Flesch-Kincaid Grade Level 6.1
_________________ _________________
Date Recruiter Initials
“Hello, my name is_________________. Thanks for calling for information about (study name) at - (choose one: UM, HSC, UNC)”.
“I will tell you a little about our study so you can decide if you would like to hear more about it. Before I do that, please tell me how you heard about our study.”
RDS coupon # _____________________ (document coupon number)
Venue location_____________________ (note venue location)
Flyer or Brochure
Word-of-mouth
We are doing this study to learn about women’s health risk behaviors. As part of the study, women answer survey questions on a computer and get tested for HIV. It will only take a few minutes to find out if you are eligible for the study. If you are eligible and decide to join the study, doing the computer survey and being tested for HIV takes about 1½ hours. Women who enroll in our study get $50 as a thank you”.
“Would you like to see if you are eligible to be in our study”?
NO, woman does NOT want to be screened:
“OK, Thanks for calling. Are you willing to answer a few
questions about why you don’t want to be screened for this
study before you go?”
IF YES: “Thank you.” Proceed
with Encounter Screening Eligibility form on the computer.
IF NO: “Ok, please call us again if you change
your mind. We can give you more information about our study and
check to see if you are eligible when you call.”
YES, woman wants to be screened:
“OK, great. I can ask you the questions to see if you are
eligible for the study right now.” Proceed with
Encounter Eligibility Screening Form
on computer.
If INELIGIBLE: “I’m sorry, but you are
not eligible for this study. Thanks for taking time to speak with
me.”
IF woman asks why she is INELIGIBLE: “To be
eligible to take part in this study, women must meet certain age,
ethnic, racial, behavioral and health criteria. When I enter
your responses into the computer, it checks to make sure that all
requirements for the study are met and then lets me know if you are
eligible or not. According to one or more of your answers, you are
not eligible.”
If ELIGIBLE: “You are eligible to be in the
study. Does our study sound like something you might be interested
in joining?
YES, eligible woman wants to enroll: If YES:
“Great. Our study van goes to (x location, y location
and z location). Are you able to meet us at any of these locations?
If YES: Schedule day, date, time and location of
the appointment.
“Please write this number down and bring it with you so you
don’t have to answer the screening questions again. If you
forget this number, we will have to ask you the questions again.
(Give caller her screening number). The screening number is good for
2 weeks. After that, we will have to ask you these questions again.”
Appointment Date___________________________________
Appointment Time___________________________________
Appointment Location________________________________
Screening Number___________________________________
If NO: “That’s OK, let’s find a
place and time that is convenient for you to meet us.”
Schedule day, date, time and alternate meeting location for the
appointment.
Appointment Date___________________________________
Appointment Time___________________________________
Appointment Location________________________________
“Please write this number down and bring it with you so you
don’t have to answer the screening questions again. If you
forget this number, we will have to ask you the questions again.
(Give caller her screening number). The screening number is good for
2 weeks. After that, we will have to ask you these questions again.”
Screening Number___________________________________
NO, eligible woman does not want to enroll:
“OK, Thanks for your interest in our study. Please call us if
you change your mind.”
Please be certain you have completed question SCR16 (and
SCR17, if possible) on the Encounter Eligibility
Screening Form.
Flesch-Kincaid Grade Level 6.7
_________________ _________________
Date Recruiter Initials
“Hello, my name is_________________. Thanks for stopping by for information about (study name) at - (choose one: UM, HSC, UNC)”.
“I will tell you a little about our study so you can decide if you would like to hear more about it. Before I do that, please tell me how you heard about our study”.
RDS coupon # _____________________ (collect coupon and document coupon number)
Venue location_____________________ (note venue location)
Flyer or Brochure
Word-of-mouth
IMPORTANT: If woman brings an RDS coupon, take the coupon and properly document the coupon number.
“We are doing this study to learn about women’s health risk behaviors. As part of the study, women answer survey questions on a computer and get tested for HIV. It will only take a few minutes to find out if you are eligible for the study. If you are eligible and decide to join the study, doing the computer survey and being tested for HIV takes about 1½ hours. Women in our study get $50 as a thank you”.
“Would you like to see if you are eligible to be in our study”?
NO, woman does NOT want to be screened:
“OK, Thanks for stopping by. Are you willing to answer a few
questions about why you don’t want to see if you are eligible
for this study before you go?”
IF YES: “Thank you.” Proceed
with n Encounter Screening
Eligibility form on the computer.
Before ending: “Please take this card and call
us if you change your mind. We can give you more information about
our study and check to see if you are eligible when you call.”
IF NO: “Please take this card and call us if you
change your mind. We can give you more information about our study
and check to see if you are eligible when you call.”
YES, woman wants to be screened:
“OK, great. I can ask you the questions to see if you are
eligible for the study in the van, where we’ll have more
privacy, or I can ask you the questions over there (motion to a
private place). Which place do you prefer?” Proceed with
Encounter Eligibility Screening Form
on computer.
If INELIGIBLE: “I’m sorry, but you are
not eligible for this study. Thanks for taking time to speak with
me.” (Offer token gift)
IF woman asks why she is INELIGIBLE: “To be
eligible to take part in this study, women must meet certain age,
ethnic, racial, behavioral and health criteria. When I enter
your responses into the computer, it checks to make sure that all
requirements for the study are met and then lets me know if you are
eligible or not. According to one or more of your answers, you are
not eligible.”
If ELIGIBLE: “You are eligible to be in the
study. Does our study sound like something you might be interested
in joining?
YES, eligible woman wants to enroll: “Great. We
can do the computer survey and HIV test right now in our study van
if you would like to be in the study and have time now.”
YES, woman can do ACASI and HIV testing now:
“OK, let’s get started.”
Administer informed consent. Resume Encounter Eligibility
Screening Form at question SCR12 on the computer. Administer the
ACASI the rapid HIV testing and counseling only after the woman
gives consent.
NO, woman can’t do ACASI and HIV testing now:
That’s OK. I can make an appointment for you to either come to
our office or meet me on (day/date/time) when our van
at (say location choices).” Set
appointment and give appointment card. (Consent women
when she returns to do the ACASI and HIV test).
Appointment Date___________________________________
Appointment Time___________________________________
Appointment Location________________________________
“Please write this number down and bring it with you so you
don’t have to answer the screening questions again. If you
forget this number, we will have to ask you the screening questions
again. (Give woman her screening number). The screening number is
good for 2 weeks. After that, we will have to ask you these
questions again.”
Screening Number___________________________________
NO, eligible woman does not want to enroll:
“OK, Thanks for your interest in our study. Please take this
card and call us if you change your mind.” Resume
Encounter Eligibility Screening Form at question SCR12 on the
computer.
Please be certain you have completed question SCR16 (and
SCR17, if possible) on Encounter Eligibility
Screening Form.
Flesch-Kincaid Grade Level 6.7
(Recruiting in venues)
STAFF REQUIREMENTS:
All research staff should have University ID available to show to women if needed. Staff should also have brochures and study related palm cards on hand.
INITIAL CONTACT:
“Hi, my name is _________ and I’m from (site name). We are recruiting women for a research study. Do you have a minute, so I can tell you more about it?” [HAND THE WOMAN A BROCHURE IF POSSIBLE]
NO, woman does not want information about the study:
“OK, thanks for you time. Are you willing to answer a few
questions about why you don’t want more information about this
study before you go?”
IF YES: “Thank you.” Proceed
with Encounter Screening Eligibility form on
the computer.
Before ending: “Please take this card and call
us if you change your mind. We can give you more information about
our study and check to see if you are eligible when you call.”
IF NO: “Please take this card and call us if you
change your mind. We can give you more information about our study
and check to see if you are eligible when you call.”
YES, woman wants more information: “We are
doing this study to learn about women’s health risk behaviors.
As part of the study, women answer survey questions on a computer
and get tested for HIV. It will only take a few minutes to find out
if you are eligible for the study. If you are eligible and
decide to join the study, doing the computer survey and being tested
for HIV takes about 1½ hours. Women in our study get $50 as
a thank you. Would you like to see if you are eligible to be in our
study?”
NO, woman does not want to be screened: “OK,
thanks. Are you willing to answer a few questions about why you
don’t want to see if you are eligible for this study before
you go?”
IF YES: “Thank you.” Proceed
with Encounter Screening Eligibility form on
the computer.
Before ending: “Please take this card and call
us if you change your mind. We can give you more information about
our study and check to see if you are eligible when you call.”
IF NO: “Please take this card and call us if you
change your mind. We can give you more information about our study
and check to see if you are eligible when you call.”
YES, woman wants to be screened: “Great, I can
ask you the questions to see if you are eligible for the study in
the van, where we’ll have more privacy, or I can ask you the
questions over there (motion to a private place). Which place do you
prefer?” Proceed with Encounter Eligibility Screening
Form on the computer..
IF INELIGIBLE: “I’m sorry, but you are
not eligible for this study. Thanks for taking time to speak with
me.” (Offer token gift)
If women asks why she is INELIGIBLE: “To be
eligible to take part in this study, women must meet certain age,
ethnic, racial, behavioral and health criteria. When I enter
your responses into the computer, it checks to make sure that all
requirements for the study are met and then lets me know if you are
eligible or not. According to one or more of your answers, you are
not eligible.”
IF ELIGIBLE: “You are eligible to be in the
study. Does our study sound like something you might be interested
in joining?
YES, eligible woman wants to enroll. “Great. We
can do the computer survey and HIV test right now in our study van
if you would like to be in the study and have time now.”
YES, eligible woman can do ACASI and HIV testing now:
Great, let’s get started.
Administer informed consent. Resume encounter Eligibility
Screening Form at question SCR12 on the computer. Administer the
ACASI the rapid HIV testing and counseling only after the woman
gives consent.
NO, eligible woman can’t do ACASI and HIV testing now:
That’s OK. I can make an appointment for you to either
come to our office or meet me on (day/date/time) when
our van at (say location choices).” Set
appointment and give appointment card. (Consent woman
when she returns to do the ACASI and HIV test).
Appointment Date___________________________________
Appointment Time___________________________________
Appointment Location________________________________
“Please write this number down and bring it with you so you
don’t have to answer the screening questions again. If you
forget this number, we will have to ask you the questions again.
(Give the woman her screening number). The screening number is only
good for 2 weeks. After that, we will have to ask you these
questions again.”
Screening Number___________________________________
NO, eligible woman does not want to enroll:
“OK, Thanks for your interest in our study. Please take this
card and call us if you change your mind.” Resume
Encounter Eligibility Screening Form at question SCR12 on the
computer.
Please be certain you have completed question SCR16 (and
SCR17, if possible on Encounter Eligibility
Screening Form.
Flesch-Kincaid Reading Level 3.5
Hello, may I speak with “Jane Doe.”
“Hi, Jane, this is ‘Assistant’ from the ‘Site Specific Name of Project’. The result of your lab test that was done as part our study has come back. It is very important that you know the result of your test. I noticed that you have not come back to get this information. We can only give you the test result in person. Would you like to set up another time to come in to get your test result?”
IF YES: What day and time would work best for you? Our van can meet you at (location) or (location). Which of these is best for you?
Schedule day, date and time of appointment.
“OK, you have an appointment on (day, date time) to come for your test result. Please write this telephone number down and call me if you want to change your appointment (give study telephone number). Thank you and we’ll see you on (appointment date).”
Appointment Date___________________________________
Appointment Time___________________________________
Appointment Location________________________________
IF NO: OK, please call us back if you change your mind and want to come in for your test result. Here is the number to call… (Give local study number).
| File Type | application/msword |
| Author | sxw2 |
| Last Modified By | sxw2 |
| File Modified | 2007-04-20 |
| File Created | 2007-04-20 |