5 survey

Appendix H – Web E-Mail Follow-up Script

WEB : Preconception Phone Follow-ups (Moderate, & Low) – Usability Test Version

LOGIN Thank you for continuing to help the National Children’s Study by completing this short questionnaire -- it takes only 3 to 5 minutes to complete!

Entering your e-mail address and home phone number will start your questionnaire.

Email address (VALID E-MAIL)

Home phone number (VALID #)

IF BOTH ARE CORRECT GO TO IDENT.

IF E-MAIL OR PHONE NUMBER DOES NOT MATCH GO TO LOGIN2.

LOGIN2 The system could not find a record that matches the e-mail address or phone number you provided. Please enter your email address and phone number again.

Email address (VALID E-MAIL)

Home phone number (VALID #)

IF BOTH ARE CORRECT GO TO IDENT

IF E-MAIL OR PHONE NUMBER DOES NOT MATCH GO TO NOLOGIN

NOLOGIN We apologize. The system cannot locate a record for the email address or phone number you entered. Please call {PH #} and a National Children’s Study representative will help identify the correct record. Representatives are available weekdays 9am to 9pm ET. We appreciate your interest in the National Children’s Study.

RETURN TO LOGIN SCREEN/LEAVE WEB APPLICATION

IDENT This questionnaire is for {NAME LASTNAME}. Are you {NAME LASTNAME }?

• Yes 1 (BOX CT01)

• No 3 (BOX CT01)

NO SELECTON MADE (BOX CT01)

PROGRAMMING INSTRUCTION:

DISPLAY RFULLNAME FROM DATEBASE. DISPLAY RFULLNAME IN ALL CAPS, NO BOLD, NO ITALICS.

INSTRUCT Throughout this questionnaire to move forward to the next question click on the “next” button. If you need to change an answer or if you made a mistake click on the “previous” button to go back

to the previous question. You should not use the “back” or “forward” buttons in your web browser.

PROGRAMMING INSTRUCTION:

FOR REMAINDER OF SURVEY OPEN SURVEY SCREENS IN A WINDOW WHICH DOES NOT SHOW THE INTERNET BROWSWER TOOLBAR.

SAVE CURRENT INSTRUMENT TIME IN MINUTES AND SECONDS TO WEBEXTDSTART.

FV001 Because this study is interested in pregnancy, it is important to know if you are currently pregnant. Are you pregnant now?

• Yes, pregnant 1 (BOX FV02)

• No, not pregnant 3 (FV008)

PROGRAMMING INSTRUCTION:

IF RESPONDENT CLICKS ‘NEXT’ BUTTON WITHOUT MAKING ANY SELECTION DISPLAY ERROR MESSAGE EACH TIME NEXT IS CLICKED.

VARIABLE NAME: PregnantNow

ERROR MESSAGE TO DISPLAY: DEFAULT2

FV008 Are you currently trying to become pregnant?

• Yes 1 (BOX FV02)

• No 3 (BOX FV02)

VARIABLE NAME: StillTryingPregUpdate

ERROR MESSAGE TO DISPLAY: DEFAULT1

BOX FV02

SET FENCEPOST1 = 1

CHECK ITEM

• IF R PREGNANT (FV001/PregnantNow = 1) THEN GO TO FV005

• ELSE GO TO JOIN.

FV005 Congratulations! When is your baby due?

Select the month for your baby’s due date.

____ (Month) (BOX FV03)

• Month unknown. 998 (JOIN)

PROGRAMMER INSTRUCTION

ALLOW SELECTION OF MONTH, NOT USER ENTRY

VARIABLE NAME: MONTH: MDueDate

ERROR MESSAGE TO DISPLAY: “Please select a month for your baby’s due date, if you are unsure make your best guess, or select month unknown.”

ERROR MESSAGE TO DISPLAY FOR BUBBLE SELECT: “Please click on the bubble that corresponds to your answer. If you do not know the month please clear that month by clicking on ‘select’.”

BOX FV03

CHECK ITEM

IF MONTH (MDueDate < CURRENT MONTH) THEN YDate = CURRENT

YEAR +1.

IF MONTH (MDueDate => CURRENT MONTH) THEN YDate = CURRENT

YEAR.

SAVE MONTH (MDueDate) AND YEAR (P1YDate) AS DATE IN

DueDate.

THEN GO TO BOX FV04.

BOX FV04

SET FENCEPOST2 = 1

CHECK ITEM

IF DATE (DueDate) IS NOT WITHIN TEN MONTHS OF CURRENT DATE, THEN GO TO FV005c.

ELSE GO TO FV005v.

FV005c The month you have entered is more than nine months from today. Select the month for your baby’s due date.

____ (Month) (BOX FV03_1)

• Month unknown. 998 (JOIN)

[PROGRAMMER INSTRUCTION]

ALLOW SELECTION OF MONTH, NOT USER ENTRY

VARIABLE NAME: MONTH: 2MDueDate

ERROR MESSAGE TO DISPLAY: “Please select a month for your baby’s due date, if you are unsure make your best guess, or select date unknown.”

ERROR MESSAGE TO DISPLAY FOR BUBBLE SELECT: “Please click on the bubble that corresponds to your answer. If you do not know the month please clear that month by clicking on ‘select’.”

BOX FV03_1

CHECK ITEM

CALCULATE APPROPRIATE YEAR:

IF MONTH (2MDueDate < CURRENT MONTH) THEN 2YDate = CURRENT YEAR +1.

IF MONTH (2MDueDate => CURRENT MONTH) THEN 2YDate = CURRENT YEAR.

SAVE MONTH (2MDueDate) AND YEAR (YDate) AS DATE IN DueDate

THEN GO TO BOX FV04_1.

BOX FV04_1

SET FENCEPOST2 = 1

CHECK ITEM

IF DATE (DueDate) IS NOT WITHIN NINE MONTHS OF CURRENT DATE, THEN GO TO BOX FV12.

ELSE GO TO FV005v.

FV005v Just to verify, the month you have given for your baby’s due date is {P1MonthDueDate}. Is this correct?

• Yes 1 (BOX FV12)

• No 3 (FV005)

VARIABLE NAME: VerifyDueDate

ERROR MESSAGE TO DISPLAY: DEFAULT1

BOX FV12

SET FENCEPOST9 = 1

PROGRAMMER INSTRUCTION:

IF CONTACT NUMBER = EVEN THEN GO TO JOIN.

ELSE IF CONTACT NUMBER = ODD THEN GO TO FV013A

JOIN Since the last time we contacted you, has anyone moved into your household?

• YES 1 (MV001)

• NO 3 (MV001)

VARIABLE NAME: JoinHH

ERROR MESSAGE TO DISPLAY: DEFAULT1

MV001 Do you plan on moving from your present address within the next two months?

• YES 1 (MV002)

• NO 3 (BOX FV12_1)

VARIABLE NAME: WillMove

ERROR MESSAGE TO DISPLAY: DEFAULT1

MV002 Do you know the address of where you will be moving to?

• YES 1 (MV003)

• NO 3 (BOX FV12_1)

VARIABLE NAME: KnowMove

ERROR MESSAGE TO DISPLAY: DEFAULT1

MV003 Enter the address you will be moving to in the fields below. If you are unsure enter only what information you know.

Street number and name: Apt #:

MoveAddr MoveApt

City: State: Zip:

MoveCity MoveSt MoveZip

MV004 Please enter the best phone number to reach you at in case we need get in touch with you after you move.

Phone Number: (__|__|__) – |__|__|__| – |__|__|__|__|

ERROR MESSAGE TO DISPLAY: “You have not entered a phone number. If you want to continue without entering a phone number click ‘next’ again.”

Is this number your home, work, cell, or some other phone number?

• Home 1 (MV006)

• Work 2 (MV006)

• Cell 3 (MV006)

• Some other number 4 (MV006)

VARIABLE NAME: MovePhType

PROGRAMMER INSTRUCTION

MAKE SELECTIONS INTO A DROP-DOWN MENU.

ERROR MESSAGE TO DISPLAY: DEFAULT2

MV006 Is {EMAIL ADDRESS} the best e-mail address to reach you once you move?

• Yes 1 (BOX FV12_1)

• No 3 (MV007)

VARIABLE NAME: MoveVerifyEmail

ERROR MESSAGE TO DISPLAY: DEFAULT1

MV007 Enter the best email address to reach you after you move in both boxes below.

Email address:

Verify Email address: (INSTRUCTION)

ERROR MESSAGES TO DISPLAY:

MESSAGE1: “You have not entered an email address; enter your email address to continue.”

MESSAGE2: “Please verify your email address; then click ‘next’ to continue.”

MESSAGE3: “The email addresses you entered do not match, please re-enter your email address.”

Is this your personal email, work email, or a family or shared email address?

• Personal 1 (BOX FV12_1)

• Work 2 (BOX FV12_1)

• Family or shared 3 (BOX FV12_1)

VARIABLE NAME: MoveEmType

ERROR MESSAGE TO DISPLAY: DEFAULT2

BOX FV12_1

SET FENCEPOST10 = 1

PROGRAMMER INSTRUCTION:

IF MV001/WillMove OR MV002/KnowMove = 3 THEN GO TO FV013A

IF MV002/KnowMove = 1 AND (MV003) MoveAddr OR MoveCity OR MoveZip = NULL THEN GO TO FV013A

IF MV002/KnowMove = 1 AND (MV003) MoveAddr AND MoveCity AND MoveZip != NULL THEN GO TO BOX FV13

FV013A Please verify your current contact information below. If anything is incorrect or has changed click on the box and type the new information.

Street number and name: Apt #:

CurrAddr CurrApt

City: State: Zip:

CurrCity CurrSt CurrZip

Phone Number: (__|__|__) – |__|__|__| – |__|__|__|__|

CurrPhone

GO TO BOX FV13

VARIABLE NAME: IN BOLD ABOVE

BOX FV13

CHECK ITEM:

IF IN PREGNANT ELIGIBLE GROUP (FV001/PregnantNow = 1) THEN GO TO CL001.

ELSE IF NOT PREGNANT (FV001/PregnantNow != 1) AND EITHER MV002/KnowMove != 1 OR FV013A/VerifyAdd != 2 OR JOIN/JoinHH != 1 THEN:

IF CONTACT = 1 (EVERY 6 WEEKS) and not trying to get pregnant (FV008/ StillTryingPregUpdate = 2) GO TO CL002.

IF CONTACT = 1 (EVERY 6 WEEKS) and trying to get pregnant (FV008/ StillTryingPregUpdate = 1) GO TO CL003.

IF CONTACT = 1 (EVERY 12 WEEKS) and not trying to get pregnant (FV008/ StillTryingPregUpdate = 2) GO TO CL004.

IF CONTACT = 1 (EVERY 12 WEEKS) and trying to get pregnant (FV008/ StillTryingPregUpdate = 1) GO TO CL005.

IF INSUFFICIENT DATA (--) GO TO CL006.

CL001 Congratulations again on your pregnancy and thank you for answering these questions.

Click the button below to close the window and end this survey.

SET FENCEPOST10 = 1.

CLOSE WINDOW.

CL002 Thank you for answering these questions. We will be back in touch with you again in about six weeks to ask a few quick questions. We’ll send you a letter about a week before then to remind you.

Click the button below to close the window and end this survey.

SET FENCEPOST10 = 1.

CLOSE WINDOW.

CL003 Thank you for answering these questions. We will be back in touch with you again in about six weeks to ask a few quick questions. We’ll send you a letter about a week before then to remind you. If you find out that you’re pregnant before the next survey, please call the toll free number for your local National Children’s Study office. The number is {SO toll free #}. Representatives are available weekdays 9am to 9pm ET.

Click the button below to close the window and end this survey.

SET FENCEPOST10 = 1.

CLOSE WINDOW.

CL004 Thank you for answering these questions. We will be back in touch with you again in about twelve weeks to ask a few quick questions. We’ll send you a letter about a week before then to remind you.

Click the button below to close the window and end this survey.

SET FENCEPOST10 = 1.

CLOSE WINDOW.

CL005 Thank you for answering these questions. We will be back in touch with you again in about twelve weeks to ask a few quick questions. We’ll send you a letter about a week before then to remind you. If you find out that you’re pregnant before the next survey, please call the toll free number for your local National Children’s Study office. The number is {SO toll free #}. Representatives are available weekdays 9am to 9pm ET.

Click the button below to close the window and end this survey.

SET FENCEPOST10 = 1.

CLOSE WINDOW.

CL006 Unfortunately; our system is having some technical difficulties right now. We may be back in touch with you again if we need additional information. Thank you for your time.

Click the button below to close the window and end this survey.

CLOSE WINDOW.

Public reporting burden for this collection of information is estimated to average 0.03 hours (2 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 currently 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 (0925-0590). Do not return the completed form to this address.

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