Survey Recruiting Debriefing

Form Approved:

OMB No: 0920-0794

Expiration Date: 12/31/2010

Transgender HIV Behavioral Survey (THBS)

Recruiter Debriefing

__________________________________________________

Public reporting burden of this collection of information is estimated to average 2 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: CDC Information Collections Review Office, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0794).

Interviewer: When a recruiter returns to get their token of appreciation for recruiting, their identity will be verified matching the Recruiter ID and any physical marks noted in the coupon database.

Say: Before I give you a token of appreciation for recruiting, I need to confirm that you are the same person who was given the coupons and not someone else. I will ask you a few questions and enter them into the computer to verify you are the recruiter.

1. What are the 1^st 2 letters of YOUR LAST name?

2. What is the 1^st letter of YOUR FIRST name?

3. What is the 1^st letter of YOUR MOTHER’S FIRST name?

4. In which MONTH were you born?

(Enter the 2-digit number corresponding to the month, e.g. 04 for April, 10 for October)

5. What are the LAST 2 digits of your YEAR of birth?

6. Do you consider yourself to be male, female, or transgender?

(Enter recruiter’s gender: M=male, F=female, T=transgender)

7. What racial/ethnic group or groups do you consider yourself to be in?

(Enter recruiter’s race/ethnicity: B= Black/African-American, H= Hispanic/Latina, W= White, A= Asian and O= Other)

INTERVIEWER INSTRUCTIONS: Create the Recruiter ID again by asking the above questions. For example, the recruiter ID of a Black male, last name Smith, first name Joe, mother’s first name Olivia, and born in November 1961 will look like this: SMJO1161MB. Search the coupon database for the record with this recruiter ID.

When the recruiter’s record has been located based on the recruiter ID, verify the physical marks. Once their identity has been verified, write down the person’s THBS survey ID and date of their THBS interview. Then ask her the questions about how recruiting went.

Survey ID: ___ ___ ___ ___

Date of THBS Interview: __ __/ __ __ / __ __ __ __

R1. How many coupons have you given out since you were first given coupons?

[Refused= R; Don’t Know=D]

________

R2. When you were giving out the coupons, did anyone refuse one?

No………………………………………………………... 0

Yes…………………………………….……………….… 1

Refused to answer………………………..……………… .R

Don't know……………..………………………. .D

If R2 not equal to 1 (yes), end the questions and thank the respondent for their time.

R3. How many people refused a coupon? ___ ___ ___

[Refused= R; Don’t Know=D]

If R3>1 go to the Multiple Persons Refused Section (below2);

If R3=1 go to the Single Person Refused Section (page 2);

Multiple persons refused

R4. Of the [insert number from R3] persons who refused coupons how many were Latino or Hispanic? [Refused= .R, Don’t Know= .D] ___ ___ ___

If R4=R3 skip to R12;

If R4-R3=1 skip to R11;

SAY: Now I would like for you to think about the persons who were not Hispanic that refused coupons. What is the race of these persons? That is, how many were:

[Refused= .R, Don’t Know= .D]

R5. African American or Black: ___ ___ ___

R6. American Indian or Alaska Native: ___ ___ ___

R7. Asian: ___ ___ ___

R8. Native Hawaiian or Other Pacific Islander: ___ ___ ___

R9. White: ___ ___ ___

Skip to R12;

Single person refused

R10. Was the person who refused a coupon Latino or Hispanic?

No………………….…………………………… 0

Yes……………………………………………… 1

Refused to answer……………………………… .R

Don't know……………..………………………. .D

If R10=1 or .R go to R12

R11. What was the race of [insert “the person” if R3=1; insert “the person who was not Hispanic or Latino” if R3>1]? who refused the coupon?

[GIVE RESPONDENT FLASHCARD B]

American Indian or Alaska Native ….……….. 1

Asian ……………….………….……….. 2

Black or African American ……….…. 3

Native Hawaiian or Other Pacific Islander 4

White….………..….………..….………..…... 5

Multiple Races………………………….…... 6

Refused to answer………………………….…... R

Don't know…….………………………….…... D

R12. Which of the following are reasons people who refused coupons gave you about why they did not want the coupon? (Read each one, Check all that apply)

They did not have time………………….......................................... 

They did not want to go to the survey locations ………….…..…… 

They don’t like research/surveys or they don’t trust researchers… 

They did not trust you (recruiter)………………………………… 

They did not want to be identified as transgender……………….. 

They already participated in the survey…………………………… 

They were too young to be eligible (less than 15 years)….……….. 

They did not live in the local area………………………………….. 

They were not transgender…………………………………………. 

They didn’t speak English or Spanish well enough to take the survey 

Some other reason……………............................………………….. 

(Specify other reason)___________________________________

Refused…………………………………………………………….. 