B1 Post-test

Form Approved

OMB Control No.: 0920-0932

Expiration date: 05/31/2021

Attachment 5: Data Collection Instrument B1 Post-Test for Comparison and Program Groups

Thank you for talking with us again. We will ask you some questions like we did before*. I will read the questions and statements to you. Some of the questions may be similar and some are new. It is ok to skip any question or stop the interview at any time. It will take about 15 minutes. May we get started?

First, we will ask some questions about your understanding from the session you just finished with the clinic staff.

A. Understanding of diagnosis

1. Have you been told that you may have TB infection and are at risk of developing TB disease? Yes / No

For the next few questions, please let me know how much you agree or disagree with the statements.

2. The doctor answered all of my questions about TB. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

3. I plan to share the information that I might have TB infection with at least one other person, such as my spouse, a parent or a friend. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

The next questions are about after you have arrived to the US and what you might do regarding follow-up TB services. Please let me know how much you agree or disagree with these statements.

B. Intentions to follow up

1. I intend to call the health department to make a follow-up appointment within 30 days of my arrival. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

2. I intend to visit the health department in the US after I arrive. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

3. I am aware that there is a website that helps immigrants find the right local health department in the US. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

4. I plan to use the (health department directory ~ name to be determined) to help find the health department. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

C. Attitudes

1. How beneficial do you think it would be to see a health care provider in the US where 1 is very beneficial and 4 is harmful? 1= Very beneficial/ 2= Beneficial/ 3= Not beneficial/ 4= Harmful

2. How easy or difficult do you think it would be to see a health care provider in the US where 1 is very easy and 4 is very difficult? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

D. Self-efficacy

1. How easy or difficult do you think it would be to contact the health department in the US regarding TB care? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

Program Group Only

2. How would you rate being able to use the written information that was given to you that you got today about contacting the health department in the US regarding your TB care? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

3. How would you rate being able to use the verbal information that was given to you got today about contacting the health department in the US regarding your TB care? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

4. How would you rate being able to use the informational video you saw today about contacting the health department in the US regarding your TB care? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

Comparison Group Only

5. How would you rate being able to use the verbal information that was given to you got today about contacting the health department in the US regarding your TB care? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

Now please tell me how much you agree or disagree with these statements.

E. Control over outcome

1. I believe it is in my control whether I go to a local health department after I arrive to the US. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

2. A person can control whether or not they get TB disease. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

F. Social Norms

1. Most people who are important to me would want me to contact the health department in the US. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

2. My doctor at this clinic wants me to contact the health department in US. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

3. Other immigrants who arrive to the US with TB infection contact the health department. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

Next I have some questions about your feelings of your own TB risk.

G. Susceptibility to TB

How likely is it that you …

1. How likely is it that you have TB infection right now? 1= Very likely/ 2= Likely/ 3= Unlikely/ 4= Not at all likely

2. How likely is it that you will ever develop TB disease? 1= Very likely/ 2= Likely/ 3= Unlikely/ 4= Not at all likely

In the next section, I am going to ask you some questions about TB in general.

H. General TB knowledge

1. Share with me what you know about TB? You may know TB as (insert colloquial term for TB in Mexico).

Only read the following if absolutely nothing is known: Tuberculosis (also called TB) is caused by germs that usually attack the lungs. Not everyone infected with TB germs becomes sick. As a result, there are two TB conditions, TB infection and TB disease. Try and answer as best as you can on the following questions.

_____Read script to participant (check if applicable)

2. How likely is it that a person with TB infection will develop TB disease if they do not get treatment for their TB infection? 1= Very likely/ 2= Likely/ 3= Unlikely/ 4= Not at all likely

3. Please let me know how much you agree with this statement: Someone can have TB infection in their body, but not have symptoms or feel sick. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

4. TB infection can become TB disease if it is not treated. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

5. When TB infection becomes active, it can make someone sick. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

I. Severity of TB

1. Having TB infection could have negative effects on a person’s health. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

2. Having TB disease could have negative effects on a person’s health. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

3. Developing TB disease could keep someone from doing their regular activities. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

4. Developing TB disease could keep someone from working. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

5. Developing TB disease could keep someone from taking care of their family. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

6. Someone who developed TB disease could spread it to their family, friends and co-workers. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

J. Benefit of TB follow-up care

1. Through treatment, TB infection can be prevented from developing into TB disease. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

2. Taking medication for TB infection can keep someone healthy. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

3. If a person who moves to the US has TB infection, going the doctor at the health department in the US would keep them healthy. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

4. If a person who recently moved to the US has TB infection, going the doctor at the health department in the US could keep their family and friends healthy. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

We are almost done with the interview. Before we finish, we will talk about your expectations about what it could be like to get TB health services in the United States after a person has immigrated there. Remember, there are no right or wrong answers.

K. Barriers to TB follow-up care

1. How easy or difficult would be it to go to the health department to see a doctor in the US for TB services? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

2. What might make it difficult for a person to call or email a health department after they arrive to the US? (Open Ended)

3. What might make it difficult for a person go to a health department after they arrive to the US? (Open Ended)

4. (Only ask if barriers are mentioned in 2 and 3): Overall, how difficult would these barriers be for a person like yourself to overcome? 1=Very easy/ 2= Easy/ 3=Difficult/ 4= Very difficult

For the next few questions, please let me know how much you agree or disagree w the statement.

5. Finding the right health department in the US for TB services would be difficult. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

6. Going to the health department to see a doctor in the US could cause a person problems1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

7. Providing an updated US address and phone number to immigration officials is important for an immigrant’s health if they have TB infection. 1=Strongly agree / 2= Agree/ 3= Disagree/ 4=Strongly disagree

Thank you!

Public reporting burden of this collection of information is estimated to average 10-18 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 0920-0932