NHTSA Form 1710 Alcohol-Impaired Driving Segmentation Study Screener

NHTSA Alcohol-Impaired Driving Segmentation Study

Cognitive Testing—Webcam IDIs

Screener

Study Specs

• RECRUIT: Online/Phone screening

• MODE: Webcam IDI

• LENGTH: Up to 60-minutes

• SAMPLE: n=18

  • English (n=9)

  • Spanish (n=9)

• SAMPLE SOURCE: Recruiter Database

• QUALIFICATION CRITERIA:

  • U.S. Nationwide

  • 21- to 54-years-old

  • Licensed drivers (mix of vehicle/motorcycle)

  • Drives at least 10 miles per week

  • Consumes alcohol at least two to three times a month

  • MEETS AT LEAST ONE OF THE FOLLOWING CRITERIA

    • Heavy drinker (has more than 1.5 drinks per hour)

    • Drove vehicle after drinking, rode motorcycle after drinking or rode with a driver who had also been drinking in the last 12 months

    • Attitudes align with at least three out of seven risk statements

    • Has been stopped by law enforcement for reckless driving or driving while impaired

    • Has been involved in a crash in the last 12 months

  • ADDITIONAL CRITERIA FOR SPANISH INTERVIEWS:

    • Hispanic (or of Latino origin)

    • Foreign-born

    • Speaks Spanish all or most of the time at home

    • Consumes Spanish-language media (TV, radio, etc.) at home

ENGLISH SCREENER

Hello, may I please speak with ______________________? This is _________ from a national opinion research company.

Good morning/afternoon/evening. I am calling to see if you would be interested in participating in a research discussion about safe driving. Please be assured that we are not selling anything and that the information we gather from the following questions will remain completely confidential and be used for research purposes only.

I need to read a brief statement before I begin. This collection of information is voluntary and will be used for formative purposes only so that we may develop communications programs designed to reduce the number of traffic-related injuries and deaths. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0682. Your participation today in this collection of information is estimated to average five minutes, including the time for reviewing instructions. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave SE, Washington, DC, 20590.

May I ask you just a few, brief questions?

S1. What is your current age? _______ [RECRUIT A MIX]

[RECORD NUMERIC RESPONSE; CODE TO LIST BELOW]

1. Under 21-years-old THANK & TERMINATE

2. 21- to 24-years-old

3. 25- to 29-years-old

4. 30- to 34-years-old

5. 35- to 39-years-old

6. 40- to 44-years-old

7. 45- to 49-years-old

8. 50- to 54-years-old

9. 55-years-old or older THANK & TERMINATE

S2. Are you:

Mark all that apply. [RECRUIT A MIX]

1. Female

2. Male

3. Transgender, non-binary, or another gender

S3. Are you of Hispanic or Latino background (Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture of origin, regardless of race)?

1. Yes [TARGET TO RECRUIT n=2]

2. No

S4. What is your race? [RECRUIT A MIX]

[ALLOW MULTIPLE RESPONSES]

1. American Indian or Alaska Native

2. Asian

3. Black or African American [TARGET TO RECRUIT n=2]

4. Native Hawaiian or other Pacific Islander

5. White

S5. Do you have a valid driver’s license or motorcycle license?

1. Yes—Driver’s license only

2. Yes—Motorcycle license only

3. Yes—Both

4. No THANK & TERMINATE

S6. On average, how many miles do you typically drive each week? If you are unsure, use

your best guess.

1. Less than 10 miles THANK & TERMINATE

2. 10–14 miles

3. 15–19 miles

4. 20–24 miles

5. 25 miles or more

S7. Do you or does any member of your household currently work for…?

[THANK & TERMINATE 1-10]

1. Marketing, advertising, public relations or marketing research firm or division of a company

2. Graphic design

3. News media or journalism organization, including newspaper, television, radio or publishing

4. Law enforcement (including corrections officers, police officers, etc.)

5. Legal industry

6. Auto insurance

7. Local, state or federal government

8. Part-time or full-time ride-sharing, such as Uber or Lyft

9. Commercial or professional driving (NOTE TO RECRUITER: If necessary, to clarify, “commercial driving” means driving as a primary part of one’s occupation or job.)

10. Alcohol industry—including brewery, winery and distillery employees; wholesale distributors; and specialty retailers (liquor stores)

11. None of the above

S7a. What is your profession (i.e., job title)? [NOTE TO RECRUITER: Check to see if the response to S7a aligns with any field in S7; if so, THANK AND TERM]

_________________________

99. I am not employed

S8. Thinking about the last 12 months, on average, how often did you consume alcoholic

drinks?

By a drink, we mean half an ounce of absolute alcohol (e.g., a 12-ounce can or glass of beer or malt beverage, a five-ounce glass of wine or a drink containing one shot of liquor). Please feel free to estimate and provide an honest response.

1. Every day

2. Five to six times a week

3. Three to four times a week

4. Twice a week

5. Once a week

6. Two to three times a month

7. Once a month or less THANK & TERMINATE

S9. Thinking about the past 30 days, did you ever consume at least two alcoholic drinks within an hour?

1. Yes [CODE AS AT-RISK]

2. No

S10. Thinking about the past 30 days, how did you get home or travel after consuming alcoholic drinks? Please select all that apply.

1. Stayed at home/didn’t need to travel

2. Rode with a designated driver

3. Taxi or ride-sharing service

4. Public transportation

5. Rode with another driver who also consumed alcohol [CODE AS AT-RISK]

6. Drove myself [CODE AS AT-RISK]

7. Other

8. I don’t remember [CODE AS AT-RISK]

S11. How well do each of the following statements describe you?

	Not at all	Not too well	Somewhat Well	Very Well	Extremely Well
I only use a designated driver if absolutely necessary	1	2	3	4	5
I know when I have had too much to drink to drive safely	1	2	3	4	5
It is better to be safe than sorry when it comes to driving after drinking	1	2	3	4	5
I would not get upset if a friend or family member tried to stop me from driving after I had had a few drinks	1	2	3	4	5
It is hard to have a good time when I’m going out if I have to be the designated driver	1	2	3	4	5
I typically do not worry about how much alcohol I am drinking	1	2	3	4	5
I sometimes do not realize that I have had too much to drink	1	2	3	4	5

IF RESPONDENT SELECTS AT LEAST THREE SCORES HIGHLIGHTED IN YELLOW, CODE AS AT-RISK

S12. Have you ever been stopped by law enforcement for reckless or drunk driving?

1. Yes [CODE AS AT-RISK]

2. No

3. I prefer not to answer [CODE AS AT-RISK]

S13. Have you been involved in a crash in the last 12 months?

1. Yes [CODE AS AT-RISK]

2. No

3. I prefer not to answer [CODE AS AT-RISK]

S14. HIDDEN QUESTION—AT-RISK CLASSIFICATION

1. Yes

   1. Drinks at least two drinks per hour (S9) OR

   2. Drove/rode after drinking (S10) OR

   3. Exhibits at least three risky attitudes (S11) OR

   4. Stopped by law enforcement (S12) OR

   5. Involved in a crash (S13)

2. No THANK & TERMINATE

S15. Have you participated in a focus group in the past six months?

1. Yes THANK & TERMINATE

2. No

3. Don’t know/refused THANK & TERMINATE

S16. Which of the following best describes your employment status? [RECRUIT A MIX]

1. Employed full-time

2. Employed part-time

3. Unemployed

4. Student

5. Homemaker

6. Retired

7. Other: _________________ [IF MILITARY, RECODE TO 1 “Employed full-time”]

S17. What was the total combined annual income before taxes of all the members of your household, including yourself, in 2022? [RECRUIT A MIX]

1. Less than $25,000

2. $25,000–$49,999

3. $50,000–$74,999

4. $75,000–$99,999

5. $100,000–$149,999

6. $150,000 or more

7. [DO NOT READ] Decline to answer

S18. In what state do you reside?

1. Alabama

2. Alaska

3. Arizona

4. Arkansas

5. California

6. Colorado

7. Connecticut

8. Delaware

9. District of Columbia

10. Florida

11. Georgia

12. Hawaii

13. Idaho

14. Illinois

15. Indiana

16. Iowa

17. Kansas

18. Kentucky

19. Louisiana

20. Maine

21. Maryland

22. Massachusetts

23. Michigan

24. Minnesota

25. Mississippi

26. Missouri

27. Montana

28. Nebraska

29. Nevada

30. New Hampshire

31. New Jersey

32. New Mexico

33. New York

34. North Carolina

35. North Dakota

36. Ohio

37. Oklahoma

38. Oregon

39. Pennsylvania

40. Rhode Island

41. South Carolina

42. South Dakota

43. Tennessee

44. Texas

45. Utah

46. Vermont

47. Virginia

48. Washington

49. West Virginia

50. Wisconsin

51. Wyoming

S19. In which city do you live? ________________ [NOTE: HOLD & REVIEW IF MORE THAN 1 PER CITY/STATE]

S20. HIDDEN QUESTION—FOUR-POINT REGION RECODE [RECRUIT A MIX]

1. Northeast (S18=07,20,22,30,31,33,39,40,46)

2. Midwest (S18=14,15,16,17,23,24,26,28,35,36,42,50)

3. South (S18=01,04,08,09,10,11,18,19,21,25,34,37,41,43,44,47,49)

4. West (S18=02,03,05,06,12,13,27,29,32,38,45,48,51)

S21. Which of the following best describes your current marital status? [RECRUIT A MIX]

1. Single, never married

2. Married/Living with partner/Civil union

3. Divorced/Separated/Widowed

4. [DO NOT READ] Declined to answer

S22. Now, please use your imagination a bit. If you could plan your perfect trip to any location in America, where would you go and who would you take with you? Why? What would you do while you’re there?

[RECORD RESPONSE IN RECRUIT GRID]

[THANK & TERMINATE IF PARTICIPANT IS UNABLE TO FORMULATE A THOUGHTFUL AND COHERENT RESPONSE OR IF THE PARTICIPANT HAS A HEAVY ACCENT THAT MAKES IT DIFFICULT TO UNDERSTAND THEM]

SPANISH SCREENER (to be translated once approved)

Hello, may I please speak with ______________________? This is _________ from a national opinion research company.

Good morning/afternoon/evening. I am calling to see if you would be interested in participating in a research discussion about safe driving. Please be assured that we are not selling anything and that the information we gather from the following questions will remain completely confidential and be used for research purposes only.

I need to read a brief statement before I begin. This collection of information is voluntary and will be used for formative purposes only so that we may develop communications programs designed to reduce the number of traffic-related injuries and deaths. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0682. Your participation today in this collection of information is estimated to average five minutes, including the time for reviewing instructions. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave SE, Washington, DC, 20590.

May I ask you just a few, brief questions?

S1. Are you of Hispanic or Latino background (Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture of origin, regardless of race)?

1. Yes

2. No THANK & TERMINATE

S2a. Were you born in the U.S. or another country?

1. I was born in the U.S. THANK & TERMINATE

2. I was born in a U.S. territory

3. I was born in a country other than the U.S.

S2b. Where were you born? [RECRUIT A MIX]

1. Mexico

2. Puerto Rico

3. Cuba

4. Central America

5. South America

6. Europe

7. Someplace else

S3. What is your current age? _______ [RECRUIT A MIX]

[RECORD NUMERIC RESPONSE; CODE TO LIST BELOW]

1. Under 21-years-old THANK & TERMINATE

2. 21- to 24-years-old

3. 25- to 29-years-old

4. 30- to 34-years-old

5. 35- to 39-years-old

6. 40- to 44-years-old

7. 45- to 49-years-old

8. 50- to 54-years-old

9. 55-years-old or older THANK & TERMINATE

S4. Are you:

Mark all that apply. [RECRUIT A MIX]

1. Female

2. Male

3. Transgender, non-binary, or another gender

S5. Do you have a valid driver’s license or motorcycle license?

1. Yes—Driver’s license only

2. Yes—Motorcycle license only

3. Yes—Both

4. No THANK & TERMINATE

S6. On average, how many miles do you typically drive each week? If you are unsure, use

your best guess.

1. Less than 10 miles THANK & TERMINATE

2. 10–14 miles

3. 15–19 miles

4. 20–24 miles

5. 25 miles or more

S7a. Do you or does any member of your household currently work for…?

[THANK & TERMINATE 1-10]

1. Marketing, advertising, public relations or marketing research firm or division of a company

2. Graphic design

3. News media or journalism organization, including newspaper, television, radio or publishing

4. Law enforcement (including corrections officers, police officers, etc.)

5. Legal industry

6. Auto insurance

7. Local, state or federal government

8. Part-time or full-time ride-sharing, such as Uber or Lyft

9. Commercial or professional driving (NOTE TO RECRUITER: If necessary, to clarify, “commercial driving” means driving as a primary part of one’s occupation or job.)

10. Alcohol industry—including brewery, winery and distillery employees; wholesale distributors; and specialty retailers (liquor stores)

11. None of the above

S7b. What is your profession (i.e., job title)? [NOTE TO RECRUITER: Check to see if the response to S7b aligns with any field in S7a; if so, THANK AND TERM]

_________________________

99. I am not employed

S8. Thinking about the last 12 months, on average, how often did you consume alcoholic

drinks?

By a drink, we mean half an ounce of absolute alcohol (e.g., a 12-ounce can or glass of beer or malt beverage, a five-ounce glass of wine, or a drink containing one shot of liquor). Please feel free to estimate and provide an honest response.

1. Every day

2. Five to six times a week

3. Three to four times a week

4. Twice a week

5. Once a week

6. Two to three times a month

7. Once a month or less THANK & TERMINATE

S9. Thinking about the past 30 days, did you ever consume at least two alcoholic drinks within an hour?

1. Yes [CODE AS AT-RISK]

2. No

S10. Thinking about the past 30 days, how did you get home or travel after consuming alcoholic drinks? Please select all that apply.

1. Stayed at home/didn’t need to travel

2. Rode with a designated driver

3. Taxi or ride-sharing service

4. Public transportation

5. Rode with another driver who also consumed alcohol [CODE AS AT-RISK]

6. Drove myself [CODE AS AT-RISK]

7. Other

8. I don’t remember [CODE AS AT-RISK]

S11. How well do each of the following statements describe you?

	Not at all	Not too well	Somewhat Well	Very Well	Extremely Well
I only use a designated driver if absolutely necessary	1	2	3	4	5
I know when I have had too much to drink to drive safely	1	2	3	4	5
It is better to be safe than sorry when it comes to driving after drinking	1	2	3	4	5
I would not get upset if a friend or family member tried to stop me from driving after I had had a few drinks	1	2	3	4	5
It is hard to have a good time when I’m going out if I have to be the designated driver	1	2	3	4	5
I typically do not worry about how much alcohol I am drinking	1	2	3	4	5
I sometimes do not realize that I have had too much to drink	1	2	3	4	5

IF RESPONDENT SELECTS AT LEAST THREE SCORES HIGHLIGHTED IN YELLOW, CODE AS AT-RISK

S12. Have you ever been stopped by law enforcement for reckless or drunk driving?

1. Yes [CODE AS AT-RISK]

2. No

3. I prefer not to answer [CODE AS AT-RISK]

S13. Have you been involved in a crash in the last 12 months?

1. Yes [CODE AS AT-RISK]

2. No

3. I prefer not to answer [CODE AS AT-RISK]

S14. HIDDEN QUESTION—AT-RISK CLASSIFICATION

1. Yes

   1. Drinks at least two drinks per hour (S9) OR

   2. Drove/rode after drinking (S10) OR

   3. Exhibits at least three risky attitudes (S11) OR

   4. Stopped by law enforcement (S12) OR

   5. Involved in a crash (S13)

2. No THANK & TERMINATE

S15. Have you participated in a focus group in the past six months?

1. Yes THANK & TERMINATE

2. No

3. Don’t know/refused THANK & TERMINATE

S16. What language do you speak most often when you are at home?

1. Spanish all of the time

2. Spanish most of the time

3. Spanish and English equally THANK & TERMINATE

4. English most of the time THANK & TERMINATE

5. English all of the time THANK & TERMINATE

S17. In what language do you watch TV programming at home?

1. Spanish all of the time

2. Spanish most of the time

3. Spanish and English equally

4. English most of the time THANK & TERMINATE

5. English all of the time THANK & TERMINATE

S18. Which of the following best describes your employment status? [RECRUIT A MIX]

1. Employed full-time

2. Employed part-time

3. Unemployed

4. Student

5. Homemaker

6. Retired

7. Other: _________________ [IF MILITARY, RECODE TO 1 “Employed full-time”]

S19. What was the total combined annual income before taxes of all the members of your household, including yourself, in 2022? [RECRUIT A MIX]

1. Less than $25,000

2. $25,000–$49,999

3. $50,000–$74,999

4. $75,000–$99,999

5. $100,000–$149,999

6. $150,000 or more

7. [DO NOT READ] Decline to answer

S20. In what state do you reside?

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana

Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon

Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

S21. In which city do you live? ________________ [NOTE: HOLD & REVIEW IF MORE THAN 1 PER CITY/STATE]

S22. HIDDEN QUESTION—FOUR-POINT REGION RECODE [RECRUIT A MIX]

1. Northeast (S20=07,20,22,30,31,33,39,40,46)

2. Midwest (S20=14,15,16,17,23,24,26,28,35,36,42,50)

3. South (S20=01,04,08,09,10,11,18,19,21,25,34,37,41,43,44,47,49)

4. West (S20=02,03,05,06,12,13,27,29,32,38,45,48,51)

S23. Which of the following best describes your current marital status? [RECRUIT A MIX]

1. Single, never married

2. Married/Living with partner/Civil union

3. Divorced/Separated/Widowed

4. [DO NOT READ] Declined to answer

S24. Now, please use your imagination a bit. If you could plan your perfect trip to any location in America, where would you go and who would you take with you? Why? What would you do while you’re there?

[RECORD RESPONSE IN RECRUIT GRID]

[THANK & TERMINATE IF PARTICIPANT IS UNABLE TO FORMULATE A THOUGHTFUL AND COHERENT RESPONSE OR IF THE PARTICIPANT HAS A HEAVY ACCENT THAT MAKES IT DIFFICULT TO UNDERSTAND THEM]

IMPAIRED SEGMENTATION COGNITIVE TESTING IDI—INVITATION

Thank you for answering my questions. We are inviting a select number of people to participate in an online, one-on-one research discussion. During this conversation, you will be asked to share your thoughts and reactions to an online survey that is being developed for drivers like yourself across the country. The discussion will last about an hour and during that time you will complete an online survey and talk about the experience. The goal is to evaluate the survey to make sure the questions are clear, easy to understand and the response options all make sense. You will share your feedback on the process with a research interviewer who will be observing. Again, this interview is for research purposes only. You will never be asked to purchase anything, and all of your responses and comments will remain strictly confidential. In appreciation for your feedback, we are offering $100 for your participation.

The interviews will be held on the following days/times (Eastern Time):

INSERT INTERVIEW CALENDAR - TBD

 

S25. Would you be available to join us during one of those days/times?

1. Yes

2. No THANK & TERMINATE

S26. Will you be able to participate in a safe, stationary environment—meaning not while in a vehicle—during the focus group?

1. Yes

2. No THANK & TERMINATE

S27. Will you be able to participate in a quiet, distraction-free environment?

1. Yes

2. No THANK & TERMINATE

S28. Will you have access to a computer (laptop or desktop—not a tablet or smartphone) with a high-speed internet connection so you can participate in the online interview during that day/time?

1. Yes

2. No THANK & TERMINATE

S29. Does your computer have a working webcam?

1. Yes

2. No THANK & TERMINATE

S30. Are you comfortable participating in a video call and sharing your screen so the interviewer can observe you while you complete the online survey?

1. Yes

2. No THANK & TERMINATE

Just so I can confirm what we just talked about, what is your name and email address?

NAME: ______________________________________________

EMAIL ADDRESS: [CONFIRM FROM ABOVE]

[THANK & TELL THEM THEY WILL RECEIVE A “REMINDER” CALL AND A VERIFICATION EMAIL AS THE DATE GETS NEARER AND POLITELY END THE CALL.]

NHTSA Form Number 1710