The Effectiveness of Peer-to-Peer Community Support to Promote Aging in Place
Phase: NA
Conditions: Wellness Programs, Hospitalization, Emergency Room
Sponsor: University of Wisconsin, Madison

 
 
 
 
 
 
 
The Effectiveness of Peer-to-Peer Community Support to Promote 
Aging in Place  
Protocol Number:  
 
000001 
Protocol Version Date: 
4/17/2016 
Coordinating Center:  
University of Wisconsin 
Study PI:  
 
 
Elizabeth A. Jacobs, MD MAPP 
800 University Bay Drive 
Suite 210 
Madison, WI 53705 
 
Study Coordinator:   
Rebecca Schwei 
Funding Sponsor:   
Patient Centered Outcomes Research Network (PCORI) 
Sub-Investigators at Research Sites 
1. Paul Castro:  
Jewish Family Service 
 
 
 
 
 
3580 Wilshire Boulevard 
 
 
 
 
 
Seventh Floor 
 
 
 
 
 
Los Angeles, CA 90010 
 
 
 
 
 
(323) 761-8800 
 
2. Kali Deyoung:  
Community Place of Greater Rochester 
145 Parsells Ave. 
Rochester, NY 14609 
(585) 327-8839 
 
3.  Jenni Frumer:  
Alpert Jewish Family and Children’s Service 
 
 
 
 
 
5841 Corporate Way 
 
 
 
 
 
Suite 200 
 
 
 
 
 
West Palm Beach, FL 33407 
 
 
 
 
 
(561) 684-1991 
 
4. Laura Pinsoneault Alliance for Strong Families and Communities 
 
 
 
 
11700 W Lake Park Dr,  
Milwaukee, WI 53224 
 
 
 
 
414-359-6603

 
 
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Table of Contents 
 
Recruitment Strategies……………………………………………………………………………………. 2 
 
Contacting Potential Participants via the Telephone Prior to Enrollment in the Study…………….. 4 
 
Inclusion and Exclusion Criteria …………………………………………………………………………. 5 
 
Matching……………………………………………………………………………………………………. 5 
 
Enrolling More than One Person per Household …………………………………………………….. 
6 
 
Enrollment in Study………………………………………………………………………………………. 
6 
 
Updating or Changing Participant Information Once Enrolled ……………………………………… 
6 
 
Reminder Letter……………………………………………………………………………………………. 7 
 
Reminder Communication at Baseline Survey…………………………………………………………. 7 
 
Consent and Baseline Visit………………………………………………………………………………. 8 
 
Monthly Postcard Reminder……………………………………………………………………………… 8 
 
3 Month Hospital, Emergency Department, and Urgent Care Data Collection via phone………… 8 
 
6 month survey data collection in-person………………………………………………………………. 9 
 
Reminder Communication for 6 month Survey ……………………………………………………….. 
9 
 
6 month Survey-Data collection via phone…………………………………………………………….. 
10 
 
9 Month Hospital, Emergency Department, and Urgent Care Data Collection via phone………… 11  
 
12 month Endline………………………………………………………………………………………….. 111 
 
Reminder Communication for 12 month Survey……………………………………………………... 
12 
 
Medical Records Review…………………………………………………………………………………. 13 
 
Unexpected Circumstances……………………………………………………………………………… 13 
 
Exiting the Study………………………………………………………………………………………….. 
13 
 
Missing Data Points for a Participant…………………………………………………………………… 
14 
 
Reentry into the Study After Exiting……………………………………………………………………. 
14 
 
Payment…………………………………………………………………………………………………… 
14 
 
Appendix 
 
Introductory Letter for Participants (Community Place, AJFCS, JFS of LA) 
 
Failed Contact Recruitment Letter (Community Place) 
 
Reminder Letter (Community Place, AJFCS) 
 
Failed Contact 3, 6, 9, 12 month data collection (Community Place) 
 
 
 

 
 
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Recruitment Strategies 
Community Place 
Community Place currently has 210 people receiving peer to peer support and 408 people on 
the wait list to receive peer to peer support. These numbers are fluid.  All people in both groups 
have access to all other services that community place offers older adults in their community 
such as access to the Senior Center, various services we can connect with through our 
caseworker (Home delivered meals, benefits eligibility, Catholic Family Center-Elder one, Food 
link, Clothing services, legal consulting services, and Life span (Financial Budgeting, caregivers 
plan, HEP, High Cap-Health Insurance, Elder abuse prevention, and Rep pay program)).  
 
 
All the people that are in the correct age range (≥65 years old) and have no known cognitive 
impairment will be uploaded into the study database in DatStat. People receiving peer to peer 
support will receive ID Numbers R100E to R499E and people receiving standard community 
services (on the wait list to receive peer to peer support) will receive ID numbers R500C to 
R999C. The following variables or a subset of these variables will be uploaded for all 
participants: ID, First Name, Last Name, Mailing Address, Phone, Age, Date of birth, gender, 
race, language preference, P2P program type, peer companion name, study group, RA first 
name, RA last name, RA telephone, RA email, Site PI. 
 
A. One recruitment strategy will be to contact people off of a pre-specified list of people 
receiving peer to peer support or on the wait list to receive peer to peer support. These 
people are already receiving community services from Community Place.  We will send 
out letters to the first 10 people on the list. The letter will give them the option to call us 
but it will also let them know that we will be calling them within the next two weeks to see 
if they are interested in participating in the research study. Research staff will select the 
next person to call and recruit to the study in the recruitment pattern according to the 
matching strategy that the biostatisticians prepared based on the sociodemographic 
breakdown of the clientele that are currently receiving peer to peer support.  We will 
send out the Introductory Letter to potential participants on the wait list and to potential 
participants currently receiving peer to peer support. We will send out eligibility letters to 
people enrolled in peer-to-peer support and on the wait list simultaneously. Every 2-3 
weeks we will send letters to 10 new people.   
 
B. A second recruitment strategy will be by making an announcement about the study at 
monthly training meetings for both Foster grandparent and senior companion programs. 
After the announcement is made, the research coordinator will approach potential 
participants at monthly training meetings and ask them if they are interested in learning 
more. If interested, we will tell them about the study, screen them for eligibility send them 
home with a consent form and set up a time to conduct the baseline interview. There is 
the possibility of enrolling 15-20 people at this meeting. This meeting occurs every 
month.  
 
C. A third recruitment strategy will be to hold informational sessions for the purpose of 
recruiting eligible participants for the study creating our “waitlist”.   These sessions will 
be held at community centers around town and in other venues where older adults 
frequent.  
 

 
 
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D. Community Place will be partnering with Star Program to recruit additional peers. 
 
Recruitment Goal: As of February 23, 2016 the new recruitment goal at Community Place will 
be to recruit 226 participants into the study (113 experimental and 113 control) 
 
Alpert Jewish Family and Children’s Service  
The Alpert Jewish Family and Children’s Service, West Palm Beach currently serves 
approximately 205 people who receive peer to peer support. There is not currently a waiting list 
so we will be recruiting people out of the community to serve as the control group.  All people in 
both groups have access to all other services that the Jewish Family and Children’s Service 
offers older adults in the community. People receiving peer to peer support will receive ID 
Numbers PB100E to PB499E and people receiving standard community services (on the wait 
list to receive peer to peer support) will receive ID numbers PB500C to PB999C.  
 
A list of participants that are currently receiving peer to peer support will be uploaded into 
DatStat. However, only first name, age, date of birth, gender and race will be uploaded into the 
system. The Research Staff will keep a separate list of contact information for these participants 
on a secure file on her computer. Once a participant agrees to be in the study, then the 
additional contact information (phone number, address, last name) will be added into DatStat.   
 
A. One recruitment strategy will be to contact people off of a pre-specified list of people 
receiving peer to peer support. These people are already receiving services from the 
Jewish Family and Children’s Service.  We will send out letters to the first 10 people on 
the list. The letter will give them the option to call us but it will also let them know that we 
will be calling them within the next two weeks to see if they are interested in participating 
in the research study. Research staff will select the next person to call based on the 
number of people they are trying to recruit in each of the pre-specified categories (ex: 
white women 65-70). The biostatisticians have created a list of the number of people we 
should recruit in each demographic bucket based on the demographic breakdown of the 
people currently receiving peer to peer support. We will then send out the Introductory 
Letter to potential participants from the sessions (on the “wait list”) and to potential 
participants currently receiving peer to peer support. We will send out eligibility letters to 
people enrolled in peer-to-peer support and to those who are eligible for peer to peer 
services simultaneously. Every 2-3 weeks we will send letters to 20 new people.   
 
B. We are also going to hold informational sessions for the purpose of recruiting eligible 
participants for the study creating our “waitlist”.   These sessions will be held in three 
adult gated communities – Century Village, Golden Lakes and Banyan Springs and also 
our sister agencies.  We will then send out the Introductory Letter to potential 
participants from the sessions (on the “wait list”). Alternatively, we will collect 
demographic information from participants at the information sessions and if it is feasible 
we may even conduct screenings on site.  
 
We will send out eligibility letters to people enrolled in peer-to-peer support and to those who 
are eligible for peer to peer services simultaneously. Every 2-3 weeks we will send letters to 20 
new people.   

 
 
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Recruitment Goal: As of September 3, 2015 the new recruitment goal at Jewish Family Services 
of Palm Beach will be to recruit 300 participants into the study (150 experimental and 150 
control) 
 
Jewish Family Service of LA 
Jewish Family Service of Los Angeles (JFSLA) currently has 57 people receiving peer to peer 
support and 35 people on the wait list to receive peer to peer support. They are actively 
expanding their program.  All people in both groups have access to all other services that 
JFSLA offers older adults in their community such as case management, mental health 
services, link to community resources, meals, and transportation.  
 
A list of participants receiving peer to peer support will be uploaded into DatStat  
 
A. One recruitment strategy will be to contact people off of a pre-specified list of people 
receiving peer to peer support or on the wait list to receive peer to peer support. These 
people are already receiving community services from JFS of LA.  We will send out 
letters to the first 10 people on the list. The letter will give them the option to call us but it 
will also let them know that we will be calling them within the next two weeks to see if 
they are interested in participating in the research study. Research staff will select the 
next person to call and recruit to the study in the recruitment pattern according to the 
matching strategy that the biostatisticians prepared based on the sociodemographic 
breakdown of the clientele that are currently receiving peer to peer support.  We will 
send out the Introductory Letter to potential participants on the wait list and to potential 
participants currently receiving peer to peer support. We will send out eligibility letters to 
people enrolled in peer-to-peer support and on the wait list simultaneously. Every 2-3 
weeks we will send letters to 10 new people.   
 
B. A second recruitment strategy will be to recruit from Park LaBrea and/or meal programs 
that are put on by JFS of LA.  
 
Recruitment Goal: As of February 23, 2016 the new recruitment goal at Jewish Family Services 
of Los Angeles will be to recruit 60 participants into the study (30 experimental and 30 control). 
 
Contacting Potential Participants via the Telephone Prior to Enrollment in the Study (If we 
are unable to reach a potential participant via telephone, we will leave the following message.)   
 
Hello {U:DATSTAT_FIRSTNAME}. My name is {U:RA_FIRST} {U:RA_LAST} from 
{U:DATSTAT_SITE}. I am calling to see if you would like to participate in a survey research 
study to better understand what helps older adults stay in their homes and communities. If you 
are interested in learning more about the Aging in Place study please call me back at 
{U:RA_TELEPHONE} and leave me a message if I’m not at my desk. Otherwise, I will call you 
back in one week to talk with you. If you are not interested in receiving any more calls from me 
about this study, please call me and let me know and I will not contact you again.  Again, my 
name is {U:RA_FIRST} and my phone number is {U:RA_TELEPHONE} and I look forward to 
talking with you soon. Have a great day. 
 
We will call back in one week for our second attempt and leave the same message. On 
the third phone call attempt one week later, we will leave the following message. 

 
 
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Hello {U:DATSTAT_FIRSTNAME}. My name is {U:RA_FIRST} {U:RA_LAST} from 
{U:DATSTAT_SITE}. I was calling again to see if you would like to participate in the research 
study about helping older adults stay in their homes and communities.  If you are interested in 
learning more about the Aging in Place study please call me back at {U:RA_TELEPHONE} and 
leave me a message if I’m not at my desk.  I will not be reaching out to you again about this 
study. Again, my name is [U:RA_FIRST] and my phone number is [U:RA_TELEPHONE] and I 
hope to talk with you soon. Have a great day. 
 
After the third failed attempt, we will send them the Letter after 3rd attempt Failed 
Recruitment Control or Letter after 3rd attempt Failed Recruitment Experimental.  All 
attempts to contact a participant will be documented in DatStat with outcome of the call.  
 
If the research staff talks with a participant but “now is not a good time” then the research staff 
and the potential participant should set up a better time to talk, whether that is tomorrow or next 
month. In this situation, the research staff should consider this contact attempt still open (i.e. if 
this is the first attempt than the first attempt stays open). It is only when you don’t reach a 
participant that the contact attempt closes and we move on to the next contact attempt.   
 
The first time the research staff successfully connects with a participant in person or via the 
telephone they will follow the screening script outlined in the screening survey.  
 
Inclusion & Exclusion Criteria 
Inclusion Criteria 
• 
≥ 65 
• 
Eligible for peer to peer companion services 
• 
Living independently or in independent care 
 
Exclusion Criteria 
• 
Receives > 40 hours of in home care from someone other than spouse 
• 
Has plans to move to a higher level of care in the next year 
• 
Has a score on the telephone interview of cognitive status (TICS) ≤ 25 
• 
Doesn’t live permanently in one location “snow birds” 
 
If in the peer to peer group the following exclusion criteria also apply 
• 
Utilization of  a peer companion is temporary 
• 
Primary reason older adult has a peer companion is to provide respite for their 
caregiver 
 
 
Matching 
For Community Place and Alpert Jewish Family and Children’s Service (AJFCS), we are 
matching participants on the following characteristics: age group (<70, 70-80, and ≥ 80 years), 
gender (male and female), race/ethnicity (African American, Hispanic, and non-Hispanic White) 
and at Community Place we are also matching based on County (Monroe or Livingston).  
 

 
 
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At both all sites we are going to recruit people from the waiting list and match them with people 
already receiving peer to peer services.  Every month research staff at UW will ask to see the 
matching spreadsheet as a way to monitor how matching is progressing at each site. 
 
Enrolling more than one person per household (added 1/14/2016) 
 
As of February 22, 2016, we will only enroll one person per household.  This is the protocol 
for determining which person from the household we will enroll.  
a. If Participant A is enrolled in the study (signed the consent form) and they say they 
would like their partner would like to participate, the research staff person will let them 
know that according to study protocol we are only allowed to enroll one person per 
household. Participant A will be the person that is enrolled in the study.  
 
b. If prior to enrollment a study staff person is informed that both partners in a couple want 
to participate in the study. The staff person will let the two participants know that we can 
only enroll one participant from the couple. If we only need one person then the research 
staff will screen and enroll that person.  
 
c. If we know in advance there is a couple interested in participating and both people are 
needed for the study then we will randomly select one person per household. In this 
case you should screen both participants. If both participants are deemed eligible to 
participate you should first assign one participant heads and one participant tails. Then 
you should pull out the randomization envelope and open it. This envelope will tell you 
which participant you will enroll.  At this time you will discard the envelope.  
 
Enrollment in Study 
Enrolling people in the study is a three step process. Step 1, is technically a pre-screen, we only 
want to upload people into DatStat who we think are eligible. If for whatever reason we find out 
that they are not eligible then we don’t want them in the database. You can email Becky and 
she will delete their entry from DatStat. It is also a good idea for all RAs to keep a list of 
participants that have been deleted to ensure that you don’t accidentally contact them again.  
Step 2 is the formal screening. If during the formal screening it turns out that they are not 
eligible then DatStat marks them as ineligible, and they will be removed from your workflow. 
They do not need to be formally exited from the study.  Step 3 is when they sign the consent 
form during the baseline survey. Once they sign the consent form then, they are officially 
enrolled in the study. Moving forward, if for whatever reason the person withdraws consent, dies 
or meets a main study outcome that would be when you officially exit them from the study using 
the exit survey. The rule of thumb is we only exit people from the study who are officially 
enrolled, and people are only officially enrolled once they sign the consent form. 
 
Updating or changing participant information once enrolled in study 
When updating or changing participant information in Discovery, you can update participant 
information however you like, including assigning someone to the most accurate study group, 
prior to the participant signing the consent form.  Once a participant signs a consent form, at 
that time we will consider all the information entered in Discovery to be updated and accurate. 
At this point some very critical variables such as study arm, race, age, gender, site, language, 
DOB, can never be changed, even if they are wrong. If at any time after the participant signs a 

 
 
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consent, you realize there is an error in one of these data categories you cannot change the 
information in Discovery but rather you need you to record that information in a participant log (a 
word document that you will keep on your computer) and you need to alert Becky of the 
change.  Every few months Becky will ask for a copy of these participant logs. The participant 
log should include the Participant ID number, the person who made the change in the DatStat 
system, the original incorrect value and the new corrected value. 
 
If at some point you realize that you made an error in updating information, you need to let 
Becky know and she will consult with the UW research team to figure out how to move forward. 
 
Reminder Letter (if participant indicates they would like one)  
After baseline visit is scheduled reminder letter with copy of the consent form is sent to 
participant. It is up to the research staff to determine if they would like to just send the reminder 
letter or if they would like to send the reminder letter with the consent form.  
 
Reminder Communication for Baseline Survey  
Research staff can place the reminder call whenever they think makes the most sense. Some 
people prefer to place a reminder call the day before and then also call the participant in the 
morning to confirm that they are still planning on the appointment. Other staff may prefer to call 
the participant the morning of the appointment. Regardless of timing, there needs to be at least 
one reminder phone call placed and logged in DatStat. Research staff can feel free to log all of 
their contact calls but at a minimum they need to log one contact.  
 
Phone call if talking to a person 
““Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to 
remind you that I have an appointment set up with you to do your baseline survey for the Aging 
in Place Study. The appointment is at {U:BASELINE_LOCATION} on {BASELINE_DATE}.  
Does this time still work for you?” 
If yes, “Is there anything special I need to know about getting access to where you live? 
Will I need to go through a security gate, or use a buzzer to let you know I have arrive?” 
(make note of anything the relevant the participant says)  “Great, I look forward to seeing 
you soon. Please call me if you have any questions. My phone number 
{U:RA_TELEPHONE} and my name is {U:RA_FIRST} {U:RA_LAST}” 
A. If no, ask them if we can find another time to set up the appointment. Research staff 
works to set up a time for the baseline survey. Change in appointment date is 
documented in DatStat. 
Phone call-voicemail 
“Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE} and I was calling to 
remind you that I have an appointment set up with you to do your baseline survey at 
{U:BASELINE_LOCATION} at {U:BASELINE:DATE} for the Aging in Place Study.   If this time 
still works for you I do not need a call back.  If you have decided you would no longer like to 

 
 
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participate in the study or would like to change your appointment time please feel free to give 
me a call back.  My phone number is {U:RA_TELEPHONE}. Thanks and have a nice day. “ 
Consent and Baseline Visit 
Please refer to the baseline survey documents for instructions on completing the baseline visit. 
Once participants sign the consent form they are officially enrolled in the study and this is 
considered time zero for that participant.  
 
Monthly Postcard Reminders  
We will send generic thank you and reminder postcards on the first of the month to all 
participants who are active in the study at months 2, 5, 8, 11. The postcard will thank them for 
being in the study and will remind the participant to please mark down the times they go the 
hospital, emergency department and urgent care on their calendars. The postcard will also 
include the contact information for the study staff.   
 
Thank you for continuing to participate in the Aging in Place Study. Don’t forget to mark down all 
the times you stay overnight in the hospital, visit the emergency room or go to urgent care on 
your study calendar. We look forward to talking with you very soon. (Card will have study staff 
phone number) 
3 Month Hospital, Emergency Department, and Urgent Care Data Collection via phone  
The window to complete the three month data collection on time is 2 weeks before the 3 month 
anniversary and 2 weeks after the 3 month anniversary. The window will close 6 weeks after the 
3 month anniversary.  
If we are unable to reach a potential participant, we will leave a message.   
 
“Hi, my name is {U:RA_FIRST} {U:RA_LAST} from{U:DATSTAT:SITE}.  I was calling to talk to 
you about the Aging in Place study. I would like to ask you a few questions for your 3 month 
survey so please give me a call back. If you have decided you would no longer like to participate 
in the study please call me with that information as well. Again this {U:RA_FIRST} {U:RA_LAST} 
from{U:DATSTAT:SITE}.   and my phone number is{RA_TELEPHONE}. Thanks and have a 
nice day. “ 
We will call back in one week for our second attempt and leave the same message. We will call 
back in one week for our third attempt and leave the same message but it will be our last 
attempt to reach that participant via phone. If no success after the third attempt DatStat will 
trigger a letter. The letter is titled Letter after 3rd attempt to contact for data collection.  All 
attempts to contact a participant will be documented in DatStat with outcome of the calls 
documented as well.  
For questions and procedures related to 3 month data collection, please refer to the 3 month 
telephone survey document. 
 
 
6 month survey data collection in-person 

 
 
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A participant is eligible to complete the sixth month survey 2 weeks before and 2 weeks after 
but data collection will be allowed 8 weeks after the 6 month anniversary. 
 
Scheduling 6 month Survey 
Call participant 1 month before sixth month anniversary and say the following.  
 
“Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to set up 
a time to meet with you in person so we can do our next survey for the Aging in Place study.” 
Set up a time to meet with the participant in person and document in DatStat. 
If we are unable to reach a potential participant, we will leave a message.   
 
“Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to set up 
a time to meet with you in person so we can do our next survey for the Aging in Place study. If 
you could call me back so I can schedule a time for us to meet, my number is 
{U:RA_TELEPHONE}. If you have decided you would no longer like to participate in the study 
please call me with that information as well. Again this is {U:RA_FIRST} {U:RA_LAST} from 
{U:DATSTAT_SITE}.  and my phone number is {U:RA_TELEPHONE}. Thanks and have a nice 
day. “ 
We will call back in one week for our second attempt and leave the same message. We will call 
back in one week for our third attempt and leave the same message but it will be our last 
attempt to reach that participant via phone. If no success after the third attempt DatStat will 
trigger a letter. The letter is titled Letter after 3rd attempt to contact for data collection.  All 
attempts to contact a participant will be documented in DatStat with outcome of the calls 
documented as well.  
 
After an appointment is set up the staff will send a reminder letter to participants that request it, 
confirming the date and time of the appointment.  Reminder Letter Document 
Reminder Communication for 6 month Survey  
Research staff can place the reminder call whenever they think makes the most sense. Some 
people prefer to place a reminder call the day before and then also call the participant in the 
morning to confirm that they are still planning on the appointment. Other staff may prefer to call 
the participant the morning of the appointment. Regardless of timing, there needs to be at least 
one reminder phone call placed and logged in DatStat. Research staff can feel free to log all of 
their contact calls but at a minimum they need to log one contact.  
 
Phone call talking to a real person 
““Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE].  I was calling to 
remind you that I have an appointment set up with you to do our next survey for the Aging in 
Place study at {U:6MONTH_LOCATION} at {U:6MONTH_TIME}. Does this time still work for 
you?” (Response: Yes, No) 

 
 
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If yes, “Great, I look forward to seeing you soon. Please call me if you have any 
questions. My phone number is {U:RA_TELEPHONE} and my name {U:RA_FIRST} 
{U:RA_LAST}. 
If no, ask them if we can find another time to set up the appointment. Research staff 
works to set up a time for the interview. Change in appointment date is documented in 
DatStat. 
Phone call- voicemail 
“Hi, my name {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE].  I was calling to remind 
you that I have an appointment set up with you to do your sixth month followup survey at 
{U:6MONTH_LOCATION} at {U:6MONHT_TIME} for the Aging in Place Study.  If this time still 
works for you I do not need a call back.  If you have decided you would no longer like to 
participate in the study or would like to change your appointment time please feel free to give 
me a call back.  My phone number is {U:RA_TELEPHONE}. Thanks and have a nice day. “ 
6 month Survey-Data collection via phone 
A participant is eligible to complete the sixth month survey 2 weeks before and 2 weeks after 
but data collection will be allowed 8 weeks after the 6 month anniversary. 
 
“Hi, my name is U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.I was calling to see if 
now would be a good time to ask you a few questions for the sixth month follow up for the Aging 
in Place Study. Is now a good time to talk? 
 
Yes- ask all questions 
 
No-set up a better time to talk and schedule it in DatStat 
If we are unable to reach a potential participant, we will leave a message.   
 
“Hi, my name is U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE]..  I was calling to set up 
a time to talk with you. If you could call me back so I can ask you some questions for the Aging 
in Place Study, my number is {U:RA_TELEPHONE}. If you have decided you would no longer 
like to participate in the study please call me with that information as well. Again this is 
{U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE] and my phone number is 
{U:RA_TELEPHONE}. Thanks and have a nice day. “ 
We will call back in one week for our second attempt and leave the same message. We will call 
back in one week for our third attempt and leave the same message but it will be our last 
attempt to reach that participant via phone. If no success after the third attempt DatStat will 
trigger a letter. The letter is titled Letter after 3rd attempt to contact for data collection.  All 
attempts to contact a participant will be documented in DatStat with outcome of the calls 
documented as well.  
 
Please refer to the 6 month survey for instructions on how to complete the 6 month data 
collection.  

 
 
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9 Month Hospital, Emergency Department, and Urgent Care Data Collection via phone  
Window to complete the nine month data collection on time is 2 weeks before the 9 month 
anniversary and 2 weeks after the 9 month anniversary. The window will close 6 weeks after the 
9 month anniversary.  
If we are unable to reach a potential participant, we will leave a message.   
 
“Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to, as 
promised the last time we spoke, to ask you information for the Aging in Place study. If you 
could call me back so I can ask you a few questions I would really appreciate it. My number is 
{U:RA_TELEPHONE}. If you have decided you would no longer like to participate in the study 
please call me with that information as well. Again this is {U:RA_FIRST} from 
{U:DATSTAT:SITE} and my telephone number is {U:RA_TELEPHONE}. Thanks and have a 
nice day. “ 
We will call back in one week for our second attempt and leave the same message. We will call 
back in one week for our third attempt and leave the same message but it will be our last 
attempt to reach that participant via phone. If no success after the third attempt DatStat will 
trigger a letter. The letter is titled Letter after 3rd attempt to contact for data collection.  All 
attempts to contact a participant will be documented in DatStat with outcome of the calls 
documented as well.  
 
Hello {U:DATSTAT_FIRST},This is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  It 
has been 3 months since I last talked to you as a part of the Aging in Place study.  Do you have 
a minute for me to ask you a few questions? (Yes, No) 
- 
If no, schedule a better time to call back 
 
Please refer to the 9 month survey for instructions on 9 month data collection.  
 
12 month Endline 
A participant is eligible to complete the sixth month survey 2 weeks before and 2 weeks after 
but data collection will be allowed 8 weeks after the 12 month anniversary. 
 
Scheduling 12 month Survey 
Call participant 1 month before 12 month anniversary and say the following.  
 
“Hi, my name is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to set up 
a time to meet with you in person for the final survey of the Aging in Place Study.”  
 
Set up a time to meet with the participant in person and document in DatStat. 
If we are unable to reach a potential participant, we will leave a message.   
 

 
 
Page 12 of 24 
 
Last Updated: 4/17/2016 
 
“Hi, my name {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to set up a 
time to meet with you in person for the Aging in Place Study. If you could call me back so I can 
schedule a time for us to meet, my number is {U:RA_TELEPHONE}. If you have decided you 
would no longer like to participate in the study please call me with that information as well. 
Again this is {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  and my phone number is 
{U:RA_TELEPHONE}. Thanks and have a nice day. “ 
We will call back in one week for our second attempt and leave the same message. We will call 
back in one week for our third attempt and leave the same message but it will be our last 
attempt to reach that participant via phone. If no success after the third attempt DatStat will 
trigger a lette. The letter is titled Letter after 3rd attempt to contact for data collection.  All 
attempts to contact a participant will be documented in DatStat with outcome of the calls 
documented as well.  
 
After an appointment is set up the staff will send Reminder Letter to participants that request it, 
confirming the date and time of the appointment.   
Reminder Communication for 12 month Survey  
Research staff can place the reminder call whenever they think makes the most sense. Some 
people prefer to place a reminder call the day before and then also call the participant in the 
morning to confirm that they are still planning on the appointment. Other staff may prefer to call 
the participant the morning of the appointment. Regardless of timing, there needs to be at least 
one reminder phone call placed and logged in DatStat. Research staff can feel free to log all of 
their contact calls but at a minimum they need to log one contact.  
 
Phone call talking to a real person 
““Hi, my name {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to remind 
you that I have an appointment set up with you to do your final 12 month survey for the Aging in 
Place Study. Your appointment is scheduled for {U:12MONTH_DATE} at 
{U:12MONTH_LOCATION}. Does this time still work for you?” 
If yes, “Great, I look forward to seeing you soon. Please call me if you have any 
questions. My phone number is {U:RA_TELEPHONE} and my name is {U:RA_FIRST} 
{U:RA_LAST} 
If no, ask them if we can find another time to set up the appointment. Research staff 
works to set up a time for the interview. Change in appointment date is documented in 
DatStat. 
Phone call voicemail 
“Hi, my name is name {U:RA_FIRST} {U:RA_LAST} from {U:DATSTAT_SITE}.  I was calling to 
remind you that I have an appointment set up with you to do your 12 month follow-up survey for 
the Aging in Place Study. Your appointment is scheduled for {U:12MONTH_DATE} at 
{U:12MONTH_LOCATION}.  If this time still works for you I do not need a call back.  If you have 

 
 
Page 13 of 24 
 
Last Updated: 4/17/2016 
 
decided you would no longer like to participate in the study or would like to change your 
appointment time please feel free to give me a call back.  My phone number is 
{U:RA_TELEPHONE}. Thanks and have a nice day. “ 
Please refer to 12 month survey for instructions on 12 month data collection.  
Medical Chart Review 
The purpose of the Medical Chart Review Component of the Study is to see if the number of 
times participants report visiting the Emergency Department or staying overnight in the Hospital 
is consistent with what is found in the medical record. 
 
Before the next in person visit 
Prior to the next in person visit research staff should confirm that the participant signed the 
consent form for the medical chart review component of the study. If the participant has signed 
the consent form researcher staff should complete an authorization for release of medical 
records for the participant. Research staff need to complete the Patient Information section of 
the form and the date range on the Medical Records to be disclosed section. Research staff 
should bring two copies of the authorization for release of medical information form to the visit.  
Research staff should also have a copy of the medical records review form for reference. 
 
At the in person visit 
During the in person visit, at some point the research staff should remind participants about the 
second component of the study that involves requesting their medical records to confirm that 
they visited the emergency room and stayed overnight in the hospital on the days that they said 
they did. Research staff will review the authorization of release of medical information form with 
the participant and will confirm that the only medical information we are requesting is related to 
the dates you visited the Emergency Department and the nights the participant spent in the 
hospital. Research staff will ask participants to sign the authorization of release of medical 
information form and will leave an extra copy with the participant. 
 
After a participant has signed the Authorization of Release of Medical Information Form 
Once a participant has signed the release form and once they have completed the study 
(completed the endline survey or met a main outcome), research staff will copy the authorization 
file and will keep the original in a locked filing cabinet. They will fax a copy of the authorization 
form and a cover page (see supporting documents) to the medical records department at every 
hospital where the participant reported visiting in the last year.  We will track the progress of the 
submission of the requests via our data collection program, DatStat.   
 
Follow up with Medical Offices 
We will follow up with the medical records department every four weeks to ensure they are 
processing our request. 
 

 
 
Page 14 of 24 
 
Last Updated: 4/17/2016 
 
Receipt of Medical Records 
All medical records will be faxed to Dr. Elizabeth Jacobs in Madison, WI.  Once we receive a 
patient’s medical record we will enter the dates of hospitalizations and emergency department 
visits into DatStat using the Medical Record Review Form 1 and Medical Record Review Form 
2. All medical records will be kept in a locked drawer in a locked office suite.  
 
Accessing medical records for people who have died  
If a participant dies prior to us accessing their medical records, we will request the legal 
guardian or spouse to sign a new form giving us permission to access their medical records. 
 
Accessing medical records for people who withdraw from the study 
If prior to the end of the study a participant withdraws from the study, we will ask them if it is still 
okay for us to access their medical records. We will remind them that they previously gave us 
permission to do so and that this will require no additional work on their part. If a participant 
agrees to this then we will follow the protocol above for accessing medical records.  
 
Unexpected Circumstances 
Some trouble shooting situations:  
• 
If the client wants to give you food or drinks politely refuse and stress the quicker we can get 
the questionnaire done he/she can get back to their regular schedule.  
• 
Participant gets tired in the middle of the questionnaire or you can tell they have lost their 
attention span to answer the questions. Try to complete study but if not you could try to 
finish questions over the phone making it easier so you don’t have to go back to their 
homes. Payment will be sent to participant upon completion of the survey if applicable 
• 
If there are interruptions (family comes home, friend comes by to visit, package gets 
dropped off, etc.)  while questionnaire is being asked allow time for the participant to focus 
back to the task at hand. 
• 
Canceling last minute may be an issue just be sure to make follow up phone calls to 
reschedule.  
• 
Not home/forgot here the phone call the day before the scheduled time is important so they 
don’t forget you are supposed to come over.  
• 
For the control group a problem we may face is the fact that they don’t know who the 
organization is and we could have higher refusals for that group.  
 
Exiting the Study 
At any time a participant has the right to exit the study. In this case you will answer the following 
questions on behalf of the participant and then they will not be contacted again for the purposes 
of the study.  
 
Why is the participant leaving the study? (DATSTAT_EXITREASON) 
 
Completed 
 
Deceased 
 
Censored (moved to a higher level of care- i.e. independent care to assisted living) 
 
Unable to Continue (you should mark this answer if the person is too sick to continue) 
 
Unable to Locate 

 
 
Page 15 of 24 
 
Last Updated: 4/17/2016 
 
 
Unwilling to Continue 
 
Withdrawn by study staff 
 
Unknown 
 
What day did this person exit the study? (DATSTAT_EXITDATE) 
 
What other information should we know about why this person left the study? 
(DATSTAT_EXITCOMMENT) 
 
 
Missing Data Points for a Participant 
If study staff are not able to contact a participant within the appropriate window of data collection 
they have not exited the study but this is considered missing data.  We will continue trying to 
contact the participant at every data collection point unless they contact us directly and ask to 
withdraw from the study. If research staff “miss” a data collection point, they should still try to 
collect the data but will have to follow the following protocol to ensure data is collected 
accurately:  
Our DatStat workflow set up in your configuration is such that the time point gets updated when 
EITHER of the following occurs: 1) the survey for that timepoint gets submitted, OR 2) the time 
point goes out of window.  For this participant, the 3 month call went out of window, and thus the 
timepoint got updated to 6 months. 
In order to enter data for the 3 month survey at this point, the following must occur: 
1. The participant must be edited and their time point set back to “3 months”  
2. The current open survey (study task = “3 month survey”) must be closed by clicking 
Edit Survey next to the task in the Study Task grid, and changing the status to Final 
Incomplete 
3. A new 3 month survey study task must be added.  To do this, while in the study Task 
grid go to the Take Action menu and select Add Survey.  Select the survey called “3 
month Survey (Ad hoc)”.  Schedule the survey, and select the Survey Pending status 
code, and click save.  You may now use this task to enter your 3 month data.  DO 
NOT do this until you’ve done steps 1 and 2. 
Any time you make a change like this you need to mark down in your study log that you are 
making this change and mark down in your survey that this was collected out of window and the 
reason why.  You also need to alert Becky that this change is made and she will record it in the 
data log, 
Reentry into the study after exited** 
If a participant has exited the study prematurely and contacts study staff about re-entry, the 
participant is only eligible to participate if 
a. They are still within the 1 year follow up period. In this case study staff will begin 
contacting participant at appropriate time points and other data will be considered 
missing.  

 
 
Page 16 of 24 
 
Last Updated: 4/17/2016 
 
b. They sign a new consent form 
c. PI and Site PI agree to allow him/her to re-enter. 
**Participants will never be allowed to collect more than $100 for participation in the study 
 
Payment 
 
Completion of baseline= $25 
Completion of sixth month survey = $25 
Completion of endline survey at 12 months = $50.  
 
Regular Payment Schedule 
Time Zero: $25 
12 Months: $75 
 
If a participant drops out after 6 months each organization will send the participant the $25 they 
have earned. 

 
 
Page 17 of 24 
 
Last Updated: 4/17/2016 
 
Appendix 
INTRODUCTORY LETTER FOR PARTICIPANTS 
 
Community Place 
      
October 26, 2015 
 
[Recipient Name] 
Dear [Recipient Name]: 
My name is Kali DeYoung and I am the Research Assistant for the Aging Services program. I 
am writing to you today about a great opportunity for you to be a part of a research project we 
are conducting through the University of Wisconsin.   
The purpose of the research is to see if aging in place help older adults live independently in 
their homes. The information you provide and the results we conclude, will help many people in 
the future who are in your same situation. 
I will be contacting you in the next two weeks (coming weeks) to discuss your participation, 
conduct a screening and if eligible, set up a time to conduct a baseline interview for this study. 
You shall receive a small compensation as a token of appreciation for participating in this 
research project. 
I appreciate your consideration and will be happy to answer any questions you may have. I 
would be grateful if you would call me when you receive this letter even to inform me you are 
not interested. I can be reached at 585-288-0021 ext. 243 or by email 
kdeyoung@communityplace.org.  Thank you for choosing [Company Name]. And I look forward 
to speaking with you about this project.  
Sincerely,  
 
 
Kali DeYoung 
 
 

 
 
Page 18 of 24 
 
Last Updated: 4/17/2016 
 
AJFCS 
 
Dear Barry 
My name is Jenny  Madlof and I am the Research Specialist for the Aging Services program at the Alpert 
Jewish Family and Children’s Service in West Palm Beach.  I am writing to you today about a great 
opportunity for you to be part of a research project we are conducting with the University of Wisconsin. 
The purpose of the research is to evaluate if aging support programs  have the potential to help older 
adults like you live more independently in your own home.  The information you provide and the results 
we conclude, will help many people in the future who are in the same situation. 
 
I shall be contacting you soon to discuss your participation, conduct a screening and, if eligible, set up a 
time to conduct a baseline interview for this study.  You shall receive a small compensation  as a token of 
appreciation for participating in this research project.   
 
I appreciate your consideration and will be happy to answer any questions you may have.   I  can be 
reached at 561-238-0410  or by email at jmadlof@jfcsonline.com .   
 
Thank you and I look forward to speaking with you about this project. 
 
Sincerely 
 
Jenny Madlof 
Research Specialist Peer-to- Peer Aging in Place Study 
 
 

 
 
Page 19 of 24 
 
Last Updated: 4/17/2016 
 
JFS of LA 
 
[Date] 
 
Dear [Recipient Name]: 
My name is Erika Zambrano-Morales and I am the Research Coordinator for the Senior Health and 
Wellness Program, an aging services program. I am writing to you today about a great opportunity for you 
to be a part of a research project Jewish Family Service of Los Angeles is conducting with the University 
of Wisconsin.  
The purpose of the research is to see if social services programs help older adults live independently in 
their homes. The information you provide and the results we conclude, may help many people in the 
future who are in your same situation. 
I will be contacting you in the coming weeks to discuss your participation, conduct a screening and if 
eligible, set up a time to conduct an interview for this study. You will receive small financial compensation 
as a token of appreciation for participating in this research project. 
I appreciate your consideration and will be happy to answer any questions you may have. Please feel free 
to give me a call if you are not interested in participating in this research project or if you have any 
questions. I can be reached at 213.260.7919 or by email               ezambrano-morales@jfsla.org.  Thank 
you and I look forward to speaking with you soon about this project.  
Sincerely, 
     , MA 
Research Coordinator 
Senior Health and Wellness Program 
Jewish Family Service of Los Angeles 
3580 Wilshire Blvd Suite 700 
Los Angeles, CA 90010 
Phone: 213.260.7919    
Fax: 323.761.8801 
Ezambrano-morales@jfsla.org 
www.jfsla.org 
 
 
Terry Shajirat, BSW 
CONNECT Program Coordinator 
West Hollywood Comprehensive Service 
Center- Jewish Family Service of Los Angeles 
7377 Santa Monica Blvd. 
West Hollywood, CA 90046 
Phone: 323.851.8202 ext. 115 
Fax: 323.876.6140 
tshajirat@jfsla.org 
www.jfsla.org 

 
Appendix 
 
Last Updated: 11/30/2015 
 
 
FAILED CONTACT FOR RECRUITMENT LETTER 
      
Community Place 
 
[Your Name] 
[Date] 
 
 
[Recipient Name] 
[Street Address]   
[City, ST Zip Code] 
Dear [Recipient Name]: 
My name is Kali DeYoung and I am the Research Assistant for the Aging Services program at the 
Community Place of Greater Rochester. I am writing to you today because I have been unable to reach 
you by phone to discuss the research project we are enrolling clients into.    
Please call or send me an e-mail at your earliest convenience so I can update your information even if 
you do not want to be a part of the research project.  I would be grateful for your call and will be happy to 
answer any questions or concerns you may have. I can be reached at 585-288-0021 ext. 243 or by email 
kdeyoung@communityplace.org.  Thank you and I hope to hear from you soon.  
Sincerely, 
[Your Name]  
Research Assistant 
 
 

 
Appendix 
 
Last Updated: 11/30/2015 
 
REMINDER LETTERS 
 
Community Place 
 
[Your Name] 
145 Parsells Avenue 
Rochester, NY 14609 
[Date] 
 
 
[Recipient Name] 
[Address] 
[City, ST ZIP Code] 
Dear [Recipient Name]: 
I am Kali DeYoung, the Research Assistant for the “Aging in Place” study. I am writing to you 
today to confirm our appointment.   
I have an appointment on my calendar for DATE at TIME. If this time still works I will see you 
then but if it isn’t a good time please let me know so we can make a new appointment. I can be 
reached at 585-288-0021 ext. 243 or by email kdeyoung@communityplace.org. (I have also 
included copies of the consent forms we will discuss and sign during our appointment.) 
{Depends on the person} Please let me know if you have any questions or concerns. I look 
forward to meeting with you. 
Sincerely, 
[Your Name]  
Research Assistant  
 
 

 
Appendix 
 
Last Updated: 11/30/2015 
 
AJFCS 
 
Dear Loretta 
My name is Jenny Madlof and I am the Research Specialist for the Older Adults Service.of the Alpert 
Jewish Family and Children’s Service in West Palm Beach..  I am writing to you today to confirm our 
appointment to do the baseline survey for the Aging in Place Research Study.   
As agreed upon today, we have an appointment for Monday, October 12, 2015 at 10:00 am in your home.     
If this time is not suitable, please let me know. I can be reached at 561-238-0410 or by email 
jmadlof@jfcsonline.com.  
I look forward to seeing you soon. 
Sincerely, 
 
[Your Name]  
Research Specialist 
 
 
 

 
Appendix 
 
Last Updated: 11/30/2015 
 
FAILED DATA COLLECTION AT 3, 6, 9 OR 12 MONTHS 
 
Community Place 
      
[Your Name] 
145 Parsells Avenue 
Rochester, NY 14609 
[Date] 
 
 
[Recipient Name] 
[Street Address] 
[City, ST  ZIP Code] 
Dear [Recipient Name]: 
 
Thank you for your participation in the study with [Company Name]. I am writing to you 
today because I have been unable to reach you by phone or e-mail to complete the next 
step of our research project. I would be happy to update your information to try and 
keep everything on track.  
Please call or send me an e-mail at your earliest convenience. I would be grateful for 
your call and will be happy to answer any questions or concerns you may have. I can be 
reached at 585-288-0021 ext. 243 or by email kdeyoung@communityplace.org. I look 
forward to hearing from you.  
Sincerely, 
[Your Name]  
Research Assistant