Important Information for Survey Respondents

You are being asked to take part in an evaluation of opioid prevention efforts in Allegany County. Your participation is completely voluntary.  All of your responses will be confidential and anonymous. No personal identifying information will be collected from you. Please be advised that although we will take every precaution to maintain confidentiality of the data, the nature of focus groups prevents us from guaranteeing confidentiality. We would like to remind participants to respect the privacy of your fellow participants and not repeat what is said in the focus group to others. None of the data collected will include the participants' names.
Your participation should take up to one hour. Your participation is completely voluntary.  There is a potential for psychological discomfort during the focus group. If you no longer wish to take part in the focus group, you may leave at any time. If there are any questions you wish not to answer, you will not be forced to participate.
The focus group will be audiotaped. By participating in the focus group, you agree to be recorded. Recordings of focus groups will be used only for the purpose of verifying accuracy of the transcripts. Following the completion of transcribing comments, the recordings will be erased. Transcripts will not include any identifying information, such as names or dates of incidents. 
Persons who volunteered to participate in the focus groups will be given the option to submit their name for a drawing for a Kindle Fire HD. One name will be drawn across the focus groups. There may also be a potential benefit of a general increase in knowledge or a reduction in opioid misuse and abuse in your community as a result of the information you share and the prevention strategies that are implemented. We do not anticipate any physical, psychological, social, legal or other risk as a result of your participation in this focus group.
 
If you have any questions about this focus group, you can discuss them with Chris Delaney or Becky Meyers at 301-759-5050.
 Clicking the "OK" button below indicates that:
  1. You have read and understood the above information
  2. You voluntarily agree to participate
  3. You are 18 years of age or older
  4. You are an Allegany County resident

If you have any questions about your rights as a participant, or if you think you have not been treated fairly, you may call Gay Hutchen at the Maryland Department of Health Institutional Review Board (IRB) at 410-767-8488 and reference the OMPP Evaluation.

We thank you for your feedback! 


 

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* 1. In the past 6 months, have you seen, heard, or participated in any aspects of the Prescribe Change campaign?

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* 2. In particular, in the past 6 months, have you seen or heard any of the campaign's messages about the dangers of the drug fentanyl?

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* 3. In particular, in the past 6 months, have you seen or heard any of the campaign's messages about "Start the Conversation," which focuses on ways to talk with your medical prescriber about opioids?

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* 4. Check all the features of the Prescribe Change campaign that you have seen, heard, or participated in in the past 6 months.

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* 5. Based on the features of the Prescribe Change campaign that you have seen, heard, and/or participated in was the campaign . . .?

  Agree Disagree Unsure
Memorable
Realistic
Interesting
Difficult to Understand
Relevant

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* 6. Of those features of the Prescribe Change campaign that you've seen or heard,  how would you rate the effectiveness of these aspects in providing information? (Rate only those aspects that you have seen or heard)

  Extremely Effective Somewhat Effective Neither Effective nor Ineffective Somewhat Ineffective Extremely Ineffective
Prescribe Change Website
Prescribe Change Facebook Page
Pop-Up Ads on Cell Phones
Prescribe Change Radio Spots
Prescribe Change Billboards
Prescribe Change Flyers/Pamphlets
Prescribe Change Wallet Cards - "Start the Conversation"
Prescribe Change Displays at Community Events (e.g., ACIT, Home Show, Hooley Plunge, etc.)
Prescribe Change Presentations (e.g., at Schools, Churches, Civic Organizations, Town Hall meetings, etc.)
Naloxone (Narcan) Training
Medication Take Back Events

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* 7. Which of the following actions did you undertake as a result of the campaign elements that you saw, heard, or participated in? (Check all that apply)

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* 8. Which of the following best describes your employment status? (Optional- Check all that apply)

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* 10. What is your age? (Optional - Check only one)

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* 11. What is your gender? (Optional - Check only one)

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* 12. Which race/ethnicity best describes you? (Optional - Check only one.)

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* 13. How could the Prescribe Change campaign be even more effective?

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* 14. Your name will be entered into a prize drawing if you volunteer to participate in a follow up focus group.

Would you be willing to participate in a focus group?

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* 15. If you answered yes to participating in a focus group, please provide us with your name, telephone number, and e-mail address.  Please know that we will not attach your name to your responses on this questionnaire.  We are simply using this information in order to schedule the follow up focus groups.

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