Form 3 In-depth Interview

ATTACHMENT 4 OMB#0925-XXXX

Exp. Date: XX/XXXX

OMB Burden Disclosure Statement

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering the data needed, 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974. Do not return the completed form to this address.

Participant ID #__________

NKDEP Evaluation – Client In-depth Interview Guide

1. Overall, how did you feel about your session with your promoter/a today on Kidney Disease? How would you describe the session?

   1. Probe: What stands out to you as something that was particularly useful?

2. What did you hear today in the presentation that means the most to you personally?

3. How helpful did you find the end of the section activities?

   1. Probe: Which of the activities were the most useful to you and why?

   2. Probe: Which of the activities were the least useful to you and why?

4. What additional information would you wished was in the presentation?

   1. Probe: If you were to change one thing in the presentation, what would it be?

5. What questions do you have about kidney disease and how it could affect you?

6. Please rate on a scale of 1 to 5 how motivated you are to create an action plan for your kidney health. Please use the following scale:
   1) highly unmotivated, 2) somewhat unmotivated, 3) neutral (not motivated or unmotivated), 4) somewhat motivated, and 5) highly motivated.

7. To make changes to your lifestyle, what other resources or information do you need?

8. Any final comments?