CATI Questionnaire CATI Questionnaire

National Survey of Substance Abuse Treatment Services (N-SSATS)

Attachment B5- N-SSATS 2019 CATI questionnaire

N-SSATS

OMB: 0930-0106

Document [pdf]
Download: pdf | pdf
ATTACHMENT B5- N-SSATS 2019 CATI QUESTIONNAIRE
MPRID – MPRID
SCREEN:

MPRID

Attachment B5- N-SSATS 2019 CATI questionnaire

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aCallSQL – Before proceeding with the interview we need to get the latest Facility information. To do this
you need to click on the box with three dots in the input field.
SCREEN:

 Before proceeding with the interview we need to get the latest Facility information. To do this you need to click on
the box with three dots in the input field.

Attachment B5- N-SSATS 2019 CATI questionnaire

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aBadSQL – There was a problem reading external database. Click on the box with three dots in the input
field to exit the case and inform your supervisor of the problem reading the SQL database. Make note of
the MPRID ([MPRID]) before exiting.
SCREEN:

There was a problem reading external database. Click on the box with three dots in the input field to exit the case and
inform your supervisor of the problem reading the SQL database. Make note of the MPRID ([MPRID]) before exiting.

Attachment B5- N-SSATS 2019 CATI questionnaire

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aSMSStatus – THIS CASE IS BEING RE-STATUSED TO [current N-SSATS Status Code of case without
leading zeros] BY THE SMS
SCREEN:
[If the case is suspended, then display: “ THIS CASE IS SUSPENDED.”]
[If the case is not suspended AND the case does have a final N-SSATS Status Code, then display: “ THIS CASE IS BEING
RE-STATUSED TO [current N-SSATS Status Code of case without leading zeros] BY THE SMS”]

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Sample_Info (MainTab) – Directory Eligible, et al
SCREEN:
Directory Eligible:
State Approved:
Interviewer Group:
Respondent’s Time:
Days Since Left Msg:
Director’s Name:
Previous Round Resp Name:
Current Round Resp Name:
Facility Name:
Current Address:

[IsDirectoryEligible as YES/NO]
[IsStateApproved as YES/NO]
Status:
[INTERVIEWER GROUP]
[Local time AND time zone, separated by spaces]
[# of days since last message was left]
[DirName]
[PrevRdRespName]
[CurrRdRespName]
[Facility Name 1]
[Location Address Line 1]
[Location City], [Location State] [Location Zip]

Phone Num: [DirPhone]
Phone Num: [PrevRdRespPhone]
Phone Num: [CurrRdRespPhone]

Facility Telephone Num:
[FacPhone]
Ext: [Facility Phone Number Extension]
Dialing Telephone Num:
[DialPhone]
Ext: [Dialing Phone Number Extension]
Parent ID:
[ParentID]
Block A Note:
[BlkANt]
Block A Note Date:
[BlkANtDtTm]
Locating Note:
[LocNt]
Locating Note Date:
[LocNtDtTm]
 CONFIRM THE FACILITY INFORMATION ON THIS SCREEN WITH THE RESPONDENT

Attachment B5- N-SSATS 2019 CATI questionnaire

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CaseHistory (MainTab) – Case History
SCREEN:
[Display the following fields and the full dialing history of the case, where the column headers are in red text, and the data rows
are in black text.]
Date/Time
Phone
Outcome
WhoMade
Appt
Notes

Attachment B5- N-SSATS 2019 CATI questionnaire

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MakeDialPhone – Phone Number Details
SCREEN:
[FinalizedMessage]
PHONE NUMBER DETAILS:
CALL CENTER DIAL PREFIX = [DialPrefix]
PHONE NUMBER = [Dialing Phone Number]
EXTENSION = [Dialing Phone Number Extension]

[RB] 1. AUTO DIAL
[RB] 2. MANUAL DIAL

[RB] 3. QUICK EXIT
[RB] 4. RESPONDENT CALLING IN

Attachment B5- N-SSATS 2019 CATI questionnaire

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DialResult – CODE RESULT OF DIALING
SCREEN:

 CODE RESULT OF DIALING

[RB] 1. SOMEONE ANSWERS
[RB] 2. NO ANSWER
[RB] 3. BUSY

[RB] 4. ANSWERING MACHINE
[RB] 5. ANSWERING SERVICE
[RB] 6. PRIVACY MANAGER

Attachment B5- N-SSATS 2019 CATI questionnaire

page 8

[RB] 7. PHONE/LINE PROBLEMS
[RB] 8. CHANGED TO NEW NUMBER
[RB] 9. NEED TO REDIAL NUMBER

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PhoneNumber[1] (MainTab) – Please give me the telephone number, area code first.
SCREEN:
Please give me the telephone number, area code first.

Attachment B5- N-SSATS 2019 CATI questionnaire

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HaveExten[1] (MainTab) – Is there an extension number?
SCREEN:
TELEPHONE NUMBER: [PhoneNumber[1] (MainTab), as “###-###-####”]
Is there an extension number?

[RB] 1. YES

[RB] 0. NO

Attachment B5- N-SSATS 2019 CATI questionnaire

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Extension[1] (MainTab) – What is the extension number?
SCREEN:
TELEPHONE NUMBER: [PhoneNumber[1] (MainTab), as “###-###-####”]
What is the extension number?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Confirm[1] (MainTab) – CONFIRM THE INFO ABOVE WITH THE RESPONDENT, THEN PRESS
ENTER.
SCREEN:
TELEPHONE NUMBER: [Dialing Phone Number, as “###-###-####”]
EXTENSION: [Dialing Phone Number Extension]
COUNTRY CODE: [CountryCode]
TIME ZONE: [aTimeZone]
OBSERVE DST: [ObserveDST]
TYPE OF PHONE: [PhoneType]
TIME OF DAY: [TimeOfDay]

 CONFIRM THE INFO ABOVE WITH THE RESPONDENT, THEN PRESS ENTER.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Verified – DID RECORDING VERIFY [Facility Name 1 AND Facility Name 2, separated by a space] AT
THIS NUMBER.
SCREEN:

 DID RECORDING VERIFY [Facility Name 1 AND Facility Name 2, separated by a space] AT THIS NUMBER.

[RB] 1. YES

[RB] 0. NO

Attachment B5- N-SSATS 2019 CATI questionnaire

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AnsService – Is this the answering service for [Facility Name 1 AND Facility Name 2, separated by a space]?
SCREEN:
Is this the answering service for [Facility Name 1 AND Facility Name 2, separated by a space]?

[RB] 1. YES, FACILITY’s ANSWERING SERVICE

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 2. NO, DEFINITELY NOT FACILITY’s [RB] 3. DON’T KNOW, WOULDN’T SAY, NO
ANSWERING SERVICE
NAME WAS GIVEN

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AnsOther – PLEASE ENTER WHAT WAS SAID.
SCREEN:

 PLEASE ENTER WHAT WAS SAID.

Attachment B5- N-SSATS 2019 CATI questionnaire

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PhoneProb – CODE PHONE PROBLEM
SCREEN:
 CODE PHONE PROBLEM

[RB] 1. NOT-IN-SERVICE; DISCONNECTED,
NON-WORKING
[RB] 2. TEMPORARILY NOT-IN-SERVICE
[RB] 3. CIRCUIT PROBLEMS; CIRCUITS
OVERLOADED

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 4. FAST BUSY; FAST RING; NO RING
[RB] 5. COMPUTER/FAX LINE
[RB] 6. PAGER
[RB] 7. CELL PHONE

page 16

[RB] 8. OTHER PHONE DEVICE

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Hello – Hello, my name is [INTERVIEWER NAME] and I am calling concerning the Federal Government's
annual survey of substance abuse treatment providers, called N-SSATS or the National Survey of
Substance Abuse Treatment Services. The N-SSATS survey is sponsored by SAMHSA, the Substance
Abuse and Mental Health Services Administration.
SCREEN:
Hello, my name is [INTERVIEWER NAME] and I am calling concerning the Federal Government's annual survey of
substance abuse treatment providers, called N-SSATS or the National Survey of Substance Abuse Treatment Services.
The N-SSATS survey is sponsored by SAMHSA, the Substance Abuse and Mental Health Services Administration.

 PRESS ENTER TO CONTINUE

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Confirm[R] – Is this [FacName1 FacName2] located at [FacAddressLine1] …
SCREEN:
Is this [FacName1 FacName2} located at
[FacAddressLine1}
[FacAddressLine2}
[FacAddressCity, FacAddressState, FacAddressZip}?

 N-SSATS is the only source of data on all known substance abuse treatment programs in the nation. Your participation will make a difference.
[RB] 1. INFORMATION IS CORRECT

[RB] 2. CORRECT FACILITY, BUT NEEDS
NAME/ADDRESS UPDATE

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[RB] 3. WRONG NUMBER
[RB] 4. HUNG UP DURING INTRODUCTION

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GetDir – May I speak with [RESPONDENT SALUTATION AND NAME] regarding this facility’s 2019 NSSATS survey?
SCREEN:
May I speak with [RESPONDENT SALUTATION AND NAME] regarding this facility’s 2019 N-SSATS survey?

[RB] 1. SPEAKING WITH FACILITY
DIRECTOR/APPROPRIATE PERSON
[RB] 2. CONNECTED TO FACILITY
DIRECTOR/APPROPRIATE PERSON

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 3. FACILITY DIRECTOR NOT AVAILABLE
[RB] 4. ANSWERING MACHINE

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Hello2 – Hello, my name is [INTERVIEWER NAME] and I am calling concerning the Federal
Government's annual survey of substance abuse treatment providers, called N-SSATS or the National
Survey of Substance Abuse Treatment Services. The N-SSATS survey is sponsored by SAMHSA, the
Substance Abuse and Mental Health Services Administration.
SCREEN:
Hello, my name is [INTERVIEWER NAME] and I am calling concerning the Federal Government's annual survey of
substance abuse treatment providers, called N-SSATS or the National Survey of Substance Abuse Treatment Services.
The N-SSATS survey is sponsored by SAMHSA, the Substance Abuse and Mental Health Services Administration.

 PRESS ENTER TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Sorry – I’m sorry. Thank you for your time.
SCREEN:
I’m sorry. Thank you for your time.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Received – All facilities providing substance abuse treatment services were recently sent the 2019 N-SSATS
packet. Did your facility receive that?
SCREEN:
All facilities providing substance abuse treatment services were recently sent the 2019 N-SSATS packet. Did your facility receive that?

 READ, IF NECESSARY: The survey packet your facility was mailed, contained:
1. Letters requesting your facility’s participation from SAMHSA an d your State or Federal Agency.
2. A yellow fact sheet with frequently asked questions and their answers.
3. A pink flyer with information on how to complete this year’s survey on the Internet.
4. The 2016 National Profile, National Survey of Substance Abuse Treatment Services (N-SSATS).

[RB] 1. RECEIVED PACKET
[RB] 2. DID NOT RECEIVE OR NOT CERTAIN
[RB] 3. NO LONGER PROVIDES SUBSTANCE
ABUSE TREATMENT
[RB] 4. NEVER PROVIDED SUBSTANCE ABUSE
SERVICES

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 5. DUPLICATE FACILITY
[RB] 6. MERGED WITH ANOTHER FACILITY
[RB] 7. FACILITY CLOSED/NO LONGER
EXISTS
[RB] 8. SATELLITE FACILITY

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[RB] 9. FACILITY IS A JAIL/PRISON
[RB] 10. CLIENT COUNTS REPORTED BY
ANOTHER FACILITY

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Intro – Recently your facility was mailed a letter from Cathie Alderks at SAMHSA along with a letter from
your State or Federal Agency Substance Abuse Director. Both letters requested the participation of your
facility in the 2019 N-SSATS. We are calling at this time to complete the survey. Is this a good time?
SCREEN:
Recently your facility was mailed a letter from Cathie Alderks at SAMHSA along with a letter from your State or Federal Agency Substance Abuse
Director. Both letters requested the participation of your facility in the 2019 N-SSATS. We are calling at this time to complete the survey. Is this a
good time?

 CONFIRM THE FACILITY INFORMATION ON THE MPRContact.Review TAB WITH THE RESPONDENT.
 IF RESPONDENT INDICATES THEIR CLIENT COUNTS WILL BE REPORTED BY ANOTHER FACILITY, READ: Putting the client
information aside, it is important for every facility to answer a few questions regarding the specific characteristics of the ir facility - even if an
administrative unit or parent facility will report your client information for you. Could I ask you these questions now? It will only take about 15
minutes.

[RB] 1. YES, CONTINUE
[RB] 2. SCHEDULE CALLBACK AT
CONVENIENT TIME
[RB] 3. COMPLETING ON THE WEB
[RB] 4. NO LONGER PROVIDES SUBSTANCE
ABUSE TREATMENT

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 5. NEVER PROVIDED SUBSTANCE ABUSE
SERVICES
[RB] 6. DUPLICATE FACILITY
[RB] 7. MERGED WITH ANOTHER FACILITY
[RB] 8. FACILITY CLOSED/NO LONGER
EXISTS

page 23

[RB] 9. SATELLITE FACILITY
[RB] 10. WRONG NUMBER
[RB] 11. COMPLETING BY MAIL
[RB] 12. FACILITY IS A JAIL/PRISON

5/22/2018

Good – Good, I am glad to hear that your facility received the packet. Have you had a chance to complete
the survey online? If you would like, we could complete it by phone right now, or you could complete it
on the Web. Since there are no client counts this year, and most of the questions are pre--filled for you if
you completed last year’s survey, the Web is the most efficient way to complete the survey.
SCREEN:
Good, I am glad to hear that your facility received the packet. Have you had a chance to complete the survey online? If you would like, we could
complete it by phone right now, or you could complete it on the Web. Since most of the questions are pre-filled for you if you completed last year’s
survey, the Web is the most efficient way to complete the survey.

 IF COMPLETED ON THE WEB, ASK WHEN THE SURVEY WAS COMPLETED.

[RB] 1. NOT COMPLETED
[RB] 2. COMPLETED ON THE WEB

[RB] 3. PREFERS TO DO ON WEB (WEB
SURVEY AT: [Survey Website URL]
[RB] 4. PROBLEM COMPLETING ON WEB
WANTS HELP

Attachment B5- N-SSATS 2019 CATI questionnaire

page 24

[RB] 5. PREFERS TO COMPLETE
SURVEY NOW BY PHONE

5/22/2018

When – Do you have any questions about completing the survey that I might be able to help you with?
SCREEN:

Do you have any questions about completing the survey that I might be able to help you with?

 ANSWER RESPONDENT’S QUESTIONS OR SEEK YOUR SUPERVISOR’S ASSISTANCE.
If you would prefer to complete it on the Web now, it is the most efficient way to complete the survey. Many of the
questions are already pre -filled with your responses from last year’s survey, to save you time. I can give you the log-on
information you’ll need. Would you like that information now?

 WEB SURVEY AT [Survey Website URL]
User ID: [MPRID] and Password: [Password]
Considering the other demands on your time, when do you think you might have a few minutes to finish the survey?
 ENTER NUMBER OF WEEKS BEFORE CALLING BACK.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Verify – Let me verify the mailing address we have for your facility, we have…
SCREEN:
Let me verify the mailing address we have for your facility, we have…
MAIL ADDRESS:
[Director First Name, Middle Initial, AND Last Name, separated by spaces] (Current Facility Director) at
[Mailing Address Line 1]
[Mailing Address Line 2]
[Mailing City], [Mailing State] [Mailing Zip]
Is that correct?

[RB] 1. YES
[RB] 2. NO
[RB] 3. PREFERS TO DO ON WEB (WEB
SURVEY AT [Survey Website URL])

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 4. PROBLEM COMPLETING ON WEB
WANTS HELP
[RB] 5. PREFERS TO COMPLETE THE
SURVEY NOW BY PHONE

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AddrCheck – The address we have is :
SCREEN:

The address we have is :
[Mailing Address Line 1]
[Mailing Address Line 2]

[Mailing City]

[Mailing State]

[Mailing Zip]

Is that correct?

 PLEASE CONFIRM FULL ADDRESS. IF RESPONDENT REFUSES TO CONFIRM ADDRESS, ASK WHICH
ADDRESS THEY WOULD LIKE THE REMAILED PACKET SENT TO. IF RESPONDENT DOESN’T KNOW
CORRECT MAILING ADDRESS, ASK IF THERE IS SOMEONE ELSE AVAILABLE WHO WOULD BE FAMILIAR
WITH THE INFORMATION.

[RB] 1. YES

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 0. NO

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Remail – We will mail a new packet immediately. If you have any questions when you receive the packet,
please call the toll-free N-SSATS helpline that is indicated on the survey.
SCREEN:

We will mail a new packet immediately. If you have any questions when you receive the packet, please call the toll-free
N-SSATS helpline that is indicated on the survey.
If you prefer, you can complete the survey on the Web and I can give you the log-on information you’ll need. The Web is
the most efficient way to complete the survey. Many of the questions are already pre-filled with your responses from last
year’s survey, to save you time. Would you like that information now?

 WEB SURVEY AT [Survey Website URL]
User ID: [MPRID] and Password: [Password]

Attachment B5- N-SSATS 2019 CATI questionnaire

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RE1 – We’ll watch for that information to come in.
SCREEN:
We’ll watch for that information to come in.
Putting the client information aside, it is important for every facility to answer a few questions regarding the specific
characteristics of their facility – even if an administrative unit or parent facility will report your client information for
you. Could I ask you these questions now? It will only take about 15 minutes.

[RB] 1. YES
[RB] 2. NO, NOT A CONVENIENT TIME

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 3. NO, NOT THE PROPER PERSON TO TALK WITH
[RB] 4. NO, WILL COMPLETE ON WEB

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RE3 – Who could answer facility-specific questions such as which types of services are offered at this
facility?
SCREEN:

Who could answer facility-specific questions such as which types of services are offered at this facility?

 WRITE DOWN THE NEW PERSON’S NAME, AND INCLUDE IT IN THE CASE NOTES WHEN YOU CLOSE THIS
CASE.

Attachment B5- N-SSATS 2019 CATI questionnaire

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RE4 – Could I please speak with that person?
SCREEN:

Could I please speak with that person?

[RB] 1. YES

[RB] 2. NOT AVAILABLE

Attachment B5- N-SSATS 2019 CATI questionnaire

page 31

[RB] 3. CONNECTED TO ANSWERING
MACHINE

5/22/2018

RE5 – Hello, my name is [INTERVIEWER NAME] and I am calling on behalf of the Federal Government’s
annual survey called the National Survey of Substance Abuse Treatment Services. This survey is
sponsored by SAMHSA, the Substance Abuse and Mental Health Services Administration. I have a few
questions I’d like to ask you. It will only take about 15 minutes. Is now a good time?
SCREEN:
Hello, my name is [INTERVIEWER NAME] and I am calling on behalf of the Federal Government’s annual survey called the
National Survey of Substance Abuse Treatment Services. This survey is sponsored by SAMHSA, the Substance Abuse and Mental
Health Services Administration. I have a few questions I’d like to ask you. It will only take about 15 minutes. Is now a good time?

[RB] 1. YES, CONTINUE

[RB] 2. NO, NOT A CONVENIENT TIME

Attachment B5- N-SSATS 2019 CATI questionnaire

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[RB] 3. NO, WILL COMPLETE ON WEB

5/22/2018

vJail – Just to confirm, this facility provides substance abuse treatment services only to incarcerated persons
or juvenile detainees. Is that correct?
SCREEN:

Just to confirm, this facility provides substance abuse treatment services only to incarcerated persons or juvenile
detainees.
Is that correct?

[RB] 1. YES, THAT IS CORRECT

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 0. NO, THAT IS NOT CORRECT

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Duplicate – Which facility is a duplicate of this one?
SCREEN:

Which facility is a duplicate of this one?

 PRESS ENTER TO CHOOSE FROM LIST OR TO ENTER FACILITY INFO

Attachment B5- N-SSATS 2019 CATI questionnaire

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Merged – Which facility was this one merged with?
SCREEN:

Which facility was this one merged with?

 PRESS ENTER TO CHOOSE FROM LIST OR TO ENTER FACILITY INFO

Attachment B5- N-SSATS 2019 CATI questionnaire

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Satellite – Which facility is this one associated with?
SCREEN:

Which facility is this one associated with?

 For the purpose of this survey a satellite facility is one that does not have permanent staff on location. Often times staff will
travel from another location to provide treatment on a limited schedule.

 PRESS ENTER TO CHOOSE FROM LIST OR TO ENTER FACILITY INFO

Attachment B5- N-SSATS 2019 CATI questionnaire

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MainFacility – May I have the name, address and phone number of the facility?
SCREEN:

May I have the name, address and phone number of the facility?

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Facility1 – What is the name of the facility? (1)
SCREEN:
NAME OF FACILITY 1: [Facility1]
NAME OF FACILITY 2: [Facility2]
What is the name of the facility?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Facility2 – What is the name of the facility? (2)
SCREEN:
NAME OF FACILITY 1: [Facility1]
NAME OF FACILITY 2: [Facility2]
What is the name of the facility?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Confirm[2] (MainTab) – CONFIRM THE FACILITY NAME ABOVE WITH THE RESPONDENT, THEN
PRESS ENTER.
SCREEN:
NAME OF FACILITY 1: [Facility1]
NAME OF FACILITY 2: [Facility2]

 CONFIRM THE FACILITY NAME ABOVE WITH THE RESPONDENT, THEN PRESS ENTER.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Address1 – What is the address?
SCREEN:
FACILITY’S ADDRESS:
[Address2]

[City]

[State]

[Address1]

[ZipCode]

What is the address?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Address2 – READ IF NECESSARY Second part of the address.
SCREEN:
FACILITY’S ADDRESS:
[Address2]

[City]

[State]

[Address1]

[ZipCode]

 READ IF NECESSARY Second part of the address.

Attachment B5- N-SSATS 2019 CATI questionnaire

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City – Town or city?
SCREEN:
FACILITY’S ADDRESS:
[Address2]

[City]

[State]

[Address1]

[ZipCode]

Town or city?

Attachment B5- N-SSATS 2019 CATI questionnaire

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State – State?
SCREEN:
FACILITY’S ADDRESS:
[Address2]

[City]

[State]

[Address1]

[ZipCode]

State?
 USE TWO CHARACTER ABBREVIATION.
 PRESS ENTER TO ENTER A FOREIGN COUNTRY.

Attachment B5- N-SSATS 2019 CATI questionnaire

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ZipCode – And what is the zip code?
SCREEN:
FACILITY’S ADDRESS:
[Address2]

[City]

[State]

[Address1]

[ZipCode]

And what is the zip code?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Confirm[3] (MainTab) – CONFIRM THE ADDRESS ABOVE WITH THE RESPONDENT, THEN PRESS
ENTER.
SCREEN:
FACILITY’S ADDRESS [Address1]
[Address2]

[City]

[State]

[ZipCode]

 CONFIRM THE ADDRESS ABOVE WITH THE RESPONDENT, THEN PRESS ENTER.

Attachment B5- N-SSATS 2019 CATI questionnaire

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PhoneNumber[2] (MainTab) – Please give me the telephone number, area code first?
SCREEN:
Please give me the telephone number, area code first?

Attachment B5- N-SSATS 2019 CATI questionnaire

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HaveExten[2] (MainTab) – Is there an extension number?
SCREEN:
TELEPHONE NUMBER: [PhoneNumber[2] (MainTab), as “###-###-####”]
Is there an extension number?

[RB] 1. YES

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 0. NO

page 48

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Extension[2] (MainTab) – What is the extension number?
SCREEN:
TELEPHONE NUMBER: [PhoneNumber[2] (MainTab), as “###-###-####”]
What is the extension number?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Confirm[4] (MainTab) – CONFIRM THE INFO ABOVE WITH THE RESPONDENT, THEN PRESS
ENTER.
SCREEN:
TELEPHONE NUMBER: [PhoneNumber[2] (MainTab), as “###-###-####”]
EXTENSION: [Extension[2] (MainTab)]
COUNTRY CODE: [CountryCode]
TIME ZONE: [aTimeZone]
OBSERVE DST: [ObserveDST]
TYPE OF PHONE: [PhoneType]
TIME OF DAY: [TimeOfDay]

 CONFIRM THE INFO ABOVE WITH THE RESPONDENT, THEN PRESS ENTER.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Message_R – *** REMINDER CALL MESSAGE *** …
SCREEN:

*** REMINDER CALL MESSAGE ***

 DID YOU LEAVE THE MESSAGE?

[RB] 1. YES

[RB] 0. NO

Attachment B5- N-SSATS 2019 CATI questionnaire

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Message_Q – *** QUESTIONNAIRE CALL MESSAGE *** …
SCREEN:

*** QUESTIONNAIRE CALL MESSAGE ***

 DID YOU LEAVE THE MESSAGE?

[RB] 1. YES

[RB] 0. NO

Attachment B5- N-SSATS 2019 CATI questionnaire

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WebHelp – I’ll try to answer your questions, or I’ll find someone who can. What problems are you having
completing the survey on the Web?
SCREEN:
I’ll try to answer your questions, or I’ll find someone who can. What problems are you having completing the survey on
the Web?

 WEB SURVEY AT [Survey Website URL] with User ID: [MPRID] and Password: [Password]


 RESPOND TO QUESTIONS. IF NECESSARY, SEEK YOUR SUPERVISOR’S ASSISTANCE.
 AFTER ANSWERING QUESTIONS, READ: So you can reach us if you have additional questions about the survey
or how to respond on the Web, please jot down our toll-free helpline. It is 1-888-324-8337.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Thanks[1] (MainTab) – Thank you so much for your time. Your responses are very important to the study
and we look forward to receiving your completed survey.
SCREEN:

Thank you so much for your time. Your responses are very important to the study and we look forward to receiving your
completed survey.

 ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Callback – USE THE 'APPOINTMENT' TAB ABOVE TO MAKE AN APPOINTMENT.
SCREEN:

 USE THE 'APPOINTMENT' TAB ABOVE TO MAKE AN APPOINTMENT.

Attachment B5- N-SSATS 2019 CATI questionnaire

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BeginSurvey – Click on the three dots to connect to the Web Browser.
SCREEN:
[If Confirm[R] = “2”, then display: Thank you for your time. Earlier, you mentioned that some contact information for your facility
needs to be updated. I’d like to do that now.]

 Click on the three dots to connect to the Web Browser.

 DO NOT CLICK THE THREE DOTS MORE THAN ONCE. IF NECESSARY, EXIT BLAISE AND RE-OPEN THE CASE TO
RECONNECT TO THE BROWSER.
 YOU SHOULD HAVE ONLY ONE BROWSER WINDOW OPEN WHILE ACCESSING THE WEB INSTRUMENT.
 IF YOUR BROWSER DOES NOT APPEAR TO OPEN, CONFIRM IF THERE IS A BROWSER WINDOW MINIMIZED AT THE
BOTTOM OF YOUR SCREEN. IF THERE IS, CLOSE IT.
 WHILE IN THE WEB INSTRUMENT, DO NOT CLOSE YOUR BROWSER WINDOW UNTIL THE CASE IS COMPLETE OR
AFTER A BREAK OFF.
 IF YOU ARE UNABLE TO ACCESS THE WEB INSTRUMENT, OR HAVE ANY PROBLEMS OR QUESTIONS, CONTACT THE
FLOOR SUPERVISOR IMMEDIATELY.

Attachment B5- N-SSATS 2019 CATI questionnaire

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aGetSMSStatus – Click on the three dots to get the SMS status.
SCREEN:

 Click on the three dots to get the SMS status.

Attachment B5- N-SSATS 2019 CATI questionnaire

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aBadSQL2 – There was a problem reading external database. Click on the box with three dots in the input
field to exit the case and inform your supervisor of the problem reading the SQL database. Make note of
the MPRID ([MPRID]) before exiting.
SCREEN:

There was a problem reading external database. Click on the box with three dots in the input field to exit the case and
inform your supervisor of the problem reading the SQL database. Make note of the MPRID ([MPRID]) before exiting.

Attachment B5- N-SSATS 2019 CATI questionnaire

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ContinueStatus – Press 1 to Continue
SCREEN:

Press 1 to Continue

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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StatusResult – INTERVIEWER: WAS THIS A …
SCREEN:
INTERVIEWER: WAS THIS A …

[RB] 1. REFUSAL
[RB] 2. APPOINTMENT

[RB] 3. SUPERVISOR
[RB] 4. REMINDER CALL COMPLETE

Attachment B5- N-SSATS 2019 CATI questionnaire

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SelectRefusal – USE THE 'BREAKOFF' TAB ABOVE TO EXIT.
SCREEN:

 USE THE 'BREAKOFF' TAB ABOVE TO EXIT.

Attachment B5- N-SSATS 2019 CATI questionnaire

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SelectAppointment – USE THE 'APPOINTMENT' TAB ABOVE TO MAKE AN APPOINTMENT.
SCREEN:

 USE THE 'APPOINTMENT' TAB ABOVE TO MAKE AN APPOINTMENT.

Attachment B5- N-SSATS 2019 CATI questionnaire

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SupReviewA – THIS CASE WILL GO TO SUPERVISORY REVIEW.
SCREEN:

 THIS CASE WILL GO TO SUPERVISORY REVIEW.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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KindOfExit (MainTab) – RECORD THE KIND OF EXIT.
SCREEN:

 RECORD THE KIND OF EXIT.
 THE WEB VERSION IS AVAILABLE.

OFFER THE WEB OPTION.

 If you prefer, you can complete the survey on the web.
[RB] 1. REFUSES TO CONTINUE
[RB] 4. SEND TO SUPERVISOR REVIEW
[RB] 6. HUNG UP DURING INTRODUCTION
[RB] 2. RESPONDENT WILL CALL MPR [RB] 5. RESPONDENT WILL COMPLETE ON THE
[RB] 3. RESPONDENT ON CELL PHONE
WEB

Attachment B5- N-SSATS 2019 CATI questionnaire

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WhoRefused (MainTab) – INDICATE WHO REFUSED.
SCREEN:

 INDICATE WHO REFUSED.
 THE WEB VERSION IS AVAILABLE. OFFER THE WEB OPTION.

 If you prefer, you can complete the survey on the web.
[RB] 1. REFUSAL BY KNOWN RESPONDENT

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 2. REFUSAL BY GATEKEEPER

page 65

[RB] 3. REFUSAL BY UNKNOWN PERSON

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RefusalReason (MainTab) – INDICATE THE REASON FOR THE REFUSAL.
SCREEN:

 INDICATE THE REASON FOR THE REFUSAL.

[RB] 1. CONFIDENTIALITY
[RB] 2. NOT INTERESTED
[RB] 3. INTERVIEW TOO LONG

[RB] 4. DOESN’T BELIEVE STUDY WILL MAKE [RB] 0. OTHER (GENERIC)
A DIFFERENCE
[RB] 98. DON’T CALL AGAIN
[RB] 5. DOESN’T LIKE TOPIC OR
ORGANIZATION

Attachment B5- N-SSATS 2019 CATI questionnaire

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RefusalSeverity (MainTab) – INDICATE SEVERITY OF THE REFUSAL.
SCREEN:

 INDICATE SEVERITY OF THE REFUSAL.

[RB] 1. SOFT

[RB] 2. MEDIUM

Attachment B5- N-SSATS 2019 CATI questionnaire

[RB] 3. ADAMANT

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CallInInfo (MainTab) – You can call us back at 1-800-783-6483 and please use reference #[MPRID]. We
look forward to hearing from you.
SCREEN:

You can call us back at 1-800-783-6483 and please use reference #[MPRID].
We look forward to hearing from you.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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WebInfo (MainTab) – Okay, that would be fine. If you would prefer to complete it on the Web, I can give
you the log-on information you’ll need. Would you like that information?
SCREEN:
Okay, that would be fine. If you would prefer to complete it on the Web, I can give you the log -on information you’ll need.
Would you like that information?

 WEB SURVEY AT [Survey Website URL] []
User ID: [User ID] and Password: [Web Password]

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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ExitRemark (MainTab) – MAKE ANY EXIT REMARKS.
SCREEN:

 MAKE ANY EXIT REMARKS.

Attachment B5- N-SSATS 2019 CATI questionnaire

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LeaveExit (MainTab) – YOU ARE NOW LEAVING THE EXIT MODULE.
SCREEN:

 YOU ARE NOW LEAVING THE EXIT MODULE.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Thanks[2] (MainTab) – Thank you for your time.
SCREEN:

Thank you for your time.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Finished – ENTER A REMARK FOR CASE [MPRID] AND GO TO THE NEXT FIELD TO SEE THE
STATUS OF THE CASE.
SCREEN:
ENTER A REMARK FOR CASE [MPRID] AND GO TO THE NEXT FIELD TO SEE THE STATUS OF THE CASE.

Attachment B5- N-SSATS 2019 CATI questionnaire

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aBadStatus – WARNING - NO STATUS CODE ASSIGNED. …
SCREEN:

WARNING - NO STATUS CODE ASSIGNED.
NOTIFY YOUR SUPERVISOR IMMEDIATELY.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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LeaveCase – THE STATUS OF CASE [MPRID] IS: …
SCREEN:
THE STATUS OF CASE [MPRID] IS:
CODE = [new CODE]
CDSP = [new CDSP]
FINAL = [new FINAL]
NSSATS FINAL = [new N-SSATS Status Code of case without leading zeros;
EXCEPTION: when N-SSATS Status Code = “007”, display “21” instead of “7”]

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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Make Appointment – Make Appointment
SCREEN:
[Display the following fields, allowing the interviewer to set up an appointment with the respondent.]
Date
Type (Exact date, Period, Weekday, No date)
Month
Year
[Calendar allowing interviewer to show any date >= System Date
Time
Type (Exact time, Day part, No time)
From (time)
To (time)
Summary [From and To date(s) and time(s) for appointment(s) selected]
[Btn: OK, Cancel, Today, Clear, Begin, Help]

Attachment B5- N-SSATS 2019 CATI questionnaire

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HardSoft – INTERVIEWER, PLEASE INDICATE THE KIND OF APPOINTMENT.
SCREEN:

 INTERVIEWER, PLEASE INDICATE THE KIND OF APPOINTMENT.

[RB] 1. FIRM APPOINTMENT

[RB] 2. MEDIUM APPOINTMENT

Attachment B5- N-SSATS 2019 CATI questionnaire

page 77

[RB] 3. SOFT APPOINTMENT

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AskForWhom – Who should we ask for when calling back?
SCREEN:

Who should we ask for when calling back?

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

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FirstName (Appointment) – First name?
SCREEN:
NAME: [FirstName, MiddleName, AND LastName (all Appointment), separated by spaces]
First name?

Attachment B5- N-SSATS 2019 CATI questionnaire

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MiddleName (Appointment) – Middle initial?
SCREEN:
NAME: [FirstName, MiddleName, AND LastName (all Appointment), separated by spaces]
Middle initial?

Attachment B5- N-SSATS 2019 CATI questionnaire

page 80

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LastName (Appointment) – Last name?
SCREEN:
NAME: [FirstName, MiddleName, AND LastName (all Appointment), separated by spaces]
Last name?

Attachment B5- N-SSATS 2019 CATI questionnaire

page 81

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Confirm[1] (Appointment) – CONFIRM THE NAME ABOVE WITH THE RESPONDENT, THEN PRESS
ENTER.
SCREEN:
NAME: [FirstName, MiddleName, AND LastName (all Appointment), separated by spaces]

 CONFIRM THE NAME ABOVE WITH THE RESPONDENT, THEN PRESS ENTER.

Attachment B5- N-SSATS 2019 CATI questionnaire

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PhoneNumber (Appointment) – Please change the number if needed, area code first.
SCREEN:
TELEPHONE NUMBER: [PhoneNumber (Appointment)]
Please change the number if needed, area code first.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Extension (Appointment) – What is the extension number?
SCREEN:
TELEPHONE EXTENSION:
What is the extension number?

Attachment B5- N-SSATS 2019 CATI questionnaire

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Confirm[2] (Appointment) – CONFIRM THE INFO ABOVE WITH THE RESPONDENT, THEN PRESS
ENTER.
SCREEN:

PHONE NUMBER: [PhoneNumber (Appointment)]
EXTENSION: [Extension (Appointment)]

 CONFIRM THE INFO ABOVE WITH THE RESPONDENT, THEN PRESS ENTER.

Attachment B5- N-SSATS 2019 CATI questionnaire

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Thanks (Appointment) – Thank you for your time.
SCREEN:

Thank you for your time.

 ENTER ANY NOTES OR COMMENTS IN THE FOLLOWING REMARKS FIELD BEFORE ENTERING CODE
TO END INTERVIEW.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

page 86

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ApptRemark – MAKE ANY GENERAL APPOINTMENT REMARKS.
SCREEN:

 MAKE ANY GENERAL APPOINTMENT REMARKS.

Attachment B5- N-SSATS 2019 CATI questionnaire

page 87

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LeaveAppt – YOU ARE NOW LEAVING THE APPOINTMENT MODULE.
SCREEN:

 YOU ARE NOW LEAVING THE APPOINTMENT MODULE.

[RB] 1. ENTER 1 TO CONTINUE

Attachment B5- N-SSATS 2019 CATI questionnaire

page 88

5/22/2018


File Typeapplication/pdf
AuthorMatt Potts
File Modified2018-05-22
File Created2018-05-22

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