4 #2_Attach 4_Screener HCP Triad_Cancer evol

OMB No. 0925-0046-02

Expiration Date 2/28/13

Attachment 4: Healthcare Professionals

Triad Discussion Recruitment Screener

Public reporting burden for 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0046-16). Do not return the completed form to this address.

Summary Table

Group	Location	Date/Time	Audience	Profession
#1	Nationwide	TBD	Healthcare professionals	General practitioners
#2	Nationwide	TBD	Healthcare professionals	General practitioners
#3	Nationwide	TBD	Healthcare professionals	General practitioners
#4	Nationwide	TBD	Healthcare professionals	General practitioners
#5	Nationwide	TBD	Healthcare professionals	Oncology nurses
#6	Nationwide	TBD	Healthcare professionals	Oncology nurses
#7	Nationwide	TBD	Healthcare professionals	Oncology nurses
#8	Nationwide	TBD	Healthcare professionals	Oncology nurses

Recruitment

Recruit 3 participants for each triad discussion.

INTRODUCTION

Good morning/afternoon/evening. My name is __________, and I’m working with [name of facility] in [LOCATION]. I’m calling today on behalf of the National Cancer Institute or NCI. NCI is conducting a study on healthcare providers’ opinions and perspectives about topics related to cancer. We are looking for people to take part in small discussion groups through a computer assisted telephone conference call. We are not selling any products or services. Everyone who is eligible and participates will be paid $[amount] as a thank you for your time.

Specifically, we are interested in learning more about healthcare providers’ reactions to new ideas for an existing Web site. Input and ideas from these discussions will help inform NCI about how to provide cancer-related information materials and educational resources to medical and health professionals and the public.

The discussion groups will be held on [Dates] and the conference call will last no more than one hour. I would like to ask you some questions to see if there is a discussion group that you could join. These questions will only take a few moments to answer. Do you have a few moments now to answer a few questions?

[If they do not have time now, ask if there is a time when they would be able to talk or a better phone number to use if in a medical office or center.]

When would be a better time for you? ______________________ [Record and re-contact]

1. Do you currently work in a clinical setting?

Yes _____

No [Terminate] _____

(Recruit only healthcare providers working in a clinical setting.)

2. What is your position in the clinical setting where you work?

[Record position] ______________________________________

1. General or family practitioner, primary care physician, or internist _____

[Eligible for Groups #1-4]

2. Oncology nurse or oncology nurse practitioner _____

[Eligible for Groups #5-8]

3. Other _____

[Terminate]

3. How many years have you been working in this position?

[Record number of years. Terminate if less than 2 years.] __________

4. Which of the following clinical settings best describes the medical practice where you work?

1. General practice or primary care setting (private or community-based) _____

2. Community health center/clinic _____

3. Cancer Center (e.g., comprehensive cancer center, university cancer center) _____

4. Hospital _____

5. Specialized practice (e.g., pediatrics, oncology, gynecology) _____

6. Other (specify _________________________ ) _____

4. Is your medical practice in an urban, suburban, or rural location?

1. Urban _____

2. Suburban _____

3. Rural _____

4. Other (specify _________________________ ) _____

6. In what U.S. state is your primary medical practice located?

[Record] ______________________

(Do not recruit any more than 2 participants from any one state. Do NOT have 2 participants from the same state in the same group.)

7. How often over the past 6 months have you personally gone on the Internet to search for information for your practice? This includes any use of the Internet as a professional resource, for patient education, or for product, condition, or treatment information.

Never / Not at all [Terminate] _____

Less than once a month [Terminate] _____

About once a month _____

Several times a month _____

Several times a week _____

8. Which of the following best matches your experience using a mobile or smart phone like an iPhone, Blackberry, or Droid in the context of your work (e.g., to look for information)?

I don’t have one of these.
I rarely or never use my smart phone in the context of my work to find information.
I sometimes use my smart phone in the context of my work to find information but find it difficult.
I am generally successful using my smart phone in the context of my work to find information.
I often use my smart phone in the context of my work to successfully find information.

[Recruit 1 to 2 “generally successful” or “successful” users in each group]

9. Are you comfortable talking about issues related to cancer information for healthcare professionals and the general public in a small group of health professionals?

Yes _____

No [Terminate] _____

(Recruit only those who are comfortable talking about this topic.)

10. We are going to ask you to look at some material on your computer using GoToMeeting, a program that will let all of the people participating in the group discussion see the same thing. Will you be able to use this product while participating in the discussion?

Yes _____

Not Sure _____

No [Terminate] _____

(Recruit only those who will or may be able to use GoToMeeting)

11. Finally, in the past year have you participated in any market research or other projects where you discussed topics related to cancer?

No [Invite to group] _____

Yes [Terminate] _____

12. [Do not ask. REcord whether respondent is male or female.]

Female _____

Male _____

***TERMINATE LANGUAGE: “Thank you for taking the time to answer our questions. Unfortunately, the category you fall into is currently full. If it should open back up, may we call you back?”

INVITE TO INTERVIEW

Thank you for answering my questions. As I mentioned, the National Cancer Institute is interested in hearing from healthcare providers about your reactions to new ideas for an existing Web site. Input and ideas from these discussions will help inform NCI about how to provide cancer-related information materials and educational resources to medical and health professionals and the public. To compensate you for your time, you will be mailed a check for $100 after participating in the discussion group. This is not a sales effort of any kind and no one will call on you as a result of your participation.

I would like to invite you to participate in a telephone discussion group with two or three other health professionals and a moderator. The discussions will last about one hour. Groups are scheduled to take place on [Date] at [Time], and you will need to be in front of a computer during the call. We will send you a meeting invitation using GoToMeeting. Can we schedule your participation?

Before we hang up, let me get the correct spelling of your name, your address so we can mail you your check, email address, and phone numbers so we can give you a reminder call the day of the group. You will receive an email today confirming your scheduled participation, along and with the toll-free conference call-in information for the discussion. Prior to the discussion, we will send you an email with some information for you to refer to on the call. We will also send you a GoToMeeting test invitation. This will allow us to test out the connection before the actual discussion. When would be a good time for us to test the connection with you?

Contact and Scheduling Information

Name: _________________________________________________

Address: _________________________________________________

City: _________________________________________________

State: _________________________________________________

Zip Code: _________________________________________________

Email: _________________________________________________

Phone: (DAY) _____________________________________

(CELL) _____________________________________

Thanks again for your time and for agreeing to participate in a call.

5

HCP – Triads – Concept Testing for Cancer.gov Evolution