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pdfIn-Person Instrument
Verification
CASEID ENTER THE CASE ID FOR THIS INTERVIEW.
BE SURE TO INCLUDE A OR B AT THE END OF THE CASE ID.
TOALLR3I
It is important that I do my job correctly; therefore, my supervisors will be checking
on my work. Would you help me by giving me your phone number? I will enter it
into this tablet. This information is kept separate from the responses that were entered
so they will still be completely private.
ON TABLET RESPONDENT SELECTION SCREEN, OPEN QC FORM.
COMPLETE VERIFICATION PROCESS (PHONE, CONFIRM ADDRESS AND,
IF YOUTH, WHO GAVE PERMISSION).
PRESS [ENTER] TO CONTINUE.
INCENT01
HAND RESPONDENT $30 CASH AND THEN:
COMPLETE THE INTERVIEW INCENTIVE RECEIPT:
MARK THE APPROPRIATE ‘CASH ACCEPTANCE’ BOX
SIGN AND DATE
ENTER CASE ID (IF NOT DONE ALREADY)
GIVE TOP COPY TO RESPONDENT
I have signed this form to indicate that I have given you $30 for this interview. At the
bottom of this form, we have included national hotline numbers that you can call if
you ever feel you need to talk to someone about mental health or drug use issues.
IF NOT DONE EARLIER, GIVE ADULT RESPONDENT OR
PARENT/GUARDIAN OF YOUTH THE Q&A BROCHURE AND SAY:
For more details on the National Survey on Drug Use and Health, this brochure
includes answers to common questions, website addresses and other information.
PRESS [ENTER] TO CONTINUE.
CALCULATE MICSR:
IF K6 AND WHO-DAS SCORE = MID OR HIGH, MICSR = 1
ELSE, MICSR=2
RECRUIT1 [IF MICSR=1] You have been selected to participate in one additional interview for
the U.S. Department of Health and Human Services. For this interview, we are selecting a mix of
people, including those who have mental health issues and those who don’t. The interview will
be conducted over the phone or through a Zoom meeting, and takes about 60 minutes to
complete.
You do not need to have an internet connection or download any Zoom software to
participate. You can be in your home, office, or another private location when you
complete the interview. Your participation in the interview is voluntary, and you can
refuse to answer any questions or stop the interview at any time.
If you agree to complete the interview, I will give you an additional $30 today.
HAND FOLLOW-UP STUDY DESCRIPTION TO RESPONDENT.
Please read this statement. It describes the follow-up interview and the legislation that
assures the confidentiality of any information you provide.
Do you agree to participate in this interview?
1 – RESPONDENT AGREES TO PARTICIPATE IN THE FOLLOW-UP
INTERVIEW
2 – RESPONDENT DOES NOT AGREE TO PARTICIPATE IN THE
FOLLOW-UP INTERVIEW
REFFEAS [IF RECRUIT1=2] Since the follow-up interview is designed to help us improve
future NSDUH surveys, it is important to understand why people might not want to
participate. Would you please tell me the reasons why you do not want to participate?
_____________[ALLOW 100]
DK/REF
RECRUIT2 [IF RECRUIT1=1] Since another interviewer will be completing the next
interview and will need to contact you beforehand, may I have your first name, phone
number, and email address?
INTERVIEWER NOTE: ADDITIONAL INFORMATION REGARDING THE FIRST
NAME, PHONE NUMBER, OR EMAIL ADDRESS PROVIDED BY THE
RESPONDENT SHOULD BE ENTERED IN THE NOTES FIELD. YOU MAY ENTER
UP TO 50 CHARACTERS.
ENTER FIRST NAME ONLY, PHONE NUMBER, EMAIL ADDRESS, AND REENTER EMAIL ADDRESS. READ THE CONTACT INFORMATION ENTERED TO
THE RESPONDENT AND CONFIRM IT IS CORRECT, THEN PRESS [ENTER] TO
CONTINUE.
_________________________FIRST NAME: [ALLOW 20]
_________________________PHONE NUMBER: [ALLOW 20]
_________________________EMAIL ADDRESS: [ALLOW 50]
_________________________RE-ENTER EMAIL ADDRESS: [ALLOW 50]
_________________________NOTES: [ALLOW 50]
DK/REF
RECRTXT [IF RECRUIT1=1 AND PHONE NUMBER IN RECRUIT2 NOT MISSING]
May RTI send text messages to the phone number you provided to
contact you about the upcoming interview?
The messages will come from an automated system and only include information related
to the follow-up interview that you schedule. Your information will not be sold to third
parties and will not be shared unless required by law. You may opt-out of these messages
at any time by replying STOP. Also, message frequency may vary and data rates may
apply.
1.
2.
YES
NO
INCENTMI [IF RECRUIT1=1]
HAND RESPONDENT $30 CASH
COMPLETE THE FOLLOW-UP INTERVIEW INCENTIVE RECEIPT:
MARK THE APPROPRIATE ‘CASH ACCEPTANCE’ BOX
SIGN AND DATE
ENTER CASE ID
GIVE TOP COPY TO RESPONDENT
PRESS [ENTER] TO CONTINUE.
RECRQR [IF RECRUIT1=1] WRITE THE RESPONDENT’S QUESTID) ON THE
SCHEDULING CARD AND THEN HAND SCHEDULING CARD TO
RESPONDENT.
Use the information on this card to go to the project’s website, enter the ID number as
your password, and schedule your follow-up interview. Please try to select a date and
time as close as possible to this interview. Appointments are limited, so we recommend
scheduling within the next 48 hours. If you need assistance, you can call the number
provided on the card.
Within a few days of scheduling your appointment, an interviewer will contact you via
phone to confirm your interview and provide meeting details.
There are the four ways in which you can participate:
1. We can call your phone at the appointment time,
2. You can call the phone number you will be provided via email and phone,
3. You can connect to the Zoom meeting with your camera on, or
4. You can connect to the Zoom meeting with your camera off.
Remember, even though the interviewer will be using Zoom, you do not need to
download any Zoom software in order to participate. If you have any questions, you can
call the phone number on the card.
PRESS [ENTER] TO CONTINUE
THANKR2
Thank you for your time.
[ALL CASES] BE SURE YOU HAVE YOUR
SECURITY KEY
Web Instrument
Incentive/Mental Illness Calibration Study Recruitment Screens/End of
Interview
INCENTTYPE
Thank you for participating in the National Survey on Drug Use and
Health! To show our appreciation for completing this interview, we would
like to send you $30, by either electronic pre-paid or physical Visa or
MasterCard gift card. Please indicate how you would like to receive your
$30.
On the next screen enter your contact information. [IF CURNTAGE < 18]
If you choose an electronic gift card, we will ask for your parent or
guardian’s email. This information will be kept separate from the answers
to this survey, and will only be used for the purpose of sending your gift
card.
1. Electronic Visa Gift Card (Delivered by email within two business
days, can only be used for online purchases, and can only be used for
purchases of equal or lesser value)
2. Electronic MasterCard Gift Card (Delivered by email within two
business days, can only be used for online purchases, and can only be
used for purchases of equal or lesser value)
3. Physical Visa Gift Card (Delivered by mail within 4-6 weeks and can
be used in stores and online)
4. Physical MasterCard Gift Card (Delivered by mail within 4-6 weeks
and can be used in stores and online)
5. No, thanks. I decline the $30
DEFINE EMAILFILL
IF CURNTAGE ≥ 18 THEN, EMAILFILL = “your”
ELSE EMAILFILL = “your parent or guardian’s”
EADDRESS [IF INCENTTYPE = 1 OR 2]
The email message will be from [email protected] and the subject line
will say “How to Redeem Your $30 [Visa OR MasterCard] Card.” If you’d like a
physical gift card instead, click Back to change your selection.
Please enter [EMAILFILL] email address to receive the electronic gift card.
[EMAILADD]
Please re-enter [EMAILFILL] email address
[EMAILADD2]
ERROR MESSAGE: IF EMAILADD NE EMAILADD2: The email addresses do
not match. Please re-enter them.
MAILINCENT
[IF INCENTTYPE = 3 OR 4] Please enter the address you want us to mail
the gift card to. If you’d like an electronic gift card instead, click Back to
change your selection.
Street address 1: [MADDRESS]
Street address 2: [MADDRESS2]
Please enter your city.
City: [MCITY]
Please enter your state.
State: [MSTATE]
Please enter your zip code.
Zip: [MZIP]
INCENTCON [IF INCENTTYPE = 3 OR 4] Your gift card will be delivered to you in a RTI
standard business sized envelope. Since we do not have your name, the letter will
be directed to you using your age.
Is this information correct?
FILL:
ADDRESS/PO BOX: [MADDRESS]
[MADDRESS2]
CITY: [MCITY]
STATE: [MSTATE]
ZIP: [MZIP]
1. Yes
2. No
IF NO IS ENTERED: Please click Back to go back one screen and enter the correct
information.
CALCULATE MICSR:
IF K6 AND WHO-DAS = MID OR HIGH, MICSR = 1
ELSE, MICSR = 2.
RECRINT [IF MICSR=1] You have been selected for a follow-up interview to the
National Survey on Drug Use and Health. This interview, sponsored by the U.S.
Department of Health and Human Services, will ask questions about mental health. For
this interview, we are selecting a mix of people, including those who have mental health
issues and those who don’t. The interview will be conducted over the phone or through a
Zoom meeting, and takes about 60 minutes to complete.
You do not need to have an internet connection or download any Zoom software to
participate. You can be in your home, office, or another private location when you
complete the interview. Your participation in the interview is voluntary, and you can
refuse to answer any questions or stop the interview at any time.
If you decide to participate in the follow-up interview, your first name, telephone
number, and email address will be collected so we can contact you about your interview.
You will be asked for permission to record the interview to ensure the interviewer
administered the interview properly. You can still be interviewed even if you do not
allow the interview to be recorded. Your interview recording may be used for quality or
training purposes.
If you agree to complete the interview, you will receive $30.
Please click NEXT to continue.
RECRUIT1 [IF MICSR=1] Federal law requires us to keep all of your answers private and
confidential. Any data you provide will only be accessed by authorized personnel for
statistical purposes according to the Confidential Information Protection and Statistical
Efficiency Act of 2002. The only exceptions to this promise of confidentiality are if you
tell the interviewer that you intend to seriously harm yourself or someone else, or if a
child has been or will be seriously harmed. In this situation, the interviewer may need to
notify a mental health professional or other authorities.
If you have questions about the study, call the Project Representative at 1-800-848-4079.
If you have questions about your rights as a study participant, call RTI’s Office of
Research Protection at 1-866-214-2043 (a toll-free number).
Do you agree to participate in this interview?
1 I agree to participate in the follow-up interview
2 I do not agree to participate in the follow-up interview
REFFEAS [IF RECRUIT1=2] Since the follow-up interview is designed to help us improve
future NSDUH surveys, it is important to understand why people might not want to participate.
Please type in the reasons you do not want to participate.
_____________[ALLOW 100]
DK/REF
RECRUIT2 [IF RECRUIT1=1] Since an interviewer will be administering the follow-up
interview and will need to contact you beforehand, please type in your first name, phone
number, and email address.
First Name: ____________________________ [ALLOW 20]
Phone Number:__________________________ [ALLOW 20]
Email Address:__________________________[ALLOW 50]
Re-enter email address: ___________________[ALLOW 50]
DK/REF
RECRTXT [IF RECRUIT1=1 AND PHONE NUMBER IN RECRUIT2 NOT MISSING]
May RTI send text messages to the phone number you provided to contact you about the
upcoming interview?
The messages will come from an automated system and only include information related
to the follow-up interview that you schedule. Your information will not be sold to third
parties and will not be shared unless required by law. You may opt-out of these messages
at any time by replying STOP. Also, message frequency may vary and data rates may
apply.
1.
2.
YES
NO
INCNTFU1 [IF RECRUIT1= 1 AND INCENTTYPE NE 5] Thank you for your time. To
show our appreciation for agreeing to participate today, we would like to send you the
additional $30 [Visa or MasterCard] Gift Card to the [physical/email] address you
provided earlier.
[FILL THE PHYSICAL ADDRESS FROM MAILINCENT OR EMAIL ADDRESS
FROM EADDRESS.]
1
2
3
INCNTFU2
Yes, I accept the incentive
No, I want to receive this gift card in a different way
I decline the incentive
[IF INCTFU1=2] Please indicate how you would like to receive your $30.
On the next screen enter your contact information. This information will
be kept separate from the answers to this survey, and will only be used for
the purpose of sending your gift card.
1. Electronic Visa Gift Card (Delivered by email within two business
days, can only be used for online purchases, and can only be used for
purchases of equal or lesser value )
2. Electronic MasterCard Gift Card (Delivered by email within two
business days, can only be used for online purchases, and can only be
used for purchases of equal or lesser value )
3. Physical Visa Gift Card (Delivered by mail within 4-6 weeks and can
be used in stores and online)
4. Physical MasterCard Gift Card (Delivered by mail within 4-6 weeks
and can be used in stores and online)
5. No, thanks. I decline the $30
EMAILFU
[IF INCNTFU2 = 1 OR 2]
The email message will be from [email protected] and the subject line
will say “How to Redeem Your $30 [Visa OR MasterCard] Card.” If you’d like a
physical gift card instead, click Back to change your selection.
Please enter [EMAILFILL] email address to receive the electronic gift card.
[EMAILADD]
Please re-enter [EMAILFILL] email address
[EMAILADD2]
ERROR MESSAGE: IF EMAILADD NE EMAILADD2: The email addresses do
not match. Please re-enter them.
PROGRAMMER: IF THE RESPONDENT GETS TO THIS SCREEN, AND
THERE IS AN EMAIL ADDRESS IN EADDRESS, FILL THAT
INFORMATION HERE.
MAILFU
[IF INCNTFU2 = 3 OR 4] Please enter the address you want us to mail the
gift card to. If you’d like an electronic gift card instead, click Back to
change your selection.
Street address 1: [MADDRESS]
Street address 2: [MADDRESS2]
Please enter your city.
City: [MCITY]
Please enter your state.
State: [MSTATE]
Please enter your zip code.
Zip: [MZIP]
PROGRAMMER: IF THE RESPONDENT GETS TO THIS SCREEN, AND
THERE IS AN ADDRESS IN MAILINCENT, FILL THAT INFORMATION
HERE.
FIEXIT [IF RECRUIT1= 1] Please click CONTINUE.
CONTINUE
[OTHERWISE] That is all the questions we have for you. Thank you for participating in
the National Survey on Drug Use and Health.
Please click FINISH to end the survey.
FINISH
POSTEXIT [IF RECRUIT1= 1]
Please click the button below to use the online scheduling system to schedule a date and
time for your follow-up interview. Although the interview averages about 60 minutes to
complete, the appointments are scheduled in two-hour timeframes. Please specify your
time zone from the dropdown list so that we can adjust the calendar accordingly. If you
modify the time zone, click the refresh scheduler button. After you launch the online
scheduler, you will not need to come back to this page.
Please try to select a date and time for your follow-up appointment as close as possible to
this interview. Appointment times are limited, so we recommend scheduling within the
next 48 hours.
Within a few days of scheduling your appointment, an interviewer will contact you via
phone to confirm your interview and provide meeting details. Remember, even though
the interviewer will be using Zoom, you do not need to download any Zoom software in
order to participate.
There are the four ways in which you can participate:
1. We can call your phone at the appointment time,
2. You can call the phone number you will be provided via email or phone,
3. You can connect to the Zoom meeting with your camera on, or
4. You can connect to the Zoom meeting with your camera off.
PROGRAMMER: LINK TO LAUNCH SCHEDULER
[OTHERWISE] For more details on the National Survey on Drug Use and Health, this
link takes you to a downloadable document at the NSDUH website that includes answers
to common questions, website addresses and other information.
File Type | application/pdf |
File Title | Microsoft Word - Attachment MICS-2_Follow-up Int Recruitment Script |
Author | cjewett |
File Modified | 2024-07-29 |
File Created | 2024-07-29 |