OMB Control Number: 0970-0355
Expiration Date: 1/31/2015
Length of time for instrument: 0.08 hours
APPENDIX C:
FPRQ Cognitive Interview Instruments for Ineligible Center Directors
3/16/12
Cognitive Interview Screener
Family-Provider Relationship Quality Measurement Project
DIRECTORS
1. Can you tell me how you learned about the study?
Local newspaper/weekly, specify which one___________________________
Flyer, specify where____________________________________________________
Craigslist
Program/clinic/center, specify _____________________________________
Child Trends staff announcement
Other, specify_________________________________________________________
Are you 18 years or older
Yes
No (GO TO STOP SCREENER)
How old is (are) the child(ren) in your school/center?
Specify _______________________________
(NOTE: IF ONLY CHILDREN 6 OR OLDER GO TO STOP SCREENER)
Okay, now I have some questions about you.
Are you of Hispanic or Latino origin?
Yes
No
What is your racial background? (NOTE: Mark one or more.)
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Other, specify__________________
In what country were you born?
Born in the U.S.
Born elsewhere (specify ________________________)
What town/city and state do you currently live in?
Specify ________________________
What language do you use in the care setting?
English only
English and Spanish
English and other:_____________________
Spanish only
Other:______________________________
What is your language preference?
English (PROCEED TO MATRIX)
Spanish **
(**NOTE: DURING ROUND 1, PROCEED TO Q 15**)
(**NOTE: DURING ROUNDS 2 OR 3, PROCEED TO MATRIX**)
Other
Are you able and interested in doing an interview in English?
Yes
No (GO TO STOP SCREENER)
PROCEED TO INTERVIEW SCREENER MATRIX
Compare respondent’s characteristics with recruitment matrix.
If prospective participant is eligible and target numbers for characteristics have not been met, proceed and schedule for the interview.
If target numbers for characteristics have been met, respondent is not eligible. GO TO STOP SCREENER.
IF POTENTIAL PARTICIPANT IS ELIGIBLE, SCHEDULE FOR INTERVIEW.
Based on what you have told me, you are eligible for the study.
INTERVIEWER: CHECK INTERVIEWER AVAILABILITY
Which time/day would work best for you?
The interview is going to be held at [INTERVIEW LOCATION]. At the end of the interview, you will receive $50.
Within the next day, we will be mailing/emailing you a reminder letter with the time, date, and location of your interview. The letter/email will also include a copy of the project consent form describing the study, what we will be doing, your rights as a study participant, and other important information. We request that you read the consent form before you attend the interview. We will also review the consent form before we begin the interview and you will have an opportunity to ask any questions or raise any concerns you may have. Can I get your mailing address/email so that I can you send you this?
Street Address:
City: State: Zip Code:
Email:
You will also receive a reminder call the day before your interview.
Is the number you provided us the best number to reach you? If not, can I have a phone number where I can reach you?
___Phone number confirmed
___New number provided (cell/landline)___________________
Thank you for agreeing to participate in this important study. We look forward to meeting you on [DATE] at [TIME]. Again, the interview will take place at [INTERVIEW LOCATION]. The day before the interview you will also receive a reminder call from us. If you have any questions before then, please feel free to call us at (202)553-2900 or toll-free at 1-888-418-4585.
IF NOT SURE WHETHER TO SCHEDULE POTENTIAL PARTICIPANT FOR INTERVIEW:
I need to talk with my supervisor to confirm whether you are eligible to participate in the study.
STOP SCREENER: Thank you. Unfortunately, you are not currently eligible to participate in our study. I’d like to thank you for your interest and time. [IF PARTICIPANT IS ELIGIBLE, BUT GROUP IS FULL] If you are interested, we can keep your information and contact you if one of the cognitive interview participants cancels.
FPRQ
Cognitive Interview Instruments for Ineligible Center Directors
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Department of Health and Human Services |
File Modified | 0000-00-00 |
File Created | 2021-01-26 |