Questionnaire-sirb-recruitment-materials-questionnaire-populate

Sourcehl7.fhir.us.sirb#current:Single Institutional Review Board (sIRB) Implementation Guide (v4.0.1)
resourceTypeQuestionnaire
idsirb-recruitment-materials-questionnaire-populate
canonicalhttp://hl7.org/fhir/us/sirb/Questionnaire/sirb-recruitment-materials-questionnaire-populate
version1.0.0
statusdraft
publisherHL7 International - BR&R Work Group
nameRecruitmentMaterials
titleRecruitment Materials
date2023-03-29T06:17:19+00:00
experimentalfalse
jurisdictionsus
Usages(none)

Research Study

  • linkId: rm1

Study Title

  • linkId: rm1.1

Short Title of the Research Study intended for the lay audience

  • linkId: rm1.1_help

IRB Protocol Number

  • linkId: rm1.2

IRB number assigned

  • linkId: rm1.2_help

Submission Type and Relying Site Selection (if applicable)

  • linkId: rm9

Is this Recruitment Materials Form being submitted to request approval for the recruitment materials for the overall study? *

The Recruitment Materials Form should be submitted to have the recruitment materials for the overall study in general reviewed and approved. Later, a Recruitment Materials Form that is customized to each specific relying site should be submitted for each relying site. Answer to indicate if this is the overall generalized recruitment materials submission.

  • linkId: rm9.1_help

External Data For linkId rm9.2

  • Flags: icon
  • linkId: ExternalDataFor_rm9.2

If this form and the associated recruitment materials are specific to a relying site, select the relying site in order to pre-populate the relying institution and relying site principal investigator details below.

  • linkId: rm9.2
  • Enable When: todo

This question and its answer will not print on the Recruitment Materials Form but are necessary for the form logic. If you do not want pre-population to occur, leave this question blank and manually fill in the relying institution and relying site principal investigator details.

  • linkId: rm9.2_help

Study Institution for which Recruitment Materials are being provided

  • linkId: rm2

Institution Name *

  • linkId: rm2.1

City *

  • linkId: rm2.2

State *

  • linkId: rm2.3

Country *

  • linkId: rm2.4

Site Principal Investigator for the Site for which Recruitment Materials are being submitted

  • linkId: rm3

Principal investigator at site for which recruitment materials are being submitted

  • linkId: rm3_help

First Name *

  • linkId: rm3.1

First or given name of the site principal investigator

  • linkId: rm3.1_help

Last Name *

  • linkId: rm3.3

Surname or family name

  • linkId: rm3.3_help

Suffix

  • linkId: rm3.2

Suffix such as Junior (Jr.), Senior (Sr.), I, II, III, IV, etc.

  • linkId: rm3.2_help

Degree(s)

  • linkId: rm3.4

Professional and Academic degrees of the site principal investigator

  • linkId: rm3.4_help

Recruitment Materials

  • linkId: rm4

Media of any type used as part of a participant recruitment strategy.

  • linkId: rm4_help

Will Recruitment Materials be Utilized? *

Will Broadcast Materials be Utilized?

The distribution of audio or video content to a dispersed audience via any electronic mass communications medium.

  • linkId: rm4.2_help

Broadcast Communication

  • linkId: rm4.3
  • Enable When: todo

Audio or video content to a dispersed audience via any electronic mass communications medium

  • linkId: rm4.3_help

Audio

  • linkId: rm4.3.1

A contiguous sound recording used to relay audible information.

  • linkId: rm4.3.1_help

Audio Description

  • linkId: rm4.3.2
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.3.2_help

Video

  • linkId: rm4.3.3

Video content to a dispersed audience via any electronic mass communications medium

  • linkId: rm4.3.3_help

Video Description

  • linkId: rm4.3.4
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.3.4_help

Radio Spot

  • linkId: rm4.3.5

A contiguous segment of audio broadcasting airtime.

  • linkId: rm4.3.5_help

Radio Spot Description

  • linkId: rm4.3.6
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.3.6_help

TV Spot

  • linkId: rm4.3.7

A contiguous segment of video broadcasting airtime.

  • linkId: rm4.3.7_help

TV Spot Description

  • linkId: rm4.3.8
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.3.8_help

Will Printed Materials be Utilized?

Materials produced by printers or publishers, such as books, magazines, booklets, brochures, newspaper.

  • linkId: rm4.4_help

Printed Communication

  • linkId: rm4.5
  • Enable When: todo

Billboard/Bus Ad

  • linkId: rm4.5.1

A large outdoor advertising space designed to capture the attention of motorists and pedestrians.

  • linkId: rm4.5.1_help

Billboard/Bus Ad Description

  • linkId: rm4.5.2
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.2_help

Brochure/Pamphlet

  • linkId: rm4.5.3

A small book or magazine that contains images and information about a company or organization's products and/or services.

  • linkId: rm4.5.3_help

Brochure/Pamphlet Description

  • linkId: rm4.5.4
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.4_help

Flyer/Notice

  • linkId: rm4.5.5

A small piece of paper with information on it about a product or event

  • linkId: rm4.5.5_help

Flyer/Notice Description

  • linkId: rm4.5.6
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.6_help

Magazine

  • linkId: rm4.5.7

A periodical publication containing articles and illustrations.

  • linkId: rm4.5.7_help

Magazine Description

  • linkId: rm4.5.8
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.8_help

Mail

  • linkId: rm4.5.9

Letters and packages conveyed by the postal system.

  • linkId: rm4.5.9_help

Mail Description

  • linkId: rm4.5.10
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.10_help

Newspaper

  • linkId: rm4.5.11

A printed publication (usually issued daily or weekly) consisting of folded unstapled sheets and containing news, feature articles and advertisements.

  • linkId: rm4.5.11_help

Newspaper Description

  • linkId: rm4.5.12
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.12_help

Postcard

  • linkId: rm4.5.13

A message by mail without an envelope.

  • linkId: rm4.5.13_help

Postcard Description

  • linkId: rm4.5.14
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.14_help

Poster/Sign

  • linkId: rm4.5.15

A large printed picture, photograph, or notice that you stick or pin to a wall or board, usually for decoration or to advertise something.

  • linkId: rm4.5.15_help

Poster/Sign Description

  • linkId: rm4.5.16
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.16_help

Table Tent

  • linkId: rm4.5.17

A self-standing promotional unit created from printed and folded card stock for table tops.

  • linkId: rm4.5.17_help

Table Tent Description

  • linkId: rm4.5.18
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.5.18_help

Will Electronic Materials be Utilized?

Computer-based technology that facilitates the sharing of ideas and information and the building of virtual networks and communities.

  • linkId: rm4.6_help

Electronic Communication

  • linkId: rm4.7
  • Enable When: todo

Email

  • linkId: rm4.7.1

Messages distributed by electronic means from one computer user to one or more recipients via a network.

  • linkId: rm4.7.1_help

Email Description

  • linkId: rm4.7.2
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.2_help

Networking Site

  • linkId: rm4.7.3

An online platform that allows users to create a public profile and interact with other users on the website.

  • linkId: rm4.7.3_help

Networking Site Description

  • linkId: rm4.7.4
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.4_help

Podcast

  • linkId: rm4.7.5

A digital audio file made available on the internet for download to a computer or mobile device. Typically available as a series.

  • linkId: rm4.7.5_help

Podcast Description

  • linkId: rm4.7.6
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.6_help

Social Media

  • linkId: rm4.7.7

A computer-based technology that facilitates the sharing of ideas and information and the building of virtual networks and communities.

  • linkId: rm4.7.7_help

Social Media Description

  • linkId: rm4.7.8
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.8_help

Web Page Advertising

  • linkId: rm4.7.11

A form of advertising on the Word Wide Web delivered by an ad server and/or embedded in a web page.

  • linkId: rm4.7.11_help

Web Page Ad Description

  • linkId: rm4.7.12
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.12_help

Web/Internet Posting

  • linkId: rm4.7.13

Communication posted for public viewing or an electronic message sent to & displayed on an online forum.

  • linkId: rm4.7.13_help

Web/Internet Posting Description

  • linkId: rm4.7.14
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.14_help

Website

  • linkId: rm4.7.15

A page or collection of pages on the World Wide Web that contains specific information which was all provided by one person, group or an organization

  • linkId: rm4.7.15_help

Website Description

  • linkId: rm4.7.16
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.16_help

Text messaging

  • linkId: rm4.7.17

Communication of messages between two or more users using mobile phones.

  • linkId: rm4.7.17_help

Texting Description

  • linkId: rm4.7.18
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.18_help

eHealth Portal

  • linkId: rm4.7.19

Communication to user(s) via the eHealth Portal or similar electronic medical record system

  • linkId: rm4.7.19_help

eHealthPortal Description

  • linkId: rm4.7.20
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.20_help

Video Conferencing

  • linkId: rm4.7.21

Use of two-way video communications via a computer, tablet or mobile phone

  • linkId: rm4.7.21_help

Video Conferencing Description

  • linkId: rm4.7.22
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.7.22_help

Will Direct Communication Materials be Utilized?

Communication addressed to a specific person.

  • linkId: rm4.8_help

Direct Communication

  • linkId: rm4.9
  • Enable When: todo

In-Person Discussion

  • linkId: rm4.9.1

Involves a person's physical presence rather than communication by phone, email, etc.,

  • linkId: rm4.9.1_help

In-Person Discussion Description

  • linkId: rm4.9.2
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.9.2_help

Letter/Invitation

  • linkId: rm4.9.3

A written, typed, or printed communication, especially one sent in an envelope by mail or messenger:

  • linkId: rm4.9.3_help

Letter/Invitation Description

  • linkId: rm4.9.4
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.9.4_help

Phone Call

  • linkId: rm4.9.5

A communication or conversation by phone.

  • linkId: rm4.9.5_help

Phone Call Description

  • linkId: rm4.9.6
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.9.6_help

Will Group Communication Materials be Utilized?

Communication addressed to a defined group of people.

  • linkId: rm4.10_help

Group Communication

  • linkId: rm4.11
  • Enable When: todo

Advertisement

  • linkId: rm4.11.1

An ad that may take many different forms. It could be a banner, a graphic image or an animated GIF of a designated pixel size and byte size.

  • linkId: rm4.11.1_help

Advertisement Description

  • linkId: rm4.11.2
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.11.2_help

Bulletin Board

  • linkId: rm4.11.3

A website or web page where users can post comments about a particular issue or topic and reply to other users' postings.

  • linkId: rm4.11.3_help

Bulletin Board Description

  • linkId: rm4.11.4
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.11.4_help

Newsletter

  • linkId: rm4.11.5

Communication issued periodically to the members of a society, business, or organization.

  • linkId: rm4.11.5_help

Newsletter Description

  • linkId: rm4.11.6
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.11.6_help

Professional Journal

  • linkId: rm4.11.7

A scholarly journal addressed to a particular professional audience such as doctors, teachers or engineers and published by a professional organization.

  • linkId: rm4.11.7_help

Professional Journal Description

  • linkId: rm4.11.8
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.11.8_help

Tip Sheet

  • linkId: rm4.11.9

A publication that containing the latest information/tips/predictions for a particular business or stock market information or horse racing results, etc.

  • linkId: rm4.11.9_help

Tip Sheet Description

  • linkId: rm4.11.10
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.11.10_help

Will Public Communication Materials be Utilized?

Communication addressed to the public.

  • linkId: rm4.12_help

Public Communication

  • linkId: rm4.13
  • Enable When: todo

Announcement

  • linkId: rm4.13.1

A public and typically formal statement about a fact, occurrence, or intention.

  • linkId: rm4.13.1_help

Announcement Description

  • linkId: rm4.13.2
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.13.2_help

Press Release

  • linkId: rm4.13.3

A written statement about a matter of public interest which is given to the press by an organization concerned with the matter.

  • linkId: rm4.13.3_help

Press Release Description

  • linkId: rm4.13.4
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.13.4_help

Public Solicitation

  • linkId: rm4.13.5

A method of communication involving asking for or trying to obtain something from someone in public.

  • linkId: rm4.13.5_help

Public Solicitation Description

  • linkId: rm4.13.6
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.13.6_help

Snowball Sampling

  • linkId: rm4.13.7

A technique among social scientists who wish to work with a population that is difficult to identify or locate.

  • linkId: rm4.13.7_help

Snowball Sampling Description

  • linkId: rm4.13.8
  • Enable When: todo

Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.

  • linkId: rm4.13.8_help

Attachments for Broadcast Communication Recruitment Materials

  • linkId: rm4.33
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm4.33.1

Attachment

  • linkId: rm4.33.2

Attachments for Printed Communication Recruitment Materials

  • linkId: rm4.35
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm4.35.1

Attachment

  • linkId: rm4.35.2

Attachments for Electronic Communication Recruitment Materials

  • linkId: rm4.37
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm4.37.1

Attachment

  • linkId: rm4.37.2

Attachments for Direct Communication Recruitment Materials

  • linkId: rm4.39
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm4.39.1

Attachment

  • linkId: rm4.39.2

Attachments for Group Communication Recruitment Materials

  • linkId: rm4.41
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm4.41.1

Attachment

  • linkId: rm4.41.2

Attachments for Public Communication Recruitment Materials

  • linkId: rm4.43
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm4.43.1

Attachment

  • linkId: rm4.43.2

Distribution List and Audience Identification

  • linkId: rm6

If recruitment material is being mailed, emailed, texted or otherwise distributed, describe where/how the distribution list will be obtained.

  • linkId: rm6.1

Describe methods that will be used to identify audiences for advertising messages (eg. web advertising will be displayed on web sites popular with a particular demographic)

  • linkId: rm6.2

Any necessary permission will be obtained for posting/airing these (for example, permission to post a flyer on a bulletin board). *

Response to Recruitment Materials

  • linkId: rm7

When potential participants respond to recruitment material, describe the information that will be provided to them about the study.

  • linkId: rm7.1

Describe the plan to respond to potential participants who respond to recruitment materials. Include how many times you will attempt to respond to call the participant back, leave a voice message, send a reply email or conduct other follow-up communication.

  • linkId: rm7.2

Types of communication methods that will be used to reply to potential participants who respond to recruitment materials *

Attach the telephone call script for responding to potential participants

  • linkId: rm7.4
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.4.1

Attachment

  • linkId: rm7.4.2

Attach the voice mail/telephone voice message script for responding to potential participants

  • linkId: rm7.5
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.5.1

Attachment

  • linkId: rm7.5.2

Attach the video conferencing script for responding to potential participants

  • linkId: rm7.6
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.6.1

Attachment

  • linkId: rm7.6.2

Attach the email script for responding to potential participants

  • linkId: rm7.7
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.7.1

Attachment

  • linkId: rm7.7.2

Attach the text messaging/texting script for responding to potential participants

  • linkId: rm7.8
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.8.1

Attachment

  • linkId: rm7.8.2

Attach the eHealth Portal messaging script for responding to potential participants

  • linkId: rm7.9
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.9.1

Attachment

  • linkId: rm7.9.2

Attach any other script for responding to potential participants

  • linkId: rm7.10
  • Enable When: todo

Describe the file that is being attached (optional)

  • linkId: rm7.10.1

Attachment

  • linkId: rm7.10.2

Administrative Use Only

  • Flags: icon
  • linkId: ADMIN00

Link ID prefix

  • Flags: icon
  • linkId: ADMIN01
  • Initial Values: rm

Questionnaire Response ID for the parent Questionnaire Response (such as the Initiate a Study Questionnaire Response), if any

  • Flags: icon
  • linkId: ADMIN02
  • Initial Values: temporarily unavailable

ID of the Research Study FHIR Resource associated with the study Questionnaire Responses

  • Flags: icon
  • linkId: ADMIN03
  • Initial Values: temporarily unavailable

Questionnaire Response ID of the local considerations Questionnaire Response, if any

  • Flags: icon
  • linkId: ADMIN04

Produced 06 Apr 2023