11e - Enhanced script caregivers

Enhanced Protocol: Field Interviewer Script for Caregivers of Children Ages 3-11

“Thank you for agreeing to participate in the Caregiver Survey and Young Child Biometric Study.”

“I am (NAME) with RTI International and we are conducting this study with funding from the U.S. Centers for Disease Control and Prevention, otherwise known as the CDC. In this study we are interested in health-related information about children between the ages of 3-17 years old. You or another adult in your household previously participated in the Adult Targeted Surveillance Survey and you agreed to complete this in home examination. “

“This study will involve you completing a survey about your child and observing while I collect measurements and saliva from your child. First, I will ask you specific questions about your child’s behaviors such as nutrition (e.g., typical consumption of various foods and beverages), physical activity habits, and tobacco use and exposure to tobacco smoke; knowledge of and attitudes about programs and policies that have been implemented in schools to prevent and reduce obesity and tobacco use; and your child’s recent weight loss/gain or recent illness or medical diagnosis that could affect biometric measurements. We will also ask about recent meals, and whether your child has had any dental work recently. I will then measure your child’s height, weight, waist circumference and collect a saliva sample to determine any exposure to second hand tobacco smoke.

“The survey will take 20 minutes for you to complete and your child’s examination will take approximately 20 minutes to complete. You will be given $10.00 in cash for your child’s participation and your time.

“Do you have any questions?”

“Great. Before we get started here is a copy of the informed consent form. Regardless of whether you were the person who participated in the phone interview, I need to have you sign the form giving us permission to interview you and take some biometric measures on your child. Please read over carefully and sign once you are finished. If you have any questions and don’t understand everything, please don’t hesitate to ask me.”

Addendum to Enhanced Protocol: Field Interviewer Script for Caregivers of Children Ages 3-11

“Your child is also invited to participate in an additional study in which your child wears an Actigraph GT3XE accelerometer around his/her waist to keep track of active and inactive time over the next 7 days. You will also be provided with a diary to record your child’s physical activities, sedentary activities such as sitting and watching television, and when he/she goes swimming, takes a shower, wakes up and goes to bed.”

For completing the accelerometry component of this study, your child will be given an additional $10.00 gift card.”

“If we receive the activity data from your child’s device and find that we do not have at least 5 days of complete data, we will ask that your child wear the accelerometer for another 7 days. You will still receive the $10 gift card for your child even if he/she refuses to wear the accelerometer for a second week.”