Qualitative Interview Guide for Never in Care

Attachment 2b. Qualitative Interview Guide and Observation Form

Never in Care Project (NIC)

2007 Qualitative Interview

VERSION 1.3

Public reporting burden of this collection of information is estimated to average 60 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: CDC, Project Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-XXXX). Do not send the completed form to this address.

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

Atlanta, GA 3033

Never in Care (NIC) 2007 Qualitative Interview

Interviewer instructions: Offer the respondent a short break before starting the qualitative interview. During the break, complete the preliminary information.

PRELIMINARY INFORMATION

P1. Interviewer: Check all responses listed in the handheld or laptop device located at the end of the standard questionnaire.

	Reponses from 2007 NIC standard questionnaire and corresponding question number:	Included
a.	Health insurance coverage during the past 3 months (D9)	
b.	Gaps in health insurance coverage during the past 3 months (D9b)	
c.	Incarcerated during the past 3 months (D11)	
d.	Currently unemployed (D12)	
e.	Barriers to HIV care and health (C1a, C1j)	
f.	Barriers to HIV care and denial of HIV status (C1b)	
g.	Barriers to HIV care and avoidance of HIV status or disclosure issues (C1c, C1d)	
h.	Barriers to HIV care and economics (C1e)	
i.	Barriers to HIV care and other responsibilities (C1f)	
j.	Barriers to HIV care and homelessness (C1g)	
k.	Barriers to HIV care and substance use (C1i)	
l.	Barriers to HIV care and religious reasons (C1m)	
m.	Barriers to HIV care and mistrust or dislike of HIV medicines (C1n)	
n.	Barriers to HIV care and mistrust or dislike of health care professionals (C1p)	
o.	Barriers to HIV care and health facilities (C1q, C1r, C1s, C1t, C1u)	
p.	Assistance accessing HIV care (H9)	
q.	ER or urgent care visits in the past 3 months (B3)	

P2. NIC ID No: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

P3. Interviewer ID: ___ ___

P4. Interview date: __ __ /__ __ / __ __ __ __

M M D D Y Y Y Y

P5. Time interview began: __ __: __ __ AM  PM

SAY: “I’d like to thank you for taking part in this interview. This interview is different from the one we just finished. I’ll ask you some questions and I want you to describe your thoughts and experiences. When we are ready to start, I will turn on a tape recorder to record our voices as we talk. Remember that all the information you give me will be private and your name will not be recorded anywhere. Please let me know if you have any questions [PAUSE FOR QUESTIONS]. I’d like to start the tape recorder now.”

Interviewer instructions: Keep in mind that respondents may not distinguish between the health care system, health professionals, and HIV medical care.

Topic: Health Care System

Q1. Tell me how you feel about medical care in the United States (U.S.)?

PROBE: positive and negative attitudes

EXAMPLE: Describe what is good and bad about medical care in the U.S.

PROBE: previous experiences

EXAMPLE: Tell me about the good and bad experiences you’ve had with medical care in the U.S.

PROBE: influence getting into care

EXAMPLE: How have your experiences with medical care in the U.S. influenced your decision to get HIV medical care?

IF NO EXPERIENCES: word of mouth

EXAMPLE: What have you heard from others about medical care in the U.S.?

Topic: Health Professionals

Q2. Tell me how you feel about health care workers.

PROBE: positive and negative experiences with health care providers

EXAMPLE: Tell me about the good and bad experiences you’ve had with a health care workers.

PROBE: influence getting into care

EXAMPLE: How have your experiences with a health care worker influenced your decision to get HIV medical care?

Interviewer instructions: If P1n is checked, then go to probe 1; otherwise, skip to probe 2.

PROBE 1: mistrust of health professionals

EXAMPLE: Earlier you said you don’t like or trust health care workers. What is it about them that you don’t like or trust?

PROBE 2: attitude about HIV care providers

EXAMPLE: How do you feel about the health care providers who treat people living with HIV?

Topic: HIV Medical Care

Q3. Tell me how you feel about HIV medical care.

PROBE: attitude about HIV medical care

EXAMPLE: Describe what is good and bad about HIV medical care.

PROBE: word of mouth

EXAMPLE: Tell me what you’ve heard about HIV medical care.

PROBE: barrier to care

EXAMPLE: How has this influenced your decision to get HIV medical care?

Q4. In your opinion, what are the advantages or disadvantages of getting into HIV medical care?

PROBE: outlook on getting into care within 3 months of diagnosis date

EXAMPLE: What are the advantages or disadvantages of getting into HIV medical care within 3 months of testing positive?

Topic: HIV Therapy

Q5. What have you heard about the medicines used for HIV?

PROBE: positive or negative outlook about HIV medications

EXAMPLE: Have you heard anything good or bad about the medicines used for HIV?

PROBE: people who use HIV medications

EXAMPLE: Do you know anyone who has used HIV medicines?

IF YES: Have you heard anything good or bad from those who have used HIV medicines?

Q6. What kind of treatment, if any, do you feel you should use for your HIV?

IF NO TREATMENT: rational for no treatment

EXAMPLE: Why do you feel that you shouldn’t use any treatment?

IF TREATMENT: perceived outcome of treatment

EXAMPLE: What do you feel this treatment will do for you?

PROBE: behaviors to minimize HIV infection

Example: Are there other things you do to take care of yourself and keep your HIV infection in check?

Topic: Barriers to Care

Interviewer instructions: If P1h is checked, then go to Q7; otherwise, skip to interviewer instructions before Q8.

Q7. Earlier, you said that you didn’t get into HIV medical care because you didn’t have enough money or health insurance. Tell me more about how this has kept you from getting into HIV care.

Interviewer instructions: If P1a and/or P1b are checked, then go to Q8; otherwise, skip to interviewer instructions before Q9.

Q8. Earlier, you said that in the past 3 months you didn’t have any or enough health insurance. What are the reasons that you didn’t have health insurance?

PROBE: lack of health insurance as a barrier to care

EXAMPLE: Did not having health insurance keep you from getting HIV medical care?

IF YES: How so?

Interviewer instructions: If P1j is checked, then go to Q9; otherwise, skip to interviewer instructions before Q10.

Q9. Earlier, you said that you didn’t get into HIV care because you were living on the street, in a shelter, in a car, or in a SRO (single room occupancy) hotel. Tell me more about this.

PROBE: homelessness as a barrier to care

EXAMPLE: How did your living situation keep you from getting into care?

Interviewer instructions: If P1d is checked, then go to Q10; otherwise, skip to interviewer instructions before Q11.

Q10. Earlier you said that you are currently unemployed. How has your unemployment status affected your HIV?

Interviewer instructions: If P1c is checked, then go to Q11; otherwise, skip to interviewer instructions before Q12.

Q11. Earlier you said that you have been in jail, detention, or prison during the past 3 months. Tell me what it is like to have HIV in jail, detention, or prison?

PROBE: care system in incarcerated settings

EXAMPLE: Tell me about the HIV medical care available in jail, detention, or prison.

PROBE: quality of care

EXAMPLE: What do you think about the quality of care given to people with HIV in jail, detention, or prison?

Interviewer instructions: If P1e is checked, then go to Q12; otherwise, skip to interviewer instructions before Q13.

Q12. Earlier you said that you did not get into HIV medical care because of reasons related to your health. Tell me more about your state of health.

PROBE: health as a barrier to care

EXAMPLE: Tell me how your health has affected getting into HIV medical care.

Interviewer instructions: If P1o is checked, then go to Q13; otherwise, skip to interviewer instructions before Q14.

Q13. Earlier you said that you didn’t get into HIV medical care because of reasons related to a health facility. Tell me about this facility.

PROBE: previous experiences

EXAMPLE: Tell me about any good or bad experiences that you’ve had with this facility.

PROBE: word-of-mouth

EXAMPLE: Tell me what you’ve heard about this facility or other facilities like it that offer HIV medical care.

Interviewer instructions: If P1i is checked, then go to Q14; otherwise, skip to interviewer instructions before Q15.

Q14. Earlier you said that you didn’t get into HIV medical care because of other responsibilities. Tell me more about your other responsibilities.

Topic: Accessing Care

Interviewer instructions: If P1p is checked, then go to Q15; otherwise, skip to interviewer instructions before Q16.

Q15. Earlier you said that someone tried to get you into HIV care. How did you feel when this person tried to get you into care?

Interviewer instructions: If P1q is checked, then go to Q16; otherwise, skip to Q17.

Q16. Earlier you said that you have been to the emergency room or urgent care clinic in the past 3 months. Tell me about those experiences and why you decided to go to the emergency room or urgent care clinic?

Q17. If you wanted HIV medical care, what kinds of things would you need or want in order to get it?

 

            PROBE: physical needs

            EXAMPLE:  How important to you is HIV medical care compared to other things that you need right now?

 

Topic: Perceived Etiology of HIV

Interviewer instructions: If P1f is checked, then go to Q18; otherwise, skip to Q19.

Q18. Earlier you said that you didn’t believe you had HIV. Why do you feel that you don’t have HIV?

Interviewer instructions: Skip to next topic.

Q19. How do you think you got HIV?

PROBE: reason for onset

EXAMPLE: Why do you think your HIV started when it did?

Topic: Illness Perceptions

Q20. How did you feel when you first learned you were HIV positive?

PROBE: feelings about status

EXAMPLE: How do you feel now about being HIV positive?

PROBE: barrier to HIV care

EXAMPLE: Has this affected your decision to get into HIV care?

Topic: Stigma

Q21. In your opinion, what do others think about people with HIV?

Q22. What do you think about people with HIV?

Topic: Access to HIV Information

Q23. If you wanted information about HIV, how would you get it?

PROBE: place

EXAMPLE: Where would you go to get information?

PROBE: person

EXAMPLE: Who would you talk with?

Q24. Is there anything else that you can tell me to help me understand why some people don’t get HIV medical care?

SAY: “We’re finished. Thank you very much for talking to me. Remember, everything you told me will be kept private. Do you have any questions about HIV, HIV care, or anything that we’ve discussed here today?”

Time interview ended: __ __: __ __ AM  PM

OMB Number:

Expiration Date:

Observation Form for the Qualitative Interview

Never in Care Project (NIC)

[completed by project staff, post-interview]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

Atlanta, GA 3033

Observation Form for the Qualitative Interview

Record your observations of the interview setting. This may include information such as a description of the interview location or any external interruptions during the interview.

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Record your observations and perceptions of the respondent. This may include information about the respondent’s behavior during the interview, resistance to answering the questions, comprehension of the questions, or mental and physical state:

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Record your observations about the respondent’s rapport with the interviewer. This may include whether the respondent was engaged or distant during the interview.

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How confident are you of the validity of the respondent’s answers?

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