1H Attachment 1-H. Study 1 Protocol 3 (R2)

Interview #4 (R2) TESTING PROTOCOL

Form Approved
OMB No. 0935.0124
Exp. Date 1/31/2024

Date: Time__ ID #:__Interviewer Initials:

1. Introduction

Thank you for taking the time to participate in the last part of this study. Our session today will take approximately 90 minutes. Today I’m going to ask you a longer set of questions about you {and your household’s} recent health care events. You will not need to go to any websites for this part of the study. I’ll be asking you all of the questions and will occasionally share my screen with you to look at some answer choices.

Let me just remind you that this is a research project and your participation is voluntary. You can skip any question and you can stop at any point. Everything that you say will be confidential – that is, no one outside the research team will know what you told us. We would very much appreciate your permission to audio and video record this conversation. The recording will be used for note-taking purposes only and may be listened to by the project or AHRQ staff. It will be destroyed when the project is over. Your name will not be linked to any of your responses, though we may include quotes that you provide in our reports. The recordings and our notes will be destroyed after we finish the project.

We’d like to audio and video record the session again, if that’s ok with you.

When we are finished with today’s interview, we will email you a 75 dollar electronic gift card as a token of appreciation for your time.

IF PARTICIPANT JOINS BY AUDIO ONLY, ASK THEM TO TURN ON THE CAMERA ON THEIR DEVICE: I would like to be able to see you during the interview to help facilitate the interview today. Would you be willing to turn on your camera?

{IF OBSERVERS: We do have observers today from Westat who are taking notes and may jump in at the end to ask questions about your experience. For now, they are on mute and their cameras are off. Is that OK with you? [IF THE RESPONDENT SAYS NO, DISMISS THE OBSERVERS]}

This survey is authorized under 42 U.S.C. 299a. The confidentiality of your responses to this survey is protected by Sections 944(c) and 308(d) of the Public Health Service Act [42 U.S.C. 299c-3(c) and 42 U.S.C. 242m(d)]. Information that could identify you will not be disclosed unless you have consented to that disclosure. Your participation is voluntary and all of your answers will be kept confidential to the extent permitted by law. Public reporting burden for this collection of information is estimated to average 90 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0124) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

2. Consent Process

Do you have any questions about anything I’ve said so far? (ADDRESS QUESTIONS)

Are you willing to take part in this part of the study? Are you willing to have the session recorded?

[ASK HOST TO START RECORDER AND GET ORAL PERMISSION TO RECORD.] It is [DATE AND TIME], do I have your permission to record this conversation? ~~~~ Thank you.

Do you have any questions before we get started?

[ADMINISTER MEPS R2 INTERVIEW UNTIL 20 MINUTES REMAIN]

Debriefing questions

Now that we’ve gone through the whole interview, please tell me your overall thoughts about it.

• What did you like about it?

• Was there anything that was difficult or confusing about it?

How easy or hard was it to recall the details of each health care event that I asked you about?

• How did you feel about having to go back through each one that you had reported in the earlier interviews to be asked more questions about each one?

• Was there anything difficult about having to answer those questions for the other people in your household?

What did you think about the way I asked you to report your events? First I asked you about anything new that had happened since your last interview, and then we went back and covered each event you had reported across the interviews. Did that make sense?

• Is there anything you’d change about that?

Then I asked you some overall questions about the entire reference period to make sure you hadn’t forgotten anything. What did you think about being asked those additional questions?

• Is there anything you’d change about that?

Those are all the questions I have for you. IF OBSERVERS PRESENT: We have observers in the session today. I’d like to invite them to send me a chat in Zoom if they have any follow-up questions they’d like me to ask.

Is there anything we have not talked about that you would like to tell me? DISCUSS ANY PARTICIPANT COMMENTS

That concludes our interview and is the end of your participation in this study. I’m going to stop the recorder now, and then will confirm your email address so that we can send you the incentive.

STOP RECORDING AND END THE INTERVIEW

CONFIRM INCENTIVE EMAIL ADDRESS

Thank you so much for your participation!

Attachment 1H: Study 1 Protocol 3 (R2) 1H-4