Appendix I Participant Screener

Appendix I – Participant Screener

OMB No: 0910-0891 Expiration Date: 09/30/2026

Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0910-0891. The time required to complete this information collection 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.

Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRAStaff@fda.hhs.gov.

In-depth Interviews with Healthcare Professionals and Health Educators on Environmental Contaminants in Food for Young Children

Recruitment Screener

Recruitment Goals

The target audience for these interviews are healthcare professionals and health educators, including pediatricians, pediatric physician assistants, pediatric registered nurses, pediatric registered dietitian nutritionists, and educators from the Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), and Expanded Food and Nutrition Education (EFNEP) programs (see Table 1 below). Participants must have professional contact with parents or caregivers of children aged 6 months to 6 years and talk to them about nutrition or diet as related to child health and development. Participants will be a mix of age, level of education, race/ethnicity, and gender; and they will be residents of varied locations throughout the U.S.

Table 1

Number	Professional Type
Healthcare Professionals and Educators
1-4	Pediatricians (4 interviewees)
5-8	Pediatric physician assistants (4 interviewees)
9-12	Pediatric registered nurses (RN) (4 interviewees)
13-16	Pediatric registered dietitian nutritionists (RD/RDN) (4 interviewees)
17-20	WIC specialists (4 interviewees)
21-24	SNAP educators (4 interviewees)
25-27	EFNEP educators (3 interviewees)

Additional recruitment goals:

• Recruit 40 participants for 27 interviews

• Recruit a mix of age, gender, race/ethnicity

• Recruit a mix of participants from different geographic regions of the U.S.

Recruitment Script

[Recruiter] is helping Westat, a research consulting company, on behalf of the U.S. Food and Drug Administration find healthcare professionals and health educators who may be interested in being interviewed about issues related to child health and nutrition. To make sure you are a good fit for the interview, please take about 2 minutes to answer the questions below.

Your participation / nonparticipation is completely voluntary, and your responses will not have an effect on your eligibility for receipt of any FDA services. In instances where respondent identity is needed (e.g., for follow-up of non-respondents), this information collection fully complies with all aspects of the Privacy Act and data will be kept private to the fullest extent allowed by law.

1. Are you a …?

• Pediatrician

• Pediatric physician’s assistant

• Pediatric registered nurse (RN)

• Other healthcare professional, please specify: _______________________

• Registered dietitian nutritionists  SKIP TO Q5

• WIC specialist  SKIP TO Q5

• SNAP educator  SKIP TO Q5

• EFNEP educator  SKIP TO Q5

• Other health educator, please specify: __________________________  SKIP TO Q5

• None of the above  NOT ELIGIBLE

Ask Healthcare Professionals:

2. Are you currently providing direct patient care?

• Yes

• No  NOT ELIGIBLE

3. About what percentage of your time would you estimate to be involved in direct patient care? __________%  NOT ELIGIBLE IF UNDER 50%

4. For how long have you provided direct patient care? _________  NOT ELIGIBLE IF UNDER 1 YEAR

Healthcare Professionals skip to Q8

Ask Health Educators:

5. Are you currently providing nutrition education directly to your clients?

• Yes

• No  NOT ELIGIBLE

6. About what percentage of your time would you estimate to be involved in providing nutrition education directly to your clients? _________%  NOT ELIGIBLE IF UNDER 25%

7. For how long have you provided nutrition education directly to your clients? __________  NOT ELIGIBLE IF UNDER 1 YEAR

Ask Both Eligible Healthcare Professional and Health Educators:

8. Are at least a quarter of your patients/clients between the ages of 6 months and 6 years, or parents/caregivers of children between these ages?

• Yes

• No  NOT ELIGIBLE

9. How often do you talk to parents/caregivers of your patients/clients about nutrition or diet as related to child’s health and development?

• Never or almost never

• Sometimes  SKIP TO Q11

• Very often  SKIP TO Q11

• Always or almost always  SKIP TO Q11

[Please make sure that we have respondents from each category (sometimes, very often, always, or most always)].

10. You answered “Never or almost never” above. What are the reasons for not discussing nutrition and dietary issues with parents/caregivers of your patients/clients? 

• I don’t feel qualified  NOT ELIGIBLE 

• It’s beyond the scope of my job  NOT ELIGIBLE  

• I do not have enough time  NOT ELIGIBLE  

• I refer dietary concerns to a specialist/educator  NOT ELIGIBLE  

• Other (specify) _____________  NOT ELIGIBLE  

11. In what type of setting do you work?

• WIC office

• SNAP office

• EFNEP office

• Hospital

• Urgent care center

• Solo practice medical office or clinic

• Group practice medical office or clinic

• Other (specify) _______________

Demographic questions:

To make sure we interview a diverse group of professionals, please answer the questions below.

12. Choose the age category you are in:

• Under 18  NOT ELIGIBLE

• 18 to 29

• 30 to 49

• 50 or 59

• 60 or older

13. Are you: (Mark all that apply)

• Female

• Male

• Transgender, non-binary, or another gender

14. Are you Hispanic or Latino?

• Yes

• No

15. What is your race? Please select one or more.

• White

• Black or African American

• Asian

• Native Hawaiian or other Pacific Islander

• American Indian or Alaska Native

• Other (specify)

Contact Information:

In the space below, please give us the best information to contact you by phone or e-mail. Please know that Westat will not share your information with anyone else and that your information will be kept private to the extent provided by law. Your personal information will be deleted upon completion of the research project.

Name ______________________________________________________________________

City, State _______________________________________________________________

Phone Number _______________________________________________________________

Email Address________________________________________________________________

Thank you for your answers to these questions. If you are selected for an interview, someone will contact you within the next 1-2 days.

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