Attachment 3

Attachment 3

Submitted to CTP RIHSC 7/2/2012
Attachment B: Parent & Youth Docs
Recruitment Email Invite for Youth Recruited via Parent Panel
Invitation from ResearchNow to Participate in Study
Subject Line:
Get Rewarded for Your Time – Study about the chemicals in tobacco products.
e-Mail Copy:
Dear ,
Your e-Rewards(R) profile indicates a *13-17* year old may reside in your household. Based on that
information, we are pleased to cordially invite your *13-17* year old to participate in a teen-focused
research survey about the chemicals in tobacco products.
e-Rewards believes another way to conduct market research with children is to first garner the help of
their parent or guardian. We hope that you will invite your child to share his or her opinions. If your
child qualifies and completes the survey:
Full reward amount: $7.50 in e-Rewards Currency
Full survey length: approximately 30 minutes
To complete the survey and earn e-Rewards Currency, simply click the link below, or copy the URL
into your browser: http://<%website%>/pro.do?FT=<%uniqueid%>
We encourage you to respond quickly -- this e-Rewards invitation will be available only until a
predetermined number of responses have been received. Please Note: you will only receive e-Rewards
credit for taking the survey once.
Continue to check your inbox and your Member home page for future opportunities to earn e-Rewards
Currency.
We value your time,
The e-Rewards Team

Parent Permission Form for Youth Recruited via Parent Panel
This study is funded by The Food and Drug Administration (FDA) and conducted by RTI International.
For this study, we would like your son or daughter to complete a short survey. Each survey asks
teenagers about the chemicals in tobacco products and about their attitudes and beliefs regarding
tobacco use. About 1,400 teenagers will complete the survey. The survey will take about 30 minutes
to complete. To show our appreciation, your family will receive $7.50 in e-rewards Currency for your
child’s participation.
There are no physical risks associated with the study. Your child’s participation in this research study
is completely up to you and your child. The survey asks questions about your child’s experiences and
thoughts regarding cigarette smoking and chemicals found in tobacco; however, your child may skip
any questions they do not want to answer. During the survey, we do not ask for your child’s name;
therefore, your child’s name will not be connected to their answers. Furthermore, we will not share
any information provided in the survey with anyone outside the research team.
To ensure your child’s answers are kept private, we will ask your child to please review the list and
take the survey in a place where no one can look over his/her shoulder and view his/her answers. We
also ask that your child complete the survey in one sitting and close the screen when he/she is done
taking the survey.
If you or your child have any questions about the study, you may contact the RTI Project Coordinator,
Jonathan Blitstein, at jblitstein@rti.org. If you or your child have any questions about your rights as a
study participant, you may contact RTI’s Office of Research Protection by phone at 1-866-214-2043 or
by email at orpe@rti.org.
I have read and understand the information provided above and the study purpose and procedures
are clear to me. (Parent chooses the appropriate box via a mouse click.)

Yes, I agree to let my child participate in this study.
No, I do not wish to let my child participate in this study.

Youth Assent Form for Youth Recruited via Parent and Youth Panels
This study is funded by the Food and Drug Administration (FDA) and conducted by RTI International.
For this study, we would like you complete a short survey. Each survey asks teenagers about the
chemicals in tobacco products and about their attitudes and beliefs regarding tobacco use. About
1,400 teenagers will complete the survey. The survey will take about 30 minutes to complete. To
show our appreciation, your family will receive $7.50 e-rewards for your participation.
There are no physical risks associated with the study. Your participation in this research study is
completely up to you. The survey asks questions about your experiences and thoughts regarding
tobacco products and cigarette smoking; however, you may skip any questions you do not want to
answer. During the survey, we do not ask for your name; therefore, your name will not be connected
to your answers. Furthermore, we will not share any information you provide in the survey with
anyone outside the research team, including your parents.
To ensure your answers are kept private, please complete survey in a place where no one can look
over your shoulder and view your answers. Also, please complete the survey in one sitting and close
the screen when you are done taking the survey.
If you have any questions about the study, you may contact the RTI Project Coordinator, Jonathan
Blitstein, at jblitstein@rti.org. If you have any questions about your rights as a study participant, you
may contact RTI’s Office of Research Protection by phone at 1-866-214-2043 or by email at
orpe@rti.org.
I have read and understand the information provided above and the study purpose and procedures
are clear to me. (Participant chooses the appropriate box via a mouse click.)

Yes, I agree to participate in this study.
No, I do not wish to participate in this study.

Submitted to CTP RIHSC on 7/2/2012
Attachment A: Adult Documents
Recruitment Email Invite for Adults
Invitation from ResearchNow to Participate in Study
Subject Line:
Get Rewarded for Your Time - Study about the chemicals in tobacco products.
e-Mail Copy:
Dear <%First%>,
Based on your e-Rewards(R) profile, you are invited to earn e-Rewards Currency for participating in a
research survey. If you qualify and complete the survey:
Full reward amount: $7.50 in e-Rewards Currency
Full survey length: approximately 30 minutes
To complete the survey and earn e-Rewards Currency, simply click the link below, or copy the URL
into your browser:
http://<%website%>/pro.do?FT=<%uniqueid%>
Important: This survey may or may not be compatible with smartphones or other mobile devices, so
please use your desktop or laptop computer to complete this survey. If you find that your device isn’t
compatible with a survey, please re-try your invitation link using your desktop or laptop computer.
We encourage you to respond quickly -- this e-Rewards invitation will be available only until a
predetermined number of responses have been received. Please Note: you will only receive eRewards credit for taking the survey once.
Continue to check your inbox and your Member home page for future opportunities to earn e-Rewards
Currency.
We value your time,
The e-Rewards Team

Attachment XX-x
Adult Consent Form
This study is funded by the Food Drug Administration (FDA) and conducted by RTI International. For
this study, we would like you complete a short survey about the chemicals in tobacco products and
about your attitudes and beliefs regarding tobacco use. About 1,750 adults age 18 – 64 will complete
the survey. The survey will take about 30 minutes to complete. To show our appreciation, you will
receive $7.50 e-rewards for your participation.
There are no physical risks associated with the study. Your participation in this research study is
completely up to you. The survey asks questions about your experiences and thoughts regarding
tobacco products and cigarette smoking; however, you may skip any questions you do not want to
answer.
During the survey, we do not ask for your name; therefore, your name will not be connected to your
answers. Furthermore, we will not share any information you provide in the survey with anyone
outside the research team. Please complete the survey in one sitting and close the screen when you
are done taking the survey.
If you have any questions about the study, you may contact the RTI Project Coordinator, Jonathan
Blitstein, at jblitstein@rti.org. If you have any questions about your rights as a study participant, you
may contact RTI’s Office of Research Protection by phone at 1-866-214-2043 or by email at
orpe@rti.org.
I have read and understand the information provided above and the study purpose and procedures
are clear to me. (Participant chooses the appropriate box via a mouse click.)

Yes, I agree to participate in this study.
No, I do not wish to participate in this study.