Screener

Form Approved

OMB No. 0920-XXXX

Exp. Date XX/XX/XXXX

Main Study Screening Script and Frequently Asked Questions (FAQ)

Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).

A Battelle Interviewer will call each office/jurisdiction prior to dissemination of the mail survey to obtain responses to the screening questions listed below.

Who Answers	Instructions
Staff Member	Follow SCRIPT 1
Office Answering Machine	Follow SCRIPT 2

SCRIPT 1

Hello, my name is [interviewer’s name] calling from Battelle Center for Analytics and Public Health on behalf of the Centers for Disease Control and Prevention (CDC).

CDC is conducting a national survey to gather information about how medical examiners and coroners classify Sudden Unexpected and Unexplained Infant Deaths (SUID). Approximately 800 medical examiners and coroners will be surveyed. The survey will be sent by mail and will take approximately 30 minutes to complete. All respondents will receive a modest honorarium for their participation. Findings from the survey will guide CDC and other organizations that develop guidelines and new training materials. Your jurisdiction was selected from among a national sample of jurisdictions that investigate and certify infant deaths.

Before we mail the surveys, we are calling medical examiners’/coroners’ offices to verify the name and contact information for the staff in each organization who would be eligible to complete the survey. Would you be able to provide this information for me or is there someone else within your organization with whom I should speak?

[If Respondent agrees to either of the above, continue with questions, below, once a staff person who is knowledgeable about the medical examiner/coroner’s office is reached]

1. [If information about medical examiner/coroner is available from our data sources]:

According to our records, the person(s) responsible for determining the cause and manner of death reported on official death certificates in your country/jurisdiction is/are [name(s)]. Is that correct? Is there anyone else who performs that function other than the individuals I just named?

[If information about medical examiner/coroner is not available from our data sources]:

Who in your organization is responsible for determining the cause and manner of death reported on official death certificates? If this function is performed by more than one person, please provide the names of all staff members who do this.

2. The mailing address we have on file for your office is [address]. Is that the correct mailing address for [name(s) of individual(s) reported in #1 above]?

Thank you for your help. Over the next two weeks we will be mailing a survey packet to [name of staff member selected to complete survey]. Please alert [name] to this and ask him/her to take the time to complete the survey and return it to us. Participation is voluntary and s/he does not have to answer every question. If you or [name] has any questions about the study, please call 1-xxx-xxxxx-xxxx. Thanks again.

SCRIPT 2

Answering Machine Message: My name is [interviewer’s name] calling from Battelle Center for Analytics and Public Health on behalf of the Centers for Disease Control and Prevention (CDC). CDC is conducting a national survey to gather information about how medical examiners and coroners classify Sudden Unexpected Unexplained Infant Deaths (SUID) and identify needs for resources and training. Please call 1-XXX-XXX-XXX so that we can quickly verify the name and contact information for the person in your organization responsible for determining the cause and manner of death reported on official death certificates. Thank you.

Refusal scripts

Too busy/doesn’t have time to answer questions - I'm sorry to have caught you at a bad time. I would be happy to call back at a more convenient time. We have interviewers available during the day and also during the evening and weekend. We would be happy to schedule an appointment and have them call you then. I only need about 5-10 minutes of your time on the phone. The survey will be mailed to the respondent, and s/he can complete it whenever it’s convenient to do so. When would be a good time for us to call you back?

Doesn’t think anyone would be interested in completing the survey - The study is designed to help CDC gain a better understanding of how infant deaths are classified and identify needs for resources and training. The person you identify as the appropriate person to contact can fill out the survey at a time that’s convenient. It will likely take the respondent 30 minutes or less to complete the survey.

Safeguards - Providing safeguards for your information is important to us. We have data collection policies and procedures to ensure that all answers are maintained in a secure manner. The contact information you provide is stored in a computer database that is separate from the database that stores the answers to our questions. All of our computer files are password protected and stored on secure servers. In addition, all of our staff sign a non-disclosure agreement as a condition of their employment. Data from this survey will only be reported in aggregate form – that is, summarized across all medical examiner/coroners’ offices.

Doesn’t think surveys are worth doing - This is an opportunity for you to contribute to CDC’s understanding of how infant deaths are classified and identify needs for resources and training. The person you identify as the appropriate person to contact can fill out the survey at a time that’s convenient for them. It will likely take the respondent 30 minutes or less to complete the survey.

FAQ scripts

What is the purpose of this study? What kinds of questions are you asking? What is this about?

This is a national survey which will have results that are intended to be representative of all medical examiners and coroners. The purpose of this study is to find out how infant deaths are classified and identify needs for resources and training. The survey will take less than 30 minutes for the person you identify to complete it. I will only take a few minutes of your time.

How did you get my name? (for screener FAQ)

Your office was on the list of medical examiners and coroners provided by Safety Source.

How will you safeguard responses? - Providing safeguards for your information is important to us. We have data collection policies and procedures to ensure that all answers are kept private. The contact information you provide is stored in a computer database that is separate from the database that stores the answers to our questions. All of our computer files are password protected and stored on secure servers. In addition, all of our staff sign a non-disclosure agreement as a condition of their employment. Data from this survey will only be reported in the aggregate -- that is, summarized across all medical examiner/coroners’ offices.

Who do you work for? Where are you calling from? What is Battelle? - I am calling from the Battelle Center for Analytics and Public Health. Battelle is a not-for-profit research organization that does research for the CDC and other government agencies.

What’s in this for me? Why should I answer your questions? - By helping us today you can help the CDC understand how infant deaths are classified and identify needs for resources and training.

I don’t have time now - I'm sorry to have caught you at a bad time. I would be happy to call back at a more convenient time. We have interviewers available during the day and also during the evening and weekend. We would be happy to schedule an appointment and have them call you then. I only need about 5-10 minutes of your time on the phone. The survey will be mailed to the respondent, and they can complete it whenever it’s convenient for them. When would be a good time for us to call you back?

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