Att 6_Screenshots

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Web-based Approaches to Reach Black or African American and Hispanic/Latino MSM for HIV Testing and Prevention Services

Att 6_Screenshots

OMB: 0920-1284

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Table of Contents for iSTAMP Know at Home Screenshots

  1. Eligibility Screener……………………………………………………………………………………………………………………………………………………. pages 2-10

  2. Baseline Survey………………………………………………………………………………………………………………………………………………………… pages 11-25

  3. Registration Survey………………………………………………………………………………………………………………………………………………….. pages 26-30

  4. Product Ordering Survey………………………………………………………………………………………………………………………………………….. pages 31-35

  5. Test Results Survey…………………………………………………………………………………………………………………………………………………… pages 36-60

  6. Follow Up Survey……………………………………………………………………………………………………………………………………………………… pages 61-82

  7. Guest Test Result Survey………………………………………………………………………………………………………………………………………….. pages 83-103



iSTAMP Eligiblity Screener

Page 1

Page 2

Page 3

Page 4

Page 5

Page 6



Page 7



End page if participant selects “No” to 1st question regarding consent/interest



End page if participant is not eligible for study



End page if participant is eligible for study





iSTAMP Baseline Survey

Page 1; INTRO, Pt 1













Page 2; Consent, Pt 2

Page 3 - Demographics

Page 4

Page 8

Page 11



Page 12

Page 14

Page 17, part 1



Page 17, part 2





Page 26



Page 29



Page 30





Page 31





Page 32





Page 33



Page 35; END







iSTAMP Registration Survey

Page 1



Page 2



Page 3

Page 4

Page 5





iSTAMP Product Ordering Survey

Page 1






Page 2



Page 3



Page 4





iSTAMP Test Results Survey

Page 1

Page 2

Page 3

Page 4



Page 5 part 1



Page 5 part 2



Page 6


Page 7



Page 8 part 1

Page 8 part 2

Page 9 part 1



Page 9 part 2


Repeat pages 6, 7, and 8 with language for SECOND OraQuick test

Page 13 part 1


Page 13 part 2



Page 14



Page 15



Page 16 part 1

Page 16 part 2



Page 17 part 1



Page 17 part 2


Repeat of pages 14, 15, and 16 with language for SECOND INSTI test.



Page 18



Page 19

Page 20



Page 21

Page 21 Part 2

Page 21 Part 3

Page 21 Part 4



End





iSTAMP Follow Up Survey

Page 1 Intro



Page 2



Page 3



Page 3 with logic



Page 7

Page 10





Page 11




Page 13 – This page is repeated for each person the participant reports on page 12



Page 14 - This page is repeated for each person the participant reports on page 12



Page 18





Page 23



Page 27



Page 30



Page 31

Page 32



Page 33

Page 34

Page 35

Page 36

Page 37. (38-41 are also ZOOM pages)

Page 42 (43-48 are also healthMpowerment pages)






Page 49 (50-55 are also HealthMindr pages)

Page 56



Page 57

END

Guest Test Result Survey

Page 1

Page 2

Page 3

Page 4



Page 5



Page 6 part 1

Page 6 part 2




Page 8 part 1


Page 8 part 2



Page 9 part 1

Page 9 part 2



Page 10




Page 11 part 1

Page 11 part 2



Page 12 part 1

Page 12 part 2



Page 13

Page 14 part 1


Page 14 part 2



Page 15 part 1

Page 15 part 2



Page 16

Page 17 part 1

Page 17 part 2



Page 18



Page 19

77


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorRao, Anirudh
File Modified0000-00-00
File Created2021-01-15

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