Current, Former, and Recently Denied WIC Participants (Individuals/Households)

OMB Number: 0584-XXXX

Expiration Date: XX/XX/XXXX

APPENDIX C15.a

DENIED WIC APPLICANT SURVEY RECRUITMENT TELEPHONE SCRIPT - ENGLISH

Instructions to reviewers: Trained recruiters will use this script to recruit denied WIC applicants to participate in the in-person Denied Applicant Survey (called an “interview” in the script). The recruiter will have the name of applicant and the date that the application was submitted (called APP_DATE). For infant or child participants, note that the recruiter will have both the name of the applicant – that is, the parent, guardian or proxy—and the name of the infant or child for whom the adult applied for WIC.

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

• If the sampled WIC applicant was a pregnant, breastfeeding, or postpartum woman: RESPONDENT = the sampled WIC

• If the sampled WIC applicant was an infant or child: RESPONDENT = the applicant (i.e., parent, guardian, or other person who applied for WIC on infant/child’s behalf)

Screening

SC1. Hello, my name is [INTERVIEWER] and I work with Capital Consulting Corporation, a company that conducts research in health and human services. I’m calling about a study we’re conducting with families in your area for the United States Department of Agriculture Food and Nutrition Service. The study is about a program designed to improve families’ access to healthy food and nutrition. May I please speak to [RESPONDENT]?

1 SPEAKING TO RESPONDENT

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

3 RESPONDENT UNAVAILABLE………………….. [GO TO SC5]

4 NO SUCH PERSON ………………... [GO TO SC4a]

5 NOT SPEAKING TO RESPONDENT, BUT QUESTION ABOUT PURPOSE OF CALL …………………………………………………… [GO TO SC1a]

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

8 (VOL) DON’T KNOW [THANK AND END. DISPO AS SOFT REFUSAL]

9 (VOL) REFUSED [THANK AND END. DISPO AS HARD REFUSAL ]

SC1a. For privacy reasons, we are not allowed to discuss this with anyone other than [RESPONDENT].”

[IF SAMPLE FLAGGED AS CELL PHONE]

SC2. Are you in a safe place to talk right now?

[IF DRIVING VOLUNTEERED, CODE AS 2]

1 YES, SAFE PLACE TO TALK

2 NO, CALL ME LATER …………………. [SCHEDULE CALLBACK]

3 NO, CB ON LANDLINE………………………….. [RECORD NUMBER, SCHEDULE CALLBACK]

4 (VOL) ON LANDLINE ………………..... [SKIP TO SC4]

8 (VOL) DON’T KNOW

9 (VOL) REFUSED

[IF SAMPLE FLAGGED AS CELL PHONE]

SC3. Are you driving?

1 YES, CALL ME LATER ……………… [SCHEDULE CALLBACK]

2 NO [SKIP TO SC6]

8 (VOL) DON’T KNOW

9 (VOL) REFUSED

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 8 minutes (0.13 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.

SC4a. It is important that I speak directly to [RESPONDENT]. Do you know how I can reach her?

1 YES [RECORD NEW PHONE AND SCHEDULE CALLBACK]

2 NO [S/O WRONG NUMBER]

8 DON’T KNOW [S/O WRONG NUMBER]

9 REFUSED [S/O WRONG NUMBER]

SC5. It is important that I speak directly to [RESPONDENT]. Do you know when she will be home?

1 YES [SCHEDULE CALLBACK]

2 NO [GO TO T1. DISPO AS CALLBACK]

8 DON’T KNOW [GO TO T1. DISPO AS CALLBACK]

9 REFUSED [GO TO T1. DISPO AS CALLBACK]

SC6. [READ TO ALL:] Are you at least 18 years old?

1. YES ……………………………………………..……...[GO TO A1]

2. NO …...[GO TO SC7]

8 DON’T KNOW …...[GO TO SC7]

9 REFUSED……………………………………………...….[GO TO SC7]

SC7. [IF < 18 YEARS]: Thank you, we’re looking for people who are at least 18 years old to participate in a survey. I appreciate your time, but you’re not eligible. Thank you for taking the time to speak with me. Goodbye.

T1. Thank you for your time. I will try calling back at another time. [DISPO AS CALLBACK]

Introduction to Purpose of Call

A1. Thank you. The Food and Nutrition Service at the USDA has asked Capital Consulting to conduct a research study about the Special Supplemental Nutrition Assistance Program for Women, Infants and Children or WIC food program.

You have been selected for this study because you [or your child] recently applied for WIC and apparently you did not qualify at that time. We are conducting a study with families who were turned down for WIC to see if the agency is following the proper procedures. The purpose of the study is to help FNS learn how they might improve the WIC program and the WIC application process.

Let me reassure you that:

• Participation is voluntary.

• The research team will protect your privacy. We won’t tell your local WIC agency who participates or not in the study. We will combine the answers you provide with answers from other households across the country and study reports will not include names, address, or other personal information about you or your family.

• Taking part in the study will not change the decision the WIC agency made about your application. However, if the answers you provide suggest that the local agency may have made a mistake, or if your circumstances have changed, you are always free to re-apply for WIC benefits at your local agency.

For this study, I would like to schedule an in-person interview to ask you about the procedures WIC used during the application process. The interview will take approximately 40 minutes, and would take place in your home at a time that is most convenient for you.

A1a. First, I’d like to confirm a couple of things. Are you currently receiving WIC?

1. YES [GO TO INELIGIBLE]

2. NO [GO TO A1b]

A1b. Next, I’d like to confirm that you applied for WIC, either for yourself or an infant or child, and you were told that you did not qualify. Is that correct?

1. YES [GO TO A2]

2. NO [GO TO WRAP UP 3]

A2. I’d like to schedule a time to come do the interview with you. But first, do you have any questions about the study?

1. YES [ANSWER QUESTIONS]

2. NO [GO TO A3]

A3. Great! Let’s find a convenient time to schedule the interview. For convenience, we are scheduling most of the interviews at people’s homes. Is it all right for me to interview you at your home?

1. YES ………………………………………………[GO TO A4]

2. NO ………………………………………………[ASK FOR THEM TO PROVIDE ALTERNATE LOCATION]

3. THEY ASK WHY…………………………………. [EXPLAIN: To reduce the burden on your time, we come to you. Most people find it easier.]

1. REFUSAL THANK-DISPO AS HARD REFUSAL WRAP-UP 2]

A4. Ideally, I’d like to find a time this week or next when you’ll be able to talk freely. I have weekday or weekend appointments in the morning, afternoon, or evening. Would you prefer a weekday or weekend time and are mornings, afternoons, or evenings best for your schedule?

1. NO GOOD TIMES THIS WEEK OR NEXT WEEK………………………………………………[GO TO A5a]

2. RESPONDENT PROVIDES PREFERENCES ………………………………………………….[MARK POSSIBLE DAYS/TIMES BELOW. USE TIMES BEST FOR PARTICIPANT/APPLICANT TO PROPOSE APPOINTMENT DATE AND TIME AND GO TO A5]

	Weekday					Weekend
	M	T	W	Th	Fr	Sat	Sun
Mornings (7am to 12pm)
Afternoon 12 to 4pm
Evenings (4 to 8pm)

A5. How does [DATE/TIME] work for you?

1. WORKS WELL [GO TO A6]

2. NOT GOOD TIME [REPEAT]

A5a. How would a later date work? We can schedule the interview in the next 3-4 weeks instead if that would be easier for you.

1. YES…………………………………………………….[GO TO A5]

2. NO INTEREST IN INTERVIEW……………………..[THANK-DISPO AS HARD REFUSAL WRAP-UP 2]

3. DON’T KNOW YET .[SUGGEST CALL BACK]

A6. Can I confirm your home address for the in-person interview?

[FILL ADDRESS FROM SAMPLE FILE]

1. CONFIRMED…………………………………….... [ASK ABOUT: parking restrictions in the area, any reason it may difficult to find your address…GO TO A7]

2. NO…………………………………………………..[ASK ABOUT: correct address for interview, parking restrictions in the area, any reason it may difficult to find your address…GO TO A7]

A7. Great! In one part of the interview, you will be asked to show certain documents. It’s very important that you gather these documents before the interview. You may have shown similar documents when you applied for WIC. The interviewer will ask to see:

• Some form of identification [IF INFANT/CHILD: for you and your child] such as a current driver’s license, birth certificate, [IF INFANT/CHILD: or hospital crib card or wrist band];

• Something showing your address from [MONTH OF APP_DATE] when you applied for WIC, such as a utility bill, rent receipt, or piece of mail that you recently received;

• Documents showing income you and other members of your family were receiving in the [MONTH OF APP_DATE] when you applied for WIC. This includes

  • Paystubs for you or other family members

  • If someone in your family is in the military, a “Leave and Earnings Statement” from [MONTH OF APP_DATE]

  • If you receive alimony or child support, divorce or court papers showing the award amount;

  • If someone in your family receives Social Security, disability benefits or SSI [Supplemental Security Income], a check stub or an award letter showing the amount;

  • If anyone was receiving unemployment in [MONTH OF APP_DATE], a check stub or award letter.

  • If anyone in your family owns a business or is self-employed, we would like to see an income tax return or W-2 form.

• In case you don’t have one of these documents, please have copies of bank statements from [MONTH OF APP_DATE] for anyone in your family with a checking or savings account.

Finally, if anyone in your family was receiving SNAP (food stamps), [STATE NAME OF MEDICAID PROGRAM(S)], or TANF (welfare) in [MONTH OF APP_DATE] when you applied for WIC, we would like to see a “Notice of Eligibility” or letter “About Your Benefits” showing the dates when they were eligible. [IF RESPONDENT MENTIONS A PROGRAM CARD OR EBT CARD: Often those kinds of cards do not show your participation dates. If that is all you can find, please also try to have a recent bank statement or a recent EBT receipt.]

Let me say again that:

• Taking part in the interview will not change the decision the WIC agency made about your application. However, you are always free to re-apply for WIC benefits at your local agency.

• We will protect your privacy. None of your personal information will appear in any study report.

Do you have any questions about the interview?

1 YES [LISTEN TO: respondents questions/concerns. ADDRESS: any issues respondent brings up with FAQ]

2 NO [RECORD APPOINTMENT DATE AND TIME. GO TO A8]

A8. I’m looking forward to seeing you on [APPOINTMENT DATE]. I’d like to call or text you a day or two before the interview to remind you that I’ll be coming. Would you prefer a phone call or a text message?

1. PHONE……………………………………………..[THANK AND CONFIRM PHONE NUMBER]

2. TEXT MESSAGES………………………………...[THANK, CONFIRM PHONE NUMBER, AND TELL THEM: “Great – I’m required to tell you that standard messaging fees may apply according to your cell phone plan.”]

INELIGIBLE

Thank you, we are looking for people who do not currently receive WIC. I appreciate your time, but you’re not eligible. Thank you for taking the time to speak with me. Goodbye.

Wrap-up 1

Again, thank you so much. We really appreciate your participation in this study.

Wrap-up 2

I understand that you are not willing to participate in this study and schedule an in-home interview. Thanks so much for taking the time to speak with me today.

Wrap-up 3

I apologize, it looks like there may be a mistake in my records. Thank you for your time. Goodbye.

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.]

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