Form 17 Attachment 20-4 BEEA CATI Script Control Group

Attachment 20-4: BEEA CATI Script for Control Group Participants
Study of Biomarkers of Exposures and Effects in Agriculture
Intro/Eligibility Telephone Script (Control Group)
OMB #: 0925-0406
Expiration date: 09/30/2016
Public reporting for this collection of information is estimated to average twenty minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining 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, ATTN: PRA (0925-0406). Do not return the
completed form to this address.

Hello, I am trying to reach (VOTER’S FIRST, MIDDLE INITIAL, LAST, SUFFIX).
IF THE VOTER IS NOT AVAILABLE NOW, ASK ABOUT AND RECORD A BETTER TIME TO
REACH HIM.
IF ASKED “WHO IS CALLING?” BEFORE YOU GET TO THE RESPONDENT:
This is _________________. I am calling Mr. (First/Last Name) about a health study. Is he
there? Thank you very much.
TO RESPONDENT:
Am I speaking to (VOTER’S FIRST, MIDDLE INITIAL, LAST, SUFFIX)?
Hello, my name is _________________. I am calling from a health study. You should have
received a letter from Dr. Charles Lynch/Marsha Dunn, Study Director in (Iowa/North Carolina)
recently, to let you know that I would be calling. Do you recall seeing that in your mail? (PAUSE
FOR RESPONSE)
Do you have a moment now to talk with me about that project?
CALL BACK: Record better day and better time.
TOO BUSY: This initial phone call will take only about 10 minutes. We can schedule for
a better time (NOTE TIME). Or if you would like, we could get started and see how it
goes. You could stop me at any time. Would that be OK?
REFUSING: (Try to respond to concerns.)
NOTE: CATI TO START HERE – INTERVIEWER WILL FIRST INDICATE IN CATI WHETHER
RESPONDENT IS STILL REFUSING OR IS ALLOWING THE CONTACT TO CONTINUE.
STILL REFUSING:

Go to Closing.

IF CONTINUING CONTACT:
Thank you. First let me make certain that I have reached the correct individual.
C1. Is your name (First/Last Name)?
a) Yes

Go to Eligibility Questions

b) No

Go to Closings

ELIGIBILITY QUESTIONS
I’m calling you today about a health study being conducted in Iowa and North Carolina. This
study includes farmers and non-farmers, and is designed to directly measure biologic effects
that may be related to various farming activities and exposures. If you are able to participate,
someone will come to your home to conduct a study visit. I’m happy to tell you that you will
receive $100.00 as a thank you for your participation.
To determine if you are eligible, I need to ask you several questions. Again, please know that
your answers are confidential, and that you may refuse to answer any particular question.
E1. What is your current age?

___________

IF less than 50 years old, go to AGE INELIGIBLE statement. IF 50 years old or older,
continue:
E2. Do you have a blood clotting disorder such as hemophilia?
a)
b)
c)
d)

Yes
No
Dk
Ref

Go to BLOOD INELIGIBLE

E3. Not including non-melanoma skin cancer, have you ever been diagnosed by a doctor with
any type of cancer?
a)
b)
c)
d)

Yes
No
Dk
Ref

Go to CANCER INELIGIBLE

E4. Since the age of 18, have you ever lived or worked on a farm?
a) Yes
b) No

Go to E7

E5 When did you last live or work on a farm?
___/___/______ OR ____ YEARS AGO
MM DD

YYYY

IF 10 years ago or less, go to CONTROL INELIGIBLE 1 statement. IF more than 10 years
ago, continue:
E6. Since the age of 18, for how many months or years in total did you live or work on a farm?
______ MONTHS OR _____ YEARS

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IF greater than 12 months, go to CONTROL INELIGIBLE 1 statement. IF 12 months or
fewer, continue:
E7. Since the age of 18, have you ever had a job that involves mixing, loading or applying
pesticides? Please count any full-time or part-time employment.
a) Yes
b) No

Go to E10

E8. When did you last have a job that involved mixing, loading, or applying pesticides?
___/___/______ OR ____ YEARS AGO
MM DD

YYYY

IF 10 years ago or fewer, go to CONTROL INELIGIBLE 1 statement. IF more than 10 years
ago, continue:
E9. Since the age of 18, for how many months or years in total did you have this job?
______ MONTHS OR _____ YEARS
IF greater than 12 months, go to CONTROL INELIGIBLE 1 statement. IF 12 months or
fewer, continue:
E.10 In the last 12 months, have you worked in any of the following occupations or industries?
Construction
a) Yes
b) No
Meat packing
a) Yes
b) No
Janitorial services
a) Yes
b) No
Furniture making
a) Yes
b) No
Mechanic or gas station attendant
a) Yes
b) No
IF yes to any, go to CONTROL INELIGIBLE 2
END OF ELIGIBILITY INTERVIEW
IF ELIGIBLE: Based on your answers, you are eligible for this study. Did you have a chance to
read the study brochure that was enclosed with the letter you received from (Dr. Lynch/Ms.
Dunn)? Do you have any questions about this study? [IF NOT, OR IF SUBJECTS HAS
QUESTIONS; READ INFORMATION FROM BROCHURE] Participation in this study will
consist of one home visit by a person who specializes in collecting specimens. The home visit
will consist of an interview using a laptop computer, urine, blood, saliva, and vacuum dust
sample collection. You will receive $100.00 for the visit as a thank you for your participation.
Would you be willing to participate in this study?
a) Yes
b) No
Refusing: Do you have any questions or concerns about the study that you would like to
speak to one of the researchers about? [TRY TO ALLEVIATE CONCERNS OR
SCHEDULE TIME TO TALK TO NCI RESEARCHERS] Go to Closings.
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Still Refusing

Go to Closings

IF “YES”:
A1. Let me verify your street address. Is it (READ ADDRESS, CITY, STATE, AND ZIP CODE)?
a) Yes
b) No

Go to A4

A2. What is the address of your current residence?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
A3. In what year did you move to this address? _________
A4. [INTERVIEWER] ENTER THE CURRENT PHONE NUMBER FROM THE CALL RECORD.
___-___-____
IF PHONE NUMBER CANNOT BE FOUND, GO TO A6.
A5. Is (CURRENT PHONE) the best number to contact you?
a) Yes
Go to A7
b) No
A6. Can you please give us the best number to contact you about the visit to your home?
___-___-____
A7. Is there another number like a cell phone or second number to contact you about this visit?
___-___-____
Thank you. As previously mentioned this study would involve a visit to your home on a date that
is convenient for you. Can I schedule a time during (MONTH) or (MONTH) for the visit?
Record date and time of visit:

Date: ___/___/_____ Time: ______am or pm

Proceed to Additional Questions (Participating)

CONTROL INELIGIBLE 1: Unfortunately, you are not eligible for this study: we are looking for
a group of men who have never worked extensively on farms or with pesticides. Go to
CLOSINGS.
CONTROL INELIGIBLE 2: Unfortunately, you are not eligible for this study: we are looking for
a group of men who are not working in certain industries, including construction, meat packing,
Janitorial services, Furniture making, and mechanics or gas station attendant. Go to
CLOSINGS.
AGE INELIGIBLE: I apologize. Our records indicated that you were within the age range we
are including in the study. However, based on this updated information on your age, you are
not eligible. Go to CLOSINGS.
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BLOOD INELIGIBLE: Unfortunately, you are not eligible for this study: we are looking for a
group of men who are able to provide blood samples. Go to CLOSINGS.
CANCER INELIGIBLE: Unfortunately, you are not eligible for this study: we are looking for a
group of men who have never been diagnosed with cancer. Go to CLOSINGS.

ADDITIONAL QUESTIONS
PARTICIPATING:
Before we finish, would you have time to answer three more quick questions about health
screening for us? It will take about two minutes of your time, if that.
a) Yes
b) No

Go to Closings

IF ”YES”, continue:

ADDITIONAL QUESTION INTRO:
These questions are aimed toward improving our understanding of cancer screening practices,
and they are a separate part of the study. As always, your answers are confidential, and you
may refuse to answer any particular question.
S1. Have you ever had a blood test for prostate cancer, for example PSA? Would you say:
a)
b)
c)
d)
e)

Never,
Once, or
More than once?
DK
REF

S2. Have you ever had a digital rectal examination of the prostate? Would you say:
a)
b)
c)
d)
e)

Never,
Once, or
More than once?
DK
REF

S3. Have you ever had a colonoscopy or sigmoidoscopy to examine the colon and rectum?
a)
b)
c)
d)
e)

Never,
Once, or
More than once?
DK
REF
CLOSINGS

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ELIGIBLE, WILLING TO PARTICIPATE:
Thank you. Those are all the questions I have for you today. The home visit will consist of an
interview, urine, blood, saliva, and vacuum dust sample collection. The urine collection
materials and a questionnaire about the vacuum dust sample collection will be sent to you about
two weeks before your visit with the appointment confirmation letter. You may use your vacuum
cleaner as you normally would, but we ask that you not empty it or change bags before the visit.
If you do need to change bags or empty the vacuum canister, we ask that you try to use the
vacuum at least once with the new bag or empty canister before your visit, so there is dust
available in the machine. You can eat and take medications as you normally would.
Meanwhile, please contact us at (800-217-1954/800-424-7883) if you have any questions about
this study. We sincerely appreciate all of your help with our research.
INELIGIBLE:
Thank you for your time today.
REFUSAL:
Thank you for your time today.
RECORD REASON FOR REFUSAL.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
NOT CORRECT RESPONDENT:
I’m sorry for the confusion. That is all the questions I have for you at this time. Thank you for
speaking with me today.

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