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Telephone Consent Info After Pre-Notification Letter

Oral Consent Info after Pre-Notification Letter – Targeted Sample for Mental Health Assessment – Telephone Interviews

 

INTRO

Hello, my name is ______________________ and I am calling from the [INSERT UNIVERSITY OR ORGANIZATION]. We recently sent a letter to [Respondent Name] indicating that we would be calling. Is [Respondent Name ] available?

1 = Yes, Speaking [Go to RESPONDENT]

2 = Yes, coming to the phone [Go to INTRO2]

3 = No, not available [Go to INTRO2 and schedule callback]

4 = No, not at this number [Go to NEWNUM]

 

NEWNUM

Do you have a telephone number where I can reach him/her?

1 = Yes [Record number. Thank you for your help, I will try that number. Hang up. Code XX, record new number in message]

2 = No [Thank you for your time. Hang up. Code XX with NEEDS DIRECTORY ASSISTANCE in the message]

 

RESPONDENT

We recently sent you a letter asking for your cooperation in a research study being conducted on behalf of the [SPONSOR]. [Go to RECEIVE]

 

INTRO2

Hello, my name is ___________________ and I am calling from the [INSERT UNIVERSITY OR ORGANIZATION]. We recently sent you a letter asking for your cooperation in a research study being conducted on behalf of [INSERT SPONSOR INFO HERE].

 

RECEIVE

Did you receive that letter? 1 = Yes

2 = No [Go to LETTER]

 

READ

Did you read the letter? 1 = Yes [Go to CONFIDENTIALITY]

2 = No

 

LETTER

I’m sorry you did not get the opportunity to read the letter. It was an explanation of the study and informed you that we would be calling. If you wish, I’ll read you a copy of the letter?

1 = Yes, read [Check Letter Version number and read appropriate letter. Go to CONFIDENTIALITY]

2 = No, but continue [Go to EXPLAIN]

3 = No, send me another letter [Record name, address, record number on Respondent Requesting New Letter sheet, code XX and schedule for DATE, callback, RESTART at CALLBACK INTRO]

 

CALLBACK INTRO

Hello, my name is ______________________ and I am calling from the [INSERT UNIVERSITY OR ORGANIZATION]. We recently re-sent a letter to [Respondent Name] indicating that we would be calling. Is [Respondent Name ] available?

1 = Yes, Speaking [Go to CALLBACK RESPONDENT]

2 = Yes, coming to the phone [Go to CALLBACK INTRO2]

3 = No, not available [Go to CALLBACK INTRO2 and schedule callback]

4 = No, not at this number [Go to CALLBACK NEWNUM]

 

CALLBACK NEWNUM

Do you have a telephone number that I can reach him/her at?

1 = Yes [Record number. Thank you for your help, I will try that number. Hang up. Code XX, record new number in message]

2 = No [Thank you for your time. Hang up. Code XX with NEEDS DIRECTORY ASSISTANCE in the message]

 

CALLBACK RESPONDENT

We recently re-sent you a letter asking for your cooperation in a research study being conducted on behalf of the [SPONSOR]. [Go to CALLBACK RECEIVE]

 

CALLBACK INTRO2

Hello, my name is ___________________ and I am calling from the [INSERT UNIVERSITY OR ORGANIZATION]. We recently re-sent you a letter asking for your cooperation in a research study being conducted on behalf of the [SPONSOR].

 

CALLBACK RECEIVE

Did you receive that letter?

1 = Yes

2 = No [Go to CALLBACK LETTER]

 

CALLBACK READ

Did you read the letter?

1 = Yes [Go to CONFIDENTIALITY]

2 = No

 

CALLBACK LETTER

I’m sorry you did not get the opportunity to read the letter. It was an explanation of the study and informed you that we would be calling. Would you like me to just go ahead and read you the letter?

1 = Yes, read [Check Letter Version number and read appropriate letter. Go to CONFIDENTIALITY]

2 = No, but continue [Go to EXPLAIN]

3 = No, send me another letter SAY: Time does not really permit me to send out another letter. We will be completing this study in the next week or so. I’d be more than happy to read the letter to you. [Read correct version of letter, then to CONFIDENTIALITY, OR Go to EXPLAIN, OR Terminate]

 

CONFIDENTIALITY

Your participation in the study is very important. The State will use the information you provide to plan for health services in its health care programs. Your participation is completely voluntary and has no impact on the services you receive from [SPONSOR]. Your identity will be confidential If we come to any question you do not want to answer, just let me know and we’ll move on. Your answers will be combined with those of other people and reported only in summary form. The study will take about 20 minutes, depending on how many of the questions apply to you. If you have questions about the study, I would be happy to provide a phone number for you to call to get more information. I would like to begin the interview now. [Go to Q1]

 

EXPLAIN

This study asks about mental health and about health services. You were chosen randomly from among participants in the [SPONSOR] state health insurance programs to be included in the study. Your participation in the study is very important. [SPONSOR] will use the information you provide to plan for health services in its health care programs. Your participation is completely voluntary and has no impact on the services you receive from [SPONSOR]. Your identity will be confidential If we come to any question you do not want to answer, just let me know and we’ll move on. Your answers will be combined with those of other people and reported only in summary form. The study will take about 20 minutes, depending on how many of the questions apply to you. If you still have questions about the study, I would be happy to provide a phone number for you to call to get more information. I would like to begin the interview now.