Form 7 Client Interview/ Focus Group Protocol

Beneficiary Interview Guide

Frontier Community Health Care Network Coordination Grant

Public Burden Statement: 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. The OMB control number for this project is 0915-XXXX. Public reporting burden for this collection of information is estimated to average .5 hour per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-29, Rockville, Maryland, 20857.

Advance Letter

Via Email

Dear Interviewee:

On behalf of the Office of Rural Health Policy, the Altarum Institute, IMPAQ International and the NORC Walsh Center for Rural Health Analysis are conducting an evaluation of the Frontier Community Health Care Network Coordination Grant. The grant is supporting the training and placement of community health workers in several Montana critical access hospitals to facilitate the coordination of care for patients.

The interview will be conducted either in-person or by telephone and will last no longer than one hour. Your participation will provide increased understanding and perspectives on access to quality care, adequate compensation, and regulations that allow for the integration and delivery of high quality care in frontier areas. With your permission, we will record the interview to assist us in taking notes and summarizing the discussion.

Findings from this evaluation will be included in reports for ORHP that may be publicly available. In those reports, data or quotations will not be linked to the identity of a particular respondent or organization.

If you have questions about this study, please contact me at knudson-alana@norc.org. Shena Popat from NORC will be contacting you within the next few days to schedule a telephone interview. For questions about your rights as a study participant, you may call the NORC Institutional Review Board Administrator at 773-256-6000.

Thank you for your participation in this very important study.

Sincerely,

Alana Knudson, PhD

Co-Director, NORC Walsh Center for Rural Health Analysis

Informed Consent

Good morning/afternoon. My name is Alana Knudson and I am a researcher at the NORC Walsh Center for Rural Health Analysis. Altarum Institute, IMPAQ International and the Walsh Center have been contracted by the HRSA Office of Rural Health Policy to ascertain your unique perspective on the Frontier Community Health Care Network Coordination Grant. The grant is supporting the training and placement of community health workers in several Montana critical access hospitals to facilitate the coordination of care for patients.

This interview will last no more than one hour. There are no risks associated with your participation. Your participation is voluntary, and you may skip questions, and stop the interview at any time without any adverse consequences. Your answers will only be reported in aggregate form, and will not identify you or your organization. Your responses will be used in a final report for ORHP. If you have any questions about your rights as a participant in this research project, please call the NORC Institutional Review Board Administrator at 773-256-6000.

Do you consent to participate in this interview? [All parties on line must say “yes” to proceed.]

Do you have any questions for me?

[If “yes” then proceed. If “no” then terminate interview.]

[BEGIN RECORDING]

NORC would like to record this interview in order to ensure our notes are as accurate and comprehensive as possible. This recording will be deleted at the end of the project. Do you consent to have this interview recorded?

[If all parties indicate “yes” then proceed, and continue to record the interview.”]

[If “no” then say: “That's fine. Please be patient as I take notes." Then, stop and delete the recording.]

Beneficiary Interview Protocol

General Discussion Guide (Will be customized for each site)

1. Where do you usually go to see a physician, a nurse practitioner, or physician assistant?

2. Why do you choose to get your care from this health care provider? (prompts listed below)

   1. Require specialty care

   2. Convenient for family

   3. Transportation

   4. Shopping

   5. Access to a pharmacist

   6. Other?

3. Is high quality health care available locally?

   1. Do you seek care locally?

      1. Why or why not?

   2. Are there services that should be provided locally but are not currently available?

   3. Does your local care provider receive information from other providers (e.g., specialists) to support your health care needs? (Prompt: share your health records, lab results, medication updates, therapy regimens, other?)

4. Do you seek care in a neighboring community?

   1. Where do you go?

   2. Why do you go there for care? (Prompts: need specialty care, more technology, more convenient for family, we shop there for other things, etc)

   3. How far away do you travel?

   4. How do you get there? (Prompts: personal transportation, ride with family or friend, county Sr. bus, Greyhound bus, other?)

   5. Are there services you would rather travel to obtain?

   6. Do you ever receive care using telemedicine?

      1. If so, do you like it? Why or why not?

   7. Do your other health care providers coordinate care with your local health care provider? (e.g., home health care, therapy, etc)

5. What have been the biggest challenges in accessing health care services that you need?

   1. Hard to make appointments?

   2. Have to wait a long to get an appointment?

   3. Problems getting information about available services?

   4. Hard to get to the facility? (transportation)

   5. Billing issues?

   6. Health insurance coverage issues?

6. Have you ever spoken with [name], the community health worker, regarding your care?

   1. Did the community health worker help you?

      1. If so, how?

      2. If not, what help do you need that you did not receive?

   2. Are there other services that would be beneficial for coordinating your health care? (e.g., person to coordinate transportation, health care person who could translate information, other?)

   3. Would you recommend using a community health worker to your friends?

      1. Why or why not?

7. Do you have any other comments to share about healthcare?

Thank you for taking the time to share your experiences and ideas with us. We greatly appreciate your input.

OMB Control Number 0915-XXXX Expiration Date: XX/XX/201X