Att 7b_Observation Form_9

Att 7b_Observation Form_9.11.13.docx

Case Studies to Explore Interventions to Support, Build, and Provide Legacy Awareness for Young Breast Cancer Survivors

Att 7b_Observation Form_9

OMB: 0920-1012

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Observation Form


Date ___________


Name of Organization: ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­________________________ Site Visitor Initials: _________


Site Visit Field Notes/Observation Form


Shape1

Purpose:

  • To note any changes in the standard site visit process or methods that could influence the quality or quantity of data site visitors sought to collect.

  • To document the use of any emergency or fall back plans that may have been used to deal with unexpected changes to the site visit process or methods.

  • To note any anomalous findings that seemed unusual or out of the ordinary.

  • To describe overall impressions of the site visit including how site visitors were received by the on-site contact and how, in general, the site visit progressed.

  • To describe nuances, innovations, etc., not captured in the interview guide.


Check all that apply below. For those boxes checked, number and explain the circumstances and your responses/actions on the following page (attach extra pages as needed).


  • 1. Changes in scheduled respondents (i.e., substitutions were made for a position or perspective)


  • 2. Certain respondents were inappropriate


  • 3. Certain respondents were unavailable


  • 4. Certain findings seemed odd or anomalous (e.g., certain respondents had an “axe to grind” or a specific agenda to get across in their interviews)


  • 5. Any miscommunications or misunderstandings (e.g., between the on-site contact and respondents/interviews; between ICF International and the on-site contact)


  • 6. Other issues important to note


For boxes checked on the first page, number and explain circumstances and your responses/actions taken.

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Describe your overall impressions of the site visit and how, in general, this site visit progressed.

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Describe any outstanding issues requiring follow up.

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Describe any nuances or innovations that cannot be captured via the interview guide.

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