Tips for Case and Contact Interviews

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Tips for Case and Contact Interviews

• Public Health Seattle and King County

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Objectives

• To improve the interviewers ability to get
  accurate and complete information from cases and
  contacts during an outbreak or disease
  investigation.

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Suggestions on how to find people

• Look people up on the internet via their name or
  address
• Go to places such as homeless shelters, bars etc.
  where cases have said contacts might be found
• Coordinate with human resource employees at place
  of work or school

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Establish an interview plan

• Introduce yourself
• State why you are there and what the goals of the
  interview are
• If patient has medical or treatment questions
  then these need to be referred back to their
  primary health care provider. If they dont have
  a provider then if possible, provide them
  assistance in linking with someone.

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Basic Positive Interview Techniques

• Put the interviewee at ease by establishing
  rapport and arranging for privacy
• Create an atmosphere free of distractions and
  interruptions
• Listen attentively be objective and avoid
  emotional reactions
• Demonstrate self confidence regarding the disease
  and public health

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Basic Positive Interview Techniques continued

• Maintain cultural sensitivity in all actions and
  interactions
• Address psychosocial and spiritual needs as
  appropriate
• Ask questions one at a time and wait for a
  response
• Resist the desire to go to another question
  before getting the full answer you need

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Basic Positive Interview Techniques continued

• Use positive questions to encourage a positive
  response
• When possible avoid negative questions to avoid
  negative responses

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Use open ended questions rather than yes or no
questions

• An open ended question is a question that can not
  be answered by a yes or a no. They are designed
  to elicit patients knowledge, feelings and
  beliefs.
• Often a standardized interview form is used. In
  this case open ended questions are not used.

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Samples of some open ended questions

• They should begin with words such as
• What?
• Why?
• Who?
• When?
• How?

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Introduction

• Break the ice with brief and comfortable dialog
• Demonstrate warmth, caring and sincerity
• Define the purpose, establish a working
  relationship and secure cooperation
• Provide reassurance that confidentiality will be
  maintained and if needed, explain how this is
  done
• Have resource information to provide if needed
  such as housing, food etc.

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Introduction continued

• Some good ways to start are
• Asking how a person is feeling now.
• Confirming their name and address
• Start with more general questions and leave the
  most sensitive questions until last.

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Information giving and receiving

• Identify and resolve the persons concerns
• Correct myths and educate about the disease and
  its transmission
• Reinforce the need for following the disease
  treatment and control plan
• assess compliance and implement measures to
  increase adherence to treatment

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Information giving and receiving continued

• Begin with the most familiar contact information
  - close contacts - and move outward slowly
• Ask for names, phone numbers and any other needed
  identifying information for each contact
• Document information as completely as possible
  while still maintaining rapport with the person

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Information giving and receiving continued

• Cover each area, (church, school, work, gym
  etc.), where person has contacts comprehensively,
  allowing the person to return to a previous area
  when needed, be flexible.
• Be aware that the patient may share information
  about people living in the US illegally or about
  illegal activities such as drug use. It is
  important that the patient know this information
  is confidential and will not be shared.

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Use of interpreters

• If a case or contact does not speak English it is
  important to use a certified health department
  interpreter.
• Often information is private and a family member
  should not be used to do the interpreting.
• If a language barrier is encountered it is best
  to get as much key information as possible and
  reschedule the interview.

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Environmental clues

• Look around you to see if there are clues that
  more people could be in the environment then
  people are telling you about. Clues such as
  pictures, toys, shoes and so on.

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Questioning suggestions

• Question
• How many people do you live with?
• How much time do you spend at home?
• Whats your job title?
• Do you abuse drugs or alcohol?

• Better question
• Who has lived in your household in the past 6
  months?
• When not at home where do you go?
• Tell me what you do at work?
• When is the last time you used drugs or alcohol?

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Questioning suggestions continued

• Do you visit with anyone?
• Do you have any friends or family?

• Tell me who visits you at home?
• Tell me about your hobbies/activities?
• Who are your friends/family?

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Questioning suggestions continued

• Ask questions about the recent past in
  increments, being sure to include the holidays
  that are significant in the culture of the
  person, the family and their environment

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Conclusion

• End the interview when the objectives have been
  met
• If theres not enough time to do a thorough
  interview then end the interview and schedule
  another interview as soon as possible. Make sure
  you have enough information to protect the
  publics health before leaving.

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Conclusion continued

• Summarize the information you have collected and
  let the person know what will happen next
• Answer any unanswered questions and provide
  information on how to contact public health
  should the person remember more contact
  information
• Express appreciation for the persons cooperation
  and time and help them feel good about their
  chance to protect others

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Conclusion continued

• The health care and the worker will need to
  decide who will notify the contacts. If possible
  there should be a time line established for this
  notification.
• The patient should be reassured that the health
  worker will not be saying who identified them as
  a contact.
• Reassess motivation for adherence, implement any
  incentives that may not be in place

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Follow up

• Arrange for return visits and re-interviews
• It usually takes more than one interview to
  ensure that accurate and complete contact
  information is obtained

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Review

• Today we learned.