Attachment 4 – Focus Group Telephone Screening Script
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Sample screening script for respondent contact by Collaborating Center for Questionnaire Design and Evaluation Research (CCQDER) Recruiter/CCQDER Staff for
GLP-1 Receptor Agonist Focus Group and Cognitive Testing Project
Dial respondent’s telephone number [hereafter referred to as R] as indicated on CCQDER voice mail system.
Note: Speak only to R. If the number is answered by voice mail, call back at another time.
CCQDER Recruiter/CCQDER Staff: Good morning/afternoon, may I speak to (name)?
If R is not available or not at home, say, “Thank you” and try again at another time.
If the person who answered the phone (NOT R) asks, “Who is calling?” or “What’s this about?” say, “I am returning their call to me. I’ll try to reach them at another time.
If R has been successfully contacted, continue...
...Hello, my name is [CCQDER Recruiter/CCQDER Staff‘s name. I am calling from the National Center for Health Statistics. You may remember that you responded to the advertisement we placed in the [name of newspaper] on [date] or flyer looking for adults to participate in a focus group about health and participation in surveys. Is this a safe time to talk? If you are driving, I will call you back. I can also call you back if you are too busy.
Wait for acknowledgment, such as, “This is a safe time to talk.”
...In order to determine if you are eligible for our study, I’ll need a few minutes of your time to ask some background questions. Answering these questions is completely voluntary. We are required by law to use your information for statistical research only and to keep it confidential. The law prohibits us from giving anyone any information that may identify you without your consent. Is this a good time to ask the questions or should I call back later?
If not a good time to talk, schedule a time to call back.
If good time to talk, continue...
1. Where did you see our advertisement/flyer?
___________________________________________________
2. How old are you? [If under age 18, go to exit script 1]
________________
3. Do you have Type 2 diabetes?
Yes
No
4. Do you consider yourself obese?
Yes
No
5. Do you take any of the following GLP-1 injectable medications?
Dulaglutide (Trulicity®)
Exenatide (Byetta®)
Exenatide extended-release (Bydureon®)
Liraglutide (Victoza®)
Lixisenatide (Adlyxin®)
Semaglutide injection (Ozempic®)
Semaglutide tablets (Rybelsus®)
Other
6. What is your gender?
Male Female Transgender, non-binary, or another gender__________
7. What is the highest level of school you have completed?
Less than High School (No Diploma or GED)
High School Diploma or GED
Associate Degree
Some College
Bachelor’s Degree
Graduate Degree
8. What is your race and/or ethnicity? Select all that apply and enter additional details in the spaces next to each option.
American Indian or Alaska Native
Additional details (Enter, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.)
__________________________________________________________________________
Asian
Additional details (Enter, for example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.)
______________________________________________________________________________
Black or African American
Additional details (Enter, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.)
___________________________________________________________________________
Hispanic or Latino
Additional details (Enter, for example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.)
___________________________________________________________________________
Middle Eastern or North African
Additional details (Enter, for example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.)
________________________________________________________________________
Native Hawaiian or other Pacific Islander
Additional details (Enter, for example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.)
________________________________________________________________________
White
Additional details (Enter, for example, English, German, Irish, Italian, Polish, Scottish, etc.)
___________________________________________________________________________
[If the recruitment needs for certain demographic groups have been achieved, go to exit script 2]. Otherwise continue.
Entry Script:
...Based on your answers to the questions so far, we would like you to take part in our focus group. The focus group will [recorded/conducted onsite or audio recorded/conducted off site]. During the focus group, you will be asked about topics related to health and participation in surveys. Your answers will help give insight into the use of new diabetes medications and find appropriate wording to use in developing survey questions about them. [FOR ON-SITE FOCUS GROUPS ONLY] Do you give permission to have your focus group video recorded? Yes/No. [If no, go to exit script 3. Video recording is essential for this project]. [FOR OFF-SITE FOCUS GROUPS ONLY] Do you give permission to have the focus group audio recorded? Yes/No. [If no, go to exit script 4. Audio recording is essential for this project].
After we talk today, you will be sent a confirmation email with the date and time of your focus group. Can we have your email address to send the confirmation email? Get e-mail. Attached with the confirmation email will be a consent form. In order to take part in the study you must read the entire consent form. The consent form tells you about the study and what you will be asked to do. If you have any questions about confidentiality, identity protection, procedures or other topics related to the study please contact me [name] at [phone number/email] any time before your interview.
Do you have any questions at this point? Pause to answer questions. If (not/you have no other questions), then let’s get you on the schedule, ok? Focus groups will be occurring on (Day, Month/Date) through (Day, Month/Date) from 8 a.m. to 6 p.m. Looking at your schedule, when would you be available to participate? Schedule. [If date/times not available go to exit script 5.]
[If remuneration is cash] What is your mailing address? We will use this address to send you $100 cash via FedEx after the completion of the interview. Packages typically take 7 business days to arrive.
[If remuneration is an electronic gift cards] After your interview, we will email you the activation code for your $100 electronic gift card with a “thank you” letter. The email will be sent right after your interview, and you will be able to use your electronic gift card immediately after activation.
A reminder call will be made to you a few days in advance. Should you have any questions or won’t be able to make the focus group, please feel free to contact me [name] at [phone number]. Thank you for responding to our ad, and I look forward to seeing you here at (DATE/TIME) Get respondent to cite date & time if possible.
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Exit script 1: I’m sorry, you have to be 18 years of age or older take part in the focus group and therefore we won’t be able to use you at this time. We appreciate your call and thank you for your interest in our study.
Exit script 2: Based upon your answers, it seems that we may already have a number of volunteers with very similar answers to yours. At this point we need to talk with people with some different characteristics. However, if we have cancellations or other slots open up, I may wish to call you back. Would it be okay if I kept your name, telephone number, and the information you provided in response to the eligibility questions until the end of this study? If yes, make notation. If no, would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? Your information will be kept for up to 5 years and you can decide at any time to be removed from our database. Email [email protected] to request removal. If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
Exit script 3: I’m sorry, willingness to be video recorded is required in order to take part in the focus group and therefore we won’t be able to use you at this time. Would it be okay if I kept your name, telephone number, and the information you provided in response to the eligibility questions until the end of this study? If yes, make notation. If no: would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? Your information will be kept for up to 5 years and you can decide at any time to be removed from our database. Email [email protected] to request removal. If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
Exit script 4: I’m sorry, willingness to be audio recorded is required in order to take part in the focus group and therefore we won’t be able to use you at this time. Would it be okay if I kept your name, telephone number, and the information you provided in response to the eligibility questions until the end of this study? If yes, make notation. If no, would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? Your information will be kept for up to 5 years and you can decide at any time to be removed from our database. Email [email protected] to request removal. If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
Exit script 5: I see...ok, we were hoping to complete this particular study between (Month/Date) and (Month/Date), so it looks like we won’t be able to schedule you at this time. Would it be okay if I kept your name, telephone number, and the information you provided in response to the eligibility questions until the end of this study? If yes, make notation. If no, would it be okay if I added your name, telephone number, age, educational level, and race to our database so that I can contact you about other studies coming up in the future? Your information will be kept for up to 5 years and you can decide at any time to be removed from our database. Email [email protected] to request removal. If yes, add to database. If no: OK, thank you for your time. Your name and any information you gave me will not be added to our database.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | wyv6 |
| File Modified | 0000-00-00 |
| File Created | 2025-05-19 |