Welcome to My Survey

Thank you for participating in our survey. Your feedback is important. 

INTRODUCTION: This questionnaire will ask you questions about primary care provider’s perceptions of the scope and role of occupational therapy for chronic illness management of adults aged 65 and older and how your perceptions relate to referrals to occupational therapy. The purpose of the study is to understand primary care provider’s perceptions of role and scope of occupational therapy (OT) practice in chronic illness management and referrals to occupational therapy based on the most current research about this collaboration.

PARTICIPATION: Taking part in this questionnaire is completely voluntary. You may stop your participation at any time. You are free to decline to answer any question you do not wish to answer. There are no right or wrong answers. All answers will remain completely anonymous. To protect anonymity the SSL encryption software has been enabled, and the IP tracking device has been disabled.

RISKS: Some of the questions ask about the attitudes and beliefs of primary care providers and may be distressing to you as you think about your own experiences. The risk is minimal and no more than that of what you might experience when reading a scholarly article you disagree with.

BENEFITS: There are no personal benefits to participating in this questionnaire. The benefits of this study in general are to understand primary care providers perceptions of OT and if their perceptions influence referrals for patients aged 65 and older with chronic illness to occupational therapy.

ANONYMITY/CONFIDENTIALITY: Your name and identity will not be used in reports or presentations of the findings of this research. Information provided to the researchers will be kept anonymous except for information which must be reported under Massachusetts and Federal law such as cases of child or elder abuse. This research project has been approved by the Institutional Review Board at Salem State University. Thank you for your help.

An analysis of the results and an explanation of the study will be available from the primary investigator after April of 2021. Feel free to contact the principle investigator if you wish to have information about the results of the study.

CONTACT: For questions or concerns about the research, please contact the principle investigator (PI), Hannah Paquette, OTA, OT/s @ h_paquette@salemstate.edu; 603-969-1780. If you have concerns about the study please contact the research advisor, Maria Parker, OTD, OTR @ mparker@salemstate.edu; 978-542-3020.

ELECTRONIC CONSENT: Continuing with this questionnaire indicates that you have read the above information, that you are voluntarily agreeing to participate and that you are 18 years of age or older.


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