Skip to main content

Table 2 Baseline surveys and sample questions

From: A randomized controlled trial for a peer-facilitated telemedicine hepatitis c treatment intervention for people who use drugs in rural communities: study protocol for the “peer tele-HCV” study

Demographics

 • What is your gender and race?

 • How much school have you finished?

 • What are your main sources of income over the last 6 months?

 • Have you been homeless in the past 6 months?

 • Do you currently have health insurance?

Baseline HCV questions

 • Have you ever been tested for HCV?

 • Have you ever been told you had HCV?

 • In the last 30 days, have you seen a medical provider for your hepatitis C infection?

Access to health

 • Do you have a way to get to medical appointments?

 • Have you ever attempted to receive medications for HCV?

 • What is your understanding of why you were able to access treatment for HCV in the past?

 • What is the main place you have received medical care in the past 6 months?

Substance use

 • Currently, which is your drug of choice for getting high?

 • How many of the last 30 days have you injected drugs or used other illicit drugs?

 • Have you ever overdosed?

Injection behavior

 • On average in the last 30 days, how often have you injected any drug?

 • Where have you gotten syringes or needles in the last 30 days?

 • In the past 30 days, how many times did you get new syringes or needles, cottons, or cookers from a syringe or needle exchange program?

 • How many times in the past 30 days did you use a syringe or needle that you know was used by somebody else?

 • How many times on average do you reuse a syringe?

Addiction treatment

 • In the last 30 days, have you gotten any treatment or help for an addiction problem?

 • How do you feel about your drug use (e.g. ashamed, fear of losing friends or family?