Telephone Recruitment and Screening Script

Form Approved

OMB No. 0920-xxxx

Expiration date: xx/xx/xxxx

Telephone Recruitment and Screening Script

Public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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, M/S D74, Atlanta, GA 30333, ATTN: PRA 0920-xxxx.

“Hello, my name is [clinic manager name]. I am calling you to invite you to participate in a study being conducted by Dr. Lyn Steffen at the University of Minnesota. I’d like to tell you about the study to see if you might be interested in participating. Is now a good time to talk?”

If No, ask “When would be a good time to call back?

If Yes: “Great. You are being contacted because you participated in the Minnesota Heart Survey. Dr. Steffen who was an investigator in the MHS study selected you to participate in this study about salt intake and food sources of salt. The purpose of the study is to determine the amount of sodium in the diet that comes from salt added to food in processing versus sodium naturally occurring in food or added to food in home cooking and at the table. This study is funded by the Centers for Disease Control and Prevention.”

“Participants in the study will be asked to attend a clinic visit at which they will be asked some questions about their salt use; home water supply; and demographic characteristic like their age and race. Also, their height and weight will be measured. After the clinic visit participants will need to complete 4 telephone interviews over the next two weeks. During each of these telephone interviews participants will be asked to report everything they ate and drank the previous day. They will also be asked to report their use of dietary supplements and non-prescription antacids. The day prior to each telephone interview participants will be asked to collect samples of all the salt they add to food in home cooking and at the table. We will provide collection kits and instructions for doing this. Some people will have to collect a small sample of their home tap water. To show appreciation to participants for their contributions to the study, $10 will be provided for each telephone interview completed, to total $40 if all four interviews are completed.”

“We also need some people to complete two additional study activities. Those who are willing to complete these additional activities will be asked to collect their urine for four days and drop the urine samples off at the study clinic. Also, they will be asked to use special salt provided by the study for about 9 days. The study provided salt is to be used in place of salt that would normally be used in cooking at home or added to food at the table. Those who agree to complete these additional study activities will receive $20 for each day of urine collection, to total $80 if all four days of urine are collected.” The $20 per urine sample acknowledges the time and effort associated with both urine collection and transportation to the clinic. Parking is free at the clinic.

“Are you interesting in participating in this study or learning more about it?”

If No, say, “Thank you for your time. We really appreciate the time you took to consider participating in this study. Have a great day.”

If Yes, say “Great! Before we go further I need to ask you a few questions to make sure you are eligible for this study. “

“First, what is your age?” [IF LESS THAN 18 OR GREATER THAN 74 THEN THE PERSON IS NOT ELIGIBLE. LET THEM KNOW THEY ARE NOT ELIGIBLE AND THANK THEM FOR THEIR TIME]

“Do you consider yourself to be Hispanic or Latino?”

O No

O Yes

“What race do you consider yourself to be…”

(select one or more)

O White

O Black/African-American

O Asian

O American Indian or Alaska Native

O Native Hawaiian or Other Pacific Islander

“Do you have any type of chronic kidney disease like end stage renal disease, renal insufficiency, or diabetes insipidus?”

O No

O Yes [PERSON IS NOT ELIGIBLE. LET THEM KNOW THEY ARE NOT ELIGIBLE FOR THE STUDY AND THANK THEM FOR THEIR TIME]

“Are you pregnant or breastfeeding?” [ASK WOMEN ONLY]

O Not applicable

O No

O Yes [PERSON IS NOT ELIGIBLE. LET THEM KNOW THEY ARE NOT ELIGIBLE FOR THE STUDY AND THANK THEM FOR THEIR TIME]

“Are you able to read and speak English?”

O Yes

O No [PERSON IS NOT ELIGIBLE. LET THEM KNOW THEY ARE NOT ELIGIBLE FOR THE STUDY AND THANK THEM FOR THEIR TIME’

“Do you have daily access to a telephone?”

O Yes

O No [PERSON IS NOT ELIGIBLE. LET THEM KNOW THEY ARE NOT ELIGIBLE FOR THE STUDY AND THANK THEM FOR THEIR TIME].

IF 18-74 YEARS OF AGE; ‘NO’ TO CHRONIC KIDNEY DISEASE AND DIABETES; ‘NO’ OR ‘NOT APPLICABLE’ TO PREGNANCY/BREASTFEEDING QUESTION; ‘YES’ TO ENGLISH QUESTION; AND ‘YES’ TO TELEPHONE ACCESS THEN PERSON IS ELIGIBLE

“Thanks for answering these questions. You are eligible to participate in this study. If you’d like to schedule a clinic visit now we could do that and I’ll mail you a written description of the study and a consent form to read before the visit. If you need more time to think about this I could mail you a written description and the consent form also, and you can call me back if you decide you want to participate. I’m also happy to answer any questions you may have right now.”

IF PERSON ASKS QUESTIONS, ANSWER THE QUESTIONS OR OFFER TO CALL BACK WITH THE ANSWER IF YOU’RE NOT SURE HOW TO RESPOND TO A PARTICULAR QUESTION.

IF PERSON INDICATES HE/SHE WOULD LIKE TO SCHEDULE A CLINIC VISIT,

• Schedule the visit

• Gather the person’s contact information

• Confirm that you’ll be mailing a letter that includes the scheduled date and time of the clinic visit; address and directions to the clinic; and study fact sheet and consent form for review prior to the clinic visit

• Ask the participant if he/she is willing to participate in the more detailed study activities that includes use of study provided salt for 9 days and collecting urine for 4 days with an additional $80 provided as compensation for doing this. Explain that only some people (about 50) will be invited to complete the urine collection activity.

IF PERSON WANTS MORE INFORMATION/ TIME TO THINK ABOUT IT,

• Collect the person’s contact information

• Confirm that you’ll be mailing additional information about the study to them for their consideration.

Contact Information

Name:

Mailing address:

Home phone:

Cell phone:

Email address:

Preferred method of contact for clinic visit reminder and other follow-up:

O email

O home phone

O cell phone- voice message

O cell phone- text message

O U.S. postal mail

O Other