Form 1 ABC Survey-Screener

OMB #: 0925-xxxx

Expiry Date: xx/xx/20xx

Awareness and Beliefs about Cancer (ABC) Study

Public reporting burden for this collection of information is estimated to average 5 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx). Do not return the completed form to this address.

SCREENER

IF APPOINTMENT PREVIOUSLY MADE

Please can I speak to [INSERT NAME FROM APPOINTMENT LOG]?

INTRODUCTION

Good morning / afternoon / evening, my name is <<(INSERT)>> and I work for the independent research agency Ipsos. We are carrying out a health research survey on behalf of the National Institutes of Health and would like to invite you, or a member of your household, to take part.

This is a national survey of people from across the United States who are aged 50 or over and the survey has already been carried out in eight other countries.

READ OUT ONLY IF ASKED: The participating countries were England, Northern Ireland, Wales, Norway, Sweden, Denmark, Australia, and Canada.

READ OUT TO ALL: The results of the survey will be used to explore differences in people’s views about cancer across different countries and to help improve cancer information for the general public. It will also help doctors to diagnose cancer earlier.

ASK ALL

SINGLE CODE

ALLOW “REFUSED” OR “DON’T KNOW” BUT THANK AND CLOSE IF THEY DO REFUSE OR DON’T KNOW

QAGE. Please could I speak to a member of the household who is aged 50 or over?

1. Yes, I am aged 50 or over CONTINUE

2. Yes, I’ll just get them REREAD INTRODUCTION AND CONTINUE

3. No – no-one aged 50 or over is in, please call back later INTERVIEWER TO SET APPOINTMENT CALL BACK TIME

4. No – no-one in household aged 50 or over THANK AND CLOSE

ASK ALL

SINGLE CODE

ALLOW “REFUSED” OR “DON’T KNOW” BUT THANK AND CLOSE IF THEY DO REFUSE OR DON’T KNOW

QS1. Could you please tell me how many people aged 50 or over currently live in your household, including yourself?

1. One CONTINUE TO INFORMATION SECTION

2. Two ASK QS2

3. Three ASK QS3

4. Four ASK QS3

5. Five ASK QS3

6. Six ASK QS3

7. Seven ASK QS3

8. Eight ASK QS3

9. Nine ASK QS3

10. Ten ASK QS3

11. None THANK AND CLOSE

IF CODE 2 AT QS1: THE CATI SCRIPT WILL SELECT ONE ADULT RANDOMLY: CATI WILL SELECT THE CURRENT RESPONDENT ON 50% OF OCCASIONS, AND THE OTHER HOUSEHOLD MEMBER ON 50% OF OCCASIONS. IF THE CURRENT RESPONDENT IS SELECTED, CONTINUE TO INFORMATION SECTION. IF OTHER HOUSEHOLD MEMBER SELECTED ASK

SINGLE CODE

ALLOW “REFUSED” BUT THANK AND CLOSE IF THEY DO REFUSE

QS2. In households where there are two adults aged 50 or older, we are using a random method to select which one of these adults takes part in this survey. On this occasion, it is the other person that I would like to speak to. May I speak to that person please?

READ OUT ONLY IF ASKED: This is to ensure we achieve a nationally representative sample of adults in the US.

1. Yes, available REREAD INTRODUCTION AND CONTINUE TO INFORMATION SECTION

2. Yes, not currently available MAKE APPOINTMENT, AND LOG NAME OF SELECTED HOUSEHOLD MEMBER

3. No THANK AND CLOSE

IF CODES 3-10 AT S1: THE CATI SCRIPT WILL SELECT ONE ADULT RANDOMLY – THE PROBABILITY OF SELECTION IS LINKED TO THE NUMBER OF HOUSEHOLD MEMBERS AT S1. CATI WILL SELECT THE CURRENT RESPONDENT IN (1/S1) OCCASIONS. IT SHOULD SELECT THE OTHER HOUSEHOLD MEMBERS IN ((S1-1)/S1) OCCASIONS. IF THE CURRENT RESPONDENT IS SELECTED, CONTINUE TO INFORMATION SECTION. IF OTHER HOUSEHOLD MEMBER SELECTED ASK

SINGLE CODE

ALLOW “REFUSED” BUT THANK AND CLOSE IF THEY DO REFUSE

QS3. Where there are three or more adults aged 50 or older, we are using a random method to select one person to interview. Not including yourself, please could I speak to the person aged 50 or over who has the next birthday?

INTERVIEWER NOTE: THIS DOES NOT INCLUDE THE PERSON YOU ARE SPEAKING TO, IT MUST BE ANOTHER MEMBER OF THE HOUSEHOLD. 

READ OUT ONLY IF ASKED: The person with the next birthday is selected to ensure we achieve a nationally representative sample of adults in the US.

1. Yes, available REREAD INTRODUCTION AND CONTINUE

2. Yes, not currently available MAKE APPOINTMENT, AND LOG NAME OF SELECTED HOUSEHOLD MEMBER

3. No THANK AND CLOSE

4. I don’t know who has the next birthday THANK AND CLOSE

Refusal and Closing Script

Thank you for your time. Goodbye.

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