Form 1 Navigator Screener Round 2

OMB#: 0925-0648 Exp. Date: 05/31/2021

Navigator for Clinicians – ROUND 2
Recruitment/Screener for
Primary Care Nurse Practitioners/Physician Assistants AND Physicians

Burden Disclosure Statement

Public reporting burden for this collection of information is estimated to average 6 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 current 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 NIH, Project clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648). Do not return the completed for to this address.

Test Description

Participants required—all of whom see adult patients:

• Primary care nurse practitioners (NPs) or physician assistants (PAs)

• Primary care physicians

Test Type: Focus group

Test Length: Approximately 60 minutes each

Incentives: $75

Round 1 (n=9)

Group 1a: 3 NPs/PAs

Group 1b: 3 Physicians

Group 1c: 3 NPs/PAs

Target Audience

Mix of required criteria.

Required Criteria:

1. Gender: mix, 2:1

2. Age: 30s and 40s

3. Years in practice: mix of years

4. Clinician type: Physicians, nurse practitioners, and physician assistants in the following

specialties only: primary care, internal medicine, or family practice only.

5. Practice type/size: mix of solo, 6-10, 11+ (NOT hospital-based, HMO, VA, Tribal)

6. Race/Ethnicity: mix

7. Setting: urban, rural, suburban

8. Clientele served: all or predominantly adults

Phone Script

Hello. My name is _____ of _______, a local marketing research firm working on behalf of the National Institutes of Health. The NIH has asked us to recruit health care professionals for online focus groups to help them develop some practical resources for patient care. If you’re selected, you will receive $200 for a 60-minute session that you can do from your own computer at work or at home. I want to assure you that this is not a sales call and the information gathered will not be used for selling you anything. The NIH is looking for input on how they can support you and other clinicians as you manage the care of adult patients with certain common behavioral health issues that have medical consequences.

1. Does this sound like something you would be interested in participating in?

   1. No [TERMINATE]

   2. Yes

Great. I would like to ask you a few questions to see if you qualify to participate in the research study. It would take 60 minutes of your time on [day, date, time].

Screener Questions

2. Do you or any member of your immediate family work for any of the following types companies: [If yes to any, TERMINATE.]

• Web design company

• Market research company

• Advertising, direct marketing, or promotion agency

• Pharmaceutical development or sales

3. Have you taken part in a research study or focus group within the last 6 months?

   1. No

   2. Yes [TERMINATE]

4. Record gender:

   1. Female

   2. Male

5. Which of the following age groups are you in:

   1. 31-36

   2. 37-40

   3. 41-46

   4. 47-50 [TERMINATE]

   5. 51 + [TERMINATE]

6. Do you spend more than half of your time in direct patient care / clinical practice? [If no, TERMINATE]

7. What proportion of your patients are young to middle-aged adults. That is, between ages 18-60? [If less than 75%, TERMINATE]

8. [NPs/PAs ONLY] What type of clinician are you?

   1. Nurse practitioner [RECRUIT 1-2 for each of the two triads]

   2. Nurse, RN or LPN [TERMINATE]

   3. Physician assistant [RECRUIT 1-2 for each of the two triads]

   4. Other [TERMINATE]

9. [NPs/PAs ONLY] Do you have any of the following certifications?

Yes No

1. Addiction medicine [TERMINATE]

2. Gerontology {TERMINATE]

3. Sports medicine

10. [Physicians ONLY] Are you board certified? And if so, what specialty? [IF anything OTHER THAN the three listed, below, TERMINATE] [Recruit a mix -- family medicine and internal medicine preferred; accept non-board certified general practitioner if needed]

1. No specialty – general practitioner

2. Yes, specialty – family medicine or internal medicine

3. Yes, specialty – other: please specify [PLEASE CONFIRM W/IQ SOLUTIONS]

11. Are you able to make referrals to specialists outside of a given network or healthcare system? If NO, ask what type of system (so we can learn), and TERMINATE

12. How many physicians are in your practice? [Recruit 1 from each practice size: solo (if possible), 2-10, 11+.]

    1. Solo practice or small practice (3-5)

    2. 6-10

    3. 11+

13. What are the specialties of the others in your practice?

    1. Note specialties [TERMINATE if mention: addiction medicine or alcohol use disorder]

14. How often do you see patients with the following behavioral or mental health issues? [Check all that apply.] [TERMINATE if they don’t say “regularly” or “sometimes” to unhealthy alcohol use]

regularly sometimes rarely

1. Depression or anxiety ( ) ( ) ( )

2. Insomnia ( ) ( ) ( )

3. Unhealthy alcohol use ( ) ( ) [TERMINATE] ( ) [TERMINATE]

4. Eating disorders ( ) ( ) ( )

15. For classification purposes only, how would you describe yourself? Which do you identify with most closely?

Race

1. African American/Black

2. American Indian/Alaska native

3. Asian

4. Native Hawaiian/Pacific Islander

5. White

Ethnicity

1. Hispanic

2. non Hispanic

INVITATION: READ THE FOLLOWING FOR PARTICIPANTS:

I’d like to invite you to take part in our focus group.

The study will be held online on [day, date, time], and will last about 60 minutes. At the beginning of the session, you will log into a specific website from your computer at work or at home. More details about the login process will follow.