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Title: Study Enrollment Link
S&A FY23 Hoffman Pilot Health Project
Survey Flow
Block: Default Question Block (13 Questions)
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Study
Information Study Information
You are being asked to
potentially participate in a research study. Key study information
you should know:
• The purpose of the study is to
understand factors that influence pilot (U.S. airline and commercial
and active duty military) healthcare seeking behavior with hopes of
better enabling the aeromedical system to serve pilots and
stakeholders.
• Participation includes a one-time
interview over the phone or Microsoft Teams that will take
approximately 30 minutes.
• We will NOT ask about your
personal health status or reasons for seeking care. This study is
only aiming to collect your perceptions and opinions.
• There
are no foreseeable physical risks and very minimal
privacy/confidentiality risks or discomforts from this study.
• The
results from this study will be used to inform U.S. airline and
commercial pilots and military aerospace leaders on factors that
influence pilot healthcare behavior. The results will also be used to
inform future research.
• Taking part in this study is
voluntary. You can skip any question and discontinue participation at
any time without penalty or loss.
• On the next page, there
are a series of screening questions (e.g., age, unique
characteristics, preferred contact method/info).
The
research team will take the following precautions to maintain the
confidentiality of your data: We will not collect any direct
identifiers, and the likelihood of re-identifying you based on the
information you provide is minimal. Data will be presented and
published in aggregate form. Electronic data will be
password-protected. The data may be accessed by the Department of
Defense for auditing purposes. A final report will be delivered to
the DoD with aggregated data that is not identifiable. There will be
no identifying information associated with your responses.
If
you have further questions regarding the study, contact the Principal
Investigator: Rachael N. Martinez, PhD, at
rachael.martinez.1@us.af.mil.
If you have questions
regarding your rights as a research subject, contact the AFRL IRB:
937-904-8100 or afrl.ir.protocolmanagement@us.af.mil.
Q1_consent By answering yes, you are stating that you have read this consent form and agree to be contacted about potential participation in this study.
Yes, I would like to be contacted for potential participation. (1)
No, I would not like to be contacted. (2)
I am not sure and would like to be contacted with more information. (3)
Skip To: End of Survey If By answering yes, you are stating that you have read this consent form and agree to be contacted... = No, I would not like to be contacted.
Q2_milvsciv Please indicate whether you are currently a United States Air Force (USAF) pilot or a U.S. airline and commercial pilot.
USAF Aircraft Pilot (fixed wing only) (1)
U.S. airline and commercial pilot (2)
Skip To: Q4_civcriteria If Please indicate whether you are currently a United States Air Force (USAF) pilot or a civilian ai... = U.S. airline and commercial pilot
Skip To: Q3_milcriteria If Please indicate whether you are currently a United States Air Force (USAF) pilot or a civilian ai... = USAF Aircraft Pilot (fixed wing only)
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Q3_milcriteria
Do you meet the following criteria as a USAF Aircraft Pilot?
-Active
Duty USAF Officer
-Completed Formal Training Unit (FTU) or
follow-on training for your respective aircraft
-Functioned as
a required air crew member as part of your official duties in the
last 6 months
Yes (1)
No (2)
Skip To: End of Survey If Do you meet the following criteria as a USAF Aircraft Pilot? -Active Duty USAF Officer -Completed... = No
Skip To: Q5_19thAF If Do you meet the following criteria as a USAF Aircraft Pilot? -Active Duty USAF Officer -Completed... = Yes
Q4_civcriteria
Do you meet all of the following criteria as a U.S. airline and
commercial pilot?
-Hold a current Airline Transport Pilot
Certificate from the Federal Aviation Administration
-Currently
employed by a commercial airline (regional or mainline) based in the
United States
-Functioned as a required air crew member for the
purposes of compensation in the last 6 months
Yes (1)
No (2)
Skip To: End of Survey If Do you meet all of the following criteria as a U.S. airline and commercial pilot? -Hold a current A... = No
Skip To: Q8_age If Do you meet all of the following criteria as a U.S. airline and commercial pilot? -Hold a current A... = Yes
Q5_19thAF Are you currently assigned to a unit within the 19th Air Force?
Yes (1)
No (2)
Skip To: Q6_spvsrpermission If Are you currently assigned to a unit within the 19th Air Force? = No
Skip To: Q8_age If Are you currently assigned to a unit within the 19th Air Force? = Yes
Q6_spvsrpermission Do you have your supervisor's permission to participate in this study (as necessary)?
Yes (1)
No (2)
Display This Question:
If Do you have your supervisor's permission to participate in this study (as necessary)? = No
Q7_seek_approval Please seek approval from your supervisor and return to this survey link to re-start the study screening questions.
Skip To: End of Survey If Please seek approval from your supervisor and return to this survey link to re-start the study sc... Is Displayed
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Q8_age Please select your age category.
18-30 years (1)
31-50 years (2)
51-65 years (3)
66+ years (4)
Q9_unique Do you feel that you bring a unique perspective to this study due to your background in any one of the following categories? Please select all that apply.
Gender (1)
Geography (3)
Race or Ethnicity (4)
Sexual Orientation (5)
Other (6) __________________________________________________
Q10_contactmethod How do you prefer to be contacted?
Phone (1)
Email (2)
Either phone or email (3)
Q11_contactinfo Please provide your preferred contact methods (phone number and/or email address).
________________________________________________________________
Q12_name How would you like the researcher to refer to you during the interview process? You can provide a first name or a preferred pseudonym. Please do not provide your first and last name.
________________________________________________________________
Skip To: End of Survey If Condition: How would you like the rese... Is Not Empty. Skip To: End of Survey.
End of Block: Default Question Block
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | S&A FY23 Hoffman Pilot Health Project |
Author | Qualtrics |
File Modified | 0000-00-00 |
File Created | 2023-11-17 |