Att D1a_Cover letter -- baseline provider survey_0209

Date

Provider name

Clinic name

Dear [Clinical Staff’s name]:

[Clinic name] is one of 18 Illinois clinics serving National Breast and Cervical Cancer Early Detection Program (NBCCEDP) patients that the Centers for Disease Control and Prevention (CDC) selected to participate in the CDC Cervical Cancer Study (Cx3 Study). The Cx3 Study is a pilot research study to provide HPV DNA tests, along with Pap tests, for cervical cancer screening in women 35-60 years of age. The study results will help CDC to decide whether or not to provide HPV testing along with Pap testing to screen for cervical cancer in the CDC Breast and Cervical Cancer Early Detection Program across the country.

As part of the study, the Battelle Centers for Public Health Research and Evaluation is conducting a survey of all providers that perform Pap tests at each participating clinic. As one of the providers that performs Pap test at [clinic name], we would like you to complete the enclosed survey. The survey includes questions about your background and your cervical cancer screening practices and opinions. Your experience and opinions are very important to us. The survey will take approximately 30-35 minutes to complete. Because your time is valuable, we have enclosed $50 to thank you for your time and effort in completing the survey.

Please do not put your name on the survey. We will not identify any person who was in the study in any papers or reports. All information provided will be kept private and will not be disclosed to anyone except the researchers conducting the study. We will not identify any person who was in the study in any papers or reports. Your survey is identified only with your study ID number. All answers that you give will be kept private. This is so because this study has been given a Certificate of Confidentiality (the Certificate of Confidentiality is pending approval). This means anything you tell us will not have to be given out to anyone, even if a court orders us to do so, unless you say it’s okay. But under the law, we must report to the state suspected cases of child abuse or if you tell us you are planning to cause serious harm to yourself or others.

Your participation in this research study is voluntary. You are free to choose to complete this survey or not. The only possible risks to you are that you may be uncomfortable answering some of the questions or that there may be a breach of confidentiality. Battelle has instituted safeguards to protect the confidentiality of your answers from accidental or purposeful disclosure. In addition, you may refuse to answer any of the questions. If you do not want to complete the survey, this decision will not affect your employment at [clinic name] in any way. Your returning this survey provides your consent. The information provided by you and other clinicians will provide valuable information to CDC to assist them in their efforts to provide cervical cancer screening to NBCCEDP women.

When you have completed the survey, please seal it in the postage-paid return envelope and return it to Battelle. If you have any questions about this research study, please call the Battelle Task Leader, Diane Manninen, Ph.D., at 1-206-528-3140. If you have any questions or concerns about your rights as a human subject in this research study, you may call the Battelle Human Subject Representative at 1-877-810-9530, extension 500.

Thank you for your time and participation in this important study.

Sincerely,

Vicki Benard

CDC Division of Cancer Prevention and Control

Appendix D1a. Cover letter – baseline provider survey