1 Survey

Appendix A A.1.2.b–5

Version 1/20/08 Visit Type: Preconception 1 Month

Target: Enrolled Female

Preconception Phone Follow-Ups (1, 2, & 4 Mo.)

INTRO1. Hello, I’m calling today from the National Children’s Study to speak with {NAME}. Is she available now?

YES (TARGET ANSWERED PHONE) 1 (START_FV)

YES (TARGET AVAILABLE) 2

NO 3 (INTRO3)

REFUSED 9--97 (CLOSE1)

DON’T KNOW 9--98 (INTRO3)

INTRO2. Hello, I’m calling today from the National Children’s Study to speak with {NAME}. Is this she?

INTERVIEWER INSTRUCTION:

WAIT FOR NEW PERSON TO PICK UP PHONE BEFORE BEGINNING QUESTION.

YES 1 (START_FV)

NO 2

REFUSED 9--97 (CLOSE1)

DON’T KNOW 9--98

INTRO3. When would be a good day of the week and time to call her back?

CLOSE1. Thanks for your time. These are all the questions I have right now.

BOX FV00

CHECK ITEM:

• IF R IN HIGH PPG GROUP AND REPORTED TRYING TO GET PREGNANT AT LAST PPG ASSIGNMENT, GO TO FV003.

• IF R IN HIGH PPG GROUP AND REPORTED NOT TRYING TO BECOME PREGNANT AT LAST PPG ASSIGNMENT, GO TO FV001.

FV001. I’m calling today just to update some information we have for you. Last time we spoke, you weren’t trying to become pregnant, but we know that plans to start a family can sometimes change.

FV002. Are you now

Trying to become pregnant, 1 (BOX FV01)

Not trying to become pregnant, or 2 (FV011)

Currently pregnant? 3 (FV005)

REFUSED 9--97 (FV011)

DON’T KNOW 9--98 (FV011)

FV004. Since we last spoke with you, have you learned that you’re pregnant?

YES 1 (FV005)

NO 2

REFUSED 7

DON’T KNOW 8

BOX FV01

CHECK ITEM:

• IF R IS A NEW TRYER (FV002 = 1), GO TO FV010.

• IF R IS A PREVIOUS TRYER (FV002 NOT ASKED), GO TO FV008.

FV005. Congratulations. When is your baby due?

|___|___| |___|___| |___|___|___|___|

MM DD YYYY

REFUSED 9—97 (FV006)

DON’T KNOW 9—98 (FV006)

BOX FV02

CHECK ITEM:

• GO TO BOX FV06.

FV006. What was the first day of your last menstrual period?

|___|___| |___|___| |___|___|___|___|

MM DD YYYY

REFUSED 9--97 (FV007)

DON’T KNOW 9--98 (FV007)

BOX FV03

• GO TO BOX FV06.

FV007. How many weeks pregnant are you now? If you’re not sure, please make your best guess.

|___|___|

NUMBER

REFUSED 9--97 (BOX FV06)

DON’T KNOW 9--98 (BOX FV06)

BOX FV04

• GO TO BOX FV06.

FV008. Are you currently trying to become pregnant?

YES 1

NO 2 (BOX FV06)

REFUSED 9--97 (BOX FV06)

DON’T KNOW 9--98 (BOX FV06)

FV009. Please continue to use the pregnancy test kits the study gave you. Do you need any more pregnancy test kits?

YES 1 (BOX FV06)

NO 2 (BOX FV06)

REFUSED 9--97 (BOX FV06)

DON’T KNOW 9--98 (BOX FV06)

FV010. Since you’re now trying to become pregnant, it’s important that some additional information be collected. The study will send you some additional materials, including pregnancy test kits and instructions for collecting additional information. These will arrive by mail in about a week.

BOX FV05

CHECK ITEM:

• GO TO BOX FV06.

FV011. This next question is about birth control. The last time you had intercourse with a man, did you use any type of contraception or do anything to prevent pregnancy?

YES 1

NO 2 (BOX FV06)

REFUSED 9--97 (BOX FV06)

DON’T KNOW 9--98 (BOX FV06)

FV012. Please listen to the following options and tell me all the types of contraception you used the last time you had intercourse with a man. Did you use:

YES NO RF DK

a. Birth control pills? 1 2 9--97 9--98

b. Condoms? 1 2 9--97 9--98

c. Depo-Provera, or other shots or injections? 1 2 9--97 9--98

d. Natural family planning, including rhythm or safe period

by calendar, temperature, or cervical mucus? 1 2 9--97 9--98

f. A diaphragm, cervical cap, or shield? 1 2 9--97 9--98

g. Foam, jelly, cream, suppository, or other insert? 1 2 9--97 9--98

h. A female condom, or vaginal pouch? 1 2 9--97 9--98

i. The patch, Norplant, Nuva ring, or the ring? 1 2 9--97 9--98

j. The TODAY sponge? 1 2 9--97 9--98

k. An IUD, Coil, or Loop? 1 2 9--97 9--98

l. Plan B or the “Morning After” pill? 1 2 9--97 9--98

m. Withdrawal or pulling out? 1 2 9--97 9--98

n. Some other method or did something else? 1 2 9--97 9--98

BOX FV06

PROGRAMMER INSTRUCTION:

RUN ALGORITHM

BOX FV07

CHECK ITEM:

• IF IN PREGNANT ELIGIBLE GROUP, GO TO FV013.

• IF IN HOLDING GROUP, GO TO FV014.

• IF IN HIGH GROUP AND TRYING TO BECOME PREGNANT, GO TO FV016.

• IF IN HIGH GROUP AND NOT TRYING TO BECOME PREGNANT, GO TO FV015.

• IF IN MODERATE/LOW GROUP AND TRYING TO BECOME PREGNANT, GO TO FV016.

• IF IN MODERATE/LOW GROUP AND NOT TRYING TO BECOME PREGNANT, GO TO FV015.

• IF IN MODERATE/LOW GROUP AND NOT TRYING TO BECOME PREGNANT, BUT REPORTED TRYING TO BECOME PREGNANT AT PREGNANCY SCREENER, GO TO FV017.

• IF IN EXTRA LOW GROUP, GO TO FV018.

FV013. {Congratulations again on your pregnancy.} Because you’re pregnant, we’d like to set up another visit at your home to tell you about the next phase of this study.

BOX FV08

• GO TO EOS.

FV014. {Congratulations again on your pregnancy.} While this study focuses on child health, at this time we are only enrolling women whose babies are due between {DATE 1} and {DATE 2}. However, if you become pregnant again, that baby may be eligible for the study later on. We’ll check in with you a few months after you baby is born to see how you’re doing and update your information. Thanks for your time.

BOX FV09

• GO TO EOS.

FV015. Thanks for your time. We’ll call you in a month or two to check in with you and see if anything has changed.

BOX FV10

• GO TO EOS.

FV016. Thanks for your time. We’ll call you in a month or two to check in with you and see if anything has changed. In the meantime, if you learn that you’re pregnant, please call [INSERT LOCAL PROCEDURES].

{We’ll mail the pregnancy test kits you requested. They will arrive in about a week.}

BOX FV11

• GO TO EOS.

FV017. Thanks for your time. We understand that plans can change and that you’re not trying to become pregnant right now. We’ll call you in a month or two to check in with you and see if anything has changed.

BOX FV12

• GO TO EOS.

FV018. Thanks for your time. We’ll call you in about a year to check in with you and update your information.

FV_END

END P1 MONTH PHONE CALL