Appendix B1
Form Approved
OMB #0920-0
Expiration Date: _________
OCCUPATIONAL SAFETY AND HEALTH INFORMATION NEEDS AND USES BY TRADE ASSOCIATIONS AND LABOR UNIONS WITHIN
EIGHT INDUSTRIAL SECTORS
Interviewer Name:
Computer Log Number:
Date:
Name of Association or Union:
Address:
Phone No.:
Fax No.:
Guidelines for Interviewers
A. First contact with Association or Union:
Hello, Is this ____________________________ (Name of association or union)? My name is ____________________________ (Name of Interviewer). I work for the Oak Ridge Institute for Science and Education (ORISE). We are working with the National Institute for Occupational Safety and Health or NIOSH (as it is commonly known) which is part of the Centers for Disease Control and Prevention. We are interested in obtaining information about the workplace (worker) safety and health resources you use in your association/union and/or disseminate to your members.
(1) Could I speak with ______________ (contact name from Association Unlimited Database)?
(1a) No ______________ ( Interviewer: If no one in this position go to (2))
(1b) Person no longer the contact ______________
(1c) New contact name ______________ (Interviewer: If available go to Section B)
(1d) If not available get date/time to call back __________
(Interviewer: Say thank you and I will call back at the suggested time and date)
(1e) Yes ____ (Interviewer: If person available go to Section B)
(1f) If person not available get the Name _________________________ and
(1g) get date/time to return call _______________________
(Interviewer: Say thank you and I will call back at the suggested time and date)
Public reporting burden of this collection of information is estimated to average 2 minutes per response. 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).
(2) I am trying to reach the person who is responsible for handling the workplace (worker) safety and health issues for the members of your organization. Could I speak to the safety manager, or executive director?
(2a) No ______ (Interviewer: Go to (3))
(2b) Yes ________ (Interviewer: If person available go to Section B)
(2c) If person not available get the name _________________and
(2d) date/time to return call __________
(Interviewer: Say thank you and I will call back at the suggested time and date)
Is there anyone you could suggest I speak to who deals with the workplace (worker) safety and health issues of your members? (Suggest- the regulatory person, membership person, or marketing person or someone else)
(3a) No __________ (Interviewer: If the person still says there is no one to speak to thank person and say good-bye. Secretaries are not eligible to answer the survey.)
(3b) Yes __________ (Interviewer: If person available go to Section B)
(3c) If yes, but person not available get name ____________
(3d) date and time to call back __________
(Interviewer: Say thank you and I will call back at the suggested time and date)
B. When responsible person is reached:
Hello, _________ (Name of person to be interviewed), my name is ______________ (Name of interviewer). I work for the Oak Ridge Institute for Science and Education (ORISE). We are working with the National Institute for Occupational Safety and Health or NIOSH (as it is commonly known) which is part of the Centers for Disease Control and Prevention. I am calling today on behalf of NIOSH to learn about the workplace (worker) safety and health issues of your members. Also, I would like to know about the workplace (worker) safety and health resources you use or send to members of your association (union). Participation in the survey is voluntary and you are free to skip any questions or stop participating at any time. Would you have a few minutes to answer some questions for me or may I call back later?
(1) No ____ (Interviewer: Ask if you can call back, if refused ask questions in Blue Box in Appendix B1 below)
Non-Response Form
1.
Before we
say good-bye,
may I ask you just two questions so that we can compare associations
(unions) that do and do not take part in the survey?
1)
No ____ (Interviewer:
Thank
person and say good-bye)
(2)
Yes ____ (Interviewer:
Go
to question 2)
2. Does
your association (union) distribute workplace (worker) safety and
health information to your members?
(1)
No ____ (Interviewer:
Go to question 3) (2)
Yes ____ (Interviewer:
Go to question 3)
3.
On a scale of 1-5, with 5 being very important and 1 being not at
all important, how important are workplace (worker) safety and
health issues to your association (union).
2
3 4 5
Thank
you for taking the time to answer these questions. Have a great
day.
(Interviewer:
Thank
person and say good-bye)
Thank you. I will call you back at ________ (time and date)
(Interviewer: Say thank you and I will call back at the suggested time and date)
(3) Yes _______
Mr/Ms. ______________(Contact) this survey will take about 15 minutes to complete. The information you provide in the interview will be kept secure and your name and phone number will be deleted from the data file immediately after the data collection is complete. Your interview will help NIOSH understand your needs in the area of workplace (worker) safety and health and be valuable in planning for the development of future NIOSH safety and health materials. (Go to question 4 of Appendix B)
Non-Response Form
1.
Before we
say good-bye,
may I ask you just two questions so that we can compare associations
(unions) that do and do not take part in the survey?
(1)
No ____ (Interviewer:
Thank
person and say good-bye)
(2)
Yes ____ (Interviewer:
Go
to question 2)
2. Does
your association (union) distribute workplace (worker) safety and
health information to your members?
(1)
No ____ (Interviewer:
Go to question 3)
(2)
Yes ____ (Interviewer:
Go to question 3)
3.
On a scale of 1-5, with 5 being very important and 1 being not at
all important, how important are workplace (worker) safety and
health issues to your association (union).
1
2 3 4 5
Thank
you for taking the time to answer these questions. Have a great
day.
(Interviewer:
Thank
person and say good-bye)
| File Type | application/msword |
| File Title | Appendix B1 |
| Author | mbg3 |
| Last Modified By | Andrea Okun |
| File Modified | 2007-08-03 |
| File Created | 2007-08-03 |