CMS-10477 Recruitment staff interview protocol and consent

Attachment 5.d. Site Visit Recruiter Interview Protocol and Consent Form
MEDICAID INCENTIVES FOR PREVENTION OF CHRONIC DISEASES EVALUATION
INTERVIEW GUIDE
Recruiter Protocol
(Individuals who have direct interaction with potential participants and are aware of problems recruiting
participants)
Roles may include the following:
• Outreach coordinators
• Community liaisons
A separate protocol has been developed for providers, clinic staff, and nurse care managers.
Questions in blue are designed to be probes that will be asked when needed.

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Introduction
Thank you for making time to speak with us today. We are researchers from Research Triangle Institute
International (RTI) and the National Academy for State Health Policy (NASHP), evaluating the
Medicaid Incentives for Prevention of Chronic Diseases demonstration.
In this discussion, we are interested in gathering your perspective on implementation progress and
challenges, program details such as the types of special populations involved or targeted by your state
initiative, your data collection processes, and the project’s evaluation progress. We are also particularly
interested in your perspective on the effectiveness and sustainability of this initiative on reducing
Medicaid and health care costs.
Our evaluation is being funded by the Centers for Medicare & Medicaid Services (CMS). As a condition
of participation, CMS expects state staff and program partners to cooperate with the evaluation team, but
ultimately your decision to participate in this aspect of the study is voluntary. If you do not wish to
participate in this interview or answer specific questions, please let us know immediately.
We believe there are minimal risks to you from participation, and every effort will be made to protect
your confidentiality. We want to assure you that we will not quote you by name. We will use some
quotes in reports, but quotes will not be attributed to an individual or his or her organization.
There are no direct benefits to you from participating in this study. But your insights will be used by
federal and state policymakers as well as other Medicaid programs to improve the impact that incentives
have on chronic disease prevention and management among Medicaid beneficiaries and address the
challenges involved in implementing an incentivized health prevention program. CMS and RTI’s
Institutional Review Board (IRB) have reviewed and approved this research protocol.
We would like to record our conversation, to ensure that our notes from today are complete. Do I have
your permission to audio record our conversation today?
Finally, we are conducting a second round of stakeholder interviews focused on beneficiaries’
satisfaction with the program so we may contact you for further information.
Are the remaining interview conditions OK with you? Do you have any questions before we begin?
Background
About the Respondent
1. What is your role in [name of state program] and how long have you been in this role?
a. What is your role in recruiting [name of state program] participants?
b. What other interactions do you have with participants?
2. [For clinic staff or partner organization staff only] How did your [organization/clinic]
become involved in [name of state program]?
a. Was your [organization/clinic] recruited to participate in [name of state program]?

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b. Did your [organization/clinic] respond to a solicitation such as an RFP to participate
in [name of state program]?
c. Is your [organization/clinic] paid to participate in [name of state program]?
3. [For clinic staff or partner organization staff only] How long has your [organization/clinic]
participated in [name of state program]?
About the Program
4. Some state participants refer to the initiative by a name different from the official program
name. Other than [name of state program], what names do participants use when referring
to this program?
a. In your opinion, do you think participants will recognize the program as [name of
state program]?
5. In your opinion, can participants distinguish between [name of state program] and general
health services provided by Medicaid?
a. Do participants recognize that they are in a special Medicaid incentive program?
Implementation Progress
Overall
6. What type of interaction/communication, if any, do you have with participant educators
such as lifestyle coaches, peer navigators?
c. How often do you interact/communicate with program educators?
d. How, if at all, could the communication between education and recruitment staff be
improved?
Recruitment
7. When did you begin recruiting participants?
b. To your knowledge, did participant recruitment occur according to the originally
proposed timeline?
i. What are the reasons participant recruitment did not follow the original
timeline?
8. How are you recruiting participants?
a. Please describe the recruitment process.

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i. Tell me about the screening process, if any, for possible participants (for
example, do you verify if they are enrolled in Medicaid or eligible for the
program)?
9. How was this recruitment strategy(ies) developed?
a. Did you assist the state in developing this recruitment strategy(ies)?
b. Did [name of state program] collaborate with any partners to develop this strategy?
Who?
10. What methods or materials, if any, are you using to recruit participants (i.e., flyers,
outreach to providers)?
a. Were any of these methods or materials adopted from another program(s)?
11. Are there specific locations or organizations you work with to recruit participants?
a. How were these locations or organizations identified?
b. In your opinion, how successful are these locations or organizations in recruiting
participants?
i. Are there additional locations or organizations you think [name of state
program] should consider?
12. How many staff recruit [name of state program] participants?
13. What type of training, if any, did you and other [name of state program] staff receive
before you began recruiting participants?
a. Please tell us about this training.
i. What type of information was covered in the training?
ii. How long is it?
iii. Who developed this training?
iv. How helpful was this training at providing you with the skills needed to
recruit participants?
v. Have there been additional “refresher” courses since the original training?
14. In your opinion, how could your training improve to be more useful, if at all?
15. What marketing strategies have been most successful at recruiting participants?
a. What made these strategies so successful?

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b. Were certain strategies more or less successful at recruiting participants with different
:
i. Patient demographics (race, age, sex)?
ii. Chronic health conditions?
iii. Other characteristics?
iv. Please describe why.
16. In your opinion, how successful have you been at recruiting participants?
a. Have you reached your participant enrollment goal?
17. What challenges have you faced recruiting participants?
a. How are you or [name of state program] addressing these challenges?
b. What challenges, if any, still remain unaddressed?
18. In your opinion, how could the participant recruitment process improve?
Incentives
19. In your opinion, what impact, if any, do the incentives have on participant recruitment
efforts?
a. Do incentives increase the likelihood that individuals will participate in the program?
b. In your opinion, is there an incentive other than the one the state is already providing
that would improve program participation?
Special Populations
As part of the Affordable Care Act, the MIPCD national demonstration is required to focus on the extent
to which special populations (such as adults with disabilities, children with special health care needs) are
able to participate in the demonstration. This section focuses on special populations the state may
engage in its program.
20. We understand that [name of state program] is planning to engage [special population listed
here], which we consider to be a special population. To what extent, if at all, are you
recruiting or engaging this special population(s) to participate in the initiative?
a. How are you recruiting or engaging this special population(s) to participate in the
initiative?
b. Are these recruitment techniques unique for this special population(s)?

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21. Based on your experience, how successful are these techniques at engaging [name of
special population(s)] to participate in [name of state program]?
a. What challenges have you faced recruiting [name of special population(s)]?
b. Are there any changes you are planning to implement to overcome these challenges?
22. What strategies are you using to recruit individuals who speak languages other than
English?
a. Have you implemented recruitment strategies in other languages or used a translator
or language lines (e.g., ATT language lines) to assist with participant recruitment?
b. Do you have recruitment materials in different languages/staff who speak different
languages?
i. Which languages?
State Grant Evaluation Progress/Data Collection
23. Does [name of state program] evaluate its recruitment strategies?
a. What processes or systems are involved in this assessment?
i. What staff are involved?
ii. Is the program’s evaluation contractor involved?
b. How often?
c. To what extent, if at all, has [name of state program] shared its recruitment strategy
evaluation findings with you?
24. What data, if any, do you collect as part of your recruitment and participant engagement
efforts?
a. How, if at all, are these data shared with [name of state program]?
b. How, if at all, do you use these data to decide which recruitment strategies to
implement?
Overall
25. To date, what key implementation lessons have you learned?
a. What advice would you give recruiters participating in similar types of prevention
programs?
26. What changes to [name of state program], if any, do you plan to implement before
beneficiary participation ends in December 2015?

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a. Why have you or your staff decided to make these changes?
27. In thinking about the various challenges you’ve shared, in your opinion, are there any
challenges that would/could have benefited from state peer-to-peer learning or technical
assistance?
28. Is there anything else about [name of state program], that we haven’t covered but that
would be important for our team to know?

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