Appendix D_IPV_Workplace

Appendix D_IPV_Workplace.1.21.08.doc

Program Effectiveness Evaluation of a Workplace Intervention for Intimate Partner Violence

Appendix D_IPV_Workplace

OMB: 0920-0789

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Company Letterhead

Manager Letter”





Dear


You are invited to participate in a web-based survey entitled, Workplace Health Survey, which is being conducted as part of a research study on domestic violence and the workplace. RTI International, a nonprofit research organization, received funding from the Centers fro Disease Control and Prevention (CDC) to conduct this research. All Managers who work in our Corporate Office and who have not taken the “Domestic Violence Training for Managers” as of (MM/DD/YY) are being asked to complete a survey.


The survey questions ask about your background, employment and training experiences, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. The survey will generate important information about domestic violence and the workplace, so that our company and other companies can better understand how to help individuals experiencing domestic violence.


Your participation in the survey is completely voluntary. If you decide not to participate, there will be no penalty or loss of benefits, pay, or work assignments and you may withdraw from the study at any time without any negative consequences. However, your opinion is very important to ensure that the results of this assessment accurately represent the experiences and opinions of managers within our company.


If you participate, you will complete this initial survey and two follow-up surveys. Each survey should take about 20-30 minutes to complete. The first survey “opens” this week and will be kept open for two weeks. Among the managers who complete the first survey within the two-week window, 50 will be randomly selected to win a $100 gift certificate for Amazon.com. Only the managers who complete the first survey will be eligible to take the second and third surveys. For each of the three surveys, of the managers who complete the survey, 50 will be randomly selected to win a $100 Amazon.com gift certificate.

This week you will be receiving an e-mail to your company e-mail account with detailed information on how to log in to this web-based survey. After logging in, you will be connected to a secure website where you will receive additional information about the study and be asked to answer the survey questions.


Your answers will be kept in confidence and will only be seen by the authorized research staff at RTI International. No <company> personnel will be able to see your individual responses. The results of this survey will be reported as group averages only; your individual answers will not be identified in any study reports. If you do not complete the survey, RTI International will contact you by email to remind you to complete the survey.


<Company> is committed to protecting the privacy of all survey participants.  Any responses and personal information collected through this voluntary survey will be used solely for data purposes and will indefinitely remain secure and confidential.  In addition, <company> will not attempt to discern the identity of respondents under any circumstances.  (If you have any questions or concerns regarding this privacy statement, please contact <company contact>)


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected]. If you have any questions about your rights as a study participant, you can call RTI International's Office of Research Protection at 1-866-214-2043 (a toll-free number)

Thank you in advance for your participation in this important study. Your answers to the survey will help us learn more about the critical issue of addressing domestic violence.



Sincerely,




Name

CEO




-2-

Recruitment Email [Baseline Manager Survey]


Subject: The Workplace Health Survey


Dear [name],


As you may know, [Company Name] is participating in a research study of domestic violence and the workplace. RTI International (a nonprofit research organization), is conducting this study for the Centers for Disease Control and Prevention (CDC) and with the full support of [Company name].


All [Company name] managers who have not taken the “Domestic Violence Training for Managers” as of [MM/DD/YY] are invited to participate. Managers who intend to take the training at some point, as well as managers who do not intend to take the training are eligible to participate. If you participate, you will complete this initial survey (link below) and two follow-up surveys. Each survey should take about 20-30 minutes to complete and can be completed during work hours. The first survey “opens” today and will be kept open for two weeks. Among the managers who complete the first survey within the two-week window, 50 will be randomly selected to win a $100 gift certificate for Amazon.com. Only the managers who complete the first survey will be eligible to take the second and third surveys. For each of the three surveys, of the managers who complete the survey, 50 will be randomly selected to win a $100 Amazon.com gift certificate.


The survey questions ask about your background, employment and training experiences, current work behavior, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. Before starting the survey, make sure that you are in a private location, so that no one can see your answers to the questions.



To take the first survey, please use the following link and enter your unique username and password.

Website: https://XXXXXXXXXXXX.rti.org

Username: <<username>>

Password: <<password>>


Your participation in the survey is completely voluntary and, if you do participate in the survey, you can refuse to answer any question that you do not want to. If you decide not to take part in the survey, there will be no penalty or loss of benefits, pay, or assignments and you may withdraw from the study at any time without any negative consequences.


Your decision about whether to participate in the survey and your responses to the survey questions will be kept completely confidential and will only be seen by the authorized research staff at RTI. No data on individual managers or employees will be provided to [Company name]; only summary data will be shared.


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected]. If you have any questions about your rights as a study participant, you can call RTI's Office of Research Protection at 1-866-214-2043 (a toll-free number).


Thank you in advance for your participation. We look forward to hearing from you.



If you need addition information regarding services for domestic violence, we encourage you to use the “Support Services” link below.


<insert link for resource list>



Recruitment Email [6-Month Follow-up Manager Survey]


Subject: The Workplace Health Survey


Dear [name],


As you may remember, [Company Name] is participating in a research study of domestic violence and the workplace. RTI International (a nonprofit research organization), is conducting this study for the Centers for Disease Control and Prevention (CDC) and with the full support of [Company name].


All [Company name] managers who completed the first survey are invited to participate in the second survey. The survey should take about 20-30 minutes to complete and can be completed during work hours. The survey “opens” today and will be kept open for two weeks. Among the managers who complete this follow-up survey within the two-week window, 50 will be randomly selected to win a $100 gift certificate for Amazon.com.


Like the last survey, this survey asks about your background, employment and training experiences, current work behavior, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. Before starting the survey, make sure that you are in a private location, so that no one can see your answers to the questions.


To take this survey, please use the following link and enter your unique username and password.


Website: https://XXXXXXXXXXXX.rti.org

Username: <<username>>

Password: <<password>>


Your participation in the survey is completely voluntary and, if you do participate in the survey, you can refuse to answer any question that you do not want to. If you decide not to take part in the survey, there will be no penalty or loss of benefits, pay, or assignments and you may withdraw from the study at any time without any negative consequences.


Your decision about whether to participate in the survey and your responses to the survey questions will be kept completely confidential and will only be seen by the authorized research staff at RTI. No data on individual managers or employees will be provided to [Company name]; only summary data will be shared.


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected].


Thank you in advance for your participation. We look forward to hearing from you.


If you need addition information regarding services for domestic violence, we encourage you to use the “Support Services” link below.


<insert link for resource list>

Recruitment Email [12-Month Follow-up Manager Survey]


Subject: The Workplace Health Survey


Dear [name],


As you may remember, [Company Name] is participating in a research study of domestic violence and the workplace. RTI International (a nonprofit research organization), is conducting this study for the Centers for Disease Control and Prevention (CDC) and with the full support of [Company name].


All [Company name] managers who completed the first survey are invited to participate in the final survey. The survey should take about 20-30 minutes to complete and can be completed during work hours. The survey “opens” today and will be kept open for two weeks. Among the managers who complete this follow-up survey within the two-week window, 50 will be randomly selected to win a $100 gift certificate for Amazon.com.


The survey questions ask about your background, employment and training experiences, current work behavior, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. Before starting the survey, make sure that you are in a private location, so that no one can see your answers to the questions.


To take the final survey, please use the following link and enter your unique username and password.


Website: https://XXXXXXXXXXXX.rti.org

Username: <<username>>

Password: <<password>>


Your participation in the survey is completely voluntary and, if you do participate in the survey, you can refuse to answer any question that you do not want to. If you decide not to take part in the survey, there will be no penalty or loss of benefits, pay, or assignments and you may withdraw from the study at any time without any negative consequences.


Your decision about whether to participate in the survey and your responses to the survey questions will be kept completely confidential and will only be seen by the authorized research staff at RTI. No data on individual managers or employees will be provided to [Company name]; only summary data will be shared.


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected].


Thank you in advance for your participation. We look forward to hearing from you.


If you need addition information regarding services for domestic violence, we encourage you to use the “Support Services” link below.


<insert link for resource list>



Company Letterhead

Employee Letter”




Dear


You are invited to participate in a web-based survey entitled, Workplace Health Survey, which is being conducted as part of a research study on domestic violence and the workplace. RTI International, a nonprofit research organization, received funding from the Centers fro Disease Control and Prevention (CDC) to conduct this research. You will be invited to participate in the initial survey. Only employees of managers that are participating in the study are being invited to complete this survey. Managers were chosen based on whether they had previously taken the “Domestic Violence Training for Managers” offered through <company>. The survey should take about 15-20 minutes to complete and can be completed during work hours. The survey “opens” this week and will be kept open for two weeks. Among the employees who complete the survey within the two-week window, 150 will be randomly selected to win a $100 gift certificate to Amazon.com. You may be invited to participate in an additional survey approximately 12 months from now.

The survey questions ask about your background, employment experiences, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. The survey will generate important information about domestic violence and the workplace, so that our company and other companies can better understand how to help individuals experiencing domestic violence.


Your participation in the survey is completely voluntary. If you decide not to participate, there will be no penalty or loss of benefits, pay, or work assignments and you may withdraw from the study at any time without any negative consequences. However, your opinion is very important to ensure that the results of this assessment accurately represent the experiences and opinions of employees within our company.

This week you will be receiving an e-mail to your company e-mail account with detailed information on how to access the web-based survey. You will be connected to a secure website where you will receive additional information about the study and be asked to answer the survey questions. The answers you provide will not be linked to your identity so no one will know how you answered any of the questions. You will not enter an identification number to take the survey. At the end of the survey, you will be given a “survey completion code“. You will then be directed to a separate website (unconnected with the survey) where you can enter to win one of the Amazon.com gift certificates. There you will enter the “survey completion code“ AND a “study identification number.“


Your answers will be kept in confidence and will only be seen by the authorized research staff at RTI International. No <company> personnel will be able to see your individual responses. The results of this survey will be reported as group averages only; your individual answers will not be identified in any study reports. If you do not complete the survey, RTI International will contact you by email to remind you to complete the survey.


<Company> is committed to protecting the privacy of all survey participants.  Any responses and personal information collected through this voluntary survey will be used solely for data purposes and will indefinitely remain secure and confidential.  In addition, <company> will not attempt to discern the identity of respondents under any circumstances.  (If you have any questions or concerns regarding this privacy statement, please contact <company contact>)


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected]. If you have any questions about your rights as a study participant, you can call RTI International's Office of Research Protection at 1-866-214-2043 (a toll-free number)

Thank you in advance for your participation in this important study. Your answers to the survey will help us learn more about the critical issue of addressing domestic violence.



Sincerely,




Name

CEO




-2-

Recruitment Email [Wave 1 Employee Survey]


Subject: The Workplace Health Survey


Dear [name],


As you are aware, [Company Name] is participating in a research study of domestic violence and the workplace. RTI International (a nonprofit research organization), is conducting this study for the Centers for Disease Control and Prevention (CDC) and with the full support of [Company name].


You are invited to participate in the initial survey (link below). Employees were selected for the survey based on their manager’s participation in this study. The survey should take about 15-20 minutes to complete and can be completed during work hours. The survey “opens” today and will be kept open for two weeks. Among the employees who complete the survey within the two-week window, 150 will be randomly selected to win a $100 gift certificate to Amazon.com.


The survey questions ask about your background, employment experiences, current work behavior, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. Before starting the survey, make sure that you are in a private location, so that no one can see your answers to the questions.


To take the survey, please use the following link.

Website: https://XXXXXXXXXXXX.rti.org


The answers you provide will not be linked to your identity so no one will know how you answered any of the questions. You will not enter an identification number to take the survey. At the end of the survey, you will be given a “survey completion code“. You will then be directed to a separate website (unconnected with the survey) where you can enter to win one of the Amazon.com gift certificates. There you will enter the “survey completion code“ AND the following “study identification number“

[STUDY IDENTIFICATION #]


Your participation in the survey is completely voluntary and, if you do participate in the survey, you can refuse to answer any question that you do not want to. If you decide not to take part in the survey, there will be no penalty or loss of benefits, pay, or assignments. No data on individual employees will be provided to [Company name]; only summary data will be shared.


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected]. If you have any questions about your rights as a study participant, you can call RTI's Office of Research Protection at 1-866-214-2043 (a toll-free number).


Thank you in advance for your participation. We look forward to hearing from you. You may be invited to participate in an additional survey approximately 12 months from now.


If you need addition information regarding services for domestic violence, we encourage you to use the “Support Services” link below.


<insert link for resource list>

Recruitment Email [Wave 2 Employee Survey]


Subject: The Workplace Health Survey


Dear [name],


As you are aware, [Company Name] is participating in a research study of domestic violence and the workplace. RTI International (a nonprofit research organization), is conducting this study for the Centers for Disease Control and Prevention (CDC) and with the full support of [Company name].


You are invited to participate in the initial survey (link below). Employees were selected for the survey based on their manager’s participation in this study. The survey should take about 15-20 minutes to complete and can be completed during work hours. The survey “opens” today and will be kept open for two weeks. Among the employees who complete the survey within the two-week window, 150 will be randomly selected to win a $100 gift certificate to Amazon.com.


The survey questions ask about your background, employment experiences, current work behavior, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. Before starting the survey, make sure that you are in a private location, so that no one can see your answers to the questions.


To take the survey, please use the following link.

Website: https://XXXXXXXXXXXX.rti.org


The answers you provide will not be linked to your identity so no one will know how you answered any of the questions. You will not enter an identification number to take the survey. At the end of the survey, you will be given a “survey completion code“. You will then be directed to a separate website (unconnected with the survey) where you can enter to win one of the Amazon.com gift certificates. There you will enter the “survey completion code“ AND the following “study identification number“

[STUDY IDENTIFICATION #]


Your participation in the survey is completely voluntary and, if you do participate in the survey, you can refuse to answer any question that you do not want to. If you decide not to take part in the survey, there will be no penalty or loss of benefits, pay, or assignments. No data on individual employees will be provided to [Company name]; only summary data will be shared.


If you would like more information about survey or need assistance completing the online survey, please call XXX-XXX-XXXX or email [email protected]. If you have any questions about your rights as a study participant, you can call RTI's Office of Research Protection at 1-866-214-2043 (a toll-free number).


Thank you in advance for your participation. We look forward to hearing from you.

Welcome to the Workplace Health Survey Website



Before starting the survey, please read these important facts.

  • The survey will generate important information about domestic violence and the workplace, so that companies can better understand how to help individuals experiencing domestic violence.

  • The survey is being conducted by RTI International (a non-profit research company in North Carolina), with the support of [FILL WITH COMPANY NAME].

    • For a letter of support from [FILL WITH CEO NAME] please view “Letter of Support.”

  • The survey takes about [15-20/20-30] minutes to complete.

  • [for managers: All managers who have not taken the “Domestic Violence Training for Managers” as of [MM/DD/YY] are invited to participate.] [for employees: Employees were selected for the survey based on their manager’s participation in this study.] We want the study to represent all eligible [COMPANY NAME] [managers/employees], so we need everyone to participate (even if you have not had any experiences with domestic violence).

  • The survey asks about your background, employment experiences, health, experiences with domestic violence, and perceptions of domestic violence and the workplace. Some of the questions might make you feel uncomfortable. We encourage you to use the “Support Services” link at the bottom of the web page if you would like to talk to someone about your experiences.

  • [For managers] Your responses to the survey questions will be kept completely confidential and will only be seen by the authorized research staff at RTI. No data on individual managers or employees will be provided to [Company name]; only summary data will be shared.

  • [For employees] The answers you provide will not be linked to your identity so no one will know how you answered any of the questions. You will not enter an identification number to take the survey.

  • The survey is voluntary and you can choose to skip any question.

  • If you have further questions about the study, please call XXX-XXX-XXXX or email [email protected]. If you have any questions about your rights as a study participant, you can call RTI's Office of Research Protection at 1-866-214-2043 (a toll-free number).




If you understand the information above, please click here to start the survey.

The Workplace Health Survey


Before starting the survey, please:


  • [For managers] Make sure you have the Study Identification Number and password that was e-mailed to you. You will need this information to start the survey.

  • [For managers] Set aside about 30 minutes to take the survey. If you need to resume the survey later, you can log on to the place that you exited by returning to the website and entering your log in information.

  • [For employees] Set aside about [20] minutes so that you can complete the survey in one sitting. If you exit the survey without completing it, you will not be able to get back to where you left off.)

  • Make sure that you are in a private location, so that no one can see your answers to the questions.



While you take the survey, please:


  • Answer honestly – the information you provide will remain completely confidential

  • Remember to click on the “Support Services” link at the bottom of each page of the survey if you become upset or would like information about support services available to individuals experiencing domestic violence.


After you complete the survey, you will be [for managers: entered in the drawing for one of the $100 Amazon.com gift certificates that will be given to 50 randomly selected survey respondents] [for employees: given a “survey completion code“. You will then be directed to a separate website (unconnected with the survey) where you can enter to win one of the $100 Amazon.com gift certificates that will be given to 150 randomly selected survey respondents. There you will enter the “survey completion code“ AND the “study identification number“ that was e-mailed to you.]



Click here to start the survey!




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