U.S. Department of Transportation
Federal Highway Administration
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Federal Highway Administration Research and Technology
Coordinating, Developing, and Delivering Highway Transportation Innovations
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Publication Number: FHWA-HRT-04-139
Date: December 2005
Enhanced Night Visibility Series, Volume VIII: Phase II—Study 6: Detection of Pavement Markings During Nighttime Driving in Clear Weather
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APPENDIX A—PARTICIPANT SCREENING QUESTIONNAIRE
Driver Screening and Demographic Questionnaire: ENV-Pavement Markings
Note to Screening Personnel:
Initial contact with the potential participants will take place over the phone. Read the following Introductory Statement, followed by the questionnaire (if they agree to participate). Regardless of how contact is made, this questionnaire must be administered before a decision is made regarding suitability for this study.
Introductory Statement (Use the following script as a guideline in the screening interview):
Good morning/afternoon! My name is _____ and I work at the Smart Road. I'm recruiting drivers for a study to evaluate new vehicle headlamps.
This study will involve you driving a car for two sessions on the Smart Road. The Smart Road is a test facility equipped with advanced data recording systems here in [contractor location]. We will pay you 20 dollars per hour. The total amount will be given to you at the end of the second session. Would you like to participate in this study?
If they agree:
Next, I would like to ask you several questions to see if you are eligible to participate.
If they do not agree:
Thanks for your time.
I would like to confirm your full name, phone number(s) (home/work) where you can be reached, hours/days when it's best to reach you, and preferred days to participate.
Name __________________________________________________________ Male / Female
Phone Numbers (Home)_________________________(Work)_________________________
Best Time to Call _________________________________________________
Best Days to Participate____________________
Criteria For Participation:
Accepted: ________ Days that will attend to Study:
Rejected: ________ Reason:__________________________________________
Screening Personnel (print name):______________________ (Date):________
Topics: research, safety
Keywords: research, safety, Age, Fluorescent Paint, Halogen, Headlamps, High Intensity Discharge, Liquid System, Nighttime, Pavement Marking, Thermoplastic, Ultraviolet, Visibility, Vision Enhancement System
TRT Terms: research, Safety and security, Safety, Transportation safety, Automobile driving at night, Road markings--Evaluation, Automobiles--Lighting--Evaluation, Night visibility, Headlamps