Appendix C3- Script for In Person Mode 5.14.18 - Samoan

Appendix C3: SCRIPT FOR IN-PERSON MODE, Samoan

Talofa o lo’u igoa o _________. O loo o’u talanoa ma tagata e fai ma sui o le Health Resources and Services Administration, Matagaluega a le Iunaite Setete mo le Soifua Maloloina o le Tina ma le Tamaitiiti i le Matagaluega o Soifua Maloloina ma Tautua mo le Lautele a le Iunaite Setete.

O a’u o se tasi mai le vaega o le su’esu’ega o loo faia ina ia faaleleia ai le malamalama i le soifua maloloina o tina ma fanau i [Amerika Samoa/Setete o le Fetorale i Maikolenisia/Atumotu o Marshall/Atumotu o le Northern Mariana/Palau]. O le faia o sou sao e aofia ai le taliina o ni fesili faasolosolo e tusa ai ma le soifua maloloina o lau fanau.

1. Pe mafai ona ou fesili atu ni nai fesili ina ia iloa ai pe ete agavaa e faisao i lenei su’esu’ega?

1 Yes [go to 2]
2 No [Thank individual for their time and end call]

99. Refused to Answer [Thank individual for their time and end call]

2. Pe e 18 ou tasaga pe ete matua atu?

1 Yes [go to 3]
2 No [Thank individual for their time and end call]

99. Refused to Answer [Thank individual for their time and end call]

3. Poo oe o le tina o se tamaitiiti e 0 e oo atu i le 17 tausaga le matua o nonofo faatasi i lou aiga?

1 Yes [go to screener]
2 No [Thank individual for their time and end call]

99 Refused to Answer

[WRITTEN INFORMED CONSENT OBTAINED AFTER DETERMINING ELIGIBLE CHILD(REN) IN THE HOUSEHOLD AND PRIOR TO LAUNCHING CORE QUESTIONNAIRE- SEE SEPARATE FORM]

[IF RESPONDENT DOES NOT CONSENT, THANK HER FOR HER TIME AND END INTERVIEW, IF RESPONDENT DOES CONSENT, LAUNCH CORE QUESIONNAIRE]

[ADDITIONAL INFORMATION PROVIDED AT END OF SURVEY]

I le fai ma sui o le Matagaluega o Soifua Maloloina ma Tautua mo le Lautele a le U.S., e momoli atu la matou faafetai mo lou taimi ma taumafaiga na e faaalu e faasoa mai ai faamatalaga e faatatau i lenei tamaitiiti, faapea oe ma lou aiga.

E tāua au tali ia i matou ma o le a fesoasoani i le su’esue’ga, aufaitulafono, ma latou o faatāuaina aiga e maua ai se malamalamaga lelei i le soifua maloloina ma tausiga faafoma’i e manaomia e fanau mai ituaiga eseese o mau faatasi ma tatou.

[FOR AMERICAN SAMOA/FEDERATED STATES OF MICRONESIA/NORTHERN MARIANA ISLANDS]

[FOR ALL IN-PERSON RESPONDENTS]

Faamolemole faafesootai Clare Davidson i le [o loo faatali le numera e vili fua] poo le [email protected] mo fesili, faitioaga poo popolega e tusa ai ma lenei su’esu’ega. Aafai e iai soo sau fesili poo ni popolega e tusa ai ma ou aiā tatau i le avea ai ma se sui e fai sao, faamolemole faafesoota’i le NORC Institutional Review Board Manager e ala i le numera o le telefoni e lē totogia (866) 309-0542. E toe fia faafetai atu ia te oe.