Tracking Calls

The Community Choice Demonstration

Attachment X_The Child Assessment and The Obesity & Type II Diabetes Risk Assessment_Tracking Calls

Tracking Calls

OMB: 2528-0337

Document [docx]
Download: docx | pdf

OMB Clearance Number: 2528-0337

Expires: XX/XX/XXXX

Attachment X: The Child Assessment and The Obesity and Type II Diabetes Risk Assessment Tracking Call Script



If you require information to be presented in an accessible format or reasonable accommodations to participate in this study, please contact us with any specific requests by calling XXX-XXX-XXXX or emailing [email protected]. If you require language assistance to participate in this study, please contact us with any specific language assistance requests or needs.



Paperwork Reduction Act Burden Statement

This collection of information is voluntary and will be used to evaluate the US Department of Housing and Urban Development’s Community Choice Demonstration. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, gathering, and maintaining the data needed, 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. The OMB number for this collection is OMB 2528-0337 which expires on XX/XX/XXXX. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to NAME at [email protected] or call XXX-XXX-XXXX. 


Privacy Act Statement 

Authority:  Section 502 of the Housing and Urban Development Act of 1970 (Public Law 91-609) (12 U.S.C. §§ 1701z-1; 1701z-2(d) and (g)).  

Purpose:  Evaluation of the Community Choice Demonstration (CCD).  

Routine Use:  The information will be used for the purpose set forth above and may be provided to Congress or other Federal, state, and local agencies, when determined necessary.  

Disclosure:  Records will be used for research and statistical analysis and will not be used to make decisions that affect the rights, benefits, or privileges of specific individuals. 

SORN ID:  Community Choice Demonstration Evaluation Data Files, HUD/PDR-09  



Note: Some study activities are being funded by the National Institute of Diabetes and Digestive and Kidney Diseases. 





Introduction

SC1. Hi, my name is [INTERVIEWER NAME] and I am calling from Abt Associates about the MOVED research study. May I please speak with [FIRST NAME] [LAST NAME]?

[IF NECESSARY: We are calling about a research study.]

INTERVIEWER: REPEAT IF PHONE IS HANDED TO RESPONDENT AFTER READING IT TO SOMEONE ELSE. PRESS CONTINUE ONCE YOU HAVE SPOKEN WITH RESPONDENT.

1

CONTINUE

[GO TO SC2]

2

NOT A GOOD TIME

[SCHEDULE CALLBACK]

3

NO, RESPONDENT NOT AVAILABLE

[GO TO SC3]

4

SENT TO VOICE MAIL

[GO TO SC4]

5

DO NOT KNOW THAT PERSON

[DISPO AS WRONG NUMBER-PERSON]

6

DO NOT WISH TO PARTICIPATE

[THANK AND END. DISPO AS SOFT REFUSAL]

7

REF (VOL)

[THANK AND END. DISPO AS HARD REFUSAL]

8

DK (VOL)

[THANK AND END. DISPO AS SOFT REFUSAL]


SC2. If you are now driving or doing any activity requiring your full attention, I need to call you back later. Are you able to talk right now without distractions?

1

YES, SAFE PLACE AND ABLE TO TALK

[GO TO SC5]

2

NO, CALL ME LATER

[SCHEDULE CALL BACK]

3

NO, CALL BACK ON ALTERNATE NUMBER

[RECORD NUMBER, SCHEDULE CALLBACK]

7

REF (VOL)

[THANK AND END. DISPO AS HARD REFUSAL]

8

DK (VOL)

[THANK AND END. DISPO AS SOFT REFUSAL]


SC3. It is important that I speak directly to [FIRST NAME] [LAST NAME]. Do you know when [FIRST NAME] [LAST NAME] will be available?

[IF NECESSARY: We are calling because [FIRST NAME] [LAST NAME] agreed to be a part of a research study].

1

YES

[SCHEDULE CALLBACK]

2

NO

[SAY YOU WILL CALL BACK ANOTHER TIME, THANK, AND END. DISPO AS GATEKEEPER ]

3

DO NOT KNOW THAT PERSON

[THANK AND END. DISPO AS WRONG NUMBER-PERSON]

7

REFUSED

[THANK AND END. DISPO AS SOFT REFUSAL]

8

DON’T KNOW

[THANK AND END. DISPO AS SOFT REFUSAL]


SC4. WHEN LEAVING A VOICE MAIL:

Hello, my name is [INTERVIEWER NAME] and I am calling from Abt Associates about the Mobility Opportunity Vouchers to Eliminate Disparities or “MOVED” research study. I am calling to confirm and update your contact information. You may contact us, toll-free at XXX-XXX-XXXX. It will take only a few minutes. Thank you and we look forward to hearing from you.


SC5: WHEN TALKING TO RESPONDENT:

I am calling you about a research study called Mobility Opportunity Vouchers to Eliminate Disparities or “MOVED”. In [date of baseline assessment] you agreed to participate in the MOVED study. Thank you for taking 5 minutes to confirm your contact information.


We are working to understand how housing and neighborhood environments affect health, such as obesity and type II diabetes, for adults and children. We will study whether helping families move to different neighborhoods affects their risk of obesity and type II diabetes and their overall well-being.


This call is part of a routine process to keep in touch with you because we value your participation in the study. I would also like to confirm that I have your correct phone number, email, and street address in our secure database. If it isn’t correct, then I can update it in my system right now. This will help make sure we can reach you for the follow-up survey, starting about [MONTHS OR YEARS UNTIL FOLLOW-UP] from now. We do this because your experiences are unique.


Your participation in this study is completely voluntary. You can choose whether or not to respond. However, the team of researchers at Abt Associates and Johns Hopkins University greatly appreciate your continued participation. Know that any information you provide will be kept private. I appreciate your time today.


Screener

First, I just need to verify that I am speaking with the correct person.

CAPI: DISPLAY DOB FROM SAMPLE


What is your date of birth? ___________ (MM/DD/YYYY)


INTERVIEWER: ENTER DATE USING FORMAT BELOW. ENTER DATE OF BIRTH (REPEAT BACK TO RESPONDENT)

________ / ________ / ____________

MM DD YYYY


  • DON’T KNOW

  • REFUSED


IF DATE OF BIRTH MATCHES WHAT IS IN OUR RECORDS, SKIP TO CONTACT INFO VERIFICATION. OTHERWISE, ASK QUESTION 2.


CAPI: DISPLAY LAST 4 DIGITS OF SOCIAL SECURITY NUMBER FROM SAMPLE


What are the last 4 digits of your Social Security Number?


INTERVIEWER: ENTER LAST FOUR DIGITS OF SOCIAL SECURITY NUMBER. (REPEAT BACK TO RESPONDENT)

_______________________________


  • DON’T KNOW

  • REFUSED


IF SOCIAL SECURITY NUMBER MATCHES WHAT IS IN OUR RECORDS, CONTINUE AND START CONTACT INFO VERFICATION. OTHERWISE, TERMINATE.


TERMINATE SCRIPT: I’m sorry, I seem to be having trouble pulling up your record. I will check with my supervisor and call you back at another time.


Contact Verification

Let’s start by verifying your name. We have your name as: (RESPONDENT). Is this correct?


  • THIS IS CORRECT (GO TO ADDRESS VERIFICATION QUESTION)

  • THIS IS NOT CORRECT (Ask: Can you please provide your name?)


INTERVIEWER: ENTER UPDATED NAME


LAST: _____________________

FIRST: _____________________

M.I.: _____________________


We have your address as: (ADDRESS). Is this correct?


  • THIS IS CORRECT (GO TO MAILING ADDRESS VERIFICATION QUESTION)

  • THIS IS NOT CORRECT (Ask: Can you please provide your address?)


INTERVIEWER: ENTER UPDATED ADDRESS


STREET: ______________________

APARTMENT/UNIT #: ______________________

CITY: ______________________

STATE: ______________________

ZIP: ______________________


We have your mailing address as: (MAILING ADDRESS). Is this correct?


  • THIS IS CORRECT (GO TO PRIMARY PHONE NUMBER VERIFICATION QUESTION)

  • THIS IS NOT CORRECT (Ask: Can you please provide your mailing address?)


INTERVIEWER: CHECK BOX OR ENTER UPDATED ADDRESS


  • MAILING ADDRESS IS THE SAME AS THE PRIMARY ADDRESS


IN CARE OF: ______________________

LAST: ______________________

FIRST: ______________________

M.I.: ______________________

STREET: ______________________

APARTMENT/UNIT #: ______________________

CITY: ______________________

STATE: ______________________

ZIP: ______________________


We have the best phone number to reach you at as: (PRIMARY PHONE NUMBER & PHONE TYPE). Is this correct?


  • THIS IS THE BEST NUMBER TO REACH ME (GO TO SECONDARY PHONE NUMBER VERIFICATION QUESTION)

  • THIS IS NOT THE BEST NUMBER TO REACH ME (Ask: Can you please provide your primary phone number and tell me if it is a cell, home, work, or other type of number?)


INTERVIEWER: ENTER BEST PHONE NUMBER AND CHECK BOX FOR TYPE


PRIMARY PHONE: _________________________________________


____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


We have your secondary phone number as: (SECONDARY PHONE NUMBER & PHONE TYPE). Is this correct?


  • THIS IS CORRECT (GO TO INSTRUCTIONS BEFORE FIRST TEXT PERMISSION QUESTION)

  • THIS IS NOT CORRECT (Ask: Can you please provide your secondary phone number and tell me if it’s a cell, home, work, or other type of number?)


INTERVIEWER: ENTER SECONDARY PHONE NUMBER AND CHECK BOX FOR TYPE


SECONDARY PHONE: _________________________________________


____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


ASK IF PRIMARY OR SECONDARY PHONE IS CELL. OTHERWISE, SKIP TO EMAIL QUESTION.

Do we have your permission to contact you via text message to your cell phone?

  • YES, YOU MAY CONTACT ME VIA TEXT MESSAGE TO MY CELL PHONE

(ASK NEXT QUESTION)

  • NO, YOU MAY NOT CONTACT ME VIA TEXT MESSAGE TO MY CELL PHONE

(SELECT “NO” RESPONSE TO NEXT QUESTION; THEN SKIP TO EMAIL QUESTION)


Do we have your permission to contact you via an automated text to your cell phone? (READ IF NEEDED: An automated text message is a prewritten message that is sent at a later date such as a text that reminds you to complete a form or call to set up an appointment.)

  • YES, YOU MAY CONTACT ME VIA AUTOMATED TEXT MESSAGE TO MY CELL PHONE

  • NO, YOU MAY NOT CONTACT ME VIA AUTOMATED TEXT MESSAGE TO MY CELL PHONE

We have the best email address to reach you as: (PRIMARY EMAIL ADDRESS). Is this the best email to reach you?


  • THIS IS THE BEST EMAIL TO REACH ME (GO TO PREFERRED METHOD OF CONTACT QUESTION)

  • THIS IS NOT THE BEST EMAIL TO REACH ME (Ask: What is the best email to reach you?)


INTERVIEWER: ENTER BEST EMAIL ADDRESS


EMAIL ADDRESS: ______________________________


INTERVIEWER: CHECK THE FOLLOWING IF RESPONDENT HAS NO EMAIL OR INTERNET ACCESS

  • I DO NOT HAVE AN EMAIL OR INTERNET ACCESS


What is your preferred method of contact? Should we (READ LIST OF ANSWER CHOICES)?


  • Call primary number

  • Call secondary number

  • Email

  • Text message

  • Other ___________________________


Next I will confirm the names, addresses and telephone numbers of the three people you previously provided us who are living outside your household and usually know where to reach you.


The contact information for the best person to know how and where to reach you is:


NAME: (NAME)


RELATIONSHIP: (RELATIONSHIP)


ADDRESS: (ADDRESS)


PRIMARY PHONE NUMBER: (PRIMARY PHONE NUMBER)


SECONDARY PHONE NUMBER: (SECONDARY PHONE NUMBER)

EMAIL: (EMAIL ADDRESS)

Is this correct?


  • THIS IS CORRECT (GO TO SECOND BEST PERSON CONTACT INFORMATION VERIFICATION QUESTION)

  • THIS IS NOT CORRECT (Ask: Can you please provide the correct contact information?)


INTERVIEWER: CHECK BOX OR ENTER UPDATED ADDRESS


  • RESPONDENT WISHES TO REMOVE THIS CONTACT FROM CONTACT FILE


FIRST NAME: ______________________

LAST NAME: ______________________

RELATIONSHIP: ______________________

STREET: ______________________

APARTMENT/UNIT #: ______________________

CITY: ______________________

STATE: ______________________

ZIP: ______________________

PRIMARY PHONE: ______________________



____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


SECONDARY PHONE: ______________________



____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


EMAIL: ______________________



The contact information for the second best person to know how and where to reach you is:


NAME: (NAME)


RELATIONSHIP: (RELATIONSHIP)


ADDRESS: (ADDRESS)


PRIMARY PHONE NUMBER: (PRIMARY PHONE NUMBER)


SECONDARY PHONE NUMBER: (SECONDARY PHONE NUMBER)


EMAIL: (EMAIL ADDRESS)


Is this correct?


  • THIS IS CORRECT (GO TO THIRD BEST PERSON CONTACT INFORMATION VERIFICATION QUESTION)

  • THIS IS NOT CORRECT (Ask: Can you please provide the correct contact information?)

INTERVIEWER: CHECK BOX OR ENTER UPDATED ADDRESS


  • RESPONDENT WISHES TO REMOVE THIS CONTACT FROM CONTACT FILE


FIRST NAME: ______________________

LAST NAME: ______________________

RELATIONSHIP: ______________________

STREET: ______________________

APARTMENT/UNIT #: ______________________

CITY: ______________________

STATE: ______________________

ZIP: ______________________

PRIMARY PHONE: ______________________



____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


SECONDARY PHONE: ______________________



____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


EMAIL: ______________________



The contact information for the third best person to know how and where to reach you is:


NAME: (NAME)


RELATIONSHIP: (RELATIONSHIP)


ADDRESS: (ADDRESS)


PRIMARY PHONE NUMBER: (PRIMARY PHONE NUMBER)


SECONDARY PHONE NUMBER: (SECONDARY PHONE NUMBER)


EMAIL: (EMAIL ADDRESS)


Is this correct?


  • THIS IS CORRECT (GO TO CONTACT REVIEW PAGE)

  • THIS IS NOT CORRECT (Ask: Can you please provide the correct contact information?)


INTERVIEWER: CHECK BOX OR ENTER UPDATED ADDRESS


  • RESPONDENT WISHES TO REMOVE THIS CONTACT FROM CONTACT FILE


FIRST NAME: ______________________

LAST NAME: ______________________

RELATIONSHIP: ______________________

STREET: ______________________

APARTMENT/UNIT #: ______________________

CITY: ______________________

STATE: ______________________

ZIP: ______________________

PRIMARY PHONE: ______________________



____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


SECONDARY PHONE: ______________________


____ CELL ____ HOME ____ WORK ____ OTHER ____ DON’T KNOW


EMAIL: ______________________


Thank you for updating your information. Please let me review and verify that the information we have on file for you is accurate. If anything is incorrect, please let me know.


INTERVIEWER: IF ANYTHING IS INCORRECT, USE THE BACK BUTTON TO GO BACK AND CORRECT THE INFORMATION ACCORDINGLY.


We have your NAME as: (NAME)


We have your ADDRESS as: (ADDRESS)


We have your MAILING ADDRESS as: (MAILING ADDRESS)


We have your primary PHONE NUMBER as: (PRIMARY PHONE NUMBER)


We have your primary EMAIL Address as: (PRIMARY EMAIL ADDRESS)



Thank you for your time today. We will be in touch again about [X] months from now, to [UPDATE CONTACT INFORMATION or CONDUCT THE FOLLOW_UP SURVEY].

1


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorTresa Kappil
File Modified0000-00-00
File Created2024-07-22

© 2024 OMB.report | Privacy Policy