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pdfHHS COVID-19 PUBLIC EDUCATION CAMPAIGN
IRB APPROVED
04/22/2021
A campaign to increase vaccine acceptance while reinforcing basic prevention measures
Foundational Focus Group – Vaccinated
General Population Screener
NOTES TO RECRUITERS
Recruit 8 to “seat” 4-6 participants
2 focus groups of vaccinated/general population
Each group must include a range/mix of:
o Ages
o Education levels
o Geographic location (mix of cities/states)
o Race/ethnicity
o Ideologies
Each group must include a roughly equal mix of genders
All participants must have received at least one dose of a COVID-19 vaccine, must intend to receive
the second dose (if applicable), and must participate in English
SCREENER
Hello, my name is
from [INSERT FACILITY NAME], a market research firm. We are recruiting for
an upcoming study to get your thoughts and opinions about COVID-19 and how it is affecting life in the
country today. This is not a sales call of any kind. I am only calling to see if you or an eligible member of
your household has an interest in participating in a 90-minute focus group that will be conducted virtually
for which you would receive a $75 incentive. I have a few questions I need to ask to see if you are qualified
for this study. You don’t have to answer any question that you don’t want to answer.
1. Are you interested in seeing if you or anyone in your household qualifies to participate in this focus
group? [ACCEPT ONLY 1 PER HOUSEHOLD]
Yes
[ ]
> CONTINUE
No
[ ]
> TERMINATE
2. In the past five years, have you or a member of your immediate family worked in any of the following
fields, companies, or organizations?
Market or public opinion research
[ ]
> TERMINATE
An advertising, public relations, or marketing agency
[ ]
> TERMINATE
News, radio, TV, print, media
[ ]
> TERMINATE
As a health care provider or medical professional (e.g.,
physician, nurse)
[ ]
> CONTINUE
At a health care company
[ ]
> CONTINUE
Construction, repair and maintenance
[ ]
> CONTINUE
For internal communications only
IRB APPROVED
04/22/2021
Finance
[ ]
> CONTINUE
None of these
[ ]
> CONTINUE
3. In order to participate, you need to have a desktop or laptop computer or a smartphone with an internet
connection. You will also need to consent to be recorded during the interview. Will you be able to meet
both of these requirements?
Yes
[ ]
> CONTINUE
No
[ ]
> TERMINATE
4. Would you be willing and able to participate in this study via a webcam or smartphone camera?
Yes
[ ]
> CONTINUE
No
[ ]
> TERMINATE
5. Have you received one or more doses of an authorized COVID-19 vaccine?
Yes
[ ]
> CONTINUE
No
[ ]
> TERMINATE
6. If the COVID-19 vaccine you received requires a second dose, do you intend to get the second dose
of the vaccine?
Yes
[ ]
> CONTINUE
No
[ ]
> TERMINATE
Already received second dose/not required to get a
second dose
[ ]
> CONTINUE
7. What is your race? Please select all that apply. [RECRUIT A MIX]
White
[ ]
> CONTINUE
Black or African American
[ ]
> CONTINUE
American Indian or Alaska Native
[ ]
> CONTINUE
Asian (e.g., Asian Indian, Chinese, Filipino, Japanese,
Korean, Vietnamese)
[ ]
> CONTINUE
Native Hawaiian or other Pacific Islander (e.g., Native
Hawaiian Samoan, Chamorro, Tongan, Fijian,
Marshallese)
[ ]
> CONTINUE
Yes
[ ]
> CONTINUE
No
[ ]
> CONTINUE
8. Are you of Hispanic, Latino, or Spanish origin?
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IRB APPROVED
04/22/2021
9. What is your gender?
Male
[ ]
> CONTINUE
Female
[ ]
> CONTINUE
Prefer to self-describe (specify)
[ ]
> CONTINUE
10. What is your age? _______________ [RECORD VERBATIM, SORT INTO GROUPS, TERMINATE
<18]
Note to recruitment: Recruit a mix of ages.
11. What city and state do you live in? CITY: ________________
Note to recruitment: Recruit a mix of locations.
STATE:_____________________
12. What is the highest level of school you have completed? [RECRUIT A MIX]
Some high school or less (no diploma)
[ ]
> CONTINUE
High school diploma or equivalent (GED)
[ ]
> CONTINUE
Some college, no degree
[ ]
> CONTINUE
Associate degree
[ ]
> CONTINUE
Bachelor’s degree
[ ]
> CONTINUE
Master’s degree
[ ]
> CONTINUE
Professional or doctorate degree
[ ]
> CONTINUE
13. Which of the following best describes you? Please select all that apply. [RECRUIT A MIX]
Employed full-time
[ ]
> CONTINUE
Employed part-time
[ ]
> CONTINUE
Self-employed
[ ]
> CONTINUE
Not employed, but looking for work
[ ]
> CONTINUE
Not employed, and not looking for work
[ ]
> CONTINUE
Stay-at-home parent
[ ]
> CONTINUE
Student
[ ]
> CONTINUE
Retired
[ ]
> CONTINUE
14. When it comes to overall public policy from the federal government, do you consider yourself liberal,
conservative, or somewhere in between?
Very liberal
[ ]
> CONTINUE
Somewhat liberal
[ ]
> CONTINUE
Neutral
[ ]
> CONTINUE
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IRB APPROVED
04/22/2021
Somewhat conservative
[ ]
> CONTINUE
Very conservative
[ ]
> CONTINUE
Prefer not to answer
[ ]
> CONTINUE
15. Last year—that is, in 2020—what was your total household income from all sources, before taxes?
[RECRUIT A MIX, ENSURE ROBUST REPRESENTATION OF <$50K]
Less than $15,000
[ ]
> CONTINUE
$15,000 to $24,999
[ ]
> CONTINUE
$25,000 to $34,999
[ ]
> CONTINUE
$35,000 to $49,999
[ ]
> CONTINUE
$50,000 to $74,999
[ ]
> CONTINUE
$75,000 to $99,999
[ ]
> CONTINUE
$100,000 to $149,999
[ ]
> CONTINUE
$150,000 to $199,999
[ ]
> CONTINUE
$200,000 and over
[ ]
> CONTINUE
Don’t know/Refused
[ ]
> CONTINUE
Thank you for taking the time to answer these questions. We will be in touch with additional information on
the study. The virtual focus group will last no longer than 90 minutes. Thank you again for your time and
we will send additional information soon.
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File Type | application/pdf |
Author | Microsoft Office User |
File Modified | 2021-04-01 |
File Created | 2020-11-20 |