Att 6_Screenshots
Att 6_Screenshots.docx
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
Table of Contents for iSTAMP Know at Home Screenshots
Eligibility Screener……………………………………………………………………………………………………………………………………………………. pages 2-10
Baseline Survey………………………………………………………………………………………………………………………………………………………… pages 11-25
Registration Survey………………………………………………………………………………………………………………………………………………….. pages 26-30
Product Ordering Survey………………………………………………………………………………………………………………………………………….. pages 31-35
Test Results Survey…………………………………………………………………………………………………………………………………………………… pages 36-60
Follow Up Survey……………………………………………………………………………………………………………………………………………………… pages 61-82
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
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Rao, Anirudh |
| File Modified | 0000-00-00 |
| File Created | 2021-01-14 |
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