Attach 3A_Interview Script and Consent Iowa

OMB NO.: 0925-0406

EXPIRATION DATE: 10/31/2011

Attachment 3A:

Interview Script and Verbal Consent for Iowa Respondents

Public reporting burden for this collection of information is estimated to average thirty-five 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.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0406).  Do not return the completed form to this address.

AHS Phase III Interview Telephone Scripts

Hello, have I reached (FIRST NAME – LAST NAME – JR/SR?)

IF NAMES ARE CONFUSING:

I am trying to reach (FIRST NAME – LAST NAME – JR/SR), who completed a telephone interview or hard copy questionnaire with us several years ago about work and health factors common in the farming community. Have I reached the right person?

INTRODUCTION

Hello Ms./Mr. _________. This is _________ with the Agricultural Heath Study at (the University of Iowa/North Carolina). You were sent a letter from Dr. Michael Alavanja recently, letting you know that I would be calling. Do you recall seeing that in your mail?

IF NO, DON’T REMEMBER STUDY>> It’s a long-term study designed to follow farmers and their families over a period of time to study protective aspects of health and possible factors of disease. Various diseases among farm families, which are of interest to scientists in this and other countries, are being studied, including the incidence of cancer. You completed a questionnaire for us either at a pesticide certification site, over the phone, or by mail several years ago.

The reason I’m calling today (tonight) is to update your information. The questions deal with your pesticide use and general health information. This should take no more than 37 minutes to complete. We appreciate all the time you have given to help with this study.

ASK FOR INTERVIEW (Verbal Consent)

Would you be willing to participate? We could do it now or schedule a time that would be more convenient for you.

IF YES TO INTERVIEW>>Is now a good time?

IOWA ONLY

Good, before we get started, I would like to ask if it is all right to tape-record this interview. The purpose is to ensure that I’ve recorded your answers correctly. We do erase the tapes after we have checked them. Please be assured that your answers are strictly confidential to the extent of the law. Your participation in this or any part of the Agricultural Health Study is voluntary and you may refuse to answer any question. Your name will not be linked to any of your information in reports. If you have questions about the study, you may call 1-800-4AG-STUDY. Is this all right with you?

IF YES TO TAPING >> Do you have any questions before we begin? Okay, let’s get started.

IF NO TO TAPING>> That’s not a problem, I’ll leave the tape recorder off then. Do you have any questions before we begin? Okay, let’s get started.

NORTH CAROLINA ONLY

Good, before we get started, my supervisor may listen in part of the interview to be sure I am doing the best job possible. Please be assured that your answers are strictly confidential to the extent of the law. Your participation in this or any part of the Agricultural Health Study is voluntary and you may refuse to answer any question. Your name will not be linked to any of your information in reports. If you have questions about the study, you may call 1-800-424-7883. Is this all right with you?

IF NO TO NOW>>When would you like us to call you back?

IF NO TO INTERVIEW>>Okay, then, thank you very much.

NO LONGER-FARMING

IF REFUSES INTERVIEW AT ANY POINT, DUE TO NO LONGER FARMING (retired or other) >>

Even though you are no longer farming, your information is still very important to us. Many of the diseases we are studying, such as cancer, may be due to exposures that occurred many years ago. This means we need to look well into the past to study the causes of these diseases. Also, since we are studying many types of exposures--not just farm exposures--it is important for us to obtain information even after you quit farming. Would you be willing to participate?

IF CONSENTS TO INTERVIEW, RESUME SCRIPT WHERE YOU LEFT OFF, ABOVE

IF REFUSES INTERVIEW, okay, then, thank you very much for your past participation.

CLOSING SCRIPT

That completes the interview. You have made a valuable contribution to our research. Thank you for taking the time to talk with me today.

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