0920-0840 Interview Guide

Form Approved

OMB No. 0920-0840

Expiration Date: 01/31/2019

Pathways: Qualitative Interviews with Post-Partum Women Associated with Congenital Syphilis Cases (Case Mothers)

Generic Information Collection Request under OMB #0920-0840

Attachment #5a

Interview Guide

Public reporting burden of this collection of information is estimated to average 90 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: OMB-PRA (0920-0840)

PATHWAYS PROJECT

INTERVIEW GUIDE

DEMOGRAPHICS

Before we get started, I would like to ask a few questions just to get to know you a little better.

D1. How old are you?

D2. What race/ethnicity do you consider yourself? Please indicate all that apply.

White

Hispanic or Latino

Black or African American

Asian

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

D3. How many children do you have?

D4. What is the highest level of school that you completed?

D5. Are you currently employed?

D6. Let’s talk about some of the places other than your home you may have stayed for some period of time during your pregnancy. (Prompt for a stay in any institutionalized setting, such as a prison or correctional facility/jail; mental health facility; drug treatment center; battered women’s shelter; and/or homeless shelter)

TIMELINE

For the purpose of this interview, we will only talk about your pregnancy during [YEAR]. While we are talking, I will also take some notes to help me remember the things we discuss but they will not be shared outside the research team.

Let us start with what you remember about being pregnant--when you found out, how you felt about it, what was going on in your life then, anything you want to tell me to get started.

Tell me what you remember most about that time.

Let the person talk for 5 minutes or so. Use silence to encourage them to talk more or use gentle probes such as “What else do you remember?”

Thank you for sharing those memories. You have given us a lot to talk about. Now let us start the timeline. We can put some of the things you told me on it.

Start Timeline Activity. Provide prompts of experiences that were shared and allow participant to add or indicate where on the timeline that experience occurred. As they are providing information also probe with questions such as “What month was that?” to develop a timeframe during and around the course of her pregnancy. Then flow into standard interview by pregnancy status but come back to timeline to help guide the interview and add things as appropriate.

Key objectives:

• To establish rapport and learn more about the woman’s general living situation.

• To ascertain

  • Potential social support as well as potential stressors

  • Attitude/feelings about the pregnancy

  • Any contact with health care system the context or reason for that

  • Timing of pregnancy diagnosis and first prenatal visits, if any

PREGNANCY DIAGNOSIS AND FIRST TRIMESTER

Okay, now that we have some things on the timeline, let us start with the early part of your pregnancy around the time when you first thought you might be pregnant.

Indicate the general area on the timeline

1. What do you remember about that time in your life?

2. Can you tell me a little about where and whom you were living when you got pregnant?

[Probe for general living situation, stability/homelessness, significant relationships, male partner(s), financial challenges, possible stressors or sources of social support in her life]

3. What were your feelings about being pregnant?

[Probe: for intendedness, wantedness of pregnancy]

4. How did you confirm your pregnancy?

[Probe: self or doctor/ health care professional, if went to prenatal care provider/medical professional, how far along she was]

5. How did [your partner or the baby’s father] feel about your pregnancy?

6. Who gave you help or advice about being pregnant?

[Probe: about any advice, questions or concerns, if any, she had about being pregnant, or about the baby; what kinds of advice or help did she receive]

7. Was there anything you felt it was important to do to keep you or your baby healthy during your pregnancy?

8. What type of health insurance did you have before you were pregnant?

[Probe: Did this (her health insurance status or type) change at all during or after your pregnancy]

9. What were the challenges to finding and seeing a doctor?

[Probe: How did you go about finding a doctor?]

10. Can you describe the experience of your first appointment?

[Probe: Did you like your doctor? Did you feel that you could trust them?]

11. [If she did not go to a doctor] What were your reasons for not going?

Key objectives:

• To ascertain

  • Feelings about prenatal care

  • Frequency of prenatal care

  • Factors that affect frequency and timing of visits, both positive/negative

  • Potential support and role of the partner

PREGNANCY PROGRESSION AND 2^ND TRIMESTER

Let us talk about what you experienced during your 2^nd trimester, months [month] to [month], what stands out about that time?

Indicate the general area on the timeline

12. What things were happening in your life during this time-period of your pregnancy?

13. How often did you go to the doctor during this time?

Let us put marks on the timeline for the visits you think you had during the first 6 months or so of your pregnancy.

14. What are some reasons you might have gone to the doctor for some prenatal care visits, but not others during this time?

[Probe: Can you give me an example?]

15. Did you visit the same doctor throughout your pregnancy?

16. Was there anyone who helped you out during this time, for example, a family member or a partner, or someone else?

[Probe: What kinds of help did they give you?]

17. How involved was [your partner or the baby’s father] during this time in getting ready for the baby?

SYPHILIS DIAGNOSIS

Key objectives:

• To ascertain awareness/knowledge about syphilis and syphilis during pregnancy

• To learn more about interactions with DIS or health providers

• To ascertain what was retained/helpful, not helpful

• To learn more about how women make decisions about giving male partner info.

• To ascertain the male partner role in diagnosis and treatment.

• To learn what factors influenced inadequate treatment for syphilis

Could come up at any point in the interview; if she brings up syphilis diagnoses earlier in interview, start these questions, then come back to whatever set of questions you left off at in interview guide.

It seems we are starting to get a helpful picture of how your pregnancy progressed during this time.

Let us talk about when you first found out you had syphilis. We can also put it on the timeline.

18. How and when did you first learn you had syphilis?

[Probe: Who told you had syphilis? How did you feel?]

19. What information were you given?

[Probe: Who gave you this information? Did you understand the information you were given?]

20. Before this syphilis diagnosis, had you ever been diagnosed with syphilis before?

21. What were you told about how syphilis could affect your baby?

22. What information did you share with the provider about who may have given you syphilis?

23. What do you remember about getting treatment?

24. How did you talk with your [significant other/sexual partner(s)] about your diagnoses?

[Probe: What happened when you did that?]

25. Do you know if the person who gave you syphilis was treated?

26. How did you feel about the interactions you had with the health care provider?

3^rd TRIMESTER

Now, let us talk about what you experienced during your 3^rd trimester, months [month] to [month], and what stands out about that time.

Indicate the general area on the timeline

27. Are there things that happened in your life during this time-period that had an effect on your pregnancy?

28. How often did you go to the doctor during this time?

29. During this time, were there reasons you might have gone to the doctor for some prenatal care visits, but not others?

[Probe: Can you give me an example?]

30. Was there anyone who helped you out during this time, for example, a family member or a partner, or someone else?

[Probe: What kinds of help did they give you?]

31. How involved was your [your partner or the baby’s father] in getting ready for the baby during this time?

POST-PREGNANCY

Let us talk about how you felt after your pregnancy and syphilis diagnosis.

32. Thinking back on things, how did this overall experience affect you?

33. What do you think is important for other women in similar situations to know?

34. What are some things you think should be done to help other women?

CLOSING

Is there anything else you would like to share or questions you have before we end our interview? I appreciate you taking your time to share your experiences with me. Would it be ok if I contacted you for any clarifications or follow-up questions later, if needed?

End interview

POST INTERVIEW: Interviewer Observational Notes:

Which questions may have been misinterpreted by the participant?

How could the question or its delivery be improved?

Were there any issues with developing the timeline?

Was there any discussion post-interview (after recording stopped) that would add additional context to the participant’s experience?