Screeners and Survey Questionnaire

HIGHLY IMPACTED POPULATION SURVEY OMB No. 0925-XXXX
Exp: XX/XXXX

Attachment D: Letters, Follow-Up Scripts, and Email Templates

PRE-NOTIFICATION CARD (on oversized post-card)

Sent to matched and unmatched households

The National Institutes of Health (NIH) is conducting survey about vaccines and other methods to prevent an infectious disease.

An eligible respondent from your household who completes the short survey will receive $20.

The survey can be completed online at www.surveyaddress.com. If you want to complete the survey online, use this login number 123456789.

You can also call us at (800) ###-#### to be interviewed or learn more.

[For sampled households with matched telephone] We will also be calling you soon to see if you would like to complete the interview.

[For sampled households without telephone] Look for additional information from NIH about the study that will be mailed to you shortly in a blue envelope with a white logo.

1^st Invitation Letter for Unmatched Households on NIH Letterhead (sent with response card)

[FIRSTNAME LASTNAME

ADDRESS

CITY, STATE ZIP ]

Dear Ms/Mr. [NAME],

Please help the National Institutes of Health (NIH). We are conducting a national survey about vaccines and other methods to prevent an infectious disease. We are interested in the opinions of all Americans on this important health issue. We will provide an eligible adult from your household $20 after completion of this short survey. You can complete the survey online at:

www.surveyaddress.com Your password is: 12345678.

OR

call us to set up a telephone interview at (800) ###-####

OR

Set up an interview using the attached response card.

[(For augmented sample only) Please provide information about yourself on the card so that the survey includes a balanced sampling of different types of people across the country].

Your opinions are important to help guide future education efforts.

If you have any questions or comments regarding this study, please contact the study’s Project Manager, Name at 800-###-#### or [email protected], or e-mail me at [email protected].

Thank you for your valuable assistance with this worthy study.

Sincerely,

Katharine Kripke

Assistant Director, Vaccine Research Program

Division of AIDS, NIAID, NIH, DHHS

Response Card for Unmatched Households ID# 12345678

National Institutes of Health Survey

Please provide us with your name and contact information

We will contact you as soon as possible.

Name _____________________________________________

Telephone Number ________________________ Type:  Cell  Landline home  Landline business

Best day and time to call:

Day	Morning	Early Afternoon	Late Afternoon	Evening
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday

Please provide basic information about yourself by checking one box in each section:

Gender:

 Male

 Female

Age:
	18-20 years
	21-30 years
	31-40 years
	41-50 years
	51-60 years
	61-70 years
	over 70 years

Ethnicity:

 Hispanic

 Not Hispanic

Race:

(check all that apply)

 Black or African

American

 Asian

 White

 American Indian
or Alaska Native

 Native Hawaiian
or Other Pacific
Islander

Reminder Letter for Matched Households on NIH Letterhead

[FIRSTNAME LASTNAME

ADDRESS

CITY, STATE ZIP ]

Dear Ms/Mr. [NAME],

Please help the National Institutes of Health (NIH). We are conducting a national survey about vaccines and other methods to prevent an infectious disease.

We have been trying to reach you over the last several days, but have been unable to make contact. We will provide an eligible adult from your household $20 after completion of this short survey. You can complete the survey online at:

www.surveyaddress.com Your password is: 12345678.

Or, call us to set up a telephone interview at (800) ###-####.

Your opinions are important to help guide future education efforts. Because your participation is important to us, we will continue to try to reach you over the next few weeks.

If you have any questions or comments regarding this study, please contact the study’s Project Manager, Name at 800-###-#### or [email protected], or e-mail me at [email protected].

Thank you for your valuable assistance with this worthy study.

Sincerely,

Katharine Kripke

Assistant Director, Vaccine Research Program

Division of AIDS, NIAID, NIH, DHHS

Reminder Card for All Households (on oversized post-card)

Sent to matched and unmatched households

We still haven’t heard from you!

The National Institutes of Health (NIH) is conducting an important national health survey about vaccines and other methods to prevent an infectious disease.

An eligible respondent from your household who completes the short survey will receive $20.

The survey can be completed online at

www.surveyaddress.com where you may find more information about the survey.

Your login number is 123456789.

OR

Call us at (800) ###-#### to be interviewed.

[For sampled households with matched telephone]

OR please speak to us when we call you in the next few days.

[For sampled households without telephone] Look for additional information from NIH about the study that will be mailed to you shortly in a blue envelope with a white logo.

2nd Invitation Letter for Unmatched Households on NIH Letterhead

[FIRSTNAME LASTNAME

ADDRESS

CITY, STATE ZIP ]

Dear Ms/Mr. [NAME],

We’ve been trying to reach you about an important study sponsored by the National Institutes of Health (NIH). We are conducting a national survey about vaccines and other methods to prevent an infectious disease.

We are interested in your thoughts and opinions, and we will provide you or an eligible adult from your household $20 after completion of this short survey. Please consider participating by accessing the website:

www.surveyaddress.com Your password is: 12345678.

Alternatively, mail us the enclosed card to set up a telephone interview, or call us at (###) ###-####. [(For augmented sample only) Please provide information about yourself on the card so that the survey includes a balanced sampling of different types of people across the country].

Your opinions are important to help guide future education efforts.

If you have any questions or comments regarding this study, please contact the study’s Project Manager, Name at 800-###-#### or [email protected], or e-mail me at [email protected] .

Thank you for your valuable assistance with this important study.

Sincerely,

Katharine Kripke

Assistant Director, Vaccine Research Program

Division of AIDS, NIAID, NIH, DHHS

Introductory Email to Knowledge Panel and Opt-in Panel Members

Knowledge Panel

Dear [First Name],

Thank you for being an integral part of KnowledgePanel!

Please help the National Institutes of Health (NIH). We are conducting a national survey on attitudes about vaccines and other methods to prevent the spread of HIV, the virus that causes AIDS.

Your opinions are important to help guide future education efforts. After you complete the survey, you will receive [KN panelist incentive].

This survey can be accessed by clicking the following link:

[LINK]

(If that does not work automatically from email, please copy the below link to your internet browser.)

[LINK]

Our Panel Member Support Center is available if you have any questions or comments. You can contact us at our toll free 1-800-782-6899 number, or simply reply to this email invitation. In order to better serve you, please be sure to reference [Survey Number] in the Subject of your message. We are always happy to hear from you!

Thanks,

KnowledgePanel Support Team

Opt-In Panel

Please help the National Institutes of Health (NIH). We are conducting a national survey on attitudes about vaccines and other methods to prevent the spread of HIV, the virus that causes AIDS.

Your opinions are important to help guide future education efforts. After you complete the survey, you will receive [KN panelist incentive].

The survey can be accessed by clicking the following link:

[LINK]

Follow Up Reminder Email to Knowledge Panel and Opt-in Panel Members

A few weeks ago, you were selected to participate in an important national survey sponsored by the National Institutes of Health (NIH) regarding vaccines and other methods to prevent the spread of HIV, the virus that causes AIDS. Our records indicate that you have not yet responded to the survey, and we would like to include your input.

Your opinions are important to help guide future educational efforts on HIV prevention. Additionally you will receive [KN panelist incentive].

This survey can be accessed by clicking the following link:

[LINK]

Follow Up Unfinished Survey Email to Knowledge Panel and Opt-in Panel Members

A few weeks ago, you were selected to participate in an important national survey sponsored by the National Institutes of Health (NIH) regarding vaccines to prevent the spread of HIV. Our records indicate that you began the survey but did not finish it. To get the most accurate results, we ask that you take to time now to complete the remainder of the survey. Remember, the results of this survey are important to help guide future education efforts about HIV prevention. Additionally you will get [KN panelist incentive] when you complete the survey.

This survey can be accessed by clicking the following link:

[LINK]

Reminder Call Script to Knowledge Panel Members

Hello, my name is [name] and I’m calling about an important survey sponsored by the National Institutes of Health regarding vaccines and other methods to prevent the spread of HIV, the virus that causes AIDS.  We need your opinions about HIV prevention research to guide future education efforts.  You should have received a notification email about this study. It is a very important survey and we are looking for your assistance in participating. We will provide you $20 for your assistance.

Please go to your member page to complete the survey online. If you have questions about the study or about your participation, you can contact us at our toll free number 1-800-782-6899.

First Voicemail Message for Matched Households

Hello, my name is [name] and I’m calling about an important survey sponsored by the National Institutes of Health.   You should have received a notification in the mail about this study. We will provide you $20 for your assistance. We’ll call back later. Thank you!

Please give us a call to discuss this important effort. The telephone number is 800-___-____, and my name is _____.

Second Voicemail Message for Matched Households

Hello, my name is [name] and I’m calling about an important survey sponsored by the National Institutes of Health.   You should have received a notification in the mail about this study. We will provide you $20 for your assistance. We will call back later. Thank you!

Please give us a call to discuss this important effort. The telephone number is 800-___-____, and my name is _____.

Collection of Data from Refusals (Outgoing CATI)

I completely understand. Thank you for speaking with me. Before you go, it would help us greatly to know…

1. What is your year of birth?

19_ _

Refused

2. (ASK ONLY IF NCESSARY) What is your gender?

Male

Female

Refused

3. Are you Hispanic or Latino?

Yes

No

Don’t Know

Refused

4. What is your race? (READ ALL BUT LAST TWO CATEGORIES; ACCEPT MULTIPLE ANSWERS) Are you….

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

An other race (Specify:____________________________)

Don’t Know

Refused

5. And has someone close to you been infected with HIV/AIDS

Yes

No

Don’t Know

Refused

Non-Response Adjustment Letter on NIH Letterhead (sent with response card)

[FIRSTNAME LASTNAME

ADDRESS

CITY, STATE ZIP ]

Dear Ms/Mr. [NAME],

Over the last month, we have been trying to reach you to get your opinion for an important survey sponsored by the National Institute of Health. We have not heard from you, so we are asking you to fill out a very brief postcard to help us understand the characteristics of people who have not responded to the survey. Your responses will make a big difference in helping us better understand the characteristics of those who participated and those who did not.

Just fill out the card and mail it back in the envelope provided. It will get to us without any stamps. We have enclosed $2 in appreciation for your effort.

All responses are completely confidential and your privacy will be protected.

If you have any questions or comments regarding this study, please contact the study’s Project Manager, Name at 800-###-#### or [email protected], or e-mail me at [email protected].

Thank you for your valuable assistance with this worthy study.

Please fill out the attached form.

Sincerely,

Katharine Kripke

Assistant Director, Vaccine Research Program

Division of AIDS, NIAID, NIH, DHHS

National Institutes of Health Survey

#123456789

1. What is year of birth?

19_ _

2. What is your gender?

	Male
	Female

3. What is your ethnicity?

   	Hispanic or Latino/Latina
   	Other

4. What is your race?

	American Indian or Alaska Native
	Asian
	Black or African American
	Native Hawaiian or Other Pacific Islander
	White
	Other

5. Has someone close to you been infected with HIV/AIDS?

	Yes
	No

0

August 7, 2009