{
"description": null,
"_filename": "example/Questionnaire-sirb-recruitment-materials-questionnaire.json",
"package_name": "hl7.fhir.us.sirb",
"subjectType": [ "ResearchStudy" ],
"date": "2021-08-10T13:15:03+00:00",
"meta": {
"source": "#FuiyLAatHKRZGbor",
"versionId": "14",
"lastUpdated": "2021-07-25T19:43:52.228+00:00"
},
"publisher": "HL7 International - BR&R Work Group",
"jurisdiction": [ {
"text": "United States of America",
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166",
"display": "United States of America"
} ]
} ],
"name": "RecruitmentMaterials",
"item": [ {
"item": [ {
"item": [ {
"text": "Short Title of the Research Study intended for the lay audience",
"type": "display",
"linkId": "rm1.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
} ],
"text": "Study Title",
"type": "string",
"linkId": "rm1.1",
"required": false
}, {
"item": [ {
"text": "IRB number assigned",
"type": "display",
"linkId": "rm1.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
} ],
"text": "IRB Protocol Number",
"type": "string",
"linkId": "rm1.2",
"required": false
} ],
"text": "Research Study",
"type": "group",
"linkId": "rm1",
"required": false
}, {
"item": [ {
"text": "Institution Name",
"type": "string",
"linkId": "rm2.1",
"required": true
}, {
"text": "City",
"type": "string",
"linkId": "rm2.2",
"required": true
}, {
"text": "State",
"type": "string",
"linkId": "rm2.3",
"required": true
}, {
"text": "Country",
"type": "string",
"linkId": "rm2.4",
"required": true
}, {
"text": "Is this institution the sIRB (Reviewing Site) or a Relying Site?",
"type": "choice",
"linkId": "rm2.5",
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "sIRB",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "sIRB (Reviewing Site)"
}
}, {
"valueCoding": {
"code": "Relying",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "Relying Site"
}
} ]
} ],
"text": "Study Institution for which Recruitment Materials are being provided",
"type": "group",
"linkId": "rm2",
"repeats": false,
"readOnly": false,
"required": false
}, {
"item": [ {
"text": "The primary site investigator to contact",
"type": "display",
"linkId": "rm3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
}, {
"item": [ {
"text": "First or given name associated with the site principal investigator",
"type": "display",
"linkId": "rm3.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
} ],
"text": "First Name",
"type": "string",
"linkId": "rm3.1",
"required": true
}, {
"item": [ {
"text": "Surname or family name associated with the site principal investigator",
"type": "display",
"linkId": "rm3.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
} ],
"text": "Last Name",
"type": "string",
"linkId": "rm3.3",
"required": true
}, {
"item": [ {
"text": "Suffix such as Junior (Jr.), Senior (Sr.), I, II, III, IV, etc. associated with the site principal investigator's name",
"type": "display",
"linkId": "rm3.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
} ],
"text": "Suffix",
"type": "string",
"linkId": "rm3.2",
"repeats": false,
"readOnly": false,
"required": false
}, {
"item": [ {
"text": "Professional and Academic degrees associated with the site principal investigator",
"type": "display",
"linkId": "rm3.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control"
} ]
}
} ]
} ],
"text": "Degree(s)",
"type": "string",
"linkId": "rm3.4",
"repeats": false,
"readOnly": false,
"required": false
} ],
"text": "Site Principal Investigator for the Site for which Recruitment Materials are being submitted",
"type": "group",
"linkId": "rm3",
"repeats": false,
"readOnly": false,
"required": false
}, {
"item": [ {
"text": "Media of any type used as part of a participant recruitment strategy.",
"type": "display",
"linkId": "rm4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
}, {
"text": "Will Recruitment Materials be Utilized?",
"type": "choice",
"linkId": "rm4.1",
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ]
}, {
"enableBehavior": "all",
"linkId": "rm4.2",
"item": [ {
"text": "The distribution of audio or video content to a dispersed audience via any electronic mass communications medium.",
"type": "display",
"linkId": "rm4.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"type": "choice",
"enableWhen": [ {
"operator": "=",
"question": "rm4.1",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"required": false,
"text": "Will Broadcast Materials be Utilized?"
}, {
"item": [ {
"text": "Audio or video content to a dispersed audience via any electronic mass communications medium",
"type": "display",
"linkId": "rm4.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
}, {
"item": [ {
"text": "A contiguous sound recording used to relay audible information.",
"type": "display",
"linkId": "rm4.3.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Audio",
"type": "boolean",
"linkId": "rm4.3.1",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.3.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Audio Description",
"type": "text",
"linkId": "rm4.3.2",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.3.1",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Video content to a dispersed audience via any electronic mass communications medium",
"type": "display",
"linkId": "rm4.3.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Video",
"type": "boolean",
"linkId": "rm4.3.3",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.3.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Video Description",
"type": "text",
"linkId": "rm4.3.4",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.3.3",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A contiguous segment of audio broadcasting airtime.",
"type": "display",
"linkId": "rm4.3.5_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Radio Spot",
"type": "boolean",
"linkId": "rm4.3.5",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.3.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Radio Spot Description",
"type": "text",
"linkId": "rm4.3.6",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.3.5",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A contiguous segment of video broadcasting airtime.",
"type": "display",
"linkId": "rm4.3.7_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "TV Spot",
"type": "boolean",
"linkId": "rm4.3.7",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.3.8_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "TV Spot Description",
"type": "text",
"linkId": "rm4.3.8",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.3.7",
"answerBoolean": true
} ],
"enableBehavior": "all"
} ],
"text": "Broadcast Communication",
"type": "group",
"linkId": "rm4.3",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.2",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"enableBehavior": "all"
}, {
"enableBehavior": "all",
"linkId": "rm4.4",
"item": [ {
"text": "Materials produced by printers or publishers, such as books, magazines, booklets, brochures, newspaper.",
"type": "display",
"linkId": "rm4.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"type": "choice",
"enableWhen": [ {
"operator": "=",
"question": "rm4.1",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"required": false,
"text": "Will Printed Materials be Utilized?"
}, {
"item": [ {
"item": [ {
"text": "A large outdoor advertising space designed to capture the attention of motorists and pedestrians.",
"type": "display",
"linkId": "rm4.5.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Billboard/Bus Ad",
"type": "boolean",
"linkId": "rm4.5.1",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Billboard/Bus Ad Description",
"type": "text",
"linkId": "rm4.5.2",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.1",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A small book or magazine that contains images and information about a company or organization's products and/or services.",
"type": "display",
"linkId": "rm4.5.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Brochure/Pamphlet",
"type": "boolean",
"linkId": "rm4.5.3",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Brochure/Pamphlet Description",
"type": "text",
"linkId": "rm4.5.4",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.3",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A small piece of paper with information on it about a product or event",
"type": "display",
"linkId": "rm4.5.5_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Flyer/Notice",
"type": "boolean",
"linkId": "rm4.5.5",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Flyer/Notice Description",
"type": "text",
"linkId": "rm4.5.6",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.5",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A periodical publication containing articles and illustrations.",
"type": "display",
"linkId": "rm4.5.7_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Magazine",
"type": "boolean",
"linkId": "rm4.5.7",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.8_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Magazine Description",
"type": "text",
"linkId": "rm4.5.8",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.7",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Letters and packages conveyed by the postal system.",
"type": "display",
"linkId": "rm4.5.9_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Mail",
"type": "boolean",
"linkId": "rm4.5.9",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.10_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Mail Description",
"type": "text",
"linkId": "rm4.5.10",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.9",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A printed publication (usually issued daily or weekly) consisting of folded unstapled sheets and containing news, feature articles and advertisements.",
"type": "display",
"linkId": "rm4.5.11_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Newspaper",
"type": "boolean",
"linkId": "rm4.5.11",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.12_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Newspaper Description",
"type": "text",
"linkId": "rm4.5.12",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.11",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A message by mail without an envelope.",
"type": "display",
"linkId": "rm4.5.13_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Postcard",
"type": "boolean",
"linkId": "rm4.5.13",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.14_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Postcard Description",
"type": "text",
"linkId": "rm4.5.14",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.13",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A large printed picture, photograph, or notice that you stick or pin to a wall or board, usually for decoration or to advertise something.",
"type": "display",
"linkId": "rm4.5.15_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Poster/Sign",
"type": "boolean",
"linkId": "rm4.5.15",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.16_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Poster/Sign Description",
"type": "text",
"linkId": "rm4.5.16",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.15",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A self-standing promotional unit created from printed and folded card stock for table tops.",
"type": "display",
"linkId": "rm4.5.17_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Table Tent",
"type": "boolean",
"linkId": "rm4.5.17",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.5.18_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Table Tent Description",
"type": "text",
"linkId": "rm4.5.18",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.5.17",
"answerBoolean": true
} ],
"enableBehavior": "all"
} ],
"text": "Printed Communication",
"type": "group",
"linkId": "rm4.5",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.4",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"enableBehavior": "all"
}, {
"enableBehavior": "all",
"linkId": "rm4.6",
"item": [ {
"text": "Computer-based technology that facilitates the sharing of ideas and information and the building of virtual networks and communities.",
"type": "display",
"linkId": "rm4.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"type": "choice",
"enableWhen": [ {
"operator": "=",
"question": "rm4.1",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"required": false,
"text": "Will Electronic Materials be Utilized?"
}, {
"item": [ {
"item": [ {
"text": "Messages distributed by electronic means from one computer user to one or more recipients via a network.",
"type": "display",
"linkId": "rm4.7.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Email",
"type": "boolean",
"linkId": "rm4.7.1",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Email Description",
"type": "text",
"linkId": "rm4.7.2",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.1",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "An online platform that allows users to create a public profile and interact with other users on the website.",
"type": "display",
"linkId": "rm4.7.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Networking Site",
"type": "boolean",
"linkId": "rm4.7.3",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Networking Site Description",
"type": "text",
"linkId": "rm4.7.4",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.3",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A digital audio file made available on the internet for download to a computer or mobile device. Typically available as a series.",
"type": "display",
"linkId": "rm4.7.5_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Podcast",
"type": "boolean",
"linkId": "rm4.7.5",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Podcast Description",
"type": "text",
"linkId": "rm4.7.6",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.5",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A computer-based technology that facilitates the sharing of ideas and information and the building of virtual networks and communities.",
"type": "display",
"linkId": "rm4.7.7_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Social Media",
"type": "boolean",
"linkId": "rm4.7.7",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.8_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Social Media Description",
"type": "text",
"linkId": "rm4.7.8",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.7",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A form of advertising on the Word Wide Web delivered by an ad server and/or embedded in a web page.",
"type": "display",
"linkId": "rm4.7.11_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Web Page Advertising",
"type": "boolean",
"linkId": "rm4.7.11",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.12_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Web Page Ad Description",
"type": "text",
"linkId": "rm4.7.12",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.11",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Communication posted for public viewing or an electronic message sent to & displayed on an online forum.",
"type": "display",
"linkId": "rm4.7.13_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Web/Internet Posting",
"type": "boolean",
"linkId": "rm4.7.13",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.14_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Web/Internet Posting Description",
"type": "text",
"linkId": "rm4.7.14",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.13",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A page or collection of pages on the World Wide Web that contains specific information which was all provided by one person, group or an organization",
"type": "display",
"linkId": "rm4.7.15_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Website",
"type": "boolean",
"linkId": "rm4.7.15",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.16_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Website Description",
"type": "text",
"linkId": "rm4.7.16",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.15",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Text messaging, or texting, is the transmission of electronic communication between two or more users, often via mobile phones.",
"type": "display",
"linkId": "rm4.7.17_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Text messaging",
"type": "boolean",
"linkId": "rm4.7.17",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.18_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Texting Description",
"type": "text",
"linkId": "rm4.7.18",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.17",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Communication to user(s) via the eHealth Portal or similar electronic medical record system",
"type": "display",
"linkId": "rm4.7.19_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "eHealth Portal",
"type": "boolean",
"linkId": "rm4.7.19",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.20_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "eHealthPortal Description",
"type": "text",
"linkId": "rm4.7.20",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.19",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Use of two-way video communications via a computer, tablet or mobile phone",
"type": "display",
"linkId": "rm4.7.21_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Video Conferencing",
"type": "boolean",
"linkId": "rm4.7.21",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.7.22_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Video Conferencing Description",
"type": "text",
"linkId": "rm4.7.22",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.7.19",
"answerBoolean": true
} ],
"enableBehavior": "all"
} ],
"text": "Electronic Communication",
"type": "group",
"linkId": "rm4.7",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.6",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"enableBehavior": "all"
}, {
"enableBehavior": "all",
"linkId": "rm4.8",
"item": [ {
"text": "Communication addressed to a specific person.",
"type": "display",
"linkId": "rm4.8_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"type": "choice",
"enableWhen": [ {
"operator": "=",
"question": "rm4.1",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"required": false,
"text": "Will Direct Communication Materials be Utilized?"
}, {
"item": [ {
"item": [ {
"text": "Involves a person's physical presence rather than communication by phone, email, etc.,",
"type": "display",
"linkId": "rm4.9.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "In-Person Discussion",
"type": "boolean",
"linkId": "rm4.9.1",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.9.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "In-Person Discussion Description",
"type": "text",
"linkId": "rm4.9.2",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.9.1",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A written, typed, or printed communication, especially one sent in an envelope by mail or messenger:",
"type": "display",
"linkId": "rm4.9.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Letter/Invitation",
"type": "boolean",
"linkId": "rm4.9.3",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.9.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Letter/Invitation Description",
"type": "text",
"linkId": "rm4.9.4",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.9.3",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A communication or conversation by phone.",
"type": "display",
"linkId": "rm4.9.5_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Phone Call",
"type": "boolean",
"linkId": "rm4.9.5",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.9.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Phone Call Description",
"type": "text",
"linkId": "rm4.9.6",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.9.5",
"answerBoolean": true
} ],
"enableBehavior": "all"
} ],
"text": "Direct Communication",
"type": "group",
"linkId": "rm4.9",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.8",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"enableBehavior": "all"
}, {
"enableBehavior": "all",
"linkId": "rm4.10",
"item": [ {
"text": "Communication addressed to a defined group of people.",
"type": "display",
"linkId": "rm4.10_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"type": "choice",
"enableWhen": [ {
"operator": "=",
"question": "rm4.1",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"required": false,
"text": "Will Group Communication Materials be Utilized?"
}, {
"item": [ {
"item": [ {
"text": "An ad that may take many different forms. It could be a banner, a graphic image or an animated GIF of a designated pixel size and byte size.",
"type": "display",
"linkId": "rm4.11.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Advertisement",
"type": "boolean",
"linkId": "rm4.11.1",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.11.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Advertisement Description",
"type": "text",
"linkId": "rm4.11.2",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.11.1",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A website or web page where users can post comments about a particular issue or topic and reply to other users' postings.",
"type": "display",
"linkId": "rm4.11.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Bulletin Board",
"type": "boolean",
"linkId": "rm4.11.3",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.11.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Bulletin Board Description",
"type": "text",
"linkId": "rm4.11.4",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.11.3",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "Communication issued periodically to the members of a society, business, or organization.",
"type": "display",
"linkId": "rm4.11.5_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Newsletter",
"type": "boolean",
"linkId": "rm4.11.5",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.11.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Newsletter Description",
"type": "text",
"linkId": "rm4.11.6",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.11.5",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A scholarly journal addressed to a particular professional audience such as doctors, teachers or engineers and published by a professional organization.",
"type": "display",
"linkId": "rm4.11.7_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Professional Journal",
"type": "boolean",
"linkId": "rm4.11.7",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.11.8_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Professional Journal Description",
"type": "text",
"linkId": "rm4.11.8",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.11.7",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A publication that containing the latest information/tips/predictions for a particular business or stock market information or horse racing results, etc.",
"type": "display",
"linkId": "rm4.11.9_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Tip Sheet",
"type": "boolean",
"linkId": "rm4.11.9",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.11.10_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Tip Sheet Description",
"type": "text",
"linkId": "rm4.11.10",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.11.9",
"answerBoolean": true
} ],
"enableBehavior": "all"
} ],
"text": "Group Communication",
"type": "group",
"linkId": "rm4.11",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.10",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"enableBehavior": "all"
}, {
"enableBehavior": "all",
"linkId": "rm4.12",
"item": [ {
"text": "Communication addressed to the public.",
"type": "display",
"linkId": "rm4.12_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"type": "choice",
"enableWhen": [ {
"operator": "=",
"question": "rm4.1",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"required": false,
"text": "Will Public Communication Materials be Utilized?"
}, {
"item": [ {
"item": [ {
"text": "A public and typically formal statement about a fact, occurrence, or intention.",
"type": "display",
"linkId": "rm4.13.1_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Announcement",
"type": "boolean",
"linkId": "rm4.13.1",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.13.2_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Announcement Description",
"type": "text",
"linkId": "rm4.13.2",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.13.1",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A written statement about a matter of public interest which is given to the press by an organization concerned with the matter.",
"type": "display",
"linkId": "rm4.13.3_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Press Release",
"type": "boolean",
"linkId": "rm4.13.3",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.13.4_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Press Release Description",
"type": "text",
"linkId": "rm4.13.4",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.13.3",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A method of communication involving asking for or trying to obtain something from someone in public.",
"type": "display",
"linkId": "rm4.13.5_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Public Solicitation",
"type": "boolean",
"linkId": "rm4.13.5",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.13.6_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Public Solicitation Description",
"type": "text",
"linkId": "rm4.13.6",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.13.5",
"answerBoolean": true
} ],
"enableBehavior": "all"
}, {
"item": [ {
"text": "A technique among social scientists who wish to work with a population that is difficult to identify or locate.",
"type": "display",
"linkId": "rm4.13.7_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Snowball Sampling",
"type": "boolean",
"linkId": "rm4.13.7",
"required": false
}, {
"item": [ {
"text": "Specify when, where, duration and frequency of the recruitment materials that will be published, aired, distributed, posted or sent.",
"type": "display",
"linkId": "rm4.13.8_help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Snowball Sampling Description",
"type": "text",
"linkId": "rm4.13.8",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.13.7",
"answerBoolean": true
} ],
"enableBehavior": "all"
} ],
"text": "Public Communication",
"type": "group",
"linkId": "rm4.13",
"required": false,
"enableWhen": [ {
"operator": "=",
"question": "rm4.12",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532"
}
} ],
"enableBehavior": "all"
} ],
"text": "Recruitment Materials",
"type": "group",
"linkId": "rm4",
"required": false
}, {
"item": [ {
"text": "If recruitment material is being mailed, emailed, texted or otherwise distributed, describe where/how the distribution list will be obtained.",
"type": "text",
"linkId": "rm6.1",
"required": false
}, {
"text": "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)",
"type": "text",
"linkId": "rm6.2",
"required": false
}, {
"text": "Any necessary permission will be obtained for posting/airing these (for example, permission to post a flyer on a bulletin board).",
"type": "choice",
"linkId": "rm6.3",
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Drop down",
"coding": [ {
"code": "drop-down",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Drop down"
} ]
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "Yes"
}
}, {
"valueCoding": {
"code": "N",
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"display": "No"
}
} ]
} ],
"text": "Distribution List and Audience Identification",
"type": "group",
"linkId": "rm6",
"repeats": false,
"readOnly": false,
"required": false
}, {
"item": [ {
"text": "When potential participants respond to recruitment material, describe the information that will be provided to them about the study.",
"type": "text",
"linkId": "rm7.1",
"required": false
}, {
"text": "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.",
"type": "text",
"linkId": "rm7.2",
"required": false
}, {
"text": "Types of communication methods that will be used to reply to potential participants who respond to recruitment materials",
"type": "open-choice",
"linkId": "rm7.3",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Check box",
"coding": [ {
"code": "check-box",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Check-box"
} ]
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "VM",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "Telephone and voice messages"
}
}, {
"valueCoding": {
"code": "VC",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "Video Conferencing"
}
}, {
"valueCoding": {
"code": "EMAIL",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "Email"
}
}, {
"valueCoding": {
"code": "TXT",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "Text messages/texting"
}
}, {
"valueCoding": {
"code": "EHPRTL",
"system": "http://hl7.org/fhir/us/sirb/CodeSystem/temporarycodes",
"display": "eHealth Portal messaging"
}
} ]
}, {
"text": "Attach the telephone and/or computer video conferencing script for responding to potential participants",
"type": "attachment",
"linkId": "rm7.4",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "image/jpeg"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "application/pdf"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal": 5
} ]
}, {
"text": "Attach the voice mail script for responding to potential participants",
"type": "attachment",
"linkId": "rm7.5",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "image/jpeg"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "application/pdf"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal": 5
} ]
}, {
"text": "Attach the email script for responding to potential participants",
"type": "attachment",
"linkId": "rm7.6",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "image/jpeg"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "application/pdf"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal": 5
} ]
}, {
"text": "Attach the text messaging script for responding to potential participants",
"type": "attachment",
"linkId": "rm7.7",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "image/jpeg"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "application/pdf"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal": 5
} ]
}, {
"text": "Attach any other script for responding to potential participants",
"type": "attachment",
"linkId": "rm7.8",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "image/jpeg"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "application/pdf"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal": 5
} ]
} ],
"text": "Response to Recruitment Materials",
"type": "group",
"linkId": "rm7",
"repeats": false,
"readOnly": false,
"required": false
}, {
"item": [ {
"text": "Link ID prefix",
"type": "string",
"linkId": "ADMIN01",
"initial": [ {
"valueString": "rm"
} ],
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
} ]
}, {
"text": "Questionnaire Response ID for the parent Questionnaire Response (such as the Initiate a Study Questionnaire Response), if any",
"type": "string",
"linkId": "ADMIN02",
"initial": [ {
"valueString": "temporarily unavailable"
} ],
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
} ]
}, {
"text": "ID of the Research Study FHIR Resource associated with the study Questionnaire Responses",
"type": "string",
"linkId": "ADMIN03",
"initial": [ {
"valueString": "temporarily unavailable"
} ],
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
} ]
}, {
"text": "Questionnaire Response ID of the local considerations Questionnaire Response, if any",
"type": "string",
"linkId": "ADMIN04",
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
} ]
} ],
"text": "Administrative Use Only",
"type": "group",
"linkId": "ADMIN00",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
} ]
} ],
"type": null,
"experimental": "false",
"resourceType": "Questionnaire",
"title": "Recruitment Materials",
"package_version": "0.1.0",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "lookupInitiateStudy",
"language": "application/x-fhir-query",
"expression": "https://docr-fhir.dev.cloud.duke.edu/hapi-fhir-jpaserver/fhir/QuestionnaireResponse/QRIDInitiateStudy",
"description": "response to get the data from"
}
} ],
"status": "draft",
"id": "a3825425-877a-49b8-88d6-49aa354fa788",
"kind": null,
"url": "http://hl7.org/fhir/us/sirb/Questionnaire/sirb-recruitment-materials-questionnaire",
"version": "0.1.0",
"contact": [ {
"name": "HL7 International - Biomedical Research and Regulation",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/rcrim",
"system": "url"
} ]
} ]
}