Hi, I’m ___________ and I’m calling from the Muskie School of Public Service in Portland, Maine. We are an organization that does research to improve services for children and families. You answered our flyer (or however you got their name).

Pause for verification. If respondent draws a blank, ask: Is there someone in your household who might have contacted us? Can we speak with that person? If person indicated they can’t talk now: “Is there a better time we could call? (Make an appointment).

Once connected with the right person:

We are organizing small groups around the state for parents to talk about their experiences finding day care for children with special needs or chronic illnesses.

We are interested in finding out about your experiences so that we can try and improve day care services for children with special needs or chronic illnesses. The information we gather will be completely confidential. Your name and your child’s name will not be used or associated with the information you provide.

Do you have any questions about the study? (answer questions)

In order for me to select and put together these groups of parents, I need to find out some details about your family. If you don’t feel comfortable answering a question, it’s fine to say so. Is it OK for me to ask some questions about your family?

If they say no, thank them for their time. If they say yes, thank them and ask them the questions below.

1.) Do you have a child with special needs or a chronic illness? Yes / No

__ If no, explain that that’s who we’re looking for and thank them for their time.
__ If yes, continue.

2.) Is that child 6 years old or younger? (If respondent has more than one child with special needs age 6 or under- determine which one has the most severe special need and ask questions about that child)

__ Yes, how old? ____________ (Boy / Girl)
__ No

__ If no, explain that that’s who we’re looking for and thank them for their time.
__ If yes, continue.

3.) How many people in your family (or household)? __________

4.) Is your total family income less than: (NOTE: These are choices for how to ask the question depending on the easiest way for them to answer the question.)

$17 per hour (if 2 earners, combined hourly wage); or
$685 weekly; or
$2,740 monthly; or
$32,900 annually

__ Yes
__ No

__ If no, explain that that’s who we’re looking for and thank them for their time.
__ If yes, continue.

5.) Has your child received a diagnosis? If so, what is it?

6.) How would you describe your child’s special need or chronic illness? (Ex. Developmental delays, how does it affect child care…)

7.) Is English your everyday language? (if no): How well would you say you spoke English? (Can explain that we may be conducting some groups or interviews in other languages.)

__ Very Well
__ Well
__ Fair… What language do you usually speak? ___________________
__ Not very well… What language do you usually speak? _______________

8. What town or city do you live in? (please make note of town, county & state)

__________________________________ How long have you lived there? ____ yrs

9. Do you or anyone else in your household work outside the home?
__ Yes
__ No

If yes,
__ Full-time?
__ Part-time?

If no, have you or anyone else in your household worked outside the home in the last two years?

__ Yes
__ No

10. Is your child with special needs in care outside of your home during the day or night?

__ Yes
__ No

If no, has that child been in care outside the home in the last two years?

__ Yes
__ No

11. Are you receiving TANF or cash assistance benefits?

__ Yes
__ No

If no, have you received them in the past two years?

__ Yes
__ No

12. Are you receiving SSI (Social Security) for your child with special needs?

__ Yes
__ No

If no, have you received it in the past two years?

__ Yes
__ No

Tell them about the stipend and explain that child care will be provided at the meetings.

If you are selected to participate, would you need child care?

__ Yes
__ No

If yes, for how many children? _________

What ages? _________________________

Please tell us about any special arrangements we need to make for your child with special needs. ________________________________________

________________________________________________________________ (if the special needs are not something we can accommodate, offer to reimburse them for child care in their home)

How did you hear about this project? (see a flyer, Head Start) ____________________

Are you available on: ______________________

Would an evening focus group work for you? ___________________________

If you’re not sure whether you want to invite them to participate, tell them you’ll call them back and ask them their:

Name:

Phone Number:

Best time to reach you?

(NOTE: If they don’t have a phone ask them if there is a number of a friend, neighbor or family member who you could call who could get in touch with them.)

If you’re not sure whether you will include the person, thank them and tell them you will call them.

If you have decided to invite the person, give them the date, time and site location and tell them that you will give them a reminder call.

Thank them for their time!!!!

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