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.
File Type | application/msword |
File Title | Maryland Lung Cancer Study: Sample Script for Hopsital Controls and Lung Cancer Case Patients |
Last Modified By | Vivian Horovitch-Kelley |
File Modified | 2010-11-20 |
File Created | 2010-03-16 |