State and Local WIC Agency Directors (SLT)

APPENDIX B7.d

DENIED APPLICANT LOG REQUEST REMINDER TELEPHONE SCRIPT

Instructions to reviewers: Interviewers will use this script to collect information on denied applicants from local agency directors and/or staff if not included in the WIC administrative data files.

In the text below, ALL CAPS signifies a potential response or instructions to the FI. Unless noted otherwise, FIs do not read aloud text that appears in ALL CAPS.

Screening

Q1. Hello, my name is [interviewer name] and I’m working with Capital Consulting Corporation, a company that does research studies in health and human services. I’m calling on behalf of the U.S. Department of Agriculture Food and Nutrition Service to follow up on an email that was recently sent to [NAME]. Is this [NAME]?

1. SPEAKING TO RESPONDENT…………………… [GO TO Q3]

2. NOT SPEAKNG TO RESPONDENT……………….[GO TO Q2]

3 NOT A GOOD TIME ………………...[SCHEDULE CALLBACK]

5 NO SUCH PERSON ………………...[S/O WRONG NUMBER]

7 NO LONGER AT THIS PHONE NUMBER [UPDATE PHONE NUMBER]

8 (VOL) DON’T KNOW ……………

9 (VOL) REFUSED ………………...

Q2. Is there a direct line on which to reach him/her? Is he/she available?

1. OFFERS DIRECT PHONE NUMBER………… [UPDATE CONTACT INFORMATION]

2. YES, AVAILABLE………………………………[GO TO Q3]

3. NOT AVAILABLE………………………………[GO TO LM1]

4. (VOL) DON’T KNOW ……………

5. (VOL) REFUSED ………………...

Q3. The email was about “The Third National Survey of WIC Participants,” a study we are conducting for the Food and Nutrition Service at the USDA. We sent this email to [NAME] on [DATE] requesting that you keep a log of individuals who apply for WIC between [DATE] and [DATE] but who are found to be ineligible for any reason (for example, applicants who do not meet any participant category criteria; who not meet income eligibility guidelines; or applicants who fail to provide necessary documentation of income, identity, or residency). A log was included as an attachment to that email. Is now a good time for you to provide that information to me?

1. YES, GO AHEAD……………………………………………[GO TO Q4]

2. NO, WANTS TO SUBMIT LOG ELECTRONICALLY… [GO TO Q5]

3. NO, RESCHEDULE …………………………………………[SCHEDULE CALLBACK]

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 35 minutes (0.58 hours) 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302, ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.

Q4. Okay, great! Thank you for providing us with this information.

1. ALL INFORMATION OBTAINED [ENTER IN TABLE; GO TO Q6]

2 PARTIAL INFORMATION OBTAINED [ENTER IN TABLE; SCHEDULE FOLLOW-UP CALL]

3 NO INFORMATION OBTAINED [SCHEDULE CALLBACK]

APPLICANT FIRST NAME

APPLICANT LAST NAME

APPLICANT FIRST NAME

DOB

APP_ID

STREET ADDRESS

APT

CITY

STATE

ZIP

PHONE NUMBER

ALTERNATE PHONE NUMBER

PREFERRED LANGUAGE

TARGET PARTICIPANT LAST NAME

TARGET PARTICIPANT FIRST NAME

REASON DENIED 1

REASON DENIED 2

REASON DENIED 3

Q5. Okay, great! Please do NOT send any information about individual applicants via email. Email is not a secure method of sending personally identifiable information. Please submit the information via our secure website [URL]. You will be asked for your PIN number, which is [NUMBER].

Q6. Thank you again for your time. Your participation is important to the success of this study, so we really appreciate it! If you have any questions for us after this call, please free to contact us at [PHONE NUMBER] or by email at [EMAIL].

SPECIAL CIRCUMSTANCES

[If any adverse events come up during phone call, FIs will be trained to skip to this text immediately.]

EMERGENCY

I am sorry to catch you at a bad time. I’ll try again later. Thank you. [END PHONE CALL. INTERVIEWER: FILL OUT ADVERSE EVENT FORM.]

Telephone Script for Leaving Messages

LM1. [with a person] My name is [interviewer NAME] and I’m working with Capital Consulting Corporation, a company that does research studies in health and human services. I am calling about a survey we are conducting on behalf of the U.S. Department of Agriculture Food and Nutrition Service. The study is called, “The Third National Survey of WIC Participants.” We sent an email to [NAME] on [DATE] requesting some information on denied WIC applicants. Please have [NAME] contact us at [PHONE NUMBER] or by email at [EMAIL]. Thank you.

LM2. [on an answering device] Hello, my name is [interviewer NAME] and I’m working with Capital Consulting Corporation, a company that does research studies in health and human services. I am calling about a survey we are conducting on behalf of the U.S. Department of Agriculture Food and Nutrition Service. The study is called, “The Third National Survey of WIC Participants.” We sent an email to you on [DATE] requesting some information on denied WIC applicants. Please contact us at [PHONE NUMBER] or by email at [EMAIL]. Thank you.

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