Childcare Service Satisfaction Survey; Purchased Care Online Survey; VHA ORD Focus Group Request; Teleretinal Patient Satisfaction Survey; Spinal Cord Home Care Satisfaction Survey

U NITED STATES

DEPARTMENT OF VETERANS AFFAIRS

Participant Screener

Script

Introduction	Good day. I hope you are doing well. My name is ________________, and I am calling today from XXX to see if you are interested in participating in a focus group we are conducting for the Veterans Health Administration Office of Research and Development. The groups will be held in a facility nearby, and if you qualify, there will be monetary compensation for your time. Participants will provide feedback on VA Research communications materials. You do not need to have participated in research or be familiar with current communications materials to participate. However, we are looking for individuals from a variety of backgrounds. Would you mind answering a few questions to determine if you qualify for one of our groups? All of the information you provide will remain private.
Question 1	Are you currently of Veteran status or a spouse or caregiver for a Veteran? ___ Yes ___ NO {THANK AND TALLY} ___ Don’t know {THANK AND TALLY} ___ Refused {THANK AND TALLY}
Question 2	For which of the following branches of the military did you (or your spouse) serve? ___ Army (to include Army National Guard and US Army Reserves) ___ Navy (To include Reserves) ___ Air Force (To include Air National Guard and Air Force Reserves) ___ Marines (To include Reserves) ___ US Coast Guard (To include Reserves) ___ Don’t Know {THANK AND TALLY} ___ Refused {THANK AND TALLY}
Question 3	Have you (or your spouse) received services from the Veterans Health Administration? ___ No/Refused {THANK AND TALLY} ___ Yes/ {CONTINUE}
Question 4	Are you employed by an ad agency, marketing research firm? ___ Yes/Refused {THANK AND TALLY} ___ No {CONTINUE}
Demographic Questions	We have a few demographic questions to help make sure we talk to people from a variety of different backgrounds. Gender [Observed] Recruit a mix for each group How old are you? __________ years. Recruit a mix from the following ranges: ___ 18-24 ___ 25-39 ___ 40-44 ___ 45-54 ___ 55-64 ___ 65-74 ___ 75 or older ___ Refused {THANK AND TALLY} Were you an active duty military member in war? If so, which ones? Read list and record  Operation Iraqi Freedom  Operation Enduring Freedom  Operation Desert Storm  Korean War  Vietnam War  World War II  Other Do you have a war-related injury or injuries? If so, what are they? Record What is the highest level of education that you have completed? Read list and recruit a mix.  Less than a high school diploma  High school graduate or GED  Technical/vocational school  Some college credit, but no degree  Associate’s degree (AA, AS)  Bachelor’s degree (BA, AB, BS)  Master’s, doctoral, or professional school degree (MA, MS, MEd, MEng, MBA, MSW, PhD, MD, JD, DVM, EdD) How would you describe your race/ethnicity? Record. Are you Hispanic or Latino? ___Yes ___No ___DK/Refused Do you consider yourself (check all that apply)? ___White ___Black/African American ___Asian ___American Indian or Alaska Native ___Native Hawaiian or other Pacific Islander
Focus Group Details/ Request for Participation	Thank you very much for answering our questions. You qualify to participate in our focus group. The focus group will be approximately 90 minutes long, and will be held on <date/time> at <location>. You will be compensated $XX for your time, and light refreshments will also be available. Also, so you are aware, the focus group session will be recorded to ensure accuracy. However, your participation and everything you say during the discussion will be kept private and used only by the research team. Would you be willing to participate in our focus group? If yes, continue to Reminder Email/Phone Call. If no, If you would like to view information on VA Research, please visit www.research.va.gov. End of Call.
Reminder Email/ Phone Call	We will provide you a reminder two to three days in advance of the focus group, which will include the address of the facility and the day and time. Would you prefer we call you or send you an email with this information? Email: Would you please provide me your email address so I can send you the information? Next go to End of Call Phone: Is this the best number to reach you at or would you prefer we call a different number? What is that number? Next go to End of Call
Not Selected	Thank you for your willingness to participate; however, we are looking for a variety of participants and we already have recruited people with your background, so we will not need your help in this set of interviews. If you would like to view information on VA Research, please visit www.research.va.gov Have a great day.
End of Call	That is everything I have today. Thank you very much for your time. Have a great day.

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