Form 1 Screener

ABCD Study Audience Feedback Teams OMB #0925-0781 | Expiration 03/31/2027

Parent/ Caregiver Phone Screener and Invitation

PAPERWORK REDUCTION ACT STATEMENT

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 5 minutes per response, including the time to review instructions and respond to questions. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, Attn: OMB-PRA 0925-0781.

Introduction

Hello, my name is _______________ and I’m calling from _________________ about an upcoming project managed by the National Institutes of Health. The National Institutes of Health—or NIH—is a government agency that supports research on health.

We would like to tell you more about the project and, if you are interested, ask you a short series of questions to see if you are eligible to participate. We estimate this to take an average of 5 minutes, and this information collection has been approved by the Office of Management and Budget under PRA 0925-0781.

NIH is looking for parents and caregivers of older teens for a dynamic and diverse parent/caregiver feedback team to share their thoughts and opinions about research on how brains develop from childhood to adulthood. We’ll discuss the kinds of questions scientists are asking about topics like teens’ health, life experiences, activities, and identities. We want to make sure scientists are asking these questions in the best way possible. We also want to get your opinions on material NIH has created to tell people about the study so that it can be engaging and relevant.

The feedback teams are groups of people who provide their thoughts and opinions through surveys, interviews, or bulletin board discussions. The input from these feedback teams will help the ABCD Study® researchers ask questions about life experiences in the best way possible.

Feedback teams started in 2024 will run for up to three years. Not every feedback team member will participate in every activity; team members will be invited to at least one, but no more than three feedback activities per year. All feedback team activities will take place online.

Participation in the feedback team is voluntary and you can stop being part of the team at any time. You can decide which feedback activities you want to join. Your individual responses and personal information will be kept private.

Is this something you would like to participate in? [RECORD YES/NO ANSWER, THEN READ TEEN FEEDBACK TEAM DESCRIPTION.]

We are also looking for older teens for a teen feedback team. Like the adult feedback team, teen feedback team members will be invited to survey, group discussion, or online bulletin board activities that will take place online.

If your teen participates, you must answer some eligibility questions and provide permission for them to participate in the feedback team. Your child will then need to answer a few eligibility questions.

Would your teen be interested in participating in the teen feedback team? [RECORD YES/NO ANSWER, THEN CONFIRM.]

Okay! I just want to confirm: [YOU, YOUR TEEN, BOTH YOU AND YOUR TEEN] are interested in participating in the [PARENT/CAREGIVER AND/OR TEEN] feedback team(s).

Eligibility Questions for Parents/Caregivers

We would like to hear feedback from a diverse group of people. We are now going to ask you some questions to get some basic information about your child, you, and your family. Do you consent to answering some basic questions? [RECORD YES/NO ANSWER, THEN CONFIRM.]

1. We will be conducting this feedback team online. To participate, [YOU/YOUR CHILD] will need to have access to one of the following: a desktop/laptop computer or tablet [tablet-type or hand-held computer device] with a video camera/web cam. Which one(s) do you or your child have available to use? [SELECT ALL THAT APPLY.]

   1. Desktop/laptop computer

   2. Tablet

   3. None of these [THANK AND TERMINATE CALL.]

1A. [ASK ALL] Do you have internet access?

_____Yes _____No [THANK AND TERMINATE CALL.]

1B. [ASK ALL] [DO YOU/DOES YOUR CHILD] have a private space where they can join the online discussion?

_____Yes _____No [THANK AND TERMINATE CALL.]

 

2. Which of the following describes your race or ethnicity? [choose one or more]

1. American Indian or Alaska Native

2. Asian

3. Black or African American

4. Hispanic or Latino

5. Middle Eastern or North African

6. Native Hawaiian or Other Pacific Islander

7. White

[RECRUIT A MIX, AS POSSIBLE.] 

The following questions are specifically about your child.

3. How old is your child?

   1. 17 years old

   2. 18 years old

   3. 19 years old [FOR AMERICAN INDIAN OR ALASKA NATIVE RESPONDENTS ONLY, IF UNABLE TO RECRUIT 17/18 YEAR OLDS OR THEIR PARENTS/CAREGIVERS.]

   4. Some other age [THANK AND TERMINATE CALL.]

4. What is your child’s gender? [ALLOW PARENT/CAREGIVER TO DESCRIBE UNPROMPTED; ALLOW MULTIPLE SELECTIONS, IF NEEDED.]

   1. Male

   2. Female

   3. Another gender identity

[RECRUIT A MIX.]

The following questions are specifically about you or the child’s family.

5. You are the:

   1. Child’s biological mother

   2. Child’s biological father

   3. Adoptive parent

   4. Child’s custodial parent

   5. Child’s other family member (grandparent, aunt, uncle)

   6. Other, please specify your relationship to the child ___________

[RECRUIT A MIX.]

6. Which of the following best describes the type of area you live in? [READ LIST.]

   1. Urban (city)

   2. Suburban

   3. Rural

   4. Small city or town

   5. American Indian or Alaska Native reservation [CLASSIFY AS RURAL.]

   6. Other. Please specify: ____________________

[RECRUIT A MIX.]

7. In which geographic region do you live?

   1. Northeast (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont)

   2. Midwest (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin)

   3. South (Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, Washington, D.C., and West Virginia)

   4. West (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming)

   5. Other U.S. territory (e.g., Puerto Rico, U.S. Virgin Islands)

8. What is the highest grade or level of school you have completed or the highest degree you have received?

1. Never attended/Kindergarten

2. 1st grade

3. 2nd grade

4. 3rd grade

5. 4th grade

6. 5th grade

7. 6th grade

8. 7th grade

9. 8th grade

10. 9th grade

11. 10th grade

12. 11th grade

13. 12th grade

14. High school graduate

15. GED or equivalent

16. Some college, no degree, or equivalent

17. Associate degree: Occupational, Technical, or Vocational

18. Associate degree: Academic Program

19. Bachelor's degree (e.g., B.A., A.B., B.S., B.B.S.)

20. Master's degree (e.g., M.A., M.S., M.Eng., M.Ed., M.B.A.)

21. Professional School degree (e.g., M.D., D.D.S., D.V.N., J.D.)

22. Doctoral degree (e.g., Ph.D., Ed.D.)

[RECRUIT A MIX.]

9. Now I want to ask a question about finances which might be slightly different from questions that you have seen before. Which of the following best describes your financial situation?

   1. Not enough to get by

   2. Just enough to get by

   3. We only have to worry about money for fun or extras

   4. We never have to worry about money

[RECRUIT A MIX.]

[IF ELIGIBLE AND CHILD IS ALSO PARTICIPACTING, ASK TO SPEAK TO CHILD AND PROCEED TO TEEN SCREENER.]

Suggested Language When Terminating a Call
Thank you very much for your time today. We are required to recruit a wide variety of participants to help with this project. Unfortunately, we have filled participant slots with your background. However, we thank you for your interest in this project.

Invitation to Feedback Teams

Thank you for answering my questions. We would like to invite you to join our parent/caregiver feedback team! The feedback teams started in 2024 will run for up to three years. There will be a maximum of three feedback activities per year. You can always choose which activities you join, and you can decide to stop being part of the feedback team at any time.

When a feedback activity is ready, we will reach out to team members with an invitation. For each feedback activity you join, we will send you a monetary token of appreciation for your time.

Would you like to join the parent/caregiver feedback team?

1. Yes [CONFIRM CONTACT INFORMATION FOR FEEDBACK ACTIVITY INVITATIONS.]

2. No [THANK AND DISMISS.]

Thanks so much for agreeing to be a part of the feedback team. Let me get the correct spelling of your name, your email, and your phone number(s). I will be contacting you to invite you to feedback team activities later this year.

NAME_______________________________________________________________________

EMAIL________________________________________________________________________

HOME PHONE_________________________________

CELL PHONE___________________________________

TODAY’S DATE________________________________

RECRUITER____________________________________

Invitation to Survey

You have been invited to take a survey. This survey will take no longer than 30 minutes to complete.

Please use this link to access the survey: _____________________

To make sure you get credit for completing the survey, you will be asked to put in a unique ID code.

Your ID code is: ___________

Please do not share this link or your ID code with anyone else, including other feedback team members.

Thank you!

Invitation to Virtual Discussion

You have been invited to participate in an interview. The virtual interview will take place on MONTH DAY, 202X, via Zoom. The interview will be no more than 30 minutes long.

Before your scheduled discussion, we will send you a confirmation text or email. We will also contact you the day before as a reminder.

If you decide not to participate, please let us know immediately. My name is ___________ and you can reach me at _____________.

Thank you!

Invitation to Online Bulletin Board

You are invited to join an online bulletin board discussion, which is set up like other online forums (such as Reddit, Facebook groups, or BabyCenter). On your own schedule while the board is open, you will join other members of the feedback team to answer some questions and share your thoughts. You will be asked a set number of questions each day. After you answer each question, you will be able to see how others in the forum answered the same question. You will be able to react to comments from other participants in the bulletin board forum as well as interact with the moderator. We expect this to take up to 60 minutes, including answering questions and commenting. We encourage you to check in over the X days to see new questions and reactions in the discussion.

The bulletin board will be open from TIME MONTH DAY, 202X, to TIME MONTH DAY, 202X. We will contact you as a reminder on the first day of the bulletin board.

Please use this link to access the bulletin board: _____________

As a reminder, please do not share this link with anyone else, including other members of the feedback team. This is to protect everyone’s privacy.

Thank you!

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