Form Screening Verifica Screening Verifica Screening Verification Script

National Mental Health Study Field Test,
Supporting Statement
Attachment AC-1 – CATI Verification Scripts –
Screening Only

CATI Verification Scripts (Screening Only)

This page intentionally left blank.

Verification Script for Codes 10, 13, 18, 26
General Information:
All skips or routing instructions to be programmed are noted next to response in brackets [ ]
Gender = Male/Female
All fills are designated by italics text in parentheses (address)
(FI Pronoun): he/she based on FI’s gender
(FI Description): age, gender, height, race
Program fill for past or future tense as follows:
Use the first portion of the fill (will/did) (stay/stayed)
If Qtr 1 and call is before Feb 15, else use second portion
If Qtr 2 and call is before May 15, else use second portion
If Qtr 3 and call is before August 15, else use second portion
If Qtr 4 and call is before November 15, else use second portion
Program fill for (3-month quarter field period)
Qtr 1= January, February, March
Qtr 2= April, May, June
Qtr 3= July, August, September
Qtr 4 = October, November, December
(Screening Date) fill: Date of final Screening Code
Fills: (first name/a resident of this household) If first name available from data, use this in fill – otherwise, use “a
resident of this household”.

Screening Information Provided for Codes 10,13,18,26:
CaseID
Phone number (designates home or work phone)
Address
Notes to Verification Caller [Additional data from Samsung Galaxy Tablet]
First Name
Screening Date (date of final Screening code)

Screening Script:
>INTRO1D<
May I speak to (first name)?
<1>
<2>
<3>
<4>
<5>
<6>
<7>

SPEAKING TO TARGET RESPONDENT [D1INTRO]
RESPONDENT AVAILABLE (NOT SPEAKING TO TARGET) [if cell number, go to
Cell_Res3, else D1INTRO]
RESPONDENT UNAVAILABLE [NORES1D]
RESPONDENT UNKNOWN [NORES1D]
RESPONDENT KNOWN, BUT WILL NEVER BE AVAILABLE [NORES1D]
OTHER [INTROSPD]
RESPONDENT KNOWN, BUT DOES NOT SPEAK ENGLISH OR SPANISH [NORES1D]

>INTROSPD<
ENTER RESPONDENT’S ANSWER VERBATIM. [NORES1D]
>NORES1D<
OK, perhaps you can help me (My name is ____________. I am calling from RTI International regarding a
study sponsored by the U.S. Department of Health and Human Services
Our records indicate that someone at this number was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored. Are you or anyone else at
this number familiar with (address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>
<3>

YES, RESPONDENT IS [D1]
YES, SOMEONE ELSE IS [SPEAKD]
NO [NORES2D]
DON’T KNOW [NORES2D]

>NORES2D<
I was given this telephone number to verify that our interviewer made contact with someone that either
lives at or is knowledgeable about (address). Is there anyone at this number who might be familiar with
(address)?
<1>
<2>
<3>

YES, RESPONDENT IS [D1]
YES, SOMEONE ELSE IS [SPEAKD]
NO [NORES2D1]
DON’T KNOW [NORES2D1]

>NORES2D1<
Is there anyone at this number who might be familiar with our interviewer who is (FI Description)?
<1>

YES, RESPONDENT IS [D1]

<2>
<3>

YES, SOMEONE ELSE IS [SPEAKD]
NO [DONED]
DON’T KNOW [DONED]

>SPEAKD<
May I speak with this person?
<1>
<2>

YES [if cell number, go to Cell_Res1, else INTRO2AD]
NO (THIS RESPONSE WILL TAKE YOU TO THE CALLBACK SCREEN) [CALLBACK]

>Cell_Res1<
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [INTRO2AD]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>INTRO2AD<
(Hello, my name is _____________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that someone at this number was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored. Are you familiar with
(address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>

YES [D1]
NO [NORES3D]

>NORES3D<
I was given this telephone number to verify that our interviewer made contact with someone that either
lives at or is knowledgeable about (address). Is there anyone at this number who might be familiar with
(address)?

<1>
<2>
<3>

YES, RESPONDENT IS [D1]
YES, SOMEONE ELSE IS [SPEAKD2]
NO [NORES3D1]
DON’T KNOW [NORES3D1]

>NORES3D1<
Is there anyone at this number who might be familiar with our interviewer who is (FI Description)?
<1>
<2>
<3>

YES, RESPONDENT IS [D1]
YES, SOMEONE ELSE IS [SPEAKD2]
NO [DONED]
DON’T KNOW [DONED]

>SPEAKD2<
May I speak with this person?
<1>
<2>

YES [if cell number, go to Cell_Res2, else INTRO2AE]
NO (THIS RESPONSE WILL TAKE YOU TO THE CALLBACK SCREEN) [CALLBACK]

>Cell_Res2<
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [INTRO2AE]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>INTRO2AE<
(Hello, my name is _____________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that someone at this number was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. This will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored. Are you familiar with
(address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)

<1>
<2>

YES [D1]
NO [NORES3D2]

>NORES3D2<
I was given this telephone number to verify that our interviewer made contact with someone that either
lives at or is knowledgeable about (address). Are you familiar with (address)?
<1>
<2>

YES, RESPONDENT IS [D1]
NO [NORES3D3]
DON’T KNOW [NORES3D3]

>NORES3D3<
Are you familiar with our interviewer who is (FI Description)?
<1>
<2>

YES, RESPONDENT IS [D1]
NO [DONED]
DON’T KNOW [DONED]

>Cell_Res3<
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [D1INTRO]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>D1INTRO<
(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that someone at this number was contacted concerning (address).
This call to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
PRESS <1> TO CONTINUE... [D1]
>D1<
IF SCREENING CODE 10, GO TO D1_10A

IF SCREENING CODE 13, GO TO D1_13A
IF SCREENING CODE 18, GO TO D1_18A
IF SCREENING CODE 26, GO TO D1_26INT
>D1_10A<
Has (address) been vacant any time within recent weeks?
<1>
<2>

YES [D2]
NO [D1_10B]
DON’T KNOW [D1_10B]

>D1_10B<
Let me verify, was (address) vacant on or around (Screening Date)?
<1>
<2>

YES [D2]
NO [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D1_13A<
(Do/Did) the people who own or occupy (address) reside somewhere else for most of the time during the 3
month period of (3-month quarter field period)?
<1>
<2>

YES [D2]
NO [D1_13B]
DON’T KNOW [D1_13C]

>D1_13B<
Let me verify, (will/did) the people who own or occupy (address) stay somewhere else for at least half of
the time during the three month period of (3-month quarter field period)?
<1>
<2>

YES [D2]
NO [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D1_13C<
To the best of your knowledge, (will/did) the people who own or occupy (address) stay somewhere else for
at least half of the time during the three month period of (3-month quarter field period)?
<1>
<2>

YES [D2]
NO [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D1_18A<
Is (address) a business, military barracks, hotel or motel, a place that was demolished or does not exist, or
another type of place that is not a residence?

<1>
<2>

YES [D2]
NO [D1_18B]
DON’T KNOW [D1_18B]

>D1_18B<
We are trying to distinguish places that are residences such as houses, town houses, apartments, and college
dormitories from the types of places I just mentioned.
To the best of your knowledge, is (address) a business, military barracks, hotel or motel, a place that was
demolished or does not exist, or another type of place that is not a residence?
<1>
YES [D2]
<2>
NO [D2]
DON’T KNOW [D2]
REFUSE [D2]
>D1_26INT<
Are you currently living at or have you recently lived at (address)?
<1>
<2>

YES [D1_26A]
NO [D1_26D]

>D1_26A<
Our records indicate that no one in your household (is going to live/lived) at (address) for most of the time
during the months of (3-month quarter field period). Is this correct?
<1>
<2>

YES (NO ONE IN HH WILL/DID LIVE THERE FOR MOST OF THE TIME) [D2]
NO (R STATES SOMEONE (WILL/DID) LIVE THERE FOR MOST OF THE TIME DURING
THE FIELD PERIOD.) [D1_26B]
DON’T KNOW [D1_26C]

>D1_26B<
Let me verify, (will/did) you or someone in your household live at (address) for at least half of the time
during the three month period of (3-month quarter field period)?
<1>
<2>

YES (SOMEONE IN HH WILL/DID LIVE THERE FOR MOST OF THE TIME) [D2]
NO (SOMEONE IN HH WILL/DID NOT LIVE THERE FOR MOST OF THE TIME) [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D1_26C<
To the best of your knowledge, (will/did) someone from your household live at (address) for at least half
of the time during the three month period of (3-month quarter field period)?

<1>
<2>

YES (SOMEONE IN HH WILL/DID LIVE THERE FOR MOST OF THE TIME) [D2]
NO (SOMEONE IN HH WILL/DID NOT LIVE THERE FOR MOST OF THE TIME) [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D1_26D<
(Will/Did) the people who resided at (address) as of (Screening date) live there for most of the time during
the months of (3-month quarter field period)?
<1>
<2>

YES (R STATES THESE RESIDENTS (WILL/DID) LIVE THERE FOR MOST OF THE TIME
DURING THE FIELD PERIOD.) [D1_ 26E]
NO [D2]
DON’T KNOW [D1_26F]

>D1_26E<
Let me verify, (will/did) the people who resided at (address) as of (Screening date) live there for at least
half of the time during the three month period of (3-month quarter field period)?
<1>
<2>

YES (SOMEONE IN HH WILL/DID LIVE THERE FOR MOST OF THE TIME) [D2]
NO (SOMEONE IN HH WILL/DID NOT LIVE THERE FOR MOST OF THE TIME) [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D1_26F<
To the best of your knowledge, (will/did) the people who resided at (address) as of (Screening date) live
there for at least half of the time during the three month period of (3-month quarter field period)?
<1>
<2>

YES (SOMEONE IN HH WILL/DID LIVE THERE FOR MOST OF THE TIME) [D2]
NO (SOMEONE IN HH WILL/DID NOT LIVE THERE FOR MOST OF THE TIME) [D2]
DON’T KNOW [D2]
REFUSE [D2]

>D2<
Did you personally speak with our interviewer?
(Our interviewer is (FI description).)
<1>
<2>

YES [IPRFD]
NO [DONED]

>IPRFD<
Was the interviewer polite and did the interviewer treat you professionally?
<1>
<2>

YES [Go to DONED]
NO [Go to ELB1D]

>ELB1D<
Would you please tell me more about that?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM.
IF NO COMMENTS, ENTER “NONE”. [DONED]
>DONED<
Those are all of the questions I have. Thank you very much for your time.
Have a good (evening/day).
ENTER <1> TO CONTINUE

This page intentionally left blank.

Verification Script for Code 22
General Information:
All skips or routing instructions to be programmed are noted next to response in brackets [ ]
Gender = male/female
All fills are designated by italics text in parentheses (address)
(FI Pronoun): he/she based on FI’s gender
(FI Description): age, gender, height, race
Program fill for past or future tense as follows:
Use the first portion of the fill (will live/lived)
If Qtr 1 and call is before Feb 15, else use second portion
If Qtr 2 and call is before May 15, else use second portion
If Qtr 3 and call is before August 15, else use second portion
If Qtr 4 and call is before November 15, else use second portion
Use the first portion of the fill (will/did)
If Qtr 1 and call is before Feb 15, else use second portion
If Qtr 2 and call is before May 15, else use second portion
If Qtr 3 and call is before August 15, else use second portion
If Qtr 4 and call is before November 15, else use second portion
Program fill for (3-month quarter field period)
Qtr 1= January, February, March
Qtr 2= April, May, June
Qtr 3= July, August, September
Qtr 4 = October, November, December
Screening Date fill: Date of final Screening Code
Fills: (first name/a resident of this household) If first name available from data, use this in fill – otherwise, use “a
resident of this household”.
Fill (were/was) - Question >C1C< uses this fill. It can either be programmed to use “were” if there are multiple
HH members and “was” if there is one HH member OR we can just offer (were/was) in the script and the TI can
select the proper fill.
(Roster Data): Age, gender, race for each HH member
(Screening Date) fill: Date of final Screening Code

Screening Information Provided for Codes 22:
CaseID
Phone number (designates home or work phone)
Address
Notes to Verification Caller [Additional data from Samsung Galaxy Tablet]
First Name
Screening Date (date of final Screening code)
Roster Data

Screening Script:
>INTROC<
May I speak to (first name)?
<1>
<2>
<3>
<4>
<5>
<6>
<7>

SPEAKING TO TARGET RESPONDENT [C1INTRO]
RESPONDENT AVAILABLE (NOT SPEAKING TO TARGET) [if cell number, go to
Cell_Res1, else C1INTRO]
RESPONDENT UNAVAILABLE [NORES1AC]
RESPONDENT UNKNOWN [NORES1AC]
RESPONDENT KNOWN, BUT WILL NEVER BE AVAILABLE [NORES1AC]
OTHER [INTROSPD]
RESPONDENT KNOWN, BUT DOES NOT SPEAK ENGLISH OR SPANISH [NORES1AC]

>INTROSPC<
ENTER RESPONDENT’S ANSWER VERBATIM. [NORES1AC]
>NORES1AC<
OK, perhaps you can help me. (My name is ____________. I am calling from RTI International regarding
a study sponsored by the U.S. Department of Health and Human Services.)
Our records indicate that someone at this number was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored. Are you or anyone else at
this number familiar with (address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>
<3>

YES, RESPONDENT IS [C1A]
YES, SOMEONE ELSE IS [SPEAKC]
NO [NORES2C]
DON’T KNOW [NORES2C]

>NORES2C<
I was given this telephone number to verify that our interviewer made contact with someone that either
lives at or is knowledgeable about (address). Is there anyone at this number who might be familiar with
(address)?
<1>
<2>
<3>

YES, RESPONDENT IS [C1A]
YES, SOMEONE ELSE IS [SPEAKC]
NO [NORES2C1]
DON’T KNOW [NORES2C1]

>NORES2C1<
Is there anyone at this number who might be familiar with our interviewer who is (FI Description) and
would have asked questions such as how many people live in this household, their ages and race?
<1>

YES, RESPONDENT IS [C1A]

<2>
<3>

YES, SOMEONE ELSE IS [SPEAKC]
NO [DONEC]
DON’T KNOW [DONEC]

>SPEAKC<
May I speak with this person?
<1>
<2>

YES [if cell number, go to Cell_Res1, else C1INTRO]
NO (THIS RESPONSE WILL TAKE YOU TO THE CALLBACK SCREEN) [CALLBACK]

>Cell_Res1<
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [C1INTRO]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>C1INTRO<
(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that someone at this number was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored. Are you familiar with
(address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>

YES [C1A]
NO [NORES3C]
DON’T KNOW [NORES3C]

>NORES3C<
I was given this telephone number to verify that our interviewer made contact with someone that either
lives at or is knowledgeable about (address). Is there anyone at this number who might be familiar with
(address)?
<1>
<2>
<3>

YES, RESPONDENT IS [C1A]
YES, SOMEONE ELSE IS [SPEAKC2]
NO [NORES3C1]
DON’T KNOW [NORES3C1]

REFUSE [NORES3C1]

>NORES3C1<
Is there anyone at this number who might be familiar with our interviewer who is (FI Description) and
would have asked questions such as how many people live in this household, their ages and race?
<1>
<2>
<3>

YES, RESPONDENT IS [C1A]
YES, SOMEONE ELSE IS [SPEAKC2]
NO [DONEC]
DON’T KNOW [DONEC]
REFUSE [DONEC]

>SPEAKC2<
May I speak with this person?
<1>
<2>

YES [if cell number, go to Cell_Res2, else C1INTRO2]
NO (THIS RESPONSE WILL TAKE YOU TO THE CALLBACK SCREEN) [CALLBACK]

>Cell_Res2<
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [C1INTRO2]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>C1INTRO2<
(Hello, my name is _____________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that someone at this number was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
Are you familiar with (address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>

YES [C1A]
NO [NORES3C2]
DON’T KNOW [NORES3C2]
REFUSE [NORES3C2]

>NORES3C2<
I was given this telephone number to verify that our interviewer made contact with someone that either
lives at or is knowledgeable about (address). Are you familiar with (address)?
<1>
<2>

YES [C1A]
NO [NORES3C3]
DON’T KNOW [NORES3C3]
REFUSE [NORES3C3]

>NORES3C3<
Are you familiar with our interviewer who is (FI Description) and would have asked questions such as how
many people live in this household, their ages and race?
<1>
<2>

YES [C1A]
NO [DONEC]
DON’T KNOW [DONEC]
REFUSE [DONEC]

>C1A<
Thinking of (address), were all occupants between the ages of 17- 65 on active military duty during recent
weeks?
<1>
<2>

YES [C1D]
NO [C1B]
DON’T KNOW [C1C]
REFUSED
[C1C]

>C1B<
Let me verify, were all household members between the ages if 17-65 who were living at (address) on or
around (Screening Date) on active military duty?
<1>
<2>

YES
[C1D]
NO
[C1D]
DON’T KNOW [C1C]
REFUSED
[C1C]

>C1C<
To the best of your knowledge, (were/was)
(Roster Data)
on active military duty on or around (Screening Date)?
<1>
<2>

YES
[C1D]
NO
[C1D]
DON’T KNOW [C1D]
REFUSED
[CID]

>C1D<
Were there any occupants age 13 - 16, living at (address) during recent weeks?

<1>
<2>

YES [C1E]
NO [C2A1]
DON’T KNOW [C2A1]
REFUSE
[C2A1]

>C1E<
Thinking of the occupants age 13 - 16, (will/did) they live at (address) for most of the time during the
months of (3 month quarter field period)?
<1>
<2>

YES [C2A1]
NO [C2A1]
DON’T KNOW [C2A1]
REFUSE [C2A1]

>C2A1<

Did the interviewer talk with you face-to-face at your home?
<1>
<2>

YES [IPRFC]
NO [C2A2]

>C2A2<
How did you speak with the interviewer?
<1>
<2>
<3>
<4>
<5>
<6>

VISIT AT HOME [IPRFC]
FRONT DESK TELEPHONE/INTERCOM [IPRFC]
TELEPHONE [C2B]
BOTH VISIT AT HOME AND TELEPHONE CONTACT [C2B]
RESPONDENT WAS NOT CONTACTED BY INTERVIEWER [C2C]
SOME OTHER WAY [C2A2ELB]

>C2A2ELB<
Please tell me how you were contacted.
ENTER COMMENTS UP TO 150 CHARACTERS.
IF DURING THE COURSE OF ELABORATION, IT BECOMES APPARENT THAT THE CONTACT
WAS IN PERSON OR OVER THE PHONE, BACK UP AND RE-CODE C2A2. [IPRFC]

>C2B<
When the interviewer called you by telephone, did (FI pronoun) make an appointment to see you or did (FI
Pronoun) complete our survey by telephone asking questions such as how many people live in this
household and what are their ages and race?
<1>
<2>

MADE APPOINTMENT ONLY [IPRFC]
COMPLETED SURVEY QUESTIONS [IPRFC]
DON’T KNOW [IPRFC]
REFUSE [IPRFC]

>C2C<
Our interviewer is (FI Description), and would have been wearing a white badge with a picture I.D. (FI
Pronoun) would have asked questions like how many people live in this household, what are their ages and
race. Do you remember this person?
<1>
<2>
=

YES [IPRFC]
NO [DONEC]

>IPRFC<
Was the interviewer polite and did the interviewer treat you professionally?
<1>
<2>

YES [Go to DONEC]
NO [Go to ELB1C]

>ELB1C<
Would you please tell me more about that?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM.
IF NO COMMENTS, ENTER “NONE”. [DONEC]
>DONEC<
Those are all of the questions I have. Thank you very much for your time.
Have a good (evening/day).
ENTER <1> TO CONTINUE

Verification Script for Code 30
General Information:
All skips or routing instructions to be programmed are noted next to response in brackets [ ]
Gender = Male/Female
All fills are designated by italics text in parentheses (address)
(FI Pronoun): he/she based on FI’s gender
(FI Description): age, gender, height, race
Program fill for past or future tense as follows:
Use the first portion of the fill (will live/lived)
If Qtr 1 and call is before Feb 15, else use second portion
If Qtr 2 and call is before May 15, else use second portion
If Qtr 3 and call is before August 15, else use second portion
If Qtr 4 and call is before November 15, else use second portion
Program fill for (3-month quarter field period)
Qtr 1= January, February, March
Qtr 2= April, May, June
Qtr 3= July, August, September
Qtr 4 = October, November, December
Program fill for (HH Count Noun)
If number rostered is 1 = person
If number rostered is >1 = people
Program fill for (HH Count Noun 2)
If number rostered is 1 = whether this person is male or female
If number rostered is >1 = how many of these people are male and how many are female
Program fill for (this/these):
If number rostered is 1 = person
If number rostered is >1 = people
Screening Date fill: Date of final Screening Code
(Roster Data): age, gender, race of each HH member
(city, state and zip code): city, state and zip code for address
(number rostered): total number of people in roster
Fills: (first name/a resident of this household) If first name available from data, use this in fill – otherwise, use “a
resident of this household”.
The responses from the following variable items will need to be available for a frequency or data dump by request:
B3B1 (verbatim elaboration on street number or name discrepancy)
B4B1 (verbatim elaboration on city, state, zip code discrepancy)
DESROSB (verbatim elaboration on roster discrepancy)

DESROSC (verbatim elaboration on roster discrepancy)

Screening Information Provided for Code 30:
CaseID
Phone number (designates home or work phone)
Address
Notes to Verification Caller [Additional data from Samsung Galaxy Tablet]
First Name
Screening Date (date of final Screening code)
Roster data

Screening Script:
>INTROB<
May I speak to (first name)?
<1>
<2>
<3>
<4>
<5>
<6>
<7>

SPEAKING TO TARGET RESPONDENT [B1INTRO]
RESPONDENT AVAILABLE (NOT SPEAKING TO TARGET] [if cell number, go to
Cell_Res1, else B1INTRO]
RESPONDENT UNAVAILABLE [CALLBACK]
RESPONDENT UNKNOWN [UNAVAILB]
RESPONDENT KNOWN, BUT WILL NEVER BE AVAILABLE [UNAVAILB]
RESPONDENT KNOWN, BUT DOES NOT SPEAK ENGLISH OR SPANISH [UNAVAILB]
RESPONDENT KNOWN, BUT UNAVIALALBE MUTLIPLE TIMES [UNAVAILB]

>UNAVAILB<
OK, perhaps you can help me. (My name is ____________. I am calling from RTI International regarding
a study sponsored by the U.S. Department of Health and Human Services.)
Our records indicate that (first name) was contacted concerning (address).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
Is this the correct phone number for (address)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>

YES [B1PROXY]
NO [DONEB]

>B1PROXY<
Did you speak to our interviewer?
<1>
<2>

YES [B1A]
NO [B1C]

>Cell_Res1<
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [B1INTRO]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>B1INTRO<
(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that you were contacted by one of our interviewers on (screening date).
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
ENTER (1) TO CONTINUE... [B1A]
>B1A<
Did the interviewer talk with you face-to-face at your home?
<1> YES [B2]
<2> NO [B1A2]
>B1A2<
How did you speak with the interviewer?
<1>
<2>
<3>
<4>
<5>
<6>

VISIT AT HOME [B2A]
FRONT DESK TELEPHONE/INTERCOM [B2A]
TELEPHONE [B1B]
BOTH VISIT AT HOME AND TELEPHONE CONTACT [B1B]
RESPONDENT WAS NOT CONTACTED BY INTERVIEWER [B1C]
SOME OTHER WAY [B1AELB1]

>B1AELB1<
Please tell me how you were contacted.
ENTER COMMENTS UP TO 150 CHARACTERS.

IF DURING THE COURSE OF ELABORATION, IT BECOMES APPARENT THAT THE CONTACT
WAS IN PERSON OR OVER THE PHONE, BACK UP AND RE-CODE B1A2. [B2A]
>B1B<
When the interviewer called you by telephone, did (FI Pronoun) make an appointment to see you or did (FI
Pronoun) complete our survey by telephone asking questions such as how many people live in this
household and what are their ages and race?
<1>
<2>

MADE APPOINTMENT ONLY [B2A]
COMPLETED SCREENING QUESTIONS [B2A]
DON’T KNOW [B1C]
REFUSE [B2A]

>B1C<
Our interviewer is (FI Description), and would have been wearing a white badge with a picture I.D. (FI
Pronoun) would have asked questions like how many people live in this household, what are their ages and
race. Do you remember this person?
<1>
<2>

YES [B1A3]
NO [B1D]

>B1A3<
Did the interviewer talk with you face-to-face at your home?
<1>
<2>

YES [B2A]
NO [B1A4]

>B1A4<
How did you speak with the interviewer?
<1>
<2>
<3>
<4>
<5>
<6>

VISIT AT HOME [B2A]
FRONT DESK TELEPHONE/INTERCOM [B2A]
TELEPHONE [B1B2]
BOTH VISIT AT HOME AND TELEPHONE CONTACT [B1B2]
RESPONDENT WAS NOT CONTACTED BY INTERVIEWER [B1D]
SOME OTHER WAY [B1AELB2]

>B1AELB2<
Please tell me how you were contacted. ENTER COMMENTS UP TO 150 CHARACTERS. IF DURING
THE COURSE OF ELABORATION, IT BECOMES APPARENT THAT THE CONTACT WAS IN
PERSON OR OVER THE PHONE, BACK UP AND RE-CODE B1A4. [B2A]
>B1B2<
When the interviewer called you by telephone, did (FI Pronoun) make an appointment to see you or did (FI
Pronoun) complete our survey by telephone asking questions such as how many people live in this
household and what are their ages and race?
<1>
<2>

MADE APPOINTMENT ONLY [B2A]
COMPLETED SCREENING QUESTIONS [B2A]
DON’T KNOW [B2A]

REFUSE [B2A]

>B1D<
According to our interviewer, including yourself, the following (HH Count Noun) age 13 or older (will
live/lived) at (address) for most of the time during the months of (3 month quarter field period):(Roster
Data)Is this information correct? TI NOTE: ROSTER AGES DO NOT NEED TO BE EXACT. A
DIFFERENCE IN AGE OF BETWEEN 1 & 2 YEARS IS ACCEPTABLE AS CORRECT. CHILDREN
AGE 12 OR YOUNGER SHOULD NOT BE INCLUDED ON ROSTER.
<1>
<2>
<3>
<4>

CORRECT ADDRESS, CORRECT INFORMATION [DONEB]
CORRECT ADDRESS, WRONG INFORMATION [DONEB]
WRONG ADDRESS, CORRECT INFORMATION [DONEB]
WRONG ADDRESS, WRONG INFORMATION [DONEB]
DON’T KNOW [DONEB]
REFUSE [DONEB]

>B2A<
According to our interviewer, including yourself, (number rostered) (HH Count Noun) age 13 or older
(will live/lived) in your household for most of the time during the months of (3-month quarter field period).
Is this correct?
<1>
<2>

YES [GENDR2]
NO [DESROSB]
DON’T KNOW [B2B]
REFUSE [B2B]

>GENDR2<
Thinking about (this/these) (number rostered) (HH Count Noun), including yourself, could you please tell
me (HH Count Noun 2)?
TI NOTE: DO NOT READ ROSTER DATA TO RESPONDENT. IF THE NUMBER OF MALES AND
FEMALES IS CORRECT, SELECT CORRECT. IF THEY DO NOT MATCH SELECT INCORRECT
AND RECORD THE RESPONDENT’S ANSWER IN THE FOLLOWING QUESTION.
(Roster data)
<1>
CORRECT [B2B]
<2>
INCORRECT [DESROSB]
DON’T KNOW [B2B]
REFUSE [B2B]
>DESROSB<

{B2=2 or GENDR2=2}

According to our interviewer, the following (HH Count Noun) age 13 or older (will live/lived) in your
household for most of the time during the months of (3-month quarter field period)?
(Roster data)
Would you please describe what is incorrect about the information?
TI NOTE: ROSTER AGES DO NOT NEED TO BE EXACT. AN AGE DISCREPANCY OF
BETWEEN 1 & 2 YEARS IS ACCEPTABLE AS CORRECT. CHILDREN AGE 12 OR YOUNGER
SHOULD NOT BE INCLUDED ON THE ROSTER

ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.IF IT BECOMES CLEAR THE
RESPONDENT WAS CONFUSED BY THE PREVIOUS QUESTION, GO BACK TO THE QUESTION
AND REREAD/PROBE FOR CLARITY.
ENTER RESPONDENT’S ANSWER VERBATIM [B3]
>B2B<

{B2A=F3, F4 or GENDR2=1, F3, F4}
According to our interviewer, the following (HH Count Noun) age 13 or older (will live/lived) in your
household for most of the time during the months of (3-month quarter field period)?
(Roster data)
Is this information correct?
TI NOTE: ROSTER AGES DO NOT NEED TO BE EXACT. AN AGE DISCREPANCY OF
BETWEEN 1 & 2 YEARS IS ACCEPTABLE AS CORRECT. CHILDREN AGE 12 OR YOUNGER
SHOULD NOT BE INCLUDED ON THE ROSTER
<1>
<2>

YES [B3]
NO [DESROSC]
DON’T KNOW [B3]
REFUSE [B3]

>DESROSC<

{B2B=2}

Would you please describe what is incorrect about the information?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM [B3]
>B3<

{DESROSB, B2B=1, F3, F4, DESROSC}
It is important that the interviewer visited the correct address. Can you please provide the street number
and street name for the address where you lived when the interviewer contacted you? Please include the
apartment or unit number as well.
TI NOTE: DO NOT READ ADDRESS TO RESPONDENT. IF THE STREET NUMBER AND NAME
MATCH THIS INFORMATION, SELECT CORRECT. IF THEY DO NOT MATCH SELECT
INCORRECT.
(address)
TI NOTE: IF RESPONDENT PROVIDES THE CORRECT STREET NUMBER AND NAME BUT NOT
THE UNIT NUMBER OR STREET IDENTIFIER, YOU SHOULD PROVIDE THE MISSING
INFORMATION TO THE RESPONDENT TO CONFIRM IT IS ACCURATE.
<1>
<2>

>B3B1<

CORRECT [B4]
INCORRECT [B3B1]
DON’T KNOW [IPRFB]
REFUSE [IPRFB]
{B3=2}

(Can you please repeat that?)

ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ADDRESS VERBATIM. IF RESPONDENT REFUSES, [A1B1]
>B4<

{B3=1; B3B1}
Is this address located in (city, state, and zip code)?
TI NOTE: IF THE CITY, STATE, AND ZIP CODE MATCH THIS INFORMATION, SELECT
CORRECT. IF THEY DO NOT MATCH SELECT INCORRECT.
<1>
<2>

>B4B1<

YES [IPRFB]
NO [B4B1]
DON’T KNOW [IPRFB]
REFUSE [IPRFB]
{B4=2}

Would you please provide the correct city, state and zip code?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ADDRESS VERBATIM. [IPRFB]
>IPRFB<
Was the interviewer polite and did the interviewer treat you professionally?
<1>
<2>

YES [DONEB]
NO [ELB1B]

>ELB1B<
Would you please tell me more about that?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM.
IF NO COMMENTS, ENTER NONE [DONEB]
>DONEB<
Those are all of the questions I have. Thank you very much for your time. Have a good (evening/day).
ENTER (1) TO CONTINUE.

Answering Machine Script for Codes 10, 13, 18, 22, 26, and 30
General Information:
Messages will be left after the first, sixth, and fourteenth call attempts.

Answering Machine Script:
>NOANSWER<
Hello, I am calling from RTI International regarding a study sponsored by the US Department of Health
and Human Services. Our records indicate that someone at this number was contacted by one of our field
interviewers and I am calling to verify the quality of our interviewer’s performance. This call will take just
a few minutes of your time. A RTI International representative will try to reach you over the next few days
to ask a few brief questions. Thank you in advance for your participation.

This page intentionally left blank.

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