OMB No. 0910-0711
Expiration Date: 06/30/2014
PUBLIC Disclosure Burden Statement
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:
Department of Health and Human Services
Food and Drug
Administration
CFSAN/PRA Comments/HFS-24
5100 Paint Branch
Parkway
College Park, MD 20740-3835.
Thank you for responding to the invitation to participate in this survey on a recent foodborne illness outbreak or food product recall.
Please be assured that all of your answers are kept confidential and no personal identifying information is retained with your answers. If any part of the survey makes you uncomfortable, please feel free to stop at any time.
We are interested in what you have heard about the current outbreak of illness from ++Hepatitis A++ in ++frozen berries ++. We are interested in ++frozen berries ++ that you would buy at a store or have at a food establishment away from home. This survey will take about 10 minutes to complete. Please allow enough time to complete the entire survey in one sitting. All responses will be kept confidential.
1. Have you heard or read anything in the ++last week++ about health risks related to eating raw ++frozen berries ++? That is, have you heard or read anything in the ++last week++ that some ++frozen berries ++ are potentially contaminated with disease-causing organisms?
1. Yes
0. No
98. Don’t know
1a. Have you heard or read anything in the++ last week ++about a ++frozen berries ++ recall? That is, have you heard or read anything in the ++last week ++ about returning frozen berries to the store, or discarding ++frozen berries ++ that are potentially contaminated with disease-causing organisms?
1. Yes
0. No
98. Don’t know
2. Have you seen anything on television in the last week about a ++frozen berries ++ recall?
1. Yes
0. No
98. Don’t know
3. Have you seen anything in the newspaper in the last week about a ++frozen berries ++ recall?
1. Yes
0. No
98. Don’t know
4. Have you seen anything on the internet in the last week about a ++frozen berries ++ recall?
1. Yes
0. No
98. Don’t know
4a. Have you heard anything on the radio in the last week about a ++frozen berries ++ recall?
1. Yes
0. No
98. Don’t know
(did not hear about recall thru ANY media at all), skip to Q12, OTHERWISE CONTINUE]
We want to ask about what you remember about the outbreak of illness from ++Hepatitis A ++ and the ++frozen berries ++ recall.
5a. Did you hear “Do not eat any ++frozen berries ++”?
1. Yes [CONTINUE – ASK 6a]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6a. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
5b. Did you hear “Do not eat certain types of ++frozen berries ++ ”?
1. Yes [CONTINUE – ASK 6b]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6b. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
5c. Did you hear “Do not eat certain brands of ++frozen berries ++ ”?
1. Yes [CONTINUE – ASK 6c]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6c. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
5d. Did you hear “Cook ++frozen berries ++ well before eating”?
1. Yes [CONTINUE – ASK 6d]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6d. How likely are you /would you be to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
5e. Did you hear “Return ++frozen berries ++ to the food store”?
1. Yes [CONTINUE – ASK 6e]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6e. How likely are you /would you be to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
5f. Did you hear “Discard ++frozen berries ++ ”?
1. Yes [CONTINUE – ASK 6f]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6f. How likely are you /would you be to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
5g. Did you hear something else about ++frozen berries ++?
Please elaborate OPEN ENDED ALLOW MORE SPACE FOR OPEN ENDED ANSWER- non-mandatory]
1. Yes [CONTINUE – ASK 6g]
0. No [Go to Q7]
98. Don’t know [Go to Q7]
6g. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
9. Did not hear advice
7. Did you seek out any of the following sources for information about the ++frozen berries ++ recall?
[RANDOMIZATION]
|
Yes |
No |
Don’t know |
7a. The Centers for Disease Control, or CDC, website |
|
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7b. The Food and Drug Administration, or FDA, website |
|
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7c. The U.S. Department of Agriculture, or USDA, website |
|
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7d. The FoodSafety.gov website |
|
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7e. News websites |
|
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7f. Food company websites |
|
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7g. The Centers for Disease Control, or CDC, 1-800 number |
|
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7h. The Food and Drug Administration, or FDA, 1-800 number |
|
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7i. Your State department of health |
|
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7j. Newspapers or television |
|
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7k. Blog articles, podcasts, or other social media sources |
|
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7l. Your local grocery store or food market |
|
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8. How informed would you say you are about the current ++frozen berries ++ recall , if 1 means you are not at all informed and 10 means you are very well informed?
1- Not at all informed
10-Very well informed
98. Don’t know
9a. On the same 10-point scale, how informed would you say you are about….
Select one for each statement
Not at all informed
Very well informed
98. Don’t know
a. The causes of ++Hepatitis A++ contamination in the current ++frozen berries ++ recall
b. What the government is doing to find the source of the ++Hepatitis A++ problem for the ++frozen berries ++ recall
c. What manufacturers/retailers are doing to find the source of the ++Hepatitis A++ problem for the ++frozen berries ++ recall
9b. On the same 10-point scale, how informed would you say you are about….
Select one for each statement
Not at all informed
Very well informed
98. Don’t know
d. The number of U.S. States involved in the ++frozen berries ++ recall.
e. Whether the State where you live is involved in the ++frozen berries ++ recall.
f. What the government is doing to make sure the ++frozen berries ++ recall doesn’t happen again
g. Ways to protect yourself from ++frozen berries ++ contaminated with ++Hepatitis A++
10. Using a 10-point scale, how informed about the current ++frozen berries ++ recall would you say are the grocery stores or markets where you usually purchase food?
1 Not at all informed
10-Very well informed
98. Don’t know
11. Using a 10-point scale, how safe do you think it is to eat ++frozen berries ++ associated with the ++frozen berries ++ recall?
1- Not at all safe
10-Very safe
98. Don’t know
12. In the past year, have you eaten raw ++frozen berries ++?
1. Yes
0. No
98. Don’t know
13. In the past month, did you eat any raw ++frozen berries ++?
1. Yes
0. No
98. Don’t know
98. Don’t know
14. Have you eaten any raw ++frozen berries ++ this week?
1. Yes
0. No
98. Don’t know
15. Do you currently have any raw ++frozen berries ++ in your home?
1. Yes
0. No
98. Don’t know
16. Would you say that raw ++frozen berries ++ are regular part of your daily food intake?
1. Yes
0. No
98. Don’t know
17. Weekly food intake?
1. Yes
0. No
98. Don’t know
18. Monthly food intake?
1. Yes
0. No
98. Don’t know
19. Since hearing about the recall, have you changed how much raw ++frozen berries ++ you eat? Are you eating:
Select one best answer
1. More raw ++frozen berries ++ .
2. The same amount of raw ++frozen berries ++ .
3. Less raw ++frozen berries ++ .
4. No raw ++frozen berries ++ at all since hearing about the recall.
5. Only raw ++frozen berries ++ that are not part of the recall.
8. Don’t know
19a.Which of the following is true? I have not eaten raw ++frozen berries ++ because.. .
.Choose all that applies
19.a.1. No particular reason
19.a.2. I have not had a taste for ++frozen berries ++
19.a.3. I have not had the opportunity
19.a.4. I want to avoid becoming ill
19.a.5. I want to follow the health advisory
19.a.6. ++frozen berries ++ is unavailable for purchase
19b. Since hearing about the recall, have you changed how often you eat ++frozen berries ++?
Have you eaten ++frozen berries ++ select one best answer
1. More often.
2. As often as usual.
3. Less often.
8. Don’t know
20. Once you hear that the ++frozen berries ++ available in stores and restaurants are no longer part of the problem that caused the outbreak of illness from ++Hepatitis A ++ outbreak, how soon will you resume eating ++frozen berries ++?
1. I have not stopped eating raw ++frozen berries ++
2. Immediately or as soon as I have an occasion to eat it
3. I plan to wait awhile.
4. I do not intend to eat raw ++frozen berries ++ again.
21. If you were unable to eat raw ++frozen berries ++ for three months, do you have other foods to choose from that could easily take its place?
1. Yes
0. No
98. Don’t know
22. On a 10-point scale, how difficult would it be for you and your family to limit how much you eat of raw ++frozen berries ++? Would you say…
1 Not at all difficult
10 Very difficult
98. Don’t know
23. Does what you know about the ++frozen berries ++ recall make you more or less likely to eat at restaurants, or does it have no impact?
1. More likely
2. Less likely
3. No impact
24. On a scale from strongly disagree to strongly agree, please indicate your response about the following
24a. I want to prevent foodborne illnesses (or getting sick from food)
Strongly disagree
10 Strongly agree
98. Don’t know
24b. I want the ability to protect myself from foodborne illnesses (or getting sick from food)
Strongly disagree
10 Strongly agree
98. Don’t know
24c. I really don’t care about foodborne illnesses (getting sick from food)
Strongly disagree
10 Strongly agree
98. Don’t know
25. In terms of protecting your health, how important do you think it is to follow the
++frozen berries ++ recall recommendations?
1 Not at all important
10 Very important
98. Don’t know
26. Do you believe you have the information you need to keep yourself and your family safe from ++Hepatitis A++ associated with the ++frozen berries ++ recall?
1. Yes
0. No
98. Don’t know
27. How believable to you is the information about outbreak of illness from ++Hepatitis A++ from raw ++frozen berries ++?
not at all believable
10 Completely believable
98. Don’t know
28. How worried are you about becoming infected or getting ill from ++frozen berries ++ or ++Hepatitis A++?
1. Not at all worried
2. Not too worried
3. Somewhat worried
4. Very worried
98. Don’t know
29. How angry are you that ++frozen berries ++ were contaminated with ++Hepatitis A++
1. Not at all angry
2. Not too angry
3. Somewhat angry
4. Very angry
98. Don’t know
30. Using a 10-point scale, how likely do you think it is that you or members of your family would get sick from eating raw ++frozen berries ++ associated with the current ++frozen berries ++ recall?
1 Not at all likely
10 Very likely
98. Don’t know
31. How likely is it that you or members of your family would have serious long-term
health problems from eating raw ++frozen berries ++ associated with the current ++frozen berries ++ recall? Would you say…
1 Not at all likely
10 Very likely
98. Don’t know
[PROG: This question is moved to the end and information display even if Q32 is code 1, 0 or 98] in other words, this display is for all respondents.]
33. How many total people, including yourself, live in your household?
(Include foster children, roommates or housemates, and people staying with you last night who have no permanent place to stay. This includes people living with you most of the time while working, even if they have another place to live. Do not include college students living away while attending college, people in a correctional facility, nursing home or psychiatric hospital last night, armed forces personnel living somewhere else, people who live or stay at another place most of the time.
[ ] [] 98. Don’t know
34. How many children younger than five years old? Please type in number. Enter 0 (zero) if none.
[ ] [] 98. Don’t know
35.
Children between 5 and 18 years? Please type in number. Enter 0
(zero) if none.
[ ] [] 98. Don’t know
36. Adults 60 years of age or older? Please type in number. Enter 0 (zero) if none.
[ ] [] 98. Don’t know
37. Are you or is anyone in your household pregnant?
1. YES, I am pregnant.
2. Yes, someone in my household is pregnant
3. NO
8. Don’t know
38. Please read the following list of health conditions and indicate if you have been told by a doctor that you have any of them: liver disease, currently receiving chemotherapy or radiation therapy, HIV, AIDS, organ transplant, or weakened immune system.
Yes, I have at least one of the conditions listed.
No, I do not have any of the conditions listed.
DON’T KNOW
39. Please select one of the following. Are you:
[PROG- YOU DO NOT NEED TO ADD “Please select one” to this particular question screen]
0. Male
1. Female
PROG - [ADD A CHECK WHERE RESPONDENT CAN NOT SELECT [MALE] IF “PREGNANT WAS SELECTED IN Q37”
40. What is your age in years?
_______
[PROG: (Range = 18-99), NUMERIC FIELD. ALSO RAW DATA SHOULD BE NUMERIC]
41. What is the highest level of education that you have completed?
1. Less than high school
2. High school graduate or GED
3. Technical/vocational school
4. Community college
5. Some college (1-3 years) towards Bachelor’s degree)
6. College (Bachelor’s degree)
7. Advanced degree (post graduate degree)
42. Are you of Hispanic or Latino origin?
1. Yes
0. No
43. What is your race? You may choose one or more categories. Are you?
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or other Pacific Islander
5. American Indian or Alaska Native
6. Other
32. Would you now like to have more information about the current ++frozen berries ++ recall advisory?
1. Yes
0 No
98. Don’t know
44. Please provide any comments you wish.
File Type | application/msword |
File Title | 10-9-08 |
Author | tempuser |
Last Modified By | Bean, Domini |
File Modified | 2013-06-06 |
File Created | 2013-06-06 |