Attachment G: Cognitive Interview Script_Decision Aid

OMB G_Cognitive Interview Script_Decision Aid_REV 2016 02 24.docx

Eisenberg Center Voluntary Customer Survey Generic Clearance for the AHRQ

Attachment G: Cognitive Interview Script_Decision Aid.docx

OMB: 0935-0128

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Cognitive Testing Interview Guide:

PROSTRATE CANCER DECISION AID



Study ID: _____________________

Date of Interview: _____________________


Instructions to interviewer are in bold and italics


Task 1: Introduction


Thank you for your interest in this study. First, I am going to review the informed consent form to you to be sure that you understand what the study is about. Next, I will ask if you have any questions or concerns about this study. Once your questions are answered, I will ask you to complete an informed consent form. After we complete the consent process, I’ll ask you some general demographic questions and then will begin the interview.


Task 2: Informed Consent Process


Go over the informed consent form with the participant. Ask if the participant has any questions and answer any question they have. If they agree to participate, have them sign and date the consent form. Sign and date it as the person obtaining consent, and give the participant a copy to keep. Also complete the informed consent documentation.


Task 3: Demographic Questionnaire


Now, let’s go over some general demographic questions. This will take less than 5 minutes.

These questions are for research purposes only and your answers will be kept strictly confidential.


  1. How old are you?


______ Years



  1. What is your race? (Please check all that apply.)

  • American Indian or Alaska Native

  • Asian

  • Black or African American

  • Native Hawaiian or Other Pacific Islander

  • White

  • Other: _______________


  1. What is your ethnicity?

  • Hispanic or Latino

  • Not Hispanic or Latino


  1. What is the highest grade/level of education that you have completed?

  • Not a high school graduate

  • High school graduate

  • Some college

  • College graduate

  • Post-graduate degree


Thank you for providing your demographic information.

Task 4: Cognitive Interview


Describe the Cognitive Interview to the participant.


  1. We are testing the script and graphics for a decision aid with the help of people like you.

  2. The goal here is to get an idea if the script and graphics are understandable. I’d like you to think aloud as we go. As you look at the graphics and read through the text, just tell me everything you are thinking.

  3. At times I will stop and ask you more questions about the terms or phrases used in the narration. I will be also taking notes at the same time.

  4. Please keep in mind that I really want to hear all of your opinions and reactions. Don't hesitate to speak up whenever something seems unclear or is hard to answer.

  5. We will do this for an hour, unless I run out of things to ask you before then.

  6. Do you have any questions before we start?



For each section of the script or individual graphic, questions like the following will be asked.


General Questions:

  1. Please tell me in your own words what this information means to you.

________________________________________________________________________________________________________________________________________________


  1. Can you tell me in your own words what the animation/graphic is showing?

________________________________________________________________________________________________________________________________________________


  1. Was this animation/graphic easy or difficult to understand? How so?

_______________________________________________________________________________________________________________________________________________


  1. Is there anything on the slide that is unclear? Please explain.

________________________________________________________________________________________________________________________________________________


Probes:

  • What does the term “[____________]” mean to you? [Watchful waiting would be an example term]

________________________________________________________________________________________________________________________________________________


Comments:

  • Notice respondent’s behavior like non-verbal cues, discomfort, hesitation or lack of understanding.

________________________________________________________________________

________________________________________________________________________


  • Notice response latency: time elapsed between the presentation of question and the indication of a response.

________________________________________________________________________

________________________________________________________________________


  • Any other comments?

________________________________________________________________________________________________________________________________________________




PI or Delegate Signature Date and Time


PI or Delegate Printed Name PI or Delegate Employee ID#

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