Prospective Studies of US Military Forces: The Millennium Cohort Study

MILLENNIUM COHORT: 2014 Panel 1-4 (follow-up)

Phase 1:

• Memorial Day postcard & email

Launch June/July 2014

1. Pre-notice letter with key study findings graphic insert (week 1)

   1. Active Duty

   2. Separated/Retired

2. Pre-notice email: (week 3)

3. Card (week 8)

   1. NOT LINKED to Family participant

   2. LINKED to Family participant

4. Email (week 9)

   1. Active Duty NOT LINKED to Family participant

   2. Separated/Retired NOT LINKED to Family participant

   3. Active Duty LINKED to Family participant

   4. Separated/Retired LINKED to Family participant

5. Endorsement letter (week 12)

6. Email (week 13)

7. Questionnaire 1 (week 15)

8. Email (week 17)

   1. Active Duty

   2. Separated/Retired

9. Email (week 19)

10. Graphic postcard (week 21)

11. Questionnaire 2 via First Class mail (week 25)

12. Email (week 27)

13. Reminder postcard /Veterans Day postcard (week 29)

Phase 2 (March 2015)

14. Letter to reconnect after the break and establish updated addresses (week 1)

15. Email (week 2)

16. Questionnaire 3 via Priority mail (week 7)

17. Email (week 14)

PHASE 1:

2014 Memorial Day Postcard

May 2014

Purpose: Annual Memorial Day postcard to do address check.

Contents: 5x7 postcard

Message:

As we remember those who gave their lives for our nation, we also reflect on the sacrifices made by current and former service members. The Millennium Cohort Study team thanks you for your service, past or present. Your service, and that of each military member who lost their life defending our nation, is remembered and honored on this Memorial Day.

We will be contacting you again in the upcoming months to learn about any changes that may have occurred in your health since we last heard from you. Your continued participation makes it possible to inform policy makers regarding your experiences and to guide prevention measures that positively impact current and former Service members.

Contents:

• 5x7 postcard image:

1a: Pre-notice letter – ACTIVE DUTY

Week 1 [Proposed start: June/July 2014]

Purpose: Thank respondents for previous participation and provide study results.

Contents: cover letter, study results pamphlet, #10 business size envelope

Study results insert

Dear _[name]__,

You are one of over 200,000 current and former service members who completed an important DoD survey (the Millennium Cohort Study) aimed at understanding the possible effects of military service on long-term health. The last questionnaire you completed for the study was in (survey month/year).

We appreciate enormously your help with this Department of Defense study, and thought you might appreciate knowing about some of the results from this effort. The enclosed summary provides just a few of the results and how they are being used. Because of occasional follow-up questionnaires, we are able to understand how health circumstances change. Even in the short period since the beginning of this research, we have been able to observe changes in health-related situations and the reasons for these changes.

Those of you who have helped with this study come from all branches and components of the military. Some of you are no longer in the active military service, while others of you continue to serve. The breadth of this study, the largest of its kind ever conducted, is especially valuable because it allows for understanding if different kinds of military service and deployments result in no specific health symptoms or in the development of a health symptom or concern. Regardless of your specific situation, your information is critically important to this effort.

We hope you’ll find these results of interest. More research findings will be posted to our website, www.millenniumcohort.org , as analyses are released and used.

In a few weeks, we will be contacting you to learn about any changes that may have occurred in your health since we last heard from you. We are eager to learn more about how participants’ lives may have been affected by military service, or whether there has been no specific effects from your military time – both are very important for understanding the ongoing health of service members.

Thanks so much for your effort to help the U.S. military provide the best medical care to current and future members of the military.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• #10 business size envelope:

• Letterhead for cover letter:

• Study Findings insert: (front)

• Study Findings insert: (back)

1b: Pre-notice letter – SEPARATED/RETIRED

Week 1 [Proposed start: June/July 2014]

Purpose: Thank respondents for previous participation and provide study results. To better engage former service members & veterans in survey completion.

Contents: cover letter, study results insert, #10 business size envelope

Dear _[name]__,

You are one of 200,000 current and former service members who completed an important DoD survey (the Millennium Cohort Study) aimed at understanding the possible effects of military service on long-term health. The last questionnaire you completed for the study was in (survey month/year).

We appreciate enormously your help with this Department of Defense study, and thought you might appreciate knowing about some of the results from this effort. The enclosed summary provides just a few of the results and how they are being used. Because of occasional follow-up questionnaires, we are able to understand how health circumstances change. Even in the short period since the beginning of this research, we have been able to observe changes in health-related situations and reasons.

We understand that you are no longer in the active military service, but we still need your continued participation. Because former service members and veterans face unique challenges, sharing your experiences will help the DoD understand the impact of health and life situations of people even after they leave military service. This knowledge may eventually lead to better treatments and preventive measures for veterans.

The breadth of this study, the largest of its kind ever conducted, is especially valuable because it allows for understanding if different kinds of military service and deployments have resulted in no specific health symptoms or in the development of a health symptom or concern. Regardless of your specific situation, your information is critically important to this effort.

We hope you’ll find these results of interest. More research findings will be posted to our website, www.millenniumcohort.org , as analyses are released and used.

In a few weeks, we will be contacting you to learn about any changes that may have occurred in your health or life situation since we last heard from you.

Thanks so much for your effort to help provide the best medical care to former and current members of the military.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• #10 business size envelope: same as 1a

• Letterhead for cover letter:: same as 1a

• Study Findings insert:

2: Pre-notice Email

Week 3

Purpose: reconnect by email. Mention more results on website .

Subject Line: Preliminary results from your participation in research study

Dear _[name]__,

We hope you recently received our letter in the mail which highlights the study progress of the service member study since it began in 2001.

You are one of 200,000 current and former service members who completed an important DoD survey aimed at understanding the possible effects of military service on long-term health. The last survey you completed for the study was in [survey month/year]. We greatly appreciate you sharing your experiences, including those after you leave the military, to evaluate the potential long-term health effects of military service.

The study produces important results that inform DoD and VA leaders regarding the associations of military experiences on future health outcomes. Our recent postal letter to you highlighted some of this study’s findings since 2001. If you did not receive our recent postal letter, we would appreciate you providing us a current postal address so that we can continue to keep you informed about results from this important national study.

In a few weeks, we will send you the new survey version, which has some important updates from the previous version. The 2014 survey also includes some questions that are similar to those which you have completed in the past so that we can track changes in experiences and health events since the previous survey.

To view our study progress and to also update your postal address, please visit our study website: website address

Meantime, as additional analyses are completed, we will post results on our website, and want to let you know that you may go there to see them.

Thanks so much for your effort to help the U.S. military provide the best medical care to current, former, and future members of the military, through your participation in this critical study.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [add link]

3a: Card NOT LINKED to Family Study participant.

Week 8

Purpose: Invitation to go the web and complete the survey.

Contents: Card, 5x7 business size envelope:

Dear _[name]__,

A few years ago, you were very helpful in completing a survey for the Millennium Cohort Study which assesses the health and well-being of service members over time. We are writing to ask for your continued help with the largest effort ever undertaken to understand if military service affects the health of military members during, as well as after, their military service is completed.

We appreciate greatly your previous help with this effort that involves all branches and components of the military. You may notice that this year’s questionnaire has been changed, removing some questions and adding others that seem to be helpful in understanding what happens over time with regard to health issues and the consequences.

Please complete the survey by going to: www.millenniumcohort.org, where you should click on Start Survey, and enter your Subject ID: xxxxxx.

Thank you for your continued help in making this the largest and most important DoD study in US military history and working with us to protect the health of members of our military service.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• 5x7 business size envelope:

• 5x7 Card: (front)

• 5x7 Card: (back)

3b: Card LINKED to Family Study participant.

Week 8

Purpose: Invitation to go the web and complete the survey.

Contents: Card, 5x7 business size envelope:

Dear _[name]__,

A few years ago, you were very helpful in completing a survey for the Millennium Cohort Study which assesses the health and well-being of service members over time. We are writing to ask for your continued help with the largest effort ever undertaken to understand if military service affects the health of military members during, as well as after, their military service is completed.

We appreciate greatly your previous help with this effort that involves all branches and components of the military. You may notice that this year’s questionnaire has been changed, removing some questions and adding others that seem to be helpful in understanding what happens over time with regard to health issues and the consequences.

Please complete the survey by going to: www.millenniumcohort.org, where you should click on Start Survey, and enter your Subject ID: xxxxxx.

In addition, your spouse will also receive an invitation to complete his/her follow-up survey as part of the Family Study, which works in partnership with this service member survey. These two studies are the only ones in history that follow the service member and their family over time as they experience both the unique challenges and achievements associated with military life.

Thank you for your continued help in making this the largest and most important DoD study in US military history and working with us to protect the health of members of our military service.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• 5x7 business size envelope: same as 3a

• 5x7 Card: same as 3a

4a: Email ACTIVE DUTY NOT LINKED to Family participant

Week 9

Purpose: reference recent postal contact. Continue to push for web completion.

Subject Line: Appreciation for your past participation

Dear _[name]__,

Last week you should have received a letter requesting your continuing participation in the largest effort ever undertaken to understand how military service may affect the health situation of military members during, as well as after, their military service is completed.

I am following up with this email to provide an electronic link, which we hope makes it easier for you to access and complete this follow-up survey. Please go to:

[link to survey]

Unlike many other surveys, this study is designed to follow you over time to understand any changes to your health and any concerns you may have. Even if you are no longer on active duty, or are not experiencing any health symptoms, your responses are still very valuable in understanding how specific military experiences do or do not affect the health of current and former service members.

Thank you for working with thousands of other service members and veterans to protect the health of current and future members of our military service.

This survey is “Official Business”. Military members may complete this at their duty station, using government equipment. If you choose, you can also complete the survey at home or elsewhere.

If you did not receive our postal mailing, then we may not have your most updated information. You are a valued participant and we want to assure that we send it to the correct postal address. Please update your contact info at: [update contact info -website]_.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

4b: Email SEPARATED/RETIRED NOT LINKED to Family participant

Week 9

Purpose: reference recent postal contact. Continue to push for web completion.

Subject Line: Appreciation for your past participation

Dear _[name]__,

Last week you should have received a letter requesting your continuing participation in the largest effort ever undertaken to understand how military service may affect the health situation of military members during, as well as after, their military service is completed.

I am following up with this email to provide an electronic link, which we hope makes it easier for you to access and complete this follow-up survey. Please go to:

[link to survey]

Some believe their continued participation in this study is no longer valuable because they have separated or retired from military service. However, the Millennium Cohort Study was designed to evaluate long-term health effects, so the continued participation of former service members is essential to the project’s success.

Thank you for working with thousands of other service members and veterans to protect the health of current and future members of our military service.

If you did not receive our postal mailing, then we may not have your most updated information. You are a valued participant and we want to assure that we send it to the correct postal address. Please update your contact info at: [update contact info -website]_.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

4c: Email ACTIVE DUTY LINKED to Family Study participant.

Week 9

Purpose: reference recent postal contact. Continue to push for web completion.

Subject Line: Appreciation for your past participation

Dear _[name]__,

Last week you should have received a letter requesting your continuing participation in the largest effort ever undertaken to understand how military service may affect the health situation of military members during, as well as after, their military service is completed.

I am following up with this email to provide an electronic link, which we hope makes it easier for you to access and complete this follow-up survey. Please go to:

[link to survey]

Unlike many other surveys, this study is designed to follow you over time to understand any changes to your health and any concerns you may have. Even if you are no longer on active duty, or are not experiencing any health symptoms, your responses are still very valuable in understanding how specific military experiences do or do not affect the health of current and former service members.

In addition, your spouse will also receive an invitation to complete his/her follow-up survey as part of the Family Study, which works in partnership with this service member survey. These two studies are the only ones in history that follow the service member and their family over time as they experience both the unique challenges and achievements associated with military life.

Thank you for working with thousands of other service members and veterans to protect the health of current and future members of our military service.

This survey is “Official Business”. Military members may complete this at their duty station, using government equipment. If you choose, you can also complete the survey at home or elsewhere.

If you did not receive our postal mailing, then we may not have your most updated information. You are a valued participant and we want to assure that we send it to the correct postal address. Please update your contact info at: [update contact info -website]_.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

4d: Email SEPARATED/RETIRED LINKED to Family participant

Week 9

Purpose: reference recent postal contact. Continue to push for web completion.

Subject Line: Appreciation for your past participation

Dear _[name]__,

Last week you should have received a letter requesting your continuing participation in the largest effort ever undertaken to understand how military service may affect the health situation of military members during, as well as after, their military service is completed.

I am following up with this email to provide an electronic link, which we hope makes it easier for you to access and complete this follow-up survey. Please go to:

[link to survey]

In addition, your spouse will also receive an invitation to complete his/her follow-up survey as part of the Family Study, which works in partnership with this service member survey. These two studies are the only ones in history that follow the service member and their family over time as they experience both the unique challenges and achievements associated with military life.

Some believe their continued participation in this study is no longer valuable because they have separated or retired from military service. However, the Millennium Cohort Study was designed to evaluate long-term health effects, so the continued participation of former service members is essential to the project’s success.

Thank you for working with thousands of other service members and veterans to protect the health of current and future members of our military service.

If you did not receive our postal mailing, then we may not have your most updated information. You are a valued participant and we want to assure that we send it to the correct postal address. Please update your contact info at: [update contact info -website]_.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

5: Endorsement Letter

Week 12

Purpose: emphasize endorsement from senior official. Emphasize official sponsorship.

Contents: cover letter, endorsement letter, #10 business size envelope

Dear _[name]__,

We truly appreciate the support of [endorsement letter pending final document] for our DoD study of the health and well-being of service members and veterans. We also appreciate your help with this important study.

The Millennium Cohort Study is the largest study in US history on the short- and long-term military effects on the health of service members and veterans. The valuable information that you and other service members have previously provided have been utilized by DoD leaders and policymakers to implement strategies to protect the health and well-being of our service members. We hope you will continue to share your experiences by going online and completing the newest version of the survey.

Just go to www.millenniumcohort.org and click Start Survey and enter your Subject ID: xxxxxx.

We really appreciate your effort to complete the survey online – completing it on the web saves DoD money and allows us to produce results more quickly.

Thanks so much for your time and sacrifices for our country.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

Contents:

• #10 business size envelope:

• Letterhead for cover letter:

• Endorsement Letter: pending receipt

6: Email

Week 13

Purpose: mention endorsement letter sent previous week.

Subject: A Letter to you from “___________”

Dear _[name]__,

Last week we sent you a postal letter to share with you [endorsement pending] support for our DoD study of the health and well-being of service members. [endorsement pending] also encourages your continued help by completing a follow-up web survey.

This request was sent to you because you had previously completed a survey for the study in_[survey month/year]. We are especially interested in hearing your thoughts and experiences because that will provide greater insight into issues facing today’s military service members and veterans. In order to gain a complete picture of military service and its effects on the health and well-being of service members over time, we need to hear from you and the other selected sample of military service members in this study.

If you have already been able to go online and complete the questionnaire, we want to say thank you. If you have not yet had time to consider our request, we hope you will be able to do so soon. To complete it, all you need to do is go to the website, www.millenniumcohort.org and click Start Survey. You will need to use the following Subject ID: xxxxxx.

Thanks so much for your consideration for completing this important study.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

7: Questionnaire #1

Week 15

Purpose: 1^st paper survey mailing via USPS First Class mail.

Contents: Kraft color 10 x13” outer envelope, Letterhead for cover letter, Full Survey, White Business Reply Envelope:

Dear _[name]__,

In the last few weeks, we have been writing to you requesting an update to the information you provided a few years ago for the Millennium Cohort Study. We are seeking to understand the long-term health and well-being implications of military service.

We appreciate enormously the effort you and others from all branches of the military have made by responding to our request for help with this study in previous years. One of the reasons we are asking you to complete this new questionnaire is that new information you provide will make your previous information much more powerful for understanding what the various military services can do to assure the long term health of members during and after their service to our country.

We are sending a paper questionnaire and return envelope in hopes this way of responding might be easier or more convenient to complete and return. This questionnaire is different from the one you completed in previous years. We’ve added a few questions of interest and taken out ones that seemed not as helpful for accomplishing the study’s purpose.

As a member of this study, you are providing a picture of the overall health of military service members throughout their lives. Your past participation and that of others like you have already helped us to provide valuable information on vaccine safety, respiratory conditions, and risk factors for stress and post-service experiences to military and VA leaders. We hope that results from this study will help with decisions on how to provide the best health care possible for service members and veterans in the future.

We thank you for completing the enclosed survey and returning it in the pre-paid envelope.

If you like, you can also use the enclosed paper survey to get a sense of the questions we are asking, and then go online (instead of returning the paper version) to complete the survey at www.millenniumcohort.org . Your unique Subject ID: xxxxxx.

Thank you for your selfless service and dedication to this study and our nation.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• Kraft color 10 x13” outer envelope:

• Letterhead for cover letter:

• Survey:

• White Business Reply Envelope:

8a: Email ACTIVE DUTY

Week 17

Purpose: email focusing on one topic.

Topic: how participation makes a difference

Subject Line: The answer to a recent question

Dear _[name]__,

We have been writing to you these last few weeks because it is important that we hear from you and want you to continue to be part of this important study. Some people have written and asked us, “How will my participation in this study make a difference?”

Simply stated, without your shared experiences and that of other service members, we will not be able to determine the potential impact of military service, both recent and remote, on the health and well-being of our service members and veterans. It is essential that we receive your information because you have been carefully selected to represent your fellow Soldiers, Sailors, Airmen, and Marines.

There are a limited number of service members taking this survey, so every individual response is needed for this to be a successful study. Ultimately, the greatest benefits of this study will not be known for many years. This is why it is essential to stay involved with the study even after you are out of the service or if you are not currently having any health concerns.

Thank you again for working with us to make the Millennium Cohort Study a success in protecting the health of current and future members of our military service.

Very sincerely,

Martin White, MPH

Principal Investigator

P.S. It’s fine to respond to either the paper questionnaire we sent or by web, whichever you find easiest. To respond by web please go to:

[link to survey]

8b: Email SEPARATED/RETIRED

Week 17

Purpose: email focusing on one topic.

Topic: how participation makes a difference & challenges faced right after separation from military

Subject Line: The answer to a recent question

Dear _[name]__,

We have been writing to you these last few weeks because it is so important that we hear from you and want you to continue to be part of this important study. Some people have written and asked us, “How will my participation in this study make a difference?”

Simply stated, without your shared experiences and that of other former service members and veterans, we will not be able to determine the potential impact of military service, both recent and remote, on health and well-being. As a former service member or veteran, is it is essential that we receive your responses because we are seeking to understand the health challenges and experiences of transitioning from military to civilian life.

Every individual response is needed for this to be a successful study. Ultimately, the greatest benefits of this study will not be known for many years. This is why it is essential to stay involved with the study even after you are out of the service or if you are not currently having any health concerns.

Thank you again for working with us to make the Millennium Cohort Study a success in protecting the health of service members and veterans.

Very sincerely,

Martin White, MPH

Principal Investigator

P.S. It’s fine to respond to either the paper questionnaire we sent or by web, whichever you find easiest. To respond by web please go to:

[link to survey]

9: Email

Week 19

Purpose: email focusing on contrasting topic from last email.

Topic: why do I need to fill out multiple surveys?

Subject Line: Why your response is important

Dear _[name]__,

We appreciate very much the questions that participants have asked. One of them is: “I filled out a previous survey, why do I need to fill out another one?”

The Millennium Cohort Study is designed to follow a select group of service members and veterans over time, and is the only study in US military history that is being conducted to answer long-term health concerns of our military force. In research, only a study that follows a group of people over time has the strength to describe long-term health outcomes of military members.

Studies using a similar design in the general population have resulted in important health findings including the discovery that high blood pressure causes heart disease and that smoking causes lung cancer. Important health facts, which may seem obvious now, were not always known to be true - they were learned through similar long-term studies. Similarly, the Department of Defense is committed to evaluate the health of service personnel throughout their military careers and after leaving military service.

Because this study is so critically important, I am sending this email to provide an electronic link to our survey. Please go to the following link and provide your valuable input:

[link to survey]

Thank you for your dedication to the health of our service members and veterans.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

10: Graphic postcard

Week 21

Purpose: target a characteristic – former military, service specific.

Contents: 5x7 graphic postcard

Dear _[name]__,

We greatly appreciate the large number of military service members and veterans who have already completed their follow-up survey, in order to help us understand better how military services affects long-term health.

We recently heard from a veteran who has been participating in this study since its beginning in 2001.

My name is Adam, and I served 20 years in the Navy and retired as a First Class Petty Officer. In 2001, I completed my first Millennium Cohort survey after receiving a letter in the mail and have continued to complete the survey every 3 years even though I have no ill effects from my 20 years of service. I think it is important that every one of us continues to participate in these surveys, and I am proud to be a part of this long term study.

We hope that you’ll complete your survey by going online to www.millenniumcohort.org. Just click Start Survey and enter your Subject ID: xxxxxx.

The large number of individuals who have taken time to answer the survey will help greatly to improve the accuracy of analyses on how service in specific military branches and how military separation may affect the health and well-being of our service members.

Thank you for considering our request.

Very sincerely,

Martin White, MPH

Principal Investigator

Other text consideration:

We recently sent you a follow-up health survey as part of the Millennium Cohort Study, however we have not yet heard back from you.

As a member of the Cohort, your continued participation is critical to understanding any long-term health impact of military service. It is vital to the success of the Millennium Cohort Study that you continue your participation, as often as you are able, even if you have retired from military service

Please complete the survey online now at:

http://www.MillenniumCohort.org

You will need your Subject ID number which can be found below the barcode on the front of this postcard.

If you have any questions, please call our toll-free number (888) 942-5222, or email us at info@millenniumcohort.org.

Contents:

• 5x7 postcard image (Front):

11: Questionnaire #2

Week 25

Purpose: 2^nd survey mailing via USPS First Class mail.

Contents: Kraft color 10 x13” outer envelope, Letterhead for cover letter, Full Survey, White Business Reply Envelope:

Dear _[name]__,

During the last two weeks, we have evaluated the responses to this year’s survey for the Millennium Cohort Study.

We are grateful for the large number of current, as well as former military members, who have responded, including some who have participated since 2001 and others who respond in later years. It’s clear to us that we are going to be able to provide insight into how and why the health of some individuals appears to have been affected by their military service, but others have not.

However, our ability to report reliable results depends not only on those who have responded, but others, including yourself, who we have not yet heard from. This is the reason we are following up with you.

Obtaining precise results that can be confidently relied on is important because responses will be used for identifying and attempting to resolve health care issues for current, past, and future military members. We hope that this request will help put us over the top for completing a study that can be used to improve the lives of individuals in all branches and components of the military.

We have additional information about this research on our web site at www.millenniumcohort.org. You can also use this link to complete the survey online by clicking Start Survey and entering your Subject ID: XXXXXXXX.

Thank you for helping make a difference.

Very sincerely,

Martin White, MPH

Principal Investigator

12: Email

Week 27

Purpose: emphasize Questionnaire 2 mailing and ‘closure’

Subject Line: Health and well-being of service members and veterans

Dear _[name]__,

We hope that you have been able to look through the questionnaire that we sent last week and complete it, and if not, that you will do that soon. The study will be coming to a close this year in just a few weeks.

It is very important that we hear from you and the other select sample of current and former service members asked to participate in this study. Only by hearing from each person can we determine if and how service in specific military branches, specific occupations, and many other factors, affect the long-term health and well-being of service members and veterans.

If you prefer to complete the survey using the web rather than the paper questionnaire, we would welcome you going online and completing it at [link to survey]

Thank you for considering our request. We are looking forward to hearing from you.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

13: Veteran’s Day PC/Reminder PC

Week 29

Purpose: reminder postcard

Contents: 5x7 Postcard

Dear _[name]__,

We also hope that you’ll take the opportunity to visit our website at www.millenniumcohort.org. You can use this link to complete the survey online by clicking Start Survey and entering your Subject ID: XXXXXXXX.

Thank you for helping us to make a difference in the lives of veterans.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• 5x7 graphic postcard: pending artwork

PHASE 2: [obtain feedback from 1^st phase to tailor 2^nd phase]

14: Letter

Week 1 [Start again in March 2015]

Purpose: reconnect after break; establish updated addresses.

Contents: cover letter, , #10 business size envelope

Dear _[name]__,

Last year we contacted you about an important Department of Defense study on the health and well-being of service members both during and after service. We have heard from the majority of the selected current and former service members participating in this effort, but are writing to you and others who have not responded because of the critical importance of this study. We also realize that some people may have been in situations of not being able to complete the survey when previously contacted.

The reason we are now reaching out to you again is because we are concerned that those who have not responded may have had either more or fewer health changes than those who have responded, and we want to be sure our conclusions from this study are as accurate as possible.

Because of the importance that each questionnaire has, we are sending this email link for you to be able to easily go online and complete the survey: www.millenniumcohort.org Click Start Survey and enter your Subject ID: xxxxxx.

Thanks so much for your effort to help the U.S. military and VA provide the best care to current, past, and future members of the military.

Very sincerely,

Martin White, MPH

Principal Investigator

Contents:

• #10 business size envelope:

• Letterhead for cover letter:

15: Email

Week 2

Purpose: reference letter, provide electronic link, add new info

Subject: New opportunity

Dear _[name]__,

Last week, I sent a letter to you about an important health study called the Millennium Cohort Study. The new information that we are now collecting on the survey will provide a more comprehensive understanding of the health concerns of service members, including active duty service members, reservists, and those who have separated.

There are several reasons that your participation is so important. First, the Millennium Cohort Study is unique in that it follows a service member over time as you experience the challenges and rewards associated with military life. Only by understanding your health and well-being over time, will we truly understand the long-term effects of military service an how to provide the best possible care for service members in the future. In addition, the study represents all service branches

Therefore, we are sending this by email to provide an electronic link, which we hope will make it easier for you to respond Please go to:

[link to survey]

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

16: Questionnaire #3 via USPS Priority Mail

Week 7

Purpose: 3^rd survey mailing via USPS Priority mail

Contents: USPS Priority Mail outer envelope, Letterhead for cover letter, Full Survey, White Business Reply Envelope

Dear _[name]__,

We recently wrote to ask you to complete your follow-up survey to an important Department of Defense study on the health and well-being of service members both during and after service. The new information that we are now collecting on the survey will provide a more comprehensive understanding of the health and well-being of military. I have enclosed a copy of the questionnaire and a return envelope, and hope that this will make it easier for you to respond.

Knowing your specific thoughts and experiences since the first survey you completed, will make your previous information much more powerful on understanding how military-related experiences including service within specific branches, deployments, length of time in service, and many other issues, affect the long-term health and well-being of service members, including active duty service members, reservists, and those who have separated or retired.

We have sent this via Priority Mail to assure delivery because of the importance a high response rate has for making sure this study produces accurate results. Obtaining precise results is important, because responses will be used for identifying and resolving health care issues experienced by military members.

Even if you are currently no longer in the service, your participation is essential in order to form a complete picture of the impact of military life. Furthermore, even if your experiences have been positive, negative, or neutral, your input is extremely valuable to the validity of this study’s findings.

We have additional information about this research on our web site at www.millenniumcohort.org. You can also use this link to complete the survey online by clicking Start Survey and entering your Subject ID: XXXXXXXX.

Thank you for helping make a difference.

Very sincerely,

Martin White, MPH

Principal Investigator

• USPS Priority Mail outer envelope:

• Letterhead for cover letter:

• Survey:

• White Business Reply Envelope:

17: Final email

Week 14

Purpose: Final email contact/last chance

Subject: Survey Ending

Dear _[name]__,

We hope that you have been able to look through the questionnaire that we sent you last week and complete it, and if not, that you will do that soon. It is very important that we hear from everyone asked to participate in this study. This is the first study of its kind looking at both short and long-term health effects of military service. Only by hearing from each person can we determine if and how service-related injuries, the military healthcare system, and life after military service time, affect the health and well-being of service members/veterans over time.

If it would be easier for you to respond online, you can complete the survey by following the link below.

[link to survey]

Your subject ID: xxxxxx

For any questions, please contact the Millennium Cohort Team at our toll-free number: 1-888-942-5222 or DSN 553-7465, or email us at: milcohortinfo@med.navy.mil or info@millenniumcohort.org.

Thank you so much for considering this final opportunity to respond.

Very sincerely,

Martin White, MPH

Principal Investigator

Some people have multiple email addresses. If we’ve reached you at an inappropriate address, please visit this web site to provide a preferred address for contacting you: [unsubscribe email link]

Thank you email AFTER survey completion, NO POST-INCENTIVE

Purpose: message of appreciation

Subject:

Dear _______,

We are writing to thank you for recently completing your survey for the Millennium Cohort Study, the largest effort ever undertaken to understand the effect of military service on health outcomes.

The information provided by you and other invited participants in this representative sample of all branches of military service, will help us provide critical information to health care providers and military leaders about the specific health concerns of service members and veterans. Among other things, it will help us understand why military service and deployments result in no specific health issues for some, and the development of health symptoms and concerns among others.

We plan to conduct a follow-up of participants in 2017, to learn about any changes in individual health that may be related in some way to military service.

Meantime, as analyses are completed, we will post results on our website, www.millenniumcohort.org , and want to let you know that you may go there to see them.

Thanks again for working with us to help make the Millennium Cohort Study a success in protecting the health of former, current, and future members of our military service.

Very sincerely,

Martin White, MPH

Principal Investigator

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Version date: 2/18/14