0920-0932 Attachment C_Final CARE Program_ECT_Telephone Interview

Form Approved

OMB No. 0920-0932

Expires xx/xx/xxxx

Telephone Interview Script: 3-5 days after CARE Kit given to the Traveler

1. General Introduction

Hello [respondent name]. My name is _________ from the Centers for Disease Control and Prevention. Someone from CDC spoke with you about your experience with the Ebola screening process at the [insert name] airport on [insert day].

At the end of our interview on [day originally interviewed] you said you would be willing to be called again. Is now a good time to talk? [if no, what would be a good time to call you back]

2. Introduction for Interview

This interview will take about 15 minutes. Before I begin I want to go over a couple of items:

• This interview is voluntary. You can decline to answer any question.

• There are no right or wrong answers. I am interested in your opinion. If you don’t understand the question, feel free to let me know and I can ask it another way. This is not a test, so feel free to say you don’t know or don’t have an opinion to offer and “ I don’t know “ is a perfectly acceptable response to any question I ask you.

• The information you provide today during our conversation will be kept secure. Your name is not part of the information we are going to ask you today, and none of the information we ask you can be linked back to you.

• With your permission, I would like to record our conversation. I do this simply to make sure that I capture all of the information that you share and so I can listen to what you have to say and not worry about taking notes. The recording helps me in writing my report and is used for that purposes only. Is it okay for me to record our conversation?

Do you have any questions before we begin?

3. Interview Questions

1. Have you opened your CARE Kit? (If no, skip to 2)

   1. What did the information say you need to do? (probe for taking temperature, recording temperature, talking to the health department)

   2. Have you been able to do what it said?

   3. How easy or hard has it been for you to do these things?

   4. Why?

2. In your opinion, how likely do you think it is that you will get sick with Ebola?

For this question, 1 is very unlikely, 2 is somewhat unlikely, 3 is likely, and 4 is very likely.

1. What about your experience makes you think you are (very unlikely/somewhat unlikely/likely/very likely) to get Ebola?

1. How serious of a health concern is Ebola to you?

For this question, 1 is not serious at all, 2 is somewhat serious, 3 is serious, and 4 is very serious.

4. Did you check your temperature twice yesterday?

5. Did you report your temperature and symptoms to the health department yesterday?

6. Based on what you’ve heard so far, how long do you need to do health checks for Ebola?

1. month 21 days 1 wk unsure

7. Over the next few weeks, how often should you take your temperature?

once once a day twice a day unsure

8. If you had a temperature of 100.4 F or 38.0 C, how likely would you be to seek medical care?

For this question, 1 is very unlikely, 2 is somewhat unlikely, 3 is likely, and 4 is very likely.

1. What (other) symptoms would prompt you to seek medical care?

2. What would you do to seek medical care?

9. How confident are you that you can check yourself for Ebola for the next few weeks?

For this question, 1 is not confident at all, 2 is somewhat unconfident, 3 is confident, and 4 is very confident.

1. What about your experience makes you feel (not confident at all/somewhat unconfident/confident/very confident) that you can check yourself for symptoms?

10. How likely is it that you will report your temperature and symptoms to the health department every day for the next few weeks?

For this question, 1 is very unlikely, 2 is somewhat unlikely, 3 is likely, and 4 is very likely.

11. What challenges might make it hard to report your health checks to the health department every day?

12. Was there any information in the CARE Kit that was unclear or confusing to you?

13. What suggestions do you have for helping us get important information to travelers who may come in the future?

Thank you so much for your participation.

Public reporting burden of this collection of information is estimated to average 15 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74,  Atlanta, Georgia 30333; ATTN:  PRA (0920-0932).