Form 10 Attach 25C and 25D Scripts for Scheduling Post-Applicati

ATTACHMENTS 25C & 25D
BEEA Script for Scheduling First Post-Application Visit for
Iowa and NC
25C. BEEA Contact Script for Scheduling First Post-Application Visit
(Recent Exposure Group) for Iowa
25D. BEEA Contact Script for Scheduling First Post-Application Visit
(Recent Exposure Group) for North Carolina

Interim telephone script v1

Attachment 25C: BEEA IA Contact Script for Scheduling First Post-Application Visit

Study of Biomarkers of Exposures and Effects in Agriculture
(Recent Exposure Group)

Public reporting burden for this collection of information is estimated to average 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.
Hello, I am calling from the University of Iowa, trying to reach (Mr. Name of AHS private
pesticide applicator).
IF THE PESTICIDE APPLICATOR IS NOT AVAILABLE NOW, ASK ABOUT AND RECORD A
BETTER TIME TO REACH HIM.
Thank you very much.
TO RESPONDENT:
My name is _________________. I am calling from the University of Iowa field station for the
Biomarkers of Exposures and Effects in Agriculture. I'm calling to find out about your farming
activities and when we can schedule your next home visit. I just have a couple of questions.
When we last spoke, you said you would be (making a decision about when to apply
diazinon/applying diazinon) in (MONTH).
Q1. Do you plan to apply diazinon during the next four weeks?
a) Yes
b) No

Advance to SCHEDULING.

Q2. Approximately when do think you may (make a decision about when to apply diazinon/
apply diazinon)?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Advance to CLOSING STATEMENT.

Interim telephone script v1

Attachment 25C: BEEA IA Contact Script for Scheduling First Post-Application Visit

Study of Biomarkers of Exposures and Effects in Agriculture
(Recent Exposure Group)
AT THE END OF THE INTERIM INTERVIEW
SCHEDULING: Based on your farming activities, we are ready to tentatively schedule the next
visit to your farm. During this visit, we will administer a brief questionnaire, and will once again
collect blood and urine samples. Do you have any questions at this time?
We would like to schedule the visit for the morning of [within 24 hours after last diazinon
application]. Would this morning work for you? [Schedule visit- if suggested morning is not
convenient, try for that afternoon, or the following morning].
____________________________________________________________________________
You will be receiving materials in the mail from us in preparation for your visit. Please contact
us if you have any questions prior to our visit, or if your schedule changes. Our telephone
number is 800-217-1954. We appreciate your help with our research.
CLOSING STATEMENT: Thank you for your time today. Based on your schedule, we will plan
to call you again in a (week/month/couple of weeks/couple of months). If your schedule
changes, please contact us at 800-217-1954. We appreciate your help with our research.

Interim telephone script v1

Attachment 25D: BEEA NC Contact Script for Scheduling First Post-Application Visit

Study of Biomarkers of Exposures and Effects in Agriculture
(Recent Exposure Group)

Public reporting burden for this collection of information is estimated to average 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.
Hello, I am calling from the Battelle, trying to reach (Mr. Name of AHS private pesticide
applicator).
IF THE PESTICIDE APPLICATOR IS NOT AVAILABLE NOW, ASK ABOUT AND RECORD A
BETTER TIME TO REACH HIM.
Thank you very much.
TO RESPONDENT:
My name is _________________. I am calling from the Battelle North Carolina Field Station for
the Biomarkers of Exposures and Effects in Agriculture. I'm calling to find out about your
farming activities and when we can schedule your next home visit. I just have a couple of
questions.
When we last spoke, you said you would be (making a decision about when to apply
diazinon/applying diazinon) in (MONTH).
Q1. Do you plan to apply diazinon during the next four weeks?
a) Yes
b) No

Advance to SCHEDULING.

Q2. Approximately when do think you may (make a decision about when to apply diazinon/
apply diazinon)?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Advance to CLOSING STATEMENT.

Interim telephone script v1

Attachment 25D: BEEA NC Contact Script for Scheduling First Post-Application Visit

Study of Biomarkers of Exposures and Effects in Agriculture
(Recent Exposure Group)
AT THE END OF THE INTERIM INTERVIEW
SCHEDULING: Based on your farming activities, we are ready to tentatively schedule the next
visit to your farm. During this visit, we will administer a brief questionnaire, and will once again
collect blood and urine samples. Do you have any questions at this time?
We would like to schedule the visit for the morning of [within 24 hours after last diazinon
application]. Would this morning work for you? [Schedule visit- if suggested morning is not
convenient, try for that afternoon, or the following morning].
____________________________________________________________________________
You will be receiving materials in the mail from us in preparation for your visit. Please contact
us if you have any questions prior to our visit, or if your schedule changes. Our telephone
number is 800-424-7883. We appreciate your help with our research.
CLOSING STATEMENT: Thank you for your time today. Based on your schedule, we will plan
to call you again in a (week/month/couple of weeks/couple of months). If your schedule
changes, please contact us at 800-424-7883. We appreciate your help with our research.

Interim telephone script v1