Formative Research to Inform an Intervention to Improve Early Detection and Surveillance of Pneumoconiosis in US Coal Miners

Attachment B

Form Approved

OMB No. 0920-1154

Exp. Date 1/31/2020

Attachment B

Elicitation Interview Protocol

Information Type	Elicitation Question
Experiential Attitude	How do you feel about black lung screenings? What do you like or dislike about them? How do you feel about mandatory black lung screenings?
Instrumental Attitude	What are the benefits of getting screened for black lung? What are the disadvantages or issues with getting screened for black lung?
Normative Influence	Who would support you in getting screened for black lung? Who would be against you getting screened for black lung?
Perceived Control	What makes or would make it easy for you to get screened? What makes or would make it hard to get screened?
Self-Efficacy	If you wanted to go get screened, how certain are you that you could? What would help you overcome any barriers to getting screened for black lung?

This interview protocol is a modification of the instrument used by Montaño & Kasprzyk (2015).

Source: Montaño, D.E., & Kasprzyk, D. (2015). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In K. Glanz, B.K. Rimer, & K. Viswanath (Eds), Health Behavior: Theory, Research and Practice (pp. 68-96). San Francisco, CA, Jossey-Bass.

Public reporting burden of this collection of information is estimated to average 60 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 - CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333 ATTN: PRA (0920-1154).