Survey on Rural Community Wealth and Health Care Provision - nonrespondents in full study screening

Rural Community Wealth and Health Care Provision Survey

Annex J_Script for sample development_7-12

Survey on Rural Community Wealth and Health Care Provision - nonrespondents in full study screening

OMB: 0536-0072

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ANNEX J



SCRIPT FOR SAMPLE DEVELOPMENT



Script for Sample Development



I am one of the research staff at Iowa State University. We are working on a project funded by the USDA Economic Research Service that is looking at how the health care industry affects (small) rural communities. As part of this project, we will be conducting telephone interviews with health care providers and community leaders in 150 rural communities that have been selected in a 9-state region.


[COMMUNITY NAME] is one of the communities chosen to be included in this project. We are now in the process of identifying the people that we should talk with in your area.


We would like to talk with people who are currently in leadership roles in different types of health care, such as a hospital, clinic, doctor’s office, or nursing home. We also want to talk with people who are leaders in your community, who might be involved in overall economic development or in recruiting health care providers.


Before we begin, I need to tell you the following disclosures. A Federal agency may not collect information from a private citizen nor is a person required to respond to an information collection unless the collection displays a valid Office of Management and Budget number. The OMB number for this collection is 0536-XXXX. All responses to this information collection are voluntary. The information provided will be used for statistical purposes only.


In accordance with the Confidential Information Protection provisions of Public Law 107-347, your responses will be kept confidential and will not be disclosed in identifiable form to anyone other than the research team. By law, everyone working on this project has taken an oath and is subject to a jail term of up to 5 years, a fine of up to $250,000, or both if he or she discloses any identifiable information about you or any other respondents to this information collection.



[SELECT APPROPRIATE QUESTIONS FROM THE OPTIONS LISTED BELOW.]


Option 1.

According to the information online, (on _______ website), [NAME] is the [JOB TITLE] of [FACILITY NAME], is that correct?

  • What phone number should we use to talk with him/her?

  • Is that a work phone or home phone?

  • What address should we use to send him/her a letter with information about the project?


Option 2.

We looked online to try to find some of this information, but were unsuccessful.

  • Who is the current [JOB TITLE] of [FACILITY NAME]?

  • Could you spell that for me please?

  • What phone number should we use to talk with him/her?

  • Is that a work phone or home phone?

  • What address should we use to send him/her a letter with information about the project?


Option 3.

We were able to get some information online, but we couldn’t find the [PHONE NUMBER / ADDRESS] for [FILL NAME OR FACILITY]. Can you help me?


Option 4.

Does your community have a [FACILITY or ORGANIZATION TYPE]?

  • What is the name of that facility?

  • What is the facility’s address?

  • Who is the director or manager?

  • What phone number should we use to talk with him/her?


Option 5.

Does your community have a [PROVIDER TYPE or LEADER TYPE]?

  • What is his/her name?

  • Where does he/she practice (or work)?

  • What phone number should we use to talk with him/her?

  • What address should we use to send him/her a letter with information about the project?


Option 6.

According to the information we found online, it looks like [COMMUNITY NAME] has XX [PROVIDER TYPE]:

[PROVIDER1 NAME]

[PROVIDER 2 NAME]

[PROVIDER 3 NAME] etc.

  • Is that the case? Are those people still practicing in your town?

  • Are there any other [PROVIDER TYPE]s currently practicing in your town?

  • IF YES: What is his/her name?

    • Where does he/she practice (or work)?

    • What phone number should we use to talk with him/her?

    • What address should we use to send him/her a letter with information about the project?


Option 7.

Are there any (other) people in your community who have been involved in recruiting health care professionals?

  • What is his/her name?

  • How has he/she been involved in the recruitment of health care professionals to work in your town?

  • Where does he/she work?

  • What phone number should we use to talk with him/her?

  • What address should we use to send him/her a letter with information about the project?


Option 8.

Are there any (other) people in your community who are active in economic development in general?

  • What is his/her name?

  • How has he/she been involved in economic development in your town?

  • Where does he/she work?

  • What phone number should we use to talk with him/her?

  • What address should we use to send him/her a letter with information about the project?


That’s all the information I need today. Do you have any questions for me?


Iowa State University thanks you for your willingness to help us with this project, and we look forward to talking with some of the people in your town very soon.




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