Sepsis Consumer Screener - AA men

Recruitment Screener

Focus Groups with African American men with comorbid conditions

Hello. My name is ____________ and I work with [NAME OF Recruiting firm]. We are working with ICF, a consulting firm in Atlanta, Georgia and the Centers for Disease Control and Prevention (CDC) to learn about consumers’ perceptions, knowledge and awareness about infections and also about the risk of developing sepsis. The discussion will be with three people total and will last about 90 minutes. We will not ask you any questions about your own health status or personal health issues.

If you participate in the group, you will receive $35 in appreciation of your time. Do you think that you might be interested in participating in this type of discussion?

• Yes (Continue with screener.)

• No (Thank person for time and end conversation.)

Would you mind if I ask you a few questions in order to determine whether or not you can participate in the discussion group?

• Yes (Continue with screener.)

• No (Thank person for time and end conversation.)

NOTE TO RECRUITER: Please continue through all questions before letting individuals know that they cannot be invited to participate at this time based on at least one of the responses they provided.

Record and keep all screened data.

Recruiter: We will conduct 3 triads with AA men.

1. What is your gender?

• Male

• Female (Terminate at end)

2. What is your age? _____ (if under 65 terminate, if 65 or older record age)

3. Would you describe yourself as Hispanic or Latino?

• Yes

• No

4. How would you describe your racial background? You may identify more than one racial background.

• American Indian or Alaska Native (Terminate at end)

• Asian (Terminate at end)

• Black or African American

• Native Hawaiian or Other Pacific Islander (Terminate at end)

• White (Terminate at end)

5. Do you have 1 or more chronic condition? (e.g., diabetes, high blood pressure, coronary artery disease)

• Yes

• No (Terminate at end)

6. What is your home zip code? ________________________

(Terminate at end any persons with zip codes not on the list from which to recruit)

7. Do you have any family members who have been recruited for this study?

• Yes (Terminate at end)

• No

7. Are you willing to participate in a discussion to discuss your views about infection, sepsis and some materials to create a sepsis prevention communication campaign? The discussion will be conducted in English.

• Yes

• No (Terminate at end)

9. Do you have access to a phone, computer, and Internet Access to participate in the discussion?

• Yes

• No (Terminate at end)

TERMINATION SCRIPT: “We appreciate your willingness to answer each of the questions. Unfortunately, you are not eligible to participate in the focus group. Thank you for your time.”

10. You are eligible to participate in the group. Are you still interested in participating?

• Yes

• No (Thank person for her time, terminate and end the conversation.)

I’m glad that you will be able to join us! The digital discussion group will last about 90 minutes. It will be held online using Adobe Connect. The group in which we would like you to participate is scheduled for: [State date and time]

8. Does this date and time work for you?

• Yes

• No (Thank person for her time, terminate and end the conversation.) [OR GET OTHER AVAILABLE TIMES THAT MIGHT WORK.]

Please confirm your name, phone number, and e-mail so we can send you instructions on joining the digital focus group. We will also send reminders to this email address.

Name
Mailing Address
Home Telephone	Pager:
Best number to reach you	Cell Phone:
E-mail

Also, please contact [Recruiter] at [PHONE NUMBER] if your plans change so that we may invite someone from the waiting list to attend instead. Otherwise, we’ll look forward to seeing you on [Month/Day/Year] at [Time].

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