Vietnam-Era Veterans Follow-up Telephone Survey

Vietnam-Era Veterans Follow-up Telephone Survey

                                                                      OMB Control Number:  2900-____

                                                                         Estimated Burden:  45 minutes

                                                                            Expiration Date:  07/31/2022

Introduction

Hello, this [IWR NAME] calling on behalf of Columbia University. May I speak with [Mr/Ms] [First Name] [Last Name] to conduct an official survey?

(IF ASKED WHO IS CALLING: This is [IWR NAME] calling from American Directions Research Group on behalf of Columbia University. Portions of this call may be monitored and recorded for quality control. We are conducting a survey about the current health and well-being of Vietnam-Era Veterans. We have previously been in contact with [Mr/Ms] [First Name] [Last Name] who has given us permission to make this call.

(IF ASKED WHETHER PERSON CAN SERVE AS PROXY FOR SAMPLED VETERAN) For this survey, we need to speak directly to [Mr/Ms] [First Name] [Last Name]. Is [Mr/Ms] [First Name] [Last Name] available?)

(IF THE SAMPLED RESPONDENT IS NOT AVAILABLE): Can you tell me a convenient time to call back to speak with him/her?)

(IF THE SAMPLED RESPONDENT SAYS THIS IS NOT A GOOD TIME): If you don't have the time now, when is a more convenient time to call you back?)

(IF THE SAMPLED RESPONDENT SAYS THEY DO NOT RECALL GIVING PERMISSION OR DO NOT RECALL THE PRIOR MAIL SURVEY): You completed an earlier survey through the mail about [insert] weeks ago and indicated that we could follow-up with you to conduct a telephone survey. I’m calling for that purpose now.

(If necessary offer toll-free number to respondent to confirm legitimacy or get more information).

Section A - Confirm Identity and Obtain Informed Consent

I am calling from American Directions Research Group, a research company that conducts telephone surveys. Columbia University in partnership with the Department of Veterans Affairs has requested we conduct a follow-up survey with you. The purpose of this follow-up study is to better understand changes in Veterans’ health status over time. With the information we obtain from this study, we can better understand factors that influence changes in health and wellbeing over time. You participated in an earlier survey, about [insert] weeks ago that was conducted through the mail or over the internet. Within that survey, you gave us permission to contact you for this follow-up survey. To have the most complete data, it is very important that we gather valuable feedback from Veterans like yourself.

I must notify you that this information is being collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. The OMB control number is 2900-____, with an expiration date of 7/31/2022. We may not conduct or sponsor, and you are not required to respond to, a collection of information unless it has a valid OMB number. We anticipate that the time to complete this call is 45 minutes. Your participation is voluntary, and your decision to respond or not respond will not have any impact on your entitlement to benefits.

Information gathered will be kept private to the extent provided by law. The data we collect will be aggregated, and disclosure of information will involve the release of statistical data and other non-identifying data for improving the quality of service delivery. No information will be attributable to you as an individual.

Portions of this call may be recorded for quality assurance purposes.

Before we begin, I want to assure you that providing information in this survey is voluntary. There is no penalty in any way if you choose not to respond. The information you provide will be treated as confidential, and your name will not be linked with your answers. Some questions in this survey deal with health issues and your military experience, and these questions may be upsetting to some people. Please let me know if there are questions you would like to skip.

Suggestions to decrease the burden for this call and other questions or comments can be sent to Altarum at 3520 Green Court, Suite 300, Ann Arbor Michigan 48105.

A1. May I have your consent to start the interview?

(1) Yes

(2) No  Terminate

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