Att B-6. Proxy Survey Protocol

Attachment B-6: Proxy Survey Protocol

Test Predictability of Falls Screening Tools

• Original respondent gets survey Day 1 of Month 1 (reporting on Month 0) and can complete from Day 1 to Day 30/31.

  • If no response after 2 weeks (Day 15), the proxy is contacted. Proxy has from Day 15 of Month 1 to Day 14 of Month 2 to complete survey (referencing Month 0).

• Day 1 of Month 2, original respondent contacted again, this time to report on Month 1.

  • If they don’t respond, proxy is contacted on Day 15 to report on Month 1.

• Note: If during proxy period, the original respondent participates (days 15 – 30/31), then drop any responses from or prompts to proxy.  

• If proxy completes 4 surveys in a row, drop original respondent from next rounds, however, include original respondent in final survey.

  • Proxy instrument includes question to ask proxy to report on falls for any prior month that has not been collected.