recruitment-populate-exampleQR
type: QuestionnaireResponse
node role: treeRoot
id:
  v: recruitment-populate-exampleQR
meta:
  version id:
    v: 1
  last updated:
    v: 2022-06-19T23:48:27.362+00:00
text:
  status:
    v: generated
  div: LinkId Text Definition Answer<img src="[binary]" alt="doco" style="background-color: inherit"/> recruitment-populate-exampleQR QuestionnaireResponse rm1 Research Study rm1.1 Study Title Study of Drug A for arthritis rm1.2 IRB Protocol Number PRO098765 rm9 Submission Type and Relying Site Selection (if applicable) rm9.1 Is this Recruitment Materials Form being submitted to request approval for the recruitment materials for the overall study? expandedYes-NoIndicator N: No ExternalDataFor_rm9.2 External Data For linkId rm9.2 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. [not stated] : Central Campus Test University | | Maria Smith, PhD | Central, MI rm2 Study Institution for which Recruitment Materials are being provided rm2.1 Institution Name Central Campus Test University rm2.2 City Central rm2.3 State MI rm2.4 Country United States rm3 Site Principal Investigator for the Site for which Recruitment Materials are being submitted rm3.1 First Name Maria rm3.3 Last Name Smith rm3.4 Degree(s) PhD rm4 Recruitment Materials rm4.1 Will Recruitment Materials be Utilized? expandedYes-NoIndicator Y: Yes rm4.2 Will Broadcast Materials be Utilized? expandedYes-NoIndicator Y: Yes rm4.3 Broadcast Communication rm4.3.7 TV Spot true rm4.3.8 TV Spot Description 30 second TV ad airing once daily for 4 weeks during nightly news on TV news show with most viewers this year rm4.4 Will Printed Materials be Utilized? expandedYes-NoIndicator Y: Yes rm4.5 Printed Communication rm4.5.1 Billboard/Bus Ad true rm4.5.2 Billboard/Bus Ad Description Billboard for 6 months on 3 interstate highway locations in MI once study opens for enrollment rm4.5.13 Postcard true rm4.5.14 Postcard Description Postcard mailed to all patients in the Central Campus Test University eHealth Portal with arthritis diagnosis codes during the month that…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/workflow-researchStudy
  value: Reference
    link: http://hl7.org/fhir/us/sirb/ResearchStudy/ResearchStudyExample-sIRB
    reference:
      v: ResearchStudy/ResearchStudyExample-sIRB
    display:
      v: ResearchStudyExample-sIRB
questionnaire:
  v: http://hl7.org/fhir/us/sirb/Questionnaire/sirb-recruitment-materials-questionnaire-populate
  link: http://hl7.org/fhir/us/sirb/Questionnaire/sirb-recruitment-materials-questionnaire-populate
status:
  v: completed
authored:
  v: 2022-06-19T23:48:21.443Z
item:
  link id:
    v: rm1
  text:
    v: Research Study
  item:
    link id:
      v: rm1.1
    text:
      v: Study Title
    answer:
      value:
        v: Study of Drug A for arthritis
  item:
    link id:
      v: rm1.2
    text:
      v: IRB Protocol Number
    answer:
      value:
        v: PRO098765
item:
  link id:
    v: rm9
  text:
    v: Submission Type and Relying Site Selection (if applicable)
  item:
    link id:
      v: rm9.1
    text:
      v: Is this Recruitment Materials Form being submitted to request approval for the recruitment materials for the overall study?
    answer:
      value: Coding
  item:
    link id:
      v: ExternalDataFor_rm9.2
    text:
      v: External Data For linkId rm9.2
    answer:
      value:
        v: Sample University Medical Center | | Jane Doe, MD | Sample City, NC
    answer:
      value:
        v: Test Example University | | Xi-Yang Lee, Jr., MD, PhD | Example, MA
    answer:
      value:
        v: Central Campus Test University | | Maria Smith, PhD | Central, MI
  item:
    link id:
      v: rm9.2
    text:
      v: 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.
    answer:
      value: Coding
item:
  link id:
    v: rm2
  text:
    v: Study Institution for which Recruitment Materials are being provided
  item:
    link id:
      v: rm2.1
    text:
      v: Institution Name
    answer:
      value:
        v: Central Campus Test University
  item:
    link id:
      v: rm2.2
    text:
      v: City
    answer:
      value:
        v: Central
  item:
    link id:
      v: rm2.3
    text:
      v: State
    answer:
      value:
        v: MI
  item:
    link id:
      v: rm2.4
    text:
      v: Country
    answer:
      value:
        v: United States
item:
  link id:
    v: rm3
  text:
    v: Site Principal Investigator for the Site for which Recruitment Materials are being submitted
  item:
    link id:
      v: rm3.1
    text:
      v: First Name
    answer:
      value:
        v: Maria
  item:
    link id:
      v: rm3.3
    text:
      v: Last Name
    answer:
      value:
        v: Smith
  item:
    link id:
      v: rm3.4
    text:
      v: Degree(s)
    answer:
      value:
        v: PhD
item:
  link id:
    v: rm4
  text:
    v: Recruitment Materials
  item:
    link id:
      v: rm4.1
    text:
      v: Will Recruitment Materials be Utilized?
    answer:
      value: Coding
  item:
    link id:
      v: rm4.2
    text:
      v: Will Broadcast Materials be Utilized?
    answer:
      value: Coding
  item:
    link id:
      v: rm4.3
    text:
      v: Broadcast Communication
    item:
      link id:
        v: rm4.3.7
      text:
        v: TV Spot
    item:
      link id:
        v: rm4.3.8
      text:
        v: TV Spot Description
  item:
    link id:
      v: rm4.4
    text:
      v: Will Printed Materials be Utilized?
    answer:
      value: Coding
  item:
    link id:
      v: rm4.5
    text:
      v: Printed Communication
    item:
      link id:
        v: rm4.5.1
      text:
        v: Billboard/Bus Ad
    item:
      link id:
        v: rm4.5.2

v: N

v: No

v: Central Campus Test University | | Maria Smith, PhD | Central, MI

v: Y

v: Yes

v: Y

v: Yes

v: true

v: 30 second TV ad airing once daily for 4 weeks during nightly news on TV news show with most viewers this year

v: Y

v: Yes

v: true

v: Billboard/Bus Ad Description

value:
  v: Billboard for 6 months on 3 interstate highway locations in MI once study opens for enrollment

link id:
  v: rm4.5.13
text:
  v: Postcard
answer:
  value:
    v: true

link id:
  v: rm4.5.14
text:
  v: Postcard Description
answer:
  value:
    v: Postcard mailed to all patients in the Central Campus Test University eHealth Portal with arthritis diagnosis codes during the month that the study opens for recruitment

link id:
  v: rm4.6
text:
  v: Will Electronic Materials be Utilized?
answer:
  value: Coding
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0532
    code:
      v: Y
    display:
      v: Yes

link id:
  v: rm4.7
text:
  v: Electronic Communication
item:
  link id:
    v: rm4.7.11
  text:
    v: Web Page Advertising
  answer:
    value:
      v: true
item:
  link id:
    v: rm4.7.12
  text:
    v: Web Page Ad Description
  answer:
    value:
      v: Ads triggered by searches for "arthritis" running for 6 months
item:
  link id:
    v: rm4.7.19
  text:
    v: eHealth Portal
  answer:
    value:
      v: true
item:
  link id:
    v: rm4.7.20
  text:
    v: eHealthPortal Description
  answer:
    value:
      v: eHealth Portal message to all patients in the Central Campus Test University eHealth Portal with arthritis diagnosis codes

link id:
  v: rm4.8
text:
  v: Will Direct Communication Materials be Utilized?
answer:
  value: Coding
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0532
    code:
      v: N
    display:
      v: No

link id:
  v: rm4.10
text:
  v: Will Group Communication Materials be Utilized?
answer:
  value: Coding
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0532
    code:
      v: N
    display:
      v: No

link id:
  v: rm4.12
text:
  v: Will Public Communication Materials be Utilized?
answer:
  value: Coding
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0532
    code:
      v: N
    display:
      v: No

link id:
  v: rm4.33
text:
  v: Attachments for Broadcast Communication Recruitment Materials
item:
  link id:
    v: rm4.33.1
  text:
    v: Describe the file that is being attached (optional)
  answer:
    value:
      v: TV Spot
item:
  link id:
    v: rm4.33.2
  text:
    v: Attachment
  answer:
    value: Attachment
      title:
        v: TVSpot.mp4

link id:
  v: rm4.35
text:
  v: Attachments for Printed Communication Recruitment Materials
item:
  link id:
    v: rm4.35.1
  text:
    v: Describe the file that is being attached (optional)
  answer:
    value:
      v: Billboard Ad
item:
  link id:
    v: rm4.35.2
  text:
    v: Attachment
  answer:
    value: Attachment
      title:
        v: BillboardAd.jpg

link id:
  v: rm4.35
text:
  v: Attachments for Printed Communication Recruitment Materials
item:
  link id:
    v: rm4.35.1
  text:
    v: Describe the file that is being attached (optional)
  answer:
    value:
      v: Postcard
item:
  link id:
    v: rm4.35.2
  text:
    v: Attachment
  answer:
    value: Attachment
      url:
        v: http://example.org/RecruitmentMaterialSamples/Postcard.doc
      title:
        v: Postcard.doc

link id:
  v: rm4.37
text:
  v: Attachments for Electronic Communication Recruitment Materials
item:
  link id:
    v: rm4.37.1
  text:
    v: Describe the file that is being attached (optional)
  answer:
    value:
      v: Web Page Advertising
item:
  link id:
    v: rm4.37.2
  text:
    v: Attachment
  answer:
    value: Attachment
      title:
        v: WebPageAd.jpg

link id:
  v: rm4.37
text:
  v: Attachments for Electronic Communication Recruitment Materials
item:
  link id:
    v: rm4.37.1
  text:
    v: Describe the file that is being attached (optional)
  answer:
    value:
      v: eHealth Portal message
item:
  link id:
    v: rm4.37.2
  text:
    v: Attachment
  answer:
    value: Attachment
      url:
        v: http://example.org/RecruitmentMaterialSamples/eHealthPortalMessage.pdf
      title:
        v: eHealthPortalMessage.pdf

link id:
  v: rm6
text:
  v: Distribution List and Audience Identification
item:
  link id:
    v: rm6.1
  text:
    v: If recruitment material is being mailed, emailed, texted or otherwise distributed, describe where/how the distribution list will be obtained.
  answer:
    value:
      v: All patients in the Central Campus Test University eHealth Portal with arthritis diagnosis codes.
item:
  link id:
    v: rm6.2
  text:
    v: 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)
  answer:
    value:
      v: TV broadcast ads are targeted at community news viewers as a whole. Web advertising is shown to search engine users who query for the keyword "arthritis".
item:
  link id:
    v: rm6.3
  text:
    v: Any necessary permission will be obtained for posting/airing these (for example, permission to post a flyer on a bulletin board).
  answer:
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0532
      code:
        v: Y
      display:
        v: Yes

link id:
  v: rm7
text:
  v: Response to Recruitment Materials
item:
  link id:
    v: rm7.1
  text:
    v: When potential participants respond to recruitment material, describe the information that will be provided to them about the study.
  answer:
    value:
      v: Inclusion and exclusion criteria, study length, study goals, explanation of a double-blind study and enrollment process.
item:
  link id:
    v: rm7.2
  text:
    v: 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.
  answer:
    value:
      v: If potential participant responds via email, then replies will be via email. If potential participant calls, then replies will be phone calls or voice messages. If potential participant responds via eHealth Portal, then replies will be via the eHealth Portal. If participants don't response, then one followup communication in the same media as the first will be one.
item:
  link id:
    v: rm7.3
  text:
    v: Types of communication methods that will be used to reply to potential participants who respond to recruitment materials
  answer:
    value: Coding
      system:
        v: http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes
      code:
        v: PHONECALL
      display:
        v: Telephone calls
  answer:
    value: Coding
      system:
        v: http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes
      code:
        v: VM
      display:
        v: Voice mail and telephone voice messages
  answer:
    value: Coding
      system:
        v: http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes
      code:
        v: EMAIL
      display:
        v: Email
  answer:
    value: Coding
      system:
        v: http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes
      code:
        v: EHPRTL
      display:
        v: eHealth Portal messaging
item:
  link id:
    v: rm7.4
  text:
    v: Attach the telephone call script for responding to potential participants
  item:
    link id:
      v: rm7.4.1
    text:
      v: Describe the file that is being attached (optional)
    answer:
      value:
        v: Telephone call reply script
  item:
    link id:
      v: rm7.4.2
    text:
      v: Attachment
    answer:
      value: Attachment
item:
  link id:
    v: rm7.5
  text:
    v: Attach the voice mail/telephone voice message script for responding to potential participants
  item:
    link id:
      v: rm7.5.1
    text:
      v: Describe the file that is being attached (optional)
    answer:
      value:
        v: Voice mail/telephone voice message script
  item:
    link id:
      v: rm7.5.2
    text:
      v: Attachment
    answer:
      value: Attachment
item:
  link id:
    v: rm7.7
  text:
    v: Attach the email script for responding to potential participants
  item:
    link id:
      v: rm7.7.1
    text:
      v: Describe the file that is being attached (optional)
    answer:
      value:
        v: Email reply message
  item:
    link id:
      v: rm7.7.2
    text:
      v: Attachment
    answer:
      value: Attachment
item:
  link id:
    v: rm7.9
  text:
    v: Attach the eHealth Portal messaging script for responding to potential participants
  item:
    link id:
      v: rm7.9.1
    text:
      v: Describe the file that is being attached (optional)
    answer:
      value:
        v: eHealth Portal reply message
  item:
    link id:
      v: rm7.9.2
    text:
      v: Attachment
    answer:
      value: Attachment

v: TelephoneReply.pdf

v: VoicemailReply.pdf

v: EmailReply.pdf

v: eHealthPortalReply.doc

link id:
  v: ADMIN00
text:
  v: Administrative Use Only
item:
  link id:
    v: ADMIN01
  text:
    v: Link ID prefix
  answer:
    value:
      v: rm
item:
  link id:
    v: ADMIN02
  text:
    v: Questionnaire Response ID for the parent Questionnaire Response (such as the Initiate a Study Questionnaire Response), if any
  answer:
    value:
      v: initiate-study-populate-exampleQR
item:
  link id:
    v: ADMIN03
  text:
    v: ID of the Research Study FHIR Resource associated with the study Questionnaire Responses
  answer:
    value:
      v: ResearchStudyExample-sIRB