Physician

Trends in U.S. Public's Awareness of Racial and Ethnic Heatlh Disparities (1999- 2008)

0990-0335_Attachment J-4_followUpPhone

Physician

OMB: 0990-0335

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Attachment J-4

Physician Survey: Telephone Prompting Scripts for Mail Non-Respondents





Attachment J-4

Form Approved OMB No. 0990-

Exp. Date XX/XX/20XX







PHYSICIAN SURVEY: TELEPHONE PROMPTING SCRIPTS FOR MAIL NON-RESPONDENTS

































According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990- . The time required to complete this information collection is estimated to average ( hours)(minutes) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer











INTRODUCTION and CONTENT:

INTRO_1C: Hello, my name is (first and last name) from NORC at the University of Chicago. About two weeks ago, we sent you a package for a survey being conducted on behalf of the Office of Minority Health. The survey is to learn more about your thoughts and opinions about racial and ethnic disparities in health care. The package we sent you contained a cover letter and a survey booklet as well as an honorarium check of $100. Have you received the package?

IF NO: Please tell me your correct address and we will mail you a copy of the survey materials. The packet will contain materials for a study we are conducting on behalf of the Office of Minority Health. The survey is to learn more about your thoughts and concerns about racial and ethnic disparities in health care. We are surveying a sample of practicing physicians throughout the United States and your participation in the survey is important to our efforts. You should be receiving the package in the mail within the next week along with a check for $100 for your participation. We will send the survey to you, but if it is more convenient for you, we can complete the survey over the telephone. It would only take about 15 minutes of your time. We could do it now or schedule another time for a phone interview. Would you like to complete the survey over the telephone?

IF YES: Good. If you haven’t already done so, the completed survey can be returned to NORC using the pre-addressed, pre-paid envelope which was included in the package. Or, if you like, we can complete the survey over the telephone. It would only take about 15 minutes of your time and all of your answers will be kept completely confidential. We could do it now or schedule another time for a phone interview. Would you like to complete the survey over the telephone?

APPT SCRIPT:

Can you give me some dates and times that are convenient for you? Thank you very much for scheduling this appointment. Can you confirm the phone number I should contact you at is ________________? Thank you for your time and we look forward to speaking with you _____________(REPEAT TIME, DATE OF APPOINTMENT).

IF NO: Ok. Do you have any questions for me about the survey? If you find you have any questions when you look more at the materials, please call the Project Director, Oscar Espinosa at 301-634-9344. This number can also be found on the cover letter included in the package. Thank you again for your participation.



VOICE MAIL SCRIPT:

RESPONDENTS DIRECT LINE:

Hello! My name is (first and last name)) from NORC at the University of Chicago. We are conducting a study on some important health care issues. You have been selected to participate in this important study. Please call our toll free number and mention the study on health care. Again our toll free number is: 1-877-236-8161. Thank You!

ADMINISTRATIVE ASSISTANT/SECRETARY LINE:

Hello! My name is (first and last name)) from NORC at the University of Chicago. We are conducting a study on some important health care issues, {RESPONDENT} has been selected to participate in this important study. Please call our toll free number at 1-877-236-8161 and mention the study on health care. Again our toll free number is: 1-877-236-8161. Thank You!

INTRODUCTION and CONTENT FOR TELEPHONE INTERVIEWS:



INTRO_1D      Hello, my name is (first and last name).  I'm calling from NORC at the University of Chicago. We scheduled an appointment with you to discuss the survey you received by mail. There is no benefit to you, but the research will help the federal government’s Office of Minority Health better understand peoples’ opinions about the differences in minority health care.           

S2_TAPE In order to review my work, my supervisor may record and listen as I ask the questions.  I’d like to continue now unless you have any questions.

S2_MORE Thank you for agreeing to participate. Let me tell you a bit more about the interview. The Office of Minority Health has asked NORC at the University of Chicago, a non-profit organization that specializes in survey research, to interview select individuals about some important health care issues including your thoughts about health care services offered in our Country today. As I mentioned, the interview will only take about 15 minutes. Your participation is voluntary and all of the information you provide will be kept confidential. You don’t have to answer any items that you do not want to answer and you can stop the interview or ask questions at any time. Do you have any questions before we begin?



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File Typeapplication/msword
File TitleAttachment 5
Authorkennedy-alene
Last Modified ByDepartment of Health and Human Services
File Modified2012-03-28
File Created2012-03-28

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