Focus Group Screener

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Screener
HRSA Focus Groups Related to Organ Donation

Summary of recruiting specifications


(RECRUIT 6 PER GROUP)

1. Thank you for your interest in this project. We are recruiting people to attend a focus group that will take place online from [time] on [date]. All participants will be paid $100 for their time. If you are eligible for the study, would you be interested in participating?
    A. Yes
    B. No (THANK AND END)

Note whether respondent is male or female and recruit a mix.
    A. Male
    B. Female

2. To begin, thinking about organ donation, do you do you strongly support, support, oppose, or strongly oppose organ donation?
    A. Strongly support
    B. Support
    C. Oppose (THANK AND END)
    D. Strongly Oppose (THANK AND END)

3. Are you a registered organ donor, either by registering on your driver’s license, a donor card, or an organ donor registry?
    A. Yes (THANK AND END)
    B. No

4. Now, I need to ask you some basic information. Which category best describes your age?
    A. Under 21 (THANK AND END)
    B. 21–35
    C. 36–49
    D. 50–65
    E. 66 or older
Recruit a mix of ages.

5. What is the highest grade you have completed in school? [READ LIST IF NECESSARY]
    A. 8th grade or less
    B. Some high school (grades 9, 10, or 11)
    C. High school graduate or GED (High school equivalency)
    D. Some college/2-year college/technical school/associate degree
    E. College graduate
    F. Some graduate school/post-graduate degree
Recruit a mix of education levels.

6. We want to make sure we represent different ethnic and racial groups in our study. Would you describe yourself as [SELECT ALL THAT APPLY]:
    A. White (THANK AND END)
    B. Black or African American
    C. Asian
    D. Native Hawaiian or Other Pacific Islander
    E. Hispanic or Latino/Latina
    F. American Indian or Alaskan Native
Some sessions will be single ethnicity. Others will be mixed.

7. What is your present occupation? ___________________
    A. Related to organ donation (THANK AND END)
    B. Related to market research (THANK AND END)
    C. All others

8. Have you ever participated in a focus group or been paid to be part of a discussion group?
    A. Yes
    B. No (SKIP TO Q10)

9. How recently did you participate in this focus group or discussion group?
    A. Within the past six months (THANK AND END)
    B. More than six months ago

10. Thank you. We are conducting an informal group discussion on issues related to organ donation, and your views would be valuable in helping us better understand this issue. The discussion will take place online on [date] at [time]. The discussion will last 90 minutes, and there will be no attempt to sell you anything or convince you to register as a donor. We are 
simply interested in your opinions. We will pay you $100 as a way of thanking you for participating. Would you be interested in attending?
    A. No (THANK AND END)
    B. Yes

11. Great! We would like to send you a message to confirm your participation in this study, and we will also call you the day before to remind you. Can you please provide me with your …?
NAME:
E-MAIL ADDRESS:
PHONE NO:
** Double check spelling of name and read back phone and e-mail to confirm ***

12. It is very important that you let us know right away if you will not be able to attend this discussion so that we may have time to find a replacement. Will you call us at [phone] if for some reason you cannot attend? [WAIT FOR AN ANSWER]

Thank you for your time and for agreeing to participate. We look forward to having you participate!