Form 0990 Debriefing

Form Approved OMB No. 0990-XXXX

Exp. Date XX/XX/2012

Debriefing Form

1. Hello, this is ____________ from Knowledge Networks. I am calling about the survey you took earlier today/yesterday/last day of week that asked your opinions on communication between you and your child. I also have another researcher who is also working on the project on the line with me – his/her name is ____________. ___________ is on the line to listen, ask a few questions of you, and try to understand how and why you answered the questions in the survey the way you did. We are still working to improve this survey. You are one of the first people to be asked to complete it, so we are very eager to hear your opinions about it.

Your answers will help us improve the questions and make the survey easier for other panel members. We will be asking you some specific questions, but if you have any other comments as we go along, please be sure to interrupt and let us know.

2. First, did you find any part of the survey difficult to understand? If so, what? [help the respondent to find the exact portion of the survey] What made this difficult to understand? What was it that you were not sure that you understood properly? Can you suggest ways of making that part easier to understand? Where there any other parts –of the survey that you found difficult to understand? [Repeat until R can no longer think of anything else].

3. Were there any parts during the survey where you weren’t sure what you were supposed to do? Specifically, what caused your uncertainty? Can you suggest ways of making that part easier to understand? Was there any other part of the survey that you weren’t sure what you were supposed to do? [Repeat until R can no longer think of anything else].

4. Now, I’m going to read a few sentences of the survey and I would like you try and remember what you first thought when you read them.

Waiting to have sex is the most effective way to prevent health risks like unwanted pregnancy or HIV/STDs.

 

What are your expectations about talking with {CHILD NAME}? If you talk early and often with {CHILD NAME} about sexual topics (such as waiting to be sexually active until he/she is older).

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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990- . The time required to complete this information collection is estimated to average ( hours)(minutes) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 537-H, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

By effectively talking with {CHILD NAME] about delaying sexual activity, you will be able to positively impact {CHILD NAME}’s future success and happiness.

If you can convince {CHILD NAME} to wait to have sex, he/she will have a better chance to succeed as an adult.

 

How often have you initiated conversations with {CHILD NAME} about sexual activity or waiting to have sex?

5. Now we would like to discuss the portion of the survey where we asked you to tell us about your PARENTAL BEHAVIOR. To refresh your memory, let us remind you of the questions we asked you about talking to your child about sexual activity.

We asked you 1) how often, 2) how much, 3) when, and 4) on what specific topics you have talked to your child about sexual activity. We would like to know what you thought when you read and answered each of those questions.

6. What type of organization or group do you think is paying for this survey? Why do you think that?

7. Do you have any other information or suggestions that would make this a better survey?

Thank you for your time. Goodbye.