Appendix 3– Telephone Screening Script
The Public Health Service Act provides us with the authority to do this research (42 United States Code 242k). All information which would permit identification of any individual, a practice, or an establishment will be held confidential, will be used for statistical purposes only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other persons without the consent of the individual or the establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and Statistical Efficiency Act (PL-107-347).
Public reporting burden for this collection of information is estimated to average 5 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, MS D-24, Atlanta, GA 30333, ATTN: PRA (0920-0222).
OMB #0920-0222; Expiration Date: 07/31/2018
Sample screening script for respondent contact by Center for Questionnaire Design and Evaluation Research
(CQDER) Recruiter/CQDER Staff for
Testing of National Health and Nutrition Examination Survey (NHANES) questions on consumer behavior, alcohol intake and exposure to second-hand e-cigarettes (English language testing) recruited through newspaper advertisement/flyer
Dial respondent’s telephone number [hereafter referred to as R] as indicated on voice mail system.
Note: Speak only to R. If the number is answered by voice mail/answering machine, call back at another time.
CQDER Recruiter/CQDER Staff: Good morning/afternoon, may I speak to (name)?
If R is not available or not at home, say, “Thank you” and try again at another time.
If the person who answered the phone (NOT R) asks, “Who is calling?” or “What’s this about?” say, “I am returning their call to me. I’ll try to reach them at another time.
If R has been successfully contacted, continue...
...Hello, my name is [CQDER Recruiter/CQDER Staff‘s name. I am calling from the Centers for Disease Control and Prevention’s National Center for Health Statistics. You may remember that you responded to the advertisement we placed in the [name of newspaper] on [date] or flyer looking for adults [who live in a household with 2 or more people, are responsible for meal planning, consume alcohol, live in a household with someone who uses electronic cigarettes or know someone who currently uses electronic cigarettes/to answer a variety of health questions].
Wait for acknowledgment, such as, “Oh, yes, I remember.”
...In order to determine if you are eligible for our study, I’ll need a few minutes of your time to ask some background questions. Answering these questions is completely voluntary. We are required by law to use your information for statistical research only and to keep it confidential. The law prohibits us from giving anyone any information that may identify you without your consent. Is this a good time to ask the questions or should I call back later?
If not a good time to talk, schedule a time to call back.
If good time to talk, continue...
1. Where did you see our advertisement/flyer?
___________________________________________________
2. How old are you? [If under age 18, go to exit script 1]
________________
3. How many years of education do you have?
9 or less 10 11 12 13 14 15 16 17 18 19
Do you live in a household of two persons or more?
Yes
No
4a. If yes, are you the person most responsible for meal-planning or food-shopping in the home?
Yes
No
Have you had at least one alcoholic drink in the past year?
Yes
No
Do you consume alcohol 3 or more times per week?
Yes
No
Do you live with someone who has used electronic cigarettes (or any other vaping device) in the past month?
Yes
No
Do you know anyone who uses electronic cigarettes (or any other vaping device)?
Yes
No
Are you Spanish, Hispanic or Latino?
Yes
No
What race or races do you consider yourself to be? You may indicate more than one race.
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
[If the recruitment needs for certain groups have been achieved, go to exit script 2].
Entry Script:
...Based on your answers to the questions so far, we would like you to take part in our study. For this study we’d like you to come here to the National Center for Health Statistics in Hyattsville, MD/agreed mutual location. An interviewer will ask you a variety of questions about consumer behavior, alcohol intake and exposure to second-hand e-cigarettes. Then the interviewer will ask you to explain what you were thinking as you answered the questions. The interviewer will also ask you about your opinions of the questions. Your answers will help us find out if the survey questions will be easy for other people to answer. Everything you say will be kept private. With your permission, we would like to record your interview. The recording is a record of what we asked and what you said about the questions. Do you give permission to have your interview video recorded? Yes/No. [If no, ask if for permission to audio record]. Do you give permission to have your interview audio recorded? Yes/No. [If no, go to exit script 3. At a minimum audio recording is essential for this project].
Do you have any questions at this point? Pause to answer questions. If (not/you have no other questions), then let’s get you on the schedule, ok? We will be interviewing (Day, Month/Date) through (Day, Month/Date) from 8 a.m. to 6 p.m. Looking at your schedule, when would you be available to participate? Schedule. [If date/times not available go to exit script 4.]
A reminder call will be made to you a few days in advance. Should you have any questions or need to change your appointment, please feel free to contact me [name] at [phone number]. Thank you for responding to our ad, and I look forward to seeing you here at (DATE/TIME) Get respondent to cite date & time if possible.
---------------------------------------------------------
Exit script 1: I’m sorry, you have to be over the age of 18 to take part in this study and therefore we won’t be able to use you at this time. We appreciate your call and thank you for your interest in our study.
Exit script 2: Based upon your answers, it seems that we may already have a number of volunteers with very similar answers to yours. At this point we need to talk with people with some different characteristics. However, if we have cancellations or other slots open up, I may wish to call you back. Would it be okay if I kept your name, telephone number, and the information you provided in response to the eligibility questions until the end of this study? If yes, make notation. If no, would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
Exit script 3: I’m sorry, willingness to be audio recorded is required in order to take part in this study and therefore we won’t be able to use you at this time. Would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
Exit script 4: I see...ok, we were hoping to complete this particular study between (Month/Date) and (Month/Date), so it looks like we won’t be able to schedule you at this time. Would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Modified | 0000-00-00 |
| File Created | 2021-01-24 |