MCH Survey Eligibility and Consent Script_No Inc_PALAUAN

PALAUAN

MCH Jurisdictional Survey Eligibility and Consent Scripts

Eligibility

Alii, a ngklek a _________. Tial research study a olngesu er kemam el omtab a ukeruul er a chedil ma rengalk ra beluu er a [American Samoa/Federated States of Micronesia/Marshall Islands/Northern Mariana Islands/Belau]. A rechad el sorir el ngar tial study a kirrir onger a bebil ra ker el kirrel a ukeruulem, kau ma rengelekem.

1. A blim a mla mengilt el mora survey. Sebechek el oker ra kau a bebil ra ker el mesal kmo ke eligible el ngar tial study?

1 Choi [go to 2]
2 Ngdiak [Thank individual for their time and end call]

99. Refused to Answer [Thank individual for their time and end call]

2. Kau ke teruich me a eai a rekim el mor bab?

1 Choi [go to 3]
2 Ngdiak [Thank individual for their time and end call]

99. Refused to Answer [Thank individual for their time and end call]

3. Kau ke delal a ngalk el tolechoi el mo teruich me a euid a rekil em kei ra imol blai (malechub ngidil redil el omekeroul er a ngalek)?

1 Choi [go to screener]
2 Ngdiak [Thank individual for their time and end call]

99 Refused to Answer

4. Maki oldingel a blai el oker el kmo ngarngii a redil el klou ra teruich ma eai a rekil el ou ngalek ra tolechoi ma lechub eng ngalek el kekerei ra teruich ma euid a rekil el sebechek el mengedecheduch er ngii

1 Choi [Go to beginning]

2 Choi engdi ng dibus [Go to 5]
Ngdiak [Thank individual for their time and leave]

Ngdi mlak el onger [Thank individual for their time and leave]

5. Ngungil ak luut el mei era telal klok

1 Choi [go to screener]
2 Ngdiak [Thank individual for their time and leave]

99 Ngdi mlak el onger [Thank individual for their time and leave]

Consent

INFORMED CONSENT OBTAINED AFTER DETERMINING ELIGIBLE CHILD(REN) IN THE HOUSEHOLD]

Aki oldingel a blai e mesuub a teletelel a ukeruul ma klisichel a bedengir a rechedil ma rengelekir. Tial survey a kirel a llach el Title V MCH Block Grant program, el omdoud er ngii a HRSA.

A tekingem a bol ousbech a rechad el ou ngerachel a program el olngeseu ra rechedil ma rengelekir ra beluam el remuul a ungil program el mora telungalk er a beluam –A cheldechedechad er tial survey a mo kakar a okouang el bung. Ma akmo oker a ker el kirel a klisichel a bedengem ma bedengel a ngelekem. Tial survey a bekord el 50 bung eng meketmokl.

Alsekum ngchetim el meruul er a tial survey, eng kmal di ungil e diak om obals. Om konei era chelechang ea uriul eng diak el sebechem, malechub eng mla mo chetim, eng dirrek el di ungil. Al ngar ngii a tekoi el meringel er kau el mesaod malechub eng metacherebesum el mesaod, ng sebechem el ouchais e diak a mondai. Ng diak el metemall a survey alsekum ng ngar ngii a ker el diak el sebechem el onger.

Altang mora ngii a ker el kora kmal mengetiit engdi ngdiak a mo kengtil alsekum e ke kongei er tial survey

A rechad el mo meruul er a tial ureor a diak el uduudel.

A rokui el tekingem ma nger a mo berrotel A rechad el momes a tekingem a di tir kei el oureor er tial survey me a tir kei el ou ngerachel ra llemeltel tial ureor A ngklem a diak el bol lechukl e uldak ngii ma tekingem A ki mo ousbech ra ngodech el olangch, ngdiak el ngklem

Tial survey a diak el bol oker el kirel a chelebedel a ngalek. Alsekum aki meruul er tial survey ea tekoi a mei el kmo ngar ngii a mengeterochel malechub ng mengelebed er a ngalek, eng ngerchelam el mo oltutakel.

Ng sebechem el omkedong er a X er a (XXX) XXX-XXXX malechub e ke email er a JMCH@norc.org al ngar ngii a kerim el kirel tial ureor. Al ngar gii a kerim el kirel a llemeltem, ng sebechem el omkedong er a NORC Institutional Review Board Manager el dengua re tir a (866) 309-0542.

Ak mo meskau tial babier me ke mo oba lecheklel a kullekoi el tekoi [Provide the paper copy of the informed consent language]

1. Ngarngii a kerim?

Choi [Answer questions, then go to B]
Ngdiak [Go to B]

Ngdi mlak el onger [Thank individual for their time and leave]

2. Ke kongei el onger el mora ker el ngar tial survey?

Choi [Thank individual and begin the questionnaire]
Ngdiak [Thank individual for their time and leave]

Ngdi mlak el onger [Thank individual for their time and leave]