FDA Ad Exposure Frequency Study
Screener
Hello, my name is _______________ and I’m from [name of company]. I’m calling on behalf of RTI International, a non-profit research organization, about a research study. I’m not selling or promoting any product. Ask to speak to someone 18 years or older.
The purpose of this study is to learn more about how people watch TV. To see if you are eligible, I’d like to ask you some questions. If you are eligible and choose to participate, all of your comments will be kept private and we will reimburse you [$100] at the end of the study.
May I continue?
Yes CONTINUE
No [Thank respondent and end call.]
CORE ELIGIBILITY CRITERIA
Have you ever been told by a doctor that you have any of the following conditions?
High Blood Pressure |
|
|
Arthritis |
|
|
Seasonal Allergies |
|
CONTINUE |
Asthma |
|
|
Diabetes |
|
|
Do you still have this medical condition?
No |
|
TERMINATE |
Yes |
|
CONTINUE |
What is your current occupation?
|
Healthcare Provider (e.g., Physician, Nurse, Counselor, Physical therapist) TERMINATE Pharmaceutical employee (e.g., Pharma Rep) TERMINATE Researcher / Scientist TERMINATE Department of Health and Human Services employee TERMINATE Market Research employee/Advertising employee TERMINATE All Other Occupations CONTINUE |
What year were you born?
_____ |
1996 or earlier CONTINUE 1997 or later TERMINATE |
What is your sex?
Male |
|
CONTINUE |
Female |
|
CONTINUE |
SCREEN FOR A MIX |
What is the highest level of education you have attained?
Less than high school |
|
CONTINUE |
High school graduate (or GED) |
|
CONTINUE |
Some college or technical school (No degree) |
|
CONTINUE |
College graduate (2- or 4-year degree) |
|
CONTINUE |
Some graduate school (No degree) |
|
CONTINUE |
Graduate school degree |
|
CONTINUE |
SCREEN FOR AT LEAST 20% with LESS THAN HS |
Which of these racial groups best describes you? [Read options below]
White |
|
CONTINUE |
Black / African American |
|
CONTINUE |
American Indian or Alaskan Native |
|
CONTINUE |
Asian |
|
CONTINUE |
Native Hawaiian or Pacific Islander |
|
CONTINUE |
Other |
|
CONTINUE |
SCREEN FOR A MIX |
Study Invitation:
Thank you for answering all of my questions. Based on your responses, you appear eligible to participate in our study.
Your participation will last about 90 minutes and should be very interesting. We will ask you to watch one hour of TV and then answer some questions about it. No one will try to sell you anything, and no one will call you later because you participated. We will reimburse you [$100] at the end of the survey for your time and participation. Can I schedule your participation?
The surveys will take place on [DATES AND TIMES TBD]. Which date and time would work best for you?
Your participation in this study is very important. If for some reason you will not be able to attend, please let us know right away. You can call us anytime at [insert phone number], and if we are not here, please leave a message.
Closing for Ineligible Participants:
I’m sorry, but you are not eligible for this study. There are many possible reasons why people are not eligible. These reasons were decided earlier by the researchers. However, thank you for your interest in this study and for taking the time to answer our questions today.
Participant Information
NAME: ________________________________________________________
ADDRESS: ________________________________________________________
CITY: ________________________________________________________
ZIP CODE: ________________________________________________________
EMAIL ________________________________________________________
What is the best time to reach you? What is the best telephone number to reach you at that time?
BEST TIME TO BE REACHED: ________________________________________
BEST PHONE NUMBER: ______________
Is there another time and number we can try if we miss you?
ALTERNATE PHONE NUMBER:
Recruiter: ____________________
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Betts, Kevin |
File Modified | 0000-00-00 |
File Created | 2021-01-24 |