Form 0920-0953 Opening Script and Eligibility Screening Form

Attachment A – Opening Script and Eligibility Screening Form

Opening script and eligibility screening form

Form Approved

OMB No. 0920-0953

Exp. Date 08/31/2021

Hello, my name is ____________. On behalf of the National Institute for Occupational Safety and Health (NIOSH), I appreciate the opportunity to talk to you about a research project we are conducting with commercial fishermen and workers in industries related to commercial fishing. This study consists of one-on-one interviews that will be audio recorded and transcribed for later analysis.

If you participate, interviewers will ask several basic questions such as your age and other demographics. They will also ask open-ended questions about commercial fishing experience, deck safety, fishing equipment used, and perceptions about risk and risk avoidance while fishing. This study will not use a set list of interview questions. Interviewers will have some basic questions to structure the discussion, but they will let the discussion take its natural course depending on what you want to talk about and what topics come up during discussion. None of the questions will be of a sensitive personal nature. Additionally, your responses will remain anonymous. Researchers will never publish any study results that could personally identify you.

Participation in this study is completely voluntary. If you decide to participate, you are free to stop at any time. You are also free to answer or not answer any questions the interviewers ask. You are volunteering your time for this interview, you will not be compensated by NIOSH for your participation. The interview will be audio recorded for accuracy, by participating you consent to being recorded. Audio recordings will be transcribed and then the audio files will be erased.

Time commitment

Overall, the interview should take between 30 minutes and 1 hour to complete.

Would you like to answer a few questions to see if you qualify to participate?

Eligibility

Pacific Northwest fishermen

1. Are you at least 18 years of age?

 Yes (if yes — ask Q2)

 No (if no — ineligible)

2. Do you currently own a commercial fishing vessel?

 Yes (if yes — skip to Q5)

 No (if no — ask Q3)

3. Are you the captain of a commercial fishing vessel?

 Yes (if yes — ask Q4)

 No (if no to both Q2 and Q3 — ineligible)

Public reporting burden of this collection of information is estimated to average 5 minutes 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. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0953).

4. (If captain but not owner): Are you authorized to select and install deck equipment on the vessel?

 Yes (if yes — ask Q5)

 No (if no — ineligible)

5. Does the vessel in question use a hydraulic capstan winch?

 Yes (if yes — eligible)

 No (if no — ineligible)

Eligibility

Shrimp fishermen

1. Are you at least 18 years of age?

 Yes (if yes — ask Q2)

 No (if no — ineligible)

2. Do you currently own a commercial fishing vessel?

 Yes (if yes — skip to Q5)

 No (if no — ask Q3)

3. Are you the captain of a commercial fishing vessel?

 Yes (if yes — ask Q4)

 No (if no to both Q2 and Q3 — ineligible)

4. (If captain but not owner): Are you authorized to select and install deck equipment on the vessel?

 Yes (if yes — ask Q5)

 No (if no — ineligible)

5. Does the vessel use an electric try-net winch?

 Yes (if yes — eligible)

 No (if no — ask Q6)

6. Does the vessel use any of these three mechanical drum winch models?

• 503 McElroy/Catchot

• 505 McElroy/Catchot

• 515 ½ Stroudsburg

 Yes (if yes — eligible)

 No (if no to Q5 and Q6 — ineligible)

Eligibility

Manufacturers/Fabricators/Vendors

1. Are you at least 18 years of age?

 Yes (if yes — ask Q2)

 No (if no — ineligible)

2. Are you an employee or manager at a company that manufactures, fabricates, or sells fishing vessel deck equipment?

 Yes (if yes — eligible)

 No (if no — ineligible)