Screening and Recruitment for Focus Groups

Form Approved

OMB No. 0920-XXXX

Exp. Date xx/xx/20xx

ATTACHMENT H:

Focus Group Screener

Focus Group Screener

Evaluation of the Field Triage Decision Scheme: The National Trauma Triage Protocol

A total of 8 focus groups will be conducted with two audiences—EMS administrators at state and local levels (including EMS educators) and EMS providers in the field. Six to eight participants will be recruited for each group, for a total of 48-64 focus group participants.

NOTES FOR RECRUITERS

• Please note that all recruitment quotas should be filled for each of the two audiences (EMS administrators and EMS providers). For example, “recruit a mix” means that there should be a mix within each audience, not the entire study population.

• Please use the following language for termination of screening:

“Thank you very much for your time today. We are looking to recruit a variety of professionals from across the country to help with this study, and we have already recruited enough people with similar backgrounds. We are still in the process of recruitment, and if we need your help, we will call you back. Again, thank you for your interest. If you have questions about the Field Triage Decision Scheme, please visit www.cdc.gov/FieldTriage or call 1-800-CDC-INFO.”

Public reporting burden of this collection of information is estimated to average 5 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).

Hello, I am _______________ with NOVA Research Company, working with the Centers for Disease Control and Prevention (CDC). We are conducting a research study with EMS professionals on behalf of the CDC. You recently completed a survey for us on the topic of the Field Triage Decision Scheme: The National Trauma Triage Protocol (Decision Scheme), and provided your contact information to participate in additional research. I would like to ask you some questions to see if you qualify to participate in a brief telephone focus group about the Decision Scheme. These questions will only take a few moments to answer. Everyone who qualifies for and participates in these focus groups will be paid $50. The focus group will include other EMS professionals, will be scheduled at a time convenient to the group, and will last up to 60 minutes. Do you have time now to answer a few questions to see if you qualify?

1. Please confirm what you stated in your survey, that you received and reviewed tool kit materials from the Centers for Disease Control and Prevention (CDC) called the “Field Triage Decision Scheme: The National Trauma Triage Protocol”?

( ) Yes Continue

( ) No Terminate

2. Which of the following best represents your job title or primary job? (Choose only one)

( ) EMS administrator (at state, regional, or local level)……………….Continue

( ) EMS educator…………………………………………………………..Continue

( ) Trauma System leadership……………………………………………Continue

( ) Medical Director………………………………………………………..Continue

( ) Emergency Medical Technician/Paramedic………..………………..Continue

( ) Other ……………………………………………………………………Terminate

Recruit 32 individuals that identify themselves as EMS administrators, EMS educators, Trauma System Leadership, or Medical Directors

Recruit 32 individuals that identify themselves as Emergency Medical Technicians/Paramedics

3. Record Gender

( ) Male Continue

( ) Female Continue

Recruit close to an even mix of genders.

4. How would you describe the location of your workplace? (Check only one)

( ) Rural Continue

( ) Suburban Continue

( ) Urban Continue

Recruit at least 6 from each location.

4a. If urban:

Do you work in a large urban city center?

( ) Yes Continue

( ) No Continue

Recruit at least 1 from a large urban city center.

5. What state do you currently work in?

Northeast

( ) Connecticut

( ) Maine

( ) Massachusetts

( ) New Hampshire

( ) New Jersey

( ) New York

( ) Pennsylvania

( ) Rhode Island

( ) Vermont

Midwest

( ) Illinois

( ) Indiana

( ) Iowa

( ) Kansas

( ) Michigan

( ) Minnesota

( ) Missouri

( ) Nebraska

( ) North Dakota

( ) Ohio

( ) Wisconsin

( ) South Dakota

South

( ) Alabama

( ) Arkansas

( ) Delaware

( ) District of Columbia

( ) Florida

( ) Georgia

( ) Kentucky

( ) Louisiana

( ) Maryland

( ) Mississippi

( ) North Carolina

( ) Oklahoma

( ) South Carolina

( ) Tennessee

( ) Texas

( ) Virginia

( ) West Virginia

West

( ) Arizona

( ) Alaska

( ) California

( ) Colorado

( ) Hawaii

( ) Idaho

( ) New Mexico

( ) Oregon

( ) Montana

( ) Utah

( ) Nevada

( ) Washington

( ) Wyoming

Recruit no more than 50% from any region. Must recruit from all 4 regions.

6. So that we can be sure that all backgrounds are represented in our study, please tell me are you Hispanic or Latino?

( ) Yes Continue

( ) No Continue

7. So that we can be sure that all backgrounds are represented in our study, please tell me what is your race?

( ) Black or African American Continue

( ) White Continue

( ) Asian Continue

( ) American Indian or Alaska Native Continue

( ) Native Hawaiian or Other Pacific Islander Continue

Recruit a mix.

8. How long have you worked as an EMS professional?

( ) under 2 years Continue

( ) 2-5 years Continue

( ) over 5 years Continue

Recruit a mix with at least one from each category.

9. Finally, can you tell me what interested you in working as an EMS professional and what you like most about your work?

This question is intended to establish whether the respondent is reasonably articulate, fluent in English, and willing to converse. If respondent has a strong accent, difficulty speaking English, serious speech impediment or has trouble communicating (e.g., “shuts down”), thank and terminate.

Invitation

Thank you for answering my questions. You qualify for the study. At this point, I am going to read you a short description of the project, and I will need you to confirm that you want to participate.

About the Project

NOVA Research Company and the Centers for Disease Control and Prevention (CDC), invite you to be in a research study participant. The goal of the study is to assess the Field Triage Decision Scheme: The National Trauma Triage Protocol initiative’s short-term impact on EMS professional’s knowledge, use, and implementation of the Decision Scheme. Please feel free to ask questions as I explain the study.

We will be conducting focus groups with EMS professionals about their opinions on the Decision Scheme materials, use of the materials, and knowledge about field triage.

If you agree, you will participate in a focus group with 6-8 other individuals that will be moderated by a trained researcher. The focus group will last for no more than 60 minutes. Information you provide will be used to write a report to inform CDC’s initiative. Your focus group will be audio recorded and researchers associated with the study may listen and take notes. Is it okay with you if we record the focus group? The notes and transcripts from recording will be used to write the report.

Information you give us will be kept private. You should use your first name only during the focus group so we can identify who is speaking, however your name will not appear in any research reports. All notes and recordings will be kept in a locked cabinet, and no one outside this project will have access to them. Recordings will be deleted after the study conclusion.

The focus group poses no risks to you. If you begin to feel uncomfortable at any time, you do not need to answer that question or you can withdraw from the focus group.

Your participation is voluntary. If you agree to participate, at the conclusion of the focus group you will be sent a check for $50.

If you have questions about your rights as a participant in this project or think you have been harmed, please call 1-800-584-8814. Leave a message with your name and phone number, and someone will call you back as soon as possible.

Do you have any questions about this project at this point?

Participant Verbal Consent

I will now read you a list of statements about this research. After these statements, I will ask you for your full name, and whether you agree to participate. This information will be kept in a secure place. It will not be connected to your focus group discussion. The focus group moderator will never know your identity, only your first name.

I understand and agree that:

• In the focus group we will be asked questions on knowledge, use, and implementation of the Decision Scheme.

• I may refuse to participate or stop my participation in the focus group at any time.

• My name and opinions will be kept secure. Only my first name will be used in the focus group.

• My focus group will be audio taped and researchers may listen.

• The focus group will only be used for research.

• No one will try to sell me anything.

• I will receive $50 for participating.

• I have asked any questions I have.

Please state your name: ____________________________________________

Do you, (Name), agree to participate in a 60-minute focus group about the Decision Scheme?

[Circle response] Yes No [Record date] ___________________________

Thank you. I would like to tell you a little more about the telephone discussion. Your session will last up to 60 minutes. You will receive $50 for participating. Focus groups are being scheduled on [list of focus group dates and times]. When are you available?

Thank you, you have been scheduled for a focus group on [Date] at [time].

We are counting on your participation, so please be sure to contact us as soon as possible if something comes up and you can't attend. You can reach me at 301-986-1891 extension ____. Also, make sure to have your toolkit materials available for the focus group as you might want to refer to them during the call.

Before we hang up, let me get the correct spelling of your name, your address, phone numbers, and email address so we can give you a reminder call, send you call in information for your focus group, and send your $50 honorarium for participating.

NAME______________________________ ___ MR. ____MRS. ____ MISS ____ MS. ___DR.

Business Phone number ______________________ Alternate # ____________________

Business Address ____________________________________________

____________________________________________

____________________________________________

Business E-mail

Thanks, again, for your time!

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