. Would you be willing and able to participate in this study via a webcam or smartphone camera?
Yes
[  ]
> CONTINUE 
No
[  ]
> TERMINATE

    5. Are you of Hispanic, Latino, or Spanish origin?
Yes
[  ]
> CONTINUE 
No
[  ]
> CONTINUE 

    6. What is your race? Please select all that apply.
White
[  ]
> CONTINUE 
Black or African American
[  ]
> CONTINUE 
American Indian or Alaska Native
[  ]
> CONTINUE 
Asian (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese)
[  ]
> CONTINUE 
Native Hawaiian or other Pacific Islander (e.g., Native Hawaiian Samoan, Chamorro, Tongan, Fijian, Marshallese)
[  ]
> CONTINUE 

ONLY ASK Q7 IF RECRUITING FOR HISPANIC/LATINO GROUPS.
    7. What language do you usually speak at home?
Only English
[  ]
> SKIP TO Q9 
More English than Spanish
[  ]
> CONTINUE to q8
Both English and Spanish equally
[  ]
> CONTINUE to q8
More Spanish than English
[  ]
> CONTINUE to q8
Only Spanish
[  ]
> skip to q9

    8. In what language would you prefer to participate in a focus group discussion?
English
[  ]
> CONTINUE 
Spanish
[  ]
> CONTINUE 

Note to Hispanic/Latino recruitment:
Here is the response option breakdown for the groups segmented by language:
    • English-speaking focus group = Only English (Q7) OR English (Q8)
    • Bilingual focus group = More English than Spanish OR Both English and Spanish Equally OR More Spanish than English (all Q7) AND Spanish (Q8)
    • Spanish-speaking focus group = Only Spanish (Q7) OR Spanish (Q8)
ONLY ASK Q9-Q11 IF RECRUITING FOR AI/AN GROUPS.

    9. Do you identify with a state- or federally-recognized tribe?
Yes
[  ]
> CONTINUE
No
[  ]
> TERMINATE

    10. What is the name of the state- or federally-recognized tribe you identify with? _______________ [RECORD VERBATIM]


    11. In what ways do you identify with this tribe? [SELECT ALL THAT APPLY.]
Enrolled
[  ]
> CONTINUE 
I have tribal affiliation or community attachment
[  ]
> CONTINUE 
None of the above
[  ]
> terminate 
RESUME ASKING ALL

    12. What is your gender?
Male
[  ]
> skip to q14
Female
[  ]
> skip to q14
Prefer to self-describe (specify)
[  ]
> CONTINue to q13 if recruiting for aian groups


    13. Because these focus groups are divided by gender, in which group, if any, would you prefer to participate?
Male
[  ]
> CONTINUE 
Female
[  ]
> CONTINUE 
Prefer not to participate

> TERMINATE

    14. What is your age? _______________ [RECORD VERBATIM, TERMINATE <18]
Note to recruitment: Recruit a mix of ages.
    15. What city and state do you live in?   CITY: ________________       STATE:_____________________
Note to recruitment: Recruit a mix of locations.
    16. To what extent do you agree or disagree with the following statement? The benefits of vaccines outweigh the risks. [RECRUIT A MIX]
Strongly disagree
[  ]
> TERMINATE 
Somewhat disagree
[  ]
> TERMINATE 
Neither disagree nor agree
[  ]
> CONTINUE 
Somewhat agree
[  ]
> CONTINUE 
Strongly agree
[  ]
> CONTINUE 

    17. If an FDA-authorized vaccine to prevent COVID-19 were available to you today at no cost, what is the likelihood you would get vaccinated? [RECRUIT A MIX]
Very unlikely
[  ]
> TERMINATE 
Somewhat unlikely
[  ]
> CONTINUE 
Neither likely nor unlikely
[  ]
> CONTINUE 
Somewhat likely
[  ]
> CONTINUE 
Very likely
[  ]
> CONTINUE 

    18. If an FDA-authorized vaccine to prevent COVID-19 were available to you today at no cost, how soon would you get vaccinated? [RECRUIT A MIX]
I would get vaccinated right away
[  ]
> CONTINUE 
Less than 1 month
[  ]
> CONTINUE 
1-3 months
[  ]
> CONTINUE 
4-6 months
[  ]
> CONTINUE 
7-12 months
[  ]
> CONTINUE 
More than 12 months
[  ]
> CONTINUE 
I would never get vaccinated
[  ]
> TERMINATE 

ONLY ASK Q19-Q21 IF RECRUITING FOR AI/AN GROUPS.
    19. I have spent time trying to find out more about being [AMERICAN INDIAN/ALASKA NATIVE], such as our history, traditions, and customs.

Yes
[  ]
> CONTINUE 
No
[  ]
> CONTINUE 

    20. I have participated in cultural traditions and/or ceremonies. 

Yes
[  ]
> CONTINUE 
No
[  ]
> CONTINUE 

    21. I look to my cultural traditions and community for health and well-being assistance (or help).

Yes
[  ]
> CONTINUE 
No
[  ]
> CONTINUE 
Note to AIAN RECRUITERS: Target “Yes” responses to Q19-21 for group scheduling.
RESUME ASKING ALL
    22. What is the highest level of school you have completed? [RECRUIT A MIX]
Some high school or less (no diploma)
[  ]
> CONTINUE 
High school diploma or equivalent (GED)
[  ]
> CONTINUE 
Some college, no degree
[  ]
> CONTINUE 
Associate degree
[  ]
> CONTINUE 
Bachelor’s degree
[  ]
> CONTINUE 
Master’s degree
[  ]
> CONTINUE 
Professional or doctorate degree
[  ]
> CONTINUE 

    23. Which of the following best describes you? Please select all that apply. [RECRUIT A MIX]
Employed full-time
[  ]
> CONTINUE to q21
Employed part-time
[  ]
> CONTINUE to q21
Self-employed
[  ]
> CONTINUE to q21
Not employed, but looking for work
[  ]
> skip to q22
Not employed, and not looking for work
[  ]
> skip to q22
Stay-at-home parent
[  ]
> skip to q22
Student
[  ]
> skip to q22
Retired
[  ]
> skip to q22

    24. From where are you currently working? [RECRUIT A MIX]
Working exclusively from home
[  ]
> CONTINUE 
Working exclusively from my workplace
[  ]
> CONTINUE 
Working both at home and my workplace
[  ]
> CONTINUE 

    25. Do you currently have any children under the age of 18 living at home? [RECRUIT A MIX]
Yes
[  ]
> CONTINUE 
No
[  ]
> CONTINUE 

    26. Last year—that is, in 2020—what was your total household income from all sources, before taxes? [RECRUIT A MIX, ENSURE ROBUST REPRESENTATION OF <$50K]
Less than $15,000
[  ]
> CONTINUE 
$15,000 to $24,999
[  ]
> CONTINUE 
$25,000 to $34,999
[  ]
> CONTINUE
$35,000 to $49,999
[  ]
> CONTINUE
$50,000 to $74,999
[  ]
> CONTINUE
$75,000 to $99,999
[  ]
> CONTINUE
$100,000 to $149,999
[  ]
> CONTINUE
$150,000 to $199,999
[  ]
> CONTINUE
$200,000 and over
[  ]
> CONTINUE
Don’t know/Refused

[  ]
> CONTINUE

Thank you for taking the time to answer these questions. We will be in touch with additional information on the study. The virtual focus group will last no longer than 90 minutes. Thank you again for your time and we will send additional information soon.