Attachment 9 IDEAL_Script - PT Interview Consent

Insight into the Determination of Exceptional Aging & Longevity (IDEAL)

Verbal Consent Script for Participant Telephone Screening Interview

Thank you for calling the IDEAL study. My name is (YOUR NAME), and I am a researcher at Westat, a collaborator with the National Institutes of Health for this study.

The purpose of this research study is to look at exceptional individuals aged 80 and older who are healthy and fully functioning. We are studying whether the characteristics and circumstance of these individuals offer clues on how to maintain physical and cognitive function in late life and prevent the disease and disability that burden most aging individuals.

As part of the IDEAL study, we will be inviting people to come to the clinic of the National Institute on Aging in Baltimore on a yearly basis so that they can complete a series of examinations, interviews, and medical tests to measure their health, physical strength, mental function, and the like. We will also collect blood and other specimens to identify genetic and biochemical markers of aging. Do you think you might be interested in participating in the IDEAL study?

{If No}: Thank you very much for calling.

{If Yes}: Before enrolling you in the study, we need to determine if you are eligible. I would like to ask you a few questions about your health and medical history. This will take approximately 10 minutes. Some of these questions may make you uncomfortable but you don’t have to answer them if you don’t want to. You also need to understand that all information that I receive from you by phone, including your name and any other identifying information, are strictly confidential and are kept under lock and key.

The following questions are only to determine whether you are eligible for the IDEAL study. Depending on the results of this interview and other results, you may be invited to join the study and will be able to make a decision about participating at that time. Remember, your participation is voluntary.

Do I have your permission to ask you these questions? ____ (YES) ____ (NO)

{If No}: Thank you very much for calling.

{If Yes}: If you need to do anything to make yourself comfortable before we conduct the interview, please go ahead.

WHEN PARTICIPANT IS READY, PROCEED.

PROCEED TO HOME VISIT INTERVIEW.

AFTER COMPLETING INTERVIEW GO TO CLOSING.

(Turn over for Applicable Closings)

Closings for Participant Home Visit Telephone Interview

CLOSING:

Those are all the questions we have today. Do you have any questions?

ANSWER QUESTIONS OR SAY OFFICE WILL CALL THEM WITH ANSWERS.

The information you’ve given me today is very helpful. Someone from the study will be following up with you in a few days to discuss what will happen next. Please call the study office if you have any further questions. Do you have that number or would you like me to give it to you?

IF NEEDED, REPEAT OFFICE TELEPHONE NUMBER.

Thank you for giving us your time.

E ND RECORD OUTCOME IN CALL RECORD

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