1C Attachment 1-B. Study 1 Recruitment screener

Form Approved
OMB No. 0935.0124
Exp. Date 1/31/2024

Recruitment Script – Adults

INTRODUCTION SCREEN. Hello, may I please speak with [NAME]?

I am calling to follow up about the web survey you recently completed about the upcoming Westat health study. You are eligible for the study, and I’d like to ask you a couple more questions and to set up a time for your first interview. As a reminder, this study involves participating in three interviews over Zoom about every three weeks. As a token of appreciation for your time, you will receive an electronic gift card after participating in each interview, with $25 for each of the first two interviews, and $75 for the final interview.

During each of the first two interviews, the interviewer will observe you as you fill out a short questionnaire to update us on any recent health care visits {IF SCREENER Q8 > 1 THEN DISPLAY: by you or any people in your household}. In the last interview, the interviewer will ask you a series of more detailed questions about any visits.

This survey is authorized under 42 U.S.C. 299a. The confidentiality of your responses to this survey is protected by Sections 944(c) and 308(d) of the Public Health Service Act [42 U.S.C. 299c-3(c) and 42 U.S.C. 242m(d)]. Information that could identify you will not be disclosed unless you have consented to that disclosure. Your participation is voluntary and all of your answers will be kept confidential to the extent permitted by law. Public reporting burden for this collection of information is estimated to average 5 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0124) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

1. Are you still interested in participating in this study?

• Yes [CONTINUE]

• No [THANK AND END CALL]

2. Do you have a few minutes now for me to ask you a few more questions and to tell you more about the study?

• Yes [CONTINUE]

• No [SET UP A TIME TO CALL BACK]

CONFIRM AGE

3. First, let me confirm your age. You said you were [SCREENER Q1] years old, correct?

• Yes [GO TO Q3]

• No

3. Can you tell me what your age is?

[ENTRY FIELD FOR NUMBERS]

[IF PARTICIPANT IS UNDER 18 THEN GO TO INELIGIBLE STATEMENT]

INELIGIBLE STATEMENT.

Thank you very much for your interest and your time, but you are not eligible for this study.

HEALTH CARE VISITS IN THE LAST 3 MONTHS

[IF SCREENER Q13=YES, CONTINUE. ELSE SKIP TO Q13.]

3. In your web survey, you answered that in the last 3 months you {IF SCREENER Q8 > 1 THEN DISPLAY: or someone in your household} had a doctor’s visit or received health care services. I’d like to ask you about each of these visits. The information you share will only be used for the purposes of this study and will be loaded into the surveys that we’ll ask you to complete as part of this study. You might want to have a calendar or health records handy as I ask you these questions.

{IF SCREENER Q8 > 1 THEN DISPLAY: Starting with you,}/{IF SCREENER Q8 = 1 THEN DISPLAY: Just to confirm,} did you have any doctor’s visits or receive any healthcare services over the last 3 months, that is, since {DATE 3 MONTHS AGO]?

• Yes [CONTINUE]

• No [GO TO Q8INTRO. IF NO OTHER PEOPLE, GO TO Q13]

3. On what date was your {next} most recent visit or health care event? If you are not sure, give your best estimate. For hospital stays, please tell me the date you were admitted to the hospital.

[MONTH/DAY/YEAR]

3. For this event, what was the name of the health care provider, hospital, facility or clinic that provided the care?

[TEXT BOX]

3. What was the main reason for receiving this health care?

[TEXT BOX]

3. Did you receive any other health care services in the last 3 months?

• Yes [LOOP BACK TO Q4 THROUGH Q7]

• No [IF SCREENER Q8=1, GO TO Q13. OTHERWISE CONTINUE.]

Q8INTRO. Now I’d like to ask the same questions about {SCREENER Q9, PERSON X}

3. Did {SCREENER Q9, PERSON X} have any doctor’s visits or receive any healthcare services over the last 3 months, that is, since {DATE 3 MONTHS AGO]?

• Yes [CONTINUE]

• No [IF ANOTHER PERSON IS LISTED IN SCREENER Q9, RETURN TO Q8INTRO FOR NEXT PERSON. IF NO OTHER PEOPLE, GO TO Q13]

3. On what date was {PERSON X}’s {next} most recent visit or health care event? If you are not sure, give your best estimate. For hospital stays, please tell me the date they were admitted to the hospital.

[MONTH/DAY/YEAR]

3. For this event, what was the name of the health care provider, hospital, facility or clinic that provided the care?

[TEXT BOX]

3. What was the main reason for receiving this health care?

[TEXT BOX]

3. Did {PERSON X} receive any other health care services in the last 3 months?

• Yes [REPEAT Q8 THROUGH Q12]

• No [IF ANOTHER PERSON IS LISTED IN SCREENER Q9, RETURN TO Q8INTRO FOR NEXT PERSON. IF NO OTHER PEOPLE, GO TO Q13]

ZOOM AND DEVICES

3. Thank you for sharing that information. Now I’d like to ask a few questions to get you set up for your first interview, which will take place over Zoom. Which device do you think you might use for this interview? [READ IF NECESSARY]

• Android Phone

• iPhone

• Tablet (Android or iPad)

• Desktop/Laptop

• Other – Specify [TEXT BOX]

• I don’t have any of the these devices [GO TO INELIGIBLE STATEMENT]

3. We would like to audio and video record the interview. Would that be ok with you?

• Yes

• No

3. During the Zoom interview, the interviewer will ask you to share your screen so that they can see your screen as you navigate through a website. Would that be ok with you?

• Yes

• No [GO TO INELIGIBLE STATEMENt]

SET UP DATE AND TIME

We would like to set up a time and date for the first interview sometime in the next two weeks.

3. First, what is your time zone?

• Pacific Time Zone

• Mountain Time Zone

• Central Time Zone

• Eastern Time Zone

3. Which day do you prefer? [MARK ALL THAT APPLY]

• Monday [DATE]

• Tuesday [DATE]

• Wednesday [DATE]

• Thursday [DATE]

• Friday [DATE]

• None of these dates work for me [SINGLE RESPONSE OPTION] [GO TO INELIGIBLE STATEMENt]

3. What time of day works best for you? [MARK ALL THAT APPLY]

[LOOP FOR EACH Q17 OPTION SELECTED]

• 09:00 AM – 10:00 AM

• 10:00 AM – 11:00 AM

• 11:00 AM – 12:00 PM

• 12:00 PM – 01:00 PM

• 01:00 PM – 02:00 PM

• 02:00 PM – 03:00 PM

• 03:00 PM – 04:00 PM

• 04:00 PM – 05:00 PM

• 05:00 PM – 06:00 PM

• None of these times work for me [SINGLE RESPONSE OPTION] [IF NO TIMES WORK FOR ANY OF THEIR AVAILABLE DATES, GO TO INELIGIBLE STATEMENT]

Thanks for providing this information. We will check with our interviewers and get back to you by email with a specific date and time for the interview. Please plan to have your household’s healthcare records handy for the interview, like calendars, provider or insurance statements, patient portal information, or payment records.

Attachment 1C: Study 1 Recruitment Script 1C-8