Form 2.3 Goal 2 Follow-Up Telephone Interview

Attachment 2d Goal II Follow Up Telephone Interview OMB #: 0925-0647

Expiration Date: 01/31/2015

Follow Up Telephone Interview

Hello, my name is ________________. I am calling to follow up on your participation in the “Evaluating the potential of saliva as a research specimen for use in the National Children's Study”. As a part of the study, we would like to collect your feedback on your experience. Would you mind answering a few questions?

If no, explain that as it is considered a part of the study, refraining from participation will mean that they will not receive any compensation for the study. Ask if they would like to reconsider. If no, politely end the conversation.

If yes, continue:

Please rate the following statements on on a 7-point scale from “1” (disagree) to “7” (agree):

1. Collecting my own saliva was hard ____.

2. Collecting my child’s saliva was hard ___.

3. I was able to collect my own samples at the right time of day ___.

4. I was able to collect my child’s samples at the right time of day ___.

5. I would be comfortable collecting my own saliva more than 4 times per day ___.

6. I would be comfortable collecting my child’s saliva more than 4 times per day __.

7. If just 1 or 2 samples were collected per day, I would be willing to collect my own samples 3-4 days in a row ___.

8. If just 1 or 2 samples were collected per day, I would be willing to collect my child’s samples 3-4 days in a row ___.

9. It would be helpful to have a pager, timer, or txt message to remind me when to collect saliva samples ___.

10. I was comfortable doing saliva collections for myself___ .

11. I was comfortable doing saliva collections for my child ___.

12. The home visitor’s instructions were clear ___.

13. The written instructions were very useful ___.

14. I am willing to store sample temporarily in my home freezer ___.

15. I would be willing to go on-line to report the times when I collected samples ___.

16. I would watch an on-line instructional video if it were available ___.

17. It was simple to package and ready the samples to be put in the mail ___.

18. I would participate in another saliva collection study if given the chance ___.

19. I would prefer to give a saliva sample rather than a blood sample ___.

20. I would prefer to give a finger stick blood sample rather than a saliva sample ___.

The next questions are open-ended. Please provide as complete of an answer as possible for each question.

1. Did you collect the samples the day after the home visitor came to your house?

2. How many days ago was the day that you did your saliva collections?

3. On the day you collected saliva, was that a pretty typical or ordinary day? Was there anything unusual that happened that day that made it more challenging to collect saliva samples or collect the samples on time?

4. What suggestions do you have that might make saliva collection easier?

5. Is there anything else that we haven’t asked you that you would like to tell us about your experience collecting saliva?

Conclusion: Thank you for participating in our study! Do you have any questions? If yes, address questions, if no, provide contact information for further information about the study: Anjali Sivan, 443-287-4581. Thank them and politely end the conversation.

Public reporting burden for this collection of information is estimated to average15 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 (0925-0647*). Do not return the completed form to this address.