1 #6_REV_Attach 6A 6D Screen and Guide

Attachment 6A: Screening Questionnaire for the Health Information National Trends Survey (English)

INTRO

NAME____________________________ PHONE__________________________

RESPONDENT Number ____________________

Hi, my name is (NAME) and I’m calling from Westat. May I speak with (NAME)?

(reintroduce yourself if needed)

Thank you for your interest in the Health Information National Trends Survey (HINTS). Let me tell you a little bit about the study and then I’ll ask you a few questions to see if you are eligible to take part.

We’re looking for people to participate in a focus group session that will last 90 minutes. In that session, you and about 7 to 9 other individuals will participate in a discussion group to talk about some materials were developing for survey about how people look for and use health-related information. We need men and women over the age of 18 to take part in the discussions. The session will be conducted at Westat, in Rockville MD, and all of the participants will receive a cash gift of $50 in appreciation for their time.

IF NEEDED: Westat, a research company in Rockville, Maryland is conducting survey research for the U.S. Department of Health and Human Services to test questions for an upcoming national survey – we’d like to get your opinion on whether the questions are easy to understand and answer.

OMB #: 0925-0589-06

Expiry Date: 5/31/2011

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 (0925-0589-06). Do not return the completed form to this address.

Q1. As I said, the session will take place at Westat’s headquarters, located on Research Boulevard in Rockville, Maryland. Are you within driving or commuting distance of our location?

PROVIDE MORE INFO IF NEEDED: Rt 28 off of 270. 1600 RESEARCH; NEAR THE CORNER OF RESEARCH AND GUDE DRIVE; AT ROCKVILLE METRO STATION - END OF RED LINE - 63 OR 54 BUS STOPS IN FRONT OF 1600; ETC.

1. Yes

2. No – TERMINATE AND THANK (“Based on the study design, our session is going to be conducted at Westat, so it looks like we can’t include you at this time.”)

Q2. ASK ONLY IF NOT OBVIOUS: Are you male or female?

• Male

• Female

Q3. Which of the following age categories are you in?

1. Under 18 – TERMINATE AND THANK (“Based on the requirements of this study, it looks like we can’t include you at this time. It is possible we will be calling you in the future for other studies.”)

2. 18 – 29

3. 30 – 44

4. 45 – 54

5. 55 – 64

6. 65 and older

INTERVIEWER: RECRUIT A MIX OF AGES.

Q4. Are you of Hispanic or Latino Origin?

1. Yes

2. No

INTERVIEWER: RECRUIT NO MORE THAN 2 HISPANIC RESPONDENTS FOR EACH ENGLISH LANGUAGE GROUP

Q5. What race do you consider yourself? (MARK ALL THAT APPLY)

1. White

2. Black or African American

3. Asian

4. Native Hawaiian or Other Pacific Islander

5. American Indian or Alaska Native

INTERVIEWER: RECRUIT SOME NON-WHITE RESPONDENTS.

Q6. What is the highest level of education you have completed?

1. 11^th grade or less

2. 12 years of school, no diploma

3. GED or high school graduate (diploma)

4. Some college or technical school

5. College or technical school graduate

6. Post-graduate

INTERVIEWER: RECRUIT A MIX OF RESPONDENTS FROM EACH EDUCATION GROUP.

Q7. When was the last time you participated in this type of focus group or discussion group?

a. 6 months ago or less –THANK AND TERMINATE (“Based on the requirements of this study, it looks like we can’t include you at this time. It is possible we will be calling you in the future for other studies.)

b. More than 6 months but less than a year

c. More than a year ago

Q8. Do you now or have you ever worked for Westat?

1. Yes – THANK AND TERMINATE

2. No

Q9. Have you ever worked for US Department of Health and Human Services or any of its agencies?

1. Yes – What agency is/was that? IF NCI, THANK AND TERMINATE

2. No

Q10. Have you ever heard of the Health Information National Trends Survey?

a. Yes – Ask where they have heard of it? [Find out if they are a researcher that uses/used

HINTS data. If they are, TERMINATE AND THANK (“Based on the

requirements of this study, it looks like we can’t include you at this time. It is possible we will be calling you in the future for other studies.”)]

b. No

Q11. What is your zip code? ______________________

INTERVIEWER – INSERT A TABLE WITH THE RECRUITING CATEGORIES SO YOU CAN FILL IT OUT AS YOU TALK TO PEOPLE.

Requirement	Status
Adult Requirements
2 or 3 of these adults should have only a HS degree or GED
2 or 3 should be African American or other minority
2 or 3 should be 44 or younger
2 or 3 should be over the age of 44

If response to Q7 = B (i.e., they have done a focus group from 6 months to a year ago), then read Closing #2

Otherwise read Closing #1

Closing #1

You are eligible to help with this research project. Just to give you a little more information, we’ll be asking people about how they get information about health and their thoughts about health-related topics. Please note, we will not share your personal information with anyone not participating in the study. Are you interested in participating?

YES — Thank you so much for your willingness to help us. If you are selected as a participant you will receive $50 cash for your participation. If you are chosen as a participant, I will call you back within two business days with the time and date for the focus group session.

NO — Thank you for taking the time to talk with me today and have a great (day/evening).

Closing #2

Thank you for answering those questions. We will contact you within the next week to indicate if you are eligible to help with this research project.

Attachment 6A: Screening Questionnaire for the Health Information National Trends Survey (Spanish)

INTRO

NAME____________________________ PHONE__________________________

RESPONDENT Number ____________________

Hola, mi nombre es (NAME) y estoy llamando de EurekaFacts de parte de Westat. ¿Puedo Hablar con (NAME)?

(reintroduce yourself if needed)

Gracias por su interés en la Encuesta Nacional de Tendencias Sobre Salud (HINTS por su siglas en Ingles). Permítame contarle un poco sobre el estudio y luego le voy hacer algunas preguntas pare ver si usted es elegible para participar.

Estamos buscando personas para participar en una sesión de grupo de discusión que durara 90 minutos. En esa sesión, usted y unas 7 a 9 otras personas participaran en un grupo de discusión para hablar de algunos materiales que estamos elaborando para un estudio acerca de cómo la gente busca y utiliza información relacionada con la salud. Necesitamos hombres y mujeres mayores de 18 años para participar en las sesiones. La sesión se realizara en EurekaFacts en Rockville MD, y todos los participantes recibirán un regalo de $50 en efectivo como agradecimiento por su tiempo.

IF NEEDED: Westat, una compañía de estudios de investigación en Rockville, MD está llevando a cabo estudios de investigación para el Departamento de Salud y Servicios Humanos de los Estados Unidos para poner a prueba preguntas para una encuesta nacional próxima – nos gustaría saber su opinión sobre si las preguntas son fáciles de entender y responder.

OMB #: 0925-0589-06

Expiry Date: 5/31/2011

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 (0925-0589-06). Do not return the completed form to this address.

Q1. Como dije, la sesión se llevara a cabo en EurekaFacts, ubicado en Hungerford Drive en Rockville, Maryland. ¿Vive usted a una distancia donde se puede conducir o viajar por transporte público a nuestra localidad?

PROVIDE MORE INFO IF NEEDED: 495 HACIA LA 270 (ROCVILLE/FREDERICK); TOME LA SALIDA/EXIT DE FALLS ROAD; TOME MARYLAND AVENUE (MD-189) Y HAGA DERECHA EN BEALL AVENUE; DESPUES HAGA IZQUIERDA EN HUNGERFORD DRIVE (MD-355); EL EDIFICIO ESTARA EN EL LADO IZQUIERDO.

3. Si

4. No – TERMINATE AND THANK (“Basado en el diseño del estudio, nuestra sesión será realizada en EurekaFacts, por lo tanto parece que no podemos incluirle a usted en este momento.”)

Q2. ¿Habla usted español?

1. Si

2. No – THANK AND TERMINATE

Q3. ¿Diría usted que habla español…?

1. Muy bien

2. Bien, o

3. No muy bien– THANK AND TERMINATE

Q4. ¿Es el español su primer idioma o su lengua materna?

1. Si

2. No – THANK AND TERMINATE

Q5. ¿Diría usted que lee el español…?

1. Muy bien

2. Bien

3. No muy bien– THANK AND TERMINATE

4. No leo el español – THANK AND TERMINATE

Q6. ¿Habla usted Ingles…?

1. Si, muy bien – THANK AND TERMINATE

2. Si, bien– THANK AND TERMINATE

3. No muy bien– CONTINUE

4. No hablo Ingles– CONTINUE

RECRUITMENT CHECK: RECRUITED PARTICIPANTS SHOULD BE NATIVE SPANISH SPEAKERS ONLY.

Q7. ASK ONLY IF NOT OBVIOUS: ¿Es usted hombre o mujer?

• Male

• Female

Q8. ¿En cuál de las siguientes categorías de edad se encuentra usted?

7. Menor de 18 años – TERMINATE AND THANK (“Basado en los requerimientos de este estudio parece que o podemos incluirle a usted en este momento. Es posible que se le llame en el futuro para otros estudios.”)

8. 18 – 29

9. 30 – 44

10. 45 – 54

11. 55 – 64

12. Mayor de 65 años

INTERVIEWER: RECRUIT A MIX OF AGES.

Q9. ¿Es usted de origen hispano o latino?

3. Si

4. No – TERMINATE AND THANK

Q10. ¿Cuál es su país de origen/En donde nació?

____________________

INTERVIEWER – REFER TO TABLE WITH AREA CATEGORIES FOR COUNTRIES SO YOU CAN FILL IT OUT.

Requirement	Status
3 of these participants should be from South America
3 of these participants should be from Central America
3 of these participants should be from Mexico
3 of these participants should be from the Caribbean

Q11. ¿De qué raza se considera usted? (MARK ALL THAT APPLY)

6. Blanco

7. Negro o Afroamericano/ Afro Americano

8. Asiatico

9. Nativo de Hawái u otra isla del Pacifico

10. Indio Americano/ Indio Nativo Americano o Nativo de Alaska

Q12. ¿Cual es el nivel más alto de estudios que usted ha completado?

7. Primaria pero menos de Secundaria

8. Secundaria pero menos de estudios universitarios

9. Algunos estudios universitarios

10. Graduado de Universidad

NOTE: (Many Latin American Countries split secondary school into two parts- “basico” and “diversificado”)

INTERVIEWER: RECRUIT A MIX OF RESPONDENTS FROM EACH EDUCATION GROUP.

Q13. ¿Cuándo fue la última vez que usted participo en este tipo de grupo de discusión o conversación?

a. Hace 6 meses o menos –THANK AND TERMINATE (“Basado en los requerimientos de este estudio parece que o podemos incluirle a usted en este momento. Es posible que se le llame en el futuro para otros estudios.”)

b. Más de 6 meses pero menos de un año

c. Hace más de un año

Q14. ¿Trabaja o ha trabajado alguna vez para Westat o alguna otra compañía de estudios de investigación?

3. Yes – THANK AND TERMINATE

4. No

Q15. ¿Ha trabajado usted para el Departamento de Salud y Servicio Humanos de los Estados Unidos o cualquiera de sus agencias?

3. Yes – Qué agencia? IF NCI (NATIONAL CANCER INSTITUTE), THANK AND TERMINATE

4. No

Q16. ¿Alguna vez ha escuchado hablar sobre la Encuesta Nacional de Tendencias Sobre Salud [Health Information National Trends Survey (HINTS por sus siglas en Ingles)]?

a. Yes – Ask Cómo supo de ésta encuesta? where they have heard of it? [Find out if they are a researcher that uses/used

HINTS data. If they are, TERMINATE AND THANK (“Basado en los requerimientos

de este estudio parece que o podemos incluirle a usted en este momento. Es posible que

se le llame en el futuro para otros estudios”)]

b. No

Q17. ¿Cual es su código Postal? ______________________

INTERVIEWER – INSERT A TABLE WITH THE RECRUITING CATEGORIES SO YOU CAN FILL IT OUT AS YOU TALK TO PEOPLE.

Requirement	Status
2 of these participants should have Primary/Grade School education
4 of these participants should have HS/Secondary School education
4 of these participants should have some college
2 of these participants should be college graduates
2 or 3 should be 44 or younger
2 or 3 should be over the age of 44

If response to Q13 = B (i.e., they have done a focus group from 6 months to a year ago), then read Closing #2

Otherwise read Closing #1

Closing #1

Usted es elegible para participar en este estudio de investigación, estaremos preguntado a la gente sobre como obtienen información acerca de la salud y sus opiniones sobre tópicos relacionados a la salud. Por favor tenga en cuenta que no compartiremos su información personal con nadie que no sea parte del estudio. ¿Esta usted interesado(a) en participar?

YES — Muchas gracias por su voluntad en ayudarnos. Si usted es seleccionado como participante usted recibirá $50 en efectivo por su participación. Si usted es elegido como participante, yo le llamare a usted dentro de dos días con la fecha y hora para la sesión de grupo de discusión.

NO — Gracias por tomarse el tiempo para hablar conmigo hoy y tenga (un buen día/unas buenas tardes).

Closing #2

Gracias por contestar las preguntas. Nos comunicaremos con usted dentro de la próxima semana para dejarle saber si usted es elegible para ayudar en este estudio de investigación.

Attachment 6D: HINTS Focus Group Moderator Guide

OMB #: 0925-0589-06

Expiry Date: 5/31/2011

Public reporting burden for this collection of information is estimated to average 1.5 hours 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 (0925-0589-06). Do not return the completed form to this address.

Thank you for joining us today.

Before we get started, let’s introduce ourselves. Tell us your first name, and something about you – what are your hobbies, do you work outside the home, something about your family – whatever you’d like to share. I’ll start, then we’ll go around the room.

Thanks, Welcome. So now, let me tell you what we’re going to do tonight.

We are a research company that conducts studies on many different topics, for many different clients. This particular project is for the U.S. Department of Health and Human Services. Tonight we want to get your feedback on some letters we’re developing as part of a large national health survey, called the Health Information National Trends Survey, or HINTS. Eventually, once the letters are finalized, we’ll mail the letters along with the survey to a sample of households in the United States. You’re here to give us your reactions to those letters, just as if you had received them in your mailbox along with the HINTS survey.

Before we go on, I need to make a few things clear.

1. The whole point of this discussion is to obtain your reactions to the materials we’ll be looking at shortly. There are no right or wrong answers – and we are interested in both positive and negative reactions. Hearing the positive and negative things helps us figure out what information to keep in the materials, what to drop and what to modify.

2. Everything said in this room will be treated as private under the Privacy Act. We will not share your name with anyone outside of this project. We also ask that you not discuss our conversation outside of this group in order to respect the privacy of everyone in the group.

3. Behind me is a one way mirror. Behind it are some people I am working with on this project. They too are very interested in hearing your feedback on our materials.

4. Also, this discussion is being videotaped – this is so that other project members who could not be here today can see and hear what you have to say directly – without me as an interpreter. I assure you that only people directly involved in this research will have access to the video.

5. Finally, and most importantly, I want everyone to get a chance to speak when they have something to say. So I’d appreciate it if everyone agrees to take turns speaking. I may occasionally interrupt so that I make sure everyone who has a comment gets a chance to make their comment before we have to move onto another topic.

ANY QUESTIONS BEFORE WE MOVE ON?

A. Initial Cover Letter

We’re going to start by taking a look at one of the letters we’re considering mailing with the HINTS survey. Take a moment and read through it, then we’ll start our discussion. (Allow about 1 minute – take cue from participants)

HAND OUT FIRST COVER LETTER IN DHHS ENVELOPE

(Trends or Shared Decision Making version, alternate which shown first by group)

1. Remember, people will receive this letter in the mail. Tell me, what information stood out the most to you in the letter, if anything. Let’s go around the room and I’ll keep track on this flip chart.

2. After collecting response from everyone, walk through each selected “message” identified by participants, and ask them to tell you more about why it stood out.

3. Anything (else) that raised questions for you? Anything you thought was missing from the letter?

• What was that?

• Why?

4. (PUT SCALE ON FLIP CHART PRIOR TO SESSION.) On a scale from 1 to 4, how would you rate this letter in terms of getting you interested in this survey with 1=Doesn’t get me interested at all, and 4=Very interested in the survey? Ask for hands for 1, 2, 3, 4. Keep tally on flip chart

5. For (4s) so tell me what about the letter got you to rate it a 4? Repeat for each value.

   • Note if anyone else had a contradictory response, and why.

6. (ASK IF THIS INFORMATION HAS NOT ALREADY BEEN DISCUSSED) Now that we have talked about what is in the letter, we are curious about whether you think you would actually read this letter if you received it in the mail. It would come to your household in an envelope pretty much like the one I gave to you, addressed in the same manner (but with your actual address)

   • Tell me, do you think you would open it? Why or why not?

   • Assuming you did open it, what would make you decide to read it, or not? (Note if they say anything about the look of the letter, such as length, logo, color, etc).

7. Any other comments on the letter you want to add before we move on?

HAND OUT SECOND VERSION OF COVER LETTER

(Trends or Shared Decision Making version, whichever version wasn’t shown first)

1. Here is another version of a letter we’re considering for the survey. Take a moment and read through this one, and then we’ll talk more about it. (Allow about 1 minute – take cue from participants)

2. Tell me, what information stood out the most to you in this letter, if anything. We’ll go around the room again (start from the opposite side) and keep track on the flip chart.

3. Anything missing from this letter?

4. Is one letter better than the other in getting you interested in participating in the survey?

1. Why does that letter do a better job at getting you interested?

2. Is there anything about the (opposite letter) that you think actually discourages your interest in the survey?

Repeat (a) and (b) for second letter if some participants pick one, and other participants pick the other.

5. (IF NOT ALREADY DISCUSSED) Assuming this letter would come in the same type of envelope, addressed in the same way as the first letter we talked about, do you think you’d be any more or less likely to read it? Why?

6. Do you have any other comments about the second letter?

7. Any other comments about how these letters compare to one another?

HAND OUT HINTS 3 VERSION OF COVER LETTER

1. Here is one last version of the letter we’re considering for the survey. Take a moment and read through this one, and then we’ll talk more about it. (Allow about 1 minute – take cue from participants)

2. Tell me, what information stood out the most to you in this letter, if anything. We’ll go around the room again (start from the opposite side) and keep track on the flip chart.

3. Anything missing from this letter?

4. For those of you who said you thought (VERSION 1/VERSION2) did more to get you interested in the survey, how does this third version of the letter compare to that one? Does this one do more or less to get you interested in the survey?

1. What about it makes it (more/less) likely to get you interested in the survey?

5. For those of you who said you thought (OTHER VERSION) did more to get you interested in the survey, how does this third version of the letter compare to that one?

1. What about it makes it (more/less) likely to get you interested in the survey?

B. Refusal Conversion/2^nd Mailing Cover Letter

START WITH REF CONVERSION LETTER VERSION THAT CORRESPONDS TO THE PREFERRED INITIAL LETTER. IF NO PREFERENCE, START WITH THE REF CONVERSION _TRENDS VERSION (LETTER 1).

Here is another letter we might use for the survey. This is a little different than the previous letters. Again, take a minute to read it and then we’ll talk about it.

1. What is the main purpose of this letter? If needed - Why do you think we would mail this version of the letter to a household?

ONCE YOU’VE GOTTEN THEIR UNDERSTANDING OF THE PURPOSE, CORRECT OR VERIFY THE PURPOSE SO THAT WE CONTINUE THE DISCUSSION WITH THE SAME, CORRECT UNDERSTANDING IN MIND.

2. Is there anything about this letter that you think does better than (PREFFERED VERSION OF INITIAL LETTER) to encourage you to participate in the survey?

3. Is there anything about this letter that might discourage you from participating in the survey?

4. What else do you think we could say in a letter like this to encourage people to take part in our survey?

HAND OUT OTHER VERSION OF REF CONVERSION LETTER.

I’ve got one last version of a letter we might mail to households (USE THE PARTICIPANTS WORDS FOR PURPOSE OF LETTER / who didn’t initially complete the survey and return it to us). Take a minute to read it and then we’ll talk about it.

1. Is there anything about this letter that you think does better than the (OTHER REF CONVERSION VERSION) to encourage you to participate in the survey?

2. Is there anything about this letter that might discourage you from participating in the survey?

3. Any other comments about this version of the letter?

C. Alternative Facts

Okay, so now we’re going to switch to a slightly different task. Here is a list of different statistics or facts that we may or may not want to include in letters we mail to households. (Summarize any discussion/comments made to this point about the inclusion of such information in the letters) I’d like you to take a minute and read over this list of facts, and then we’ll talk about them a little more. Some of these you might recognize from the letters we looked at earlier.

1. Let’s imagine the survey decides to go ahead and include some facts or statistics in one of the letters we mail to households. Looking at this list, I’d like you each to pick the statistic that you think does the most to encourage your interest in the survey. (HAVE A FLIP CHART PAGE IN ADVANCE WITH ABBREVIATED FACTS TO KEEP TRACK)

2. IDENTIFY THE TOP 2 or 3, THEN ASK: So what is it about these statistics that you liked?

   1. Does anyone have a differing opinion on (SAME TOP 2 OR 3)?

3. Are there any other statistics on this list that you find interesting? Why?

4. Are there any that you think might actually reduce your interest in the survey, maybe make you less likely to complete the questionnaires? Why

5. How many statistics or facts do you think we should include in a letter? One of the example letters we looked at earlier had three. Do you think we should include more, less or is 3 about right?

6. Any other facts that, if available from the survey, you think might really draw people’s interest?

I. Wrap-up

Any other comments on any of these letters?

1. How about in any of those first 3 letters we’re considering for mailing with the first time we mail the survey questionnaires to a household?

2. How about for any of the second set of letters we’d mail to households who didn’t send us back any completed questionnaires?

Before I let you go, I want to check with my colleagues behind the mirror to see if there is anything more they’d like me to ask you about.

-- DISTRIBUTE INCENTIVE MONEY –

FLIP CHART PAGES

RATING OF LETTER (FIRST SHOWN):

Q: How would you rate this letter in terms of getting you interested in this survey?

1= Does not get me interested in the survey

4= Really got me interested in the survey

Scale	Version X
1
2
3
4

FACTIOD PAGE:

Which Fact do you think most encourages interest in this survey?

	Abbreviated Factoid	Preference Tally
1
2
3
4
5
6
7

Spanish language version of the Moderator Guide is still being translated. For more information about the translation process and timing refer to the Justification Memo.

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