Outcome Follow-up Questionnaire in Person

Food and Drug Administration's Research and Evaluation Survey for the Public Education Campaign on Tobacco among LGBT (RESPECT)

Attachment 13 Longitudinal Screener_FU3

Outcome Follow-up Questionnaire in Person

OMB: 0910-0808

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IRB 13819

ATTACHMENT 13: LONGITUDINAL SCREENER

[LONGITUDINAL RESPONDENTS THAT LAUNCH THE MAIN SURVEY WILL FIRST SEE THE LONGITUDINAL SCREENER CONSENT AND THEN THE QUESTIONS IN THIS ATTACHMENT. ATTACHMENT 2 INCLUDES PLACEHOLDERS FOR THESE DOCUMENTS.]

Z0. [IF LONGITUDINAL (RFU1=1) OR LONGITUDINAL NR (RNE=1)] Before we begin, we have a couple of general questions about you. You may have seen these questions before, but we appreciate you responding to them again.

NEXT

PROGRAMMER: VALIDATE FORMAT FOR EMAIL ADDRESS. IF FORMAT IS INCORRECT, PLEASE DISPLAY “Please enter a valid email address.” IF THE EMAIL ADDRESSES DON’T MATCH PLEASE DISPLAY “The email addresses do not match. Please try again.”

Z1. [IF LONGITUDINAL (RFU1=1) OR LONGITUDINAL NR (RNE=1)] What is the 5-digit zip code where you currently live?

__ __ __ __ __ (5-digit, numeric responses only)

Z2. [IF LONGITUDINAL (RFU1=1)] What is your date of birth?

PROGRAMMER: DISPLAY A DROP DOWN LIST OF 12 MONTHS AND ANOTHER OF YEARS 1985 – 2005.

Z2a. You have entered your month and year of birth as [FILL FROM Z2]. Is that correct?

1 Yes

2 No GO BACK TO Z2


ASK: All longitudinal respondents who have been recruited in prior waves

_________________________________________________________________________________

Z3. [IF LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)]

What is your current gender identity?

1 Male

2 Female

3 Trans male/Trans man

4 Trans female/Trans woman

5 Genderqueer/Gender non-conforming

6 Different identity (please state) ________________________

9 Prefer not to answer



ASK: All longitudinal respondents who have been recruited in prior waves

_________________________________________________________________________

Z4. [IF LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)]

What sex were you assigned at birth, on your original birth certificate?

1 Female

2 Male

9 Prefer not to answer



ASK: All longitudinal respondents who have been recruited in prior waves

_________________________________________________________________________

Z5. [IF Z3= 1 or 3 AND LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)]



Which of the following best represents how you think of yourself?

1 Gay – GO TO Z9

2 Straight, that is, not gay – GO TO Z9

3 Bisexual – GO TO Z9

4 Something else – GO TO Z7

5 I don’t know the answer – GO TO Z8

9 Prefer not to answer – GO TO Z9



ASK: All longitudinal respondents who have been recruited in prior waves and who are male or trans male

_________________________________________________________________________

Z6. [IF Z3= 2 OR 4 AND LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)] Which of the following best represents how you think of yourself?

1 Lesbian or gay – GO TO Z9

2 Straight, that is, not lesbian or gay – GO TO Z9

3 Bisexual - GO TO Z9

4 Something else – GO TO Z7

5 I don’t know the answer – GO TO Z8

9 Prefer not to answer – GO TO Z9



ASK: All longitudinal respondents who have been recruited in prior waves and who are female or trans female

_________________________________________________________________________

Z7. [IF Z6=4 OR Z5=4 AND LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)]

What do you mean by something else?

1 You are not straight, but identify with another label such as queer, trisexual, omnisexual, or pansexual – GO TO Z9

2 You are transgender, transsexual, or gender variant - GO TO Z9

3 You have not figured out or are in the process of figuring out your sexuality - GO TO Z9

4 You do not think of yourself as having sexuality - GO TO Z9

5 You do not use labels to identify yourself - GO TO Z9

6 You mean something else (please state) - GO TO Z9 ________________

9 Prefer not to answer - GO TO Z9



ASK: All longitudinal respondents who have been recruited in prior waves and who report ‘something else’ in Z5 or Z6

_________________________________________________________________________

Z8. [IF Z6=5 OR Z5=5 AND LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)] What do you mean by don’t know?

1 You don’t understand the words

2 You understand the words, but you have not figured out or are in the process of figuring out your sexuality

3 You mean something else

9 Prefer not to answer



ASK: All longitudinal respondents who have been recruited in prior waves and who report ‘don’t know’ in Z6

_________________________________________________________________________

Z9. [IF LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1)]

What is your age? ____________ (Range: 15-80)

ASK: All longitudinal respondents who have been recruited in prior waves

_________________________________________________________________________

PROGRAMMER: IF LONGITUDINAL OR LONGITUDINAL NR (LI_W3=1) THEN SET ELIGFLAG. IF [Z1 IS THE SAME ZIP OR DMA AS FRAME INFORMATION, OR IF FRAME DMA=CONTROL AND Z1=CONTROL, OR FRAME DMA=TREATMENT AND Z1=TREATMENT, AND Z2 MATCHES SAMPLE FRAME INFORMATION AND (LONGITUDINAL (LC_W3=1) AND Z9= 18 to 26-years-old OR LONGITUDINAL NR (LI_W3=1) AND Z9= LAST KNOWN AGE OR LAST KNOWN AGE+1 OR LAST KNOWN AGE +2) AND [Z3= 3 to 5 OR Z5= 1 or 3 OR Z6= 1 or 3 OR Z7= 1 or 2 or 6] THEN ELIGFLAG=1. ELSE ELIGFLAG=2.

NOTE: This programming directs who is eligible for the study. To be eligible, respondents must be in the same zip code or the same DMA as they were previously. If they are not in the same DMA, the DMA that they are in must remain a control or a treatment DMA. They must have the same date of birth as previously reported. They must be between 18 and 26 years old or be the same age as last wave or one year older than last wave. They must also be LGBT, but their sexual orientation or identity is not compared to that of last survey.

_________________________________________________________________________

INELIG [IF (ELIGFLAG=2 AND LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1))]

Thank you for your responses. Based on your responses, you are not eligible to participate in the study. We have no further questions at this time.

ASK: Respondents who are ineligible due to responses to the screening questions.

_________________________________________________________________________



ELIG [IF (ELIGFLAG=1 AND LONGITUDINAL (LC_W3=1) OR LONGITUDINAL NR (LI_W3=1))]

Please click Next to continue.

NEXT

ASK: Respondents who are eligible due to responses to the screening questions.

_________________________________________________________________________



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKosa, Katherine
File Modified0000-00-00
File Created2021-01-22

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