Telephone Script

Attach 22 - REVISED_Telephone Interview Script_11-10-2010.doc

Resource for the Collection and Evaluation of Human Tissues and Cells from Donors with an Epidemiology Profile (NCI)

Telephone Script

OMB: 0925-0623

Document [doc]
Download: doc | pdf

Attachment # _22___

REVISED Sample Telephone Script for Population Controls

Hello. My name is ________. I am from the University of Maryland and we are currently conducting a study of cancer in the greater Baltimore region. To do this we need to interview some people who currently have cancer and some people who do not currently have cancer.


In order to conduct this study we have been given permission by the University of Maryland Institutional Review Board to search a variety of records for names, addresses and telephone numbers of those people who may be eligible to participate in this study. This information will be kept private under the Privacy Act, and will only be used to contact you and never divulge this information to any one else. We mailed you a letter with information about this study, did you receive it? (If no, explain the study further based on the letter that is sent)


If it is all right with you, may I ask you a few questions to see if you are eligible to participate?

☐ Yes ☐ No


If no, complete a refusal questionnaire form. If yes, complete all questions from the Population Controls Screener.


If the subject is not eligible, explain to him, that he is not eligible to participate.


I am sorry you are not eligible to be a participant in this study. I want to thank you for your time. Have a nice day.

If a subject is not able to participate because of poor health but may become able to participate at a later time when he is feeling better:


I am very sorry that you are not feeling well enough to participate at this time. If it is all right with you, we may contact you in the future to see if you are feeling better and if you are, to ask you if you are willing to participate at that time. ☐ Yes ☐ No


If the subject is eligible, explain to him, the main purpose of the study and what the study would require.


The main purpose of our cancer study is to research certain hereditary risk factors to see if these factors help predict who is likely to get cancer and who is less susceptible.


If you agree to participate I will:
ask you questions about your diet, lifestyle, type of work, medical history and tobacco use and collect a blood sample from you, up to 65 ml, which is about four or five tablespoons or a quarter of what is collected when you donate blood. I will give you a container to use to collect a urine sample. I may also ask you to use mouthwash to collect cheek cells, if needed.


Participating in this study will take approximately an hour of your time, for which you will receive $50.00 as a token of appreciation.


Do you think you would be interested in participating in this study? ☐ Yes ☐ No

If the subject is interested in participating in the study, set up a day and time for the interview to be conducted.

If the subject is not interested in participating, thank him for his time.

Thank you for your help in this study and have a good day.

2/1/2021

File Typeapplication/msword
File TitleMaryland Lung Cancer Study: Sample Script for Hopsital Controls and Lung Cancer Case Patients
Last Modified ByVivian Horovitch-Kelley
File Modified2010-11-20
File Created2010-03-16

© 2024 OMB.report | Privacy Policy