Media Tracking Screener

Evaluation of the Food and Drug Administrations's General Market Youth Tobacco Prevention Campaign

Attachment 13_Notifications_tracked changes

Media Tracking Screener

OMB: 0910-0753

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0910-0753 can be found here:

2022-04-07 - No material or nonsubstantive change to a currently approved collection
2020-09-23 - No material or nonsubstantive change to a currently approved collection

Document [doc]

Download: doc | pdf

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Attachment 13: Notifications

Notifications Related to the Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT)

Interview—Unable to Contact

[DATE]

Resident Attention: [age] year old [gender] resident

[STREET ADDRESS]

[CITY], [STATE] [ZIP]

Dear Resident:

Recently, a Field Interviewer from RTI International came to your home and asked you and your child to take part in the Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT). Your child could not complete the interview at that time and has been away or was not free each time the interviewer has come back since then. Your help in this study is important—this is why we keep trying to reach you and your child.

A limited number of people were randomly chosen to represent the population of the United States. If you choose not to take part, your experiences and views—as well as the thousands of people you represent—will not be heard.

You and your child’s answers to the survey questions are combined with the answers of thousands of other people and reported only as overall numbers. To further protect your privacy, the survey is set up so that your child records most of their own answers—the interviewer never sees or hears them. Also, you can always refuse to answer any question.

To ensure the accuracy of survey results, we need to interview as many eligible youth aged 11 to 16 as we can. The results of this study will help policy makers and researchers understand media use among today’s youth as well as their attitudes and beliefs about tobacco use.

Your help is critical to the success of this study, and we are happy to work around your schedule so that you and your child can be included. Please feel free to call me to set up an interview time—the interview can also be done at another location such as a public library.

We know that your time is important. To thank you for your time, your child will be offered a $20 incentive at the end of the interview.

Thank you for your time. I hope you and your child will choose to take part in this very important and useful study.

Sincerely,

[FS NAME], Field Supervisor

P.S. Please, if you have any questions or would like to set up an appointment, call me toll-free at [TOLL-FREE NUMBER].

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Screening—Unable to Contact

[DATE]

Resident

[STREET ADDRESS]

[CITY], [STATE] [ZIP]

Dear Resident:

Recently, a Field Interviewer from RTI International tried to contact your household about taking part in the Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT). So far, we have not been able to speak with anyone in your house. Your help in this study is important—this is why we keep trying to reach you.

Some people are cautious about talking to a stranger at the door, and we understand that. Please know that we are not selling anything—we have just a few general questions to ask that will take about 5 minutes.

You do not have to let the interviewer into your home—you can answer the questions right at your door.

After these few questions, someone in your household may or may not be randomly chosen to take part in the full interview. If someone is chosen for the full interview, they will be given a $20 incentive at the end of the interview to thank them for their time.

A limited number of households were randomly selected to represent the population of the United States. Your household cannot be replaced. If you choose not to take part, your experiences and views—as well as the thousands of people you represent—will not be heard.

Thank you for your time. I hope you’ll choose to take part in this very important and useful study.

Sincerely,

[FS NAME], Field Supervisor

P.S. Please, if you have any questions or would like to set up an appointment, call me toll-free at [TOLL-FREE NUMBER].

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Interview Call Me-Youth

[DATE]

Resident

Attention: Parent of [age and gender of respondent]

[NAME OF COMPLEX]

[ADDRESS]

[CITY], [STATE] [ZIP]

Dear Resident:

Recently, an interviewer from RTI International came to your home and asked your [SON/DAUGHTER] to take part in the Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT). [HIS/HER] help in this study is important—which is why we keep trying to reach you.

We want to give you more information about the study:

A limited number of people—including your [SON/DAUGHTER]—were randomly chosen to take part.
As a thank you, [HE/SHE] will be given a $20 incentive at the end of the interview.
All information provided is kept completely confidential and will be used only for statistical purposes.

We are happy to work around your family’s schedule so that your [SON/DAUGHTER] can be included. Please call our supervisor for your area, [FIRST & LAST NAME], to set up an appointment.

Please call:

[FIRST & LAST NAME]

[PHONE NUMBER] (toll free)

If [MR./MS. LAST NAME] is not available when you call, please leave your phone number, address, and the time you want to be visited for your [SON'S/DAUGHTER'S] interview. [HE/SHE] will call you to confirm the appointment.

Thank you for your time. Your call to [MR./MS. LAST NAME] is very important to the success of this study, and I thank you in advance for your help.

Sincerely,

National Field Director

OMB NO. 0910-XXXX

EXP. DATE XX/XX/XXXX

Interview—Needs Clarification

[DATE]

Resident Attention: [age] year old [gender] resident

[STREET ADDRESS]

[CITY], [STATE] [ZIPCODE]

Dear Resident,

Recently, a Field Interviewer from RTI International came to your home and asked you to take part in a research study for the U.S. Food and Drug Administration’s (FDA’s) Center for Tobacco Products. At the time, you had some concerns about the study.

A limited number of people were randomly chosen to represent the population of the United States. You cannot be replaced. If you choose not to take part, your experiences and views—as well as the thousands of people you represent—will not be heard.

Your child’s answers to the survey questions are combined with the answers of thousands of other youth and reported only as overall numbers. To further protect their privacy, the survey is set up so that your child enters most of their own answers into a laptop computer—the interviewer never sees or hears them. Also, you can always refuse to answer any question.

The results of this study help policy makers and researchers understand youth awareness of and exposure to campaign ads—including their knowledge, attitudes, and beliefs about tobacco use—so that informed decisions about policies and programs can be made. By taking part in this study, you and your child will make a direct impact on important tobacco-related education activities.

Your help is critical to the success of this study, and we are happy to work around your schedule so that you can be included.

We know that you and your child’s time is important. To thank you for your time, your child will be given a $20 incentive at the end of the interview.

Thank you for your time. I hope you’ll reconsider and choose to take part in this very important and useful study.

Sincerely,

[FS NAME], Field Supervisor

P.S. Please, if you have any questions or would like to set up an appointment, call me toll-free at [TOLL-FREE NUMBER].

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Interview —"Nothing in it for me"/Uncooperative

[DATE]

Resident Attention: [age] year old [gender] resident

[STREET ADDRESS]

[CITY], [STATE] [ZIPCODE]

Dear Resident,

The results of this study will help policy makers and researchers understand youth awareness of and exposure to campaign ads—including their knowledge, attitudes, and beliefs about tobacco use—so that informed decisions about policies and programs can be made. By taking part in this study, you and your child will make a direct impact on important tobacco-related education activities.

A limited number of people were randomly chosen to represent the population of the United States—and you were one of them! You cannot be replaced. If you choose not to take part, your experiences and views—as well as the thousands of people you represent—will not be heard.

We know that your time is important. To thank you for your time, your child will be given a $20 incentive at the end of their interview.

Thank you for your time. I hope you’ll reconsider and choose to take part in this very important and useful study.

Sincerely,

[FS NAME], Field Supervisor

P.S. Please, if you have any questions, call me toll-free at [TOLL-FREE NUMBER].

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Interview—Too Busy/No Time

[DATE]

Resident

[STREET ADDRESS] Attention: [age] year old [gender] resident

[CITY], [STATE] [ZIPCODE]

Dear Resident:

A limited number of youth were randomly chosen to represent the population of the United States. Your child cannot be replaced. If your child chooses not to take part, their experiences and views—as well as the thousands of people they represent—will not be heard.

As you know, this country is made up of all kinds of people, and so we are interviewing all kinds of people—including busy people like you and your child. If we only interviewed people who have a lot of free time, then active people like you would not be fairly represented. You and your child’s participation is critical to the success of this study, and we are happy to work around your schedule so that they can be included.

We know that your time is important. To thank you for your time, your child will be given a $20 incentive at the end of the interview.

We combine your child’s answers with the answers of thousands of other youth and report them only as overall numbers. The survey is set up so that you record most of your own answers—the interviewer never sees or hears them. Also, you can always refuse to answer any question.

The results of this study will help policy makers and researchers understand media use among today’s youth as well as their attitudes and beliefs about tobacco use. By taking part in this study, you and your child will make a direct impact on important education activities to reduce tobacco use.

Thank you for your time. I hope you’ll reconsider and choose to take part in this very important study.

Sincerely,

[FS NAME], Field Supervisor

P.S. Please, if you have any questions or would like to set up an appointment, call me toll-free at [TOLL-FREE NUMBER].

________________________

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT)

RTI International • P.O. Box 12194 • Research Triangle Park, North Carolina 27709-2194 USA

YOUTH INTERVIEW INCENTIVE RECEIPT FORM

Thank you for taking part in an interview as part of a research study being carried out by RTI International for the U.S. Food and Drug Administration’s Center for Tobacco Products. To thank you for your time, we are offering you a $20 incentive. Please note that you received (or refused) this incentive by checking the appropriate box and signing below.

 I received a $20.00 incentive payment.

 I refused the incentive payment.

Your Name: ___________________________ Interviewer’s Signature:__________________________

Your Signature: ______________________________

Date:______________________________



Fill in Respondent ID#

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT)

RTI International • P.O. Box 12194 • Research Triangle Park, North Carolina 27709-2194 USA

YOUTH INTERVIEW INCENTIVE RECEIPT FORM

Thank you taking part in an interview as part of a research study being carried out by RTI International for the U.S. Food and Drug Administration’s Center for Tobacco Products. To thank you for your time, we are offering you a $20 incentive. Please note that you received (or refused) this incentive by checking the appropriate box and signing below.

 I received a $20.00 incentive payment.

 I refused the incentive payment.

Your Name: ___________________________ Interviewer’s Signature:_________________________

Your Signature: _______________________________

Date:______________________________



Fill in Respondent ID#

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

OMB No.:

OMB Expiration Date:

Canvas 6 Expires: 01-31-03

RESIDENT [DATE]

[ADDRESS]

RTI International has been conducting a nationwide survey for the U.S. Food and Drug Administration on tobacco and media use among youth. Our records show that a [AGE] year old [GENDER] in your household was interviewed. We would appreciate it if [HE/SHE] would take some time to answer a few questions about [HIS/HER] experience.

This information is only used to check the quality of our interviewer’s performance.

1. Were you interviewed in-person or over the telephone?

In-person ___ Over the telephone___

2. Did the interviewer provide you with a laptop computer for you to enter some of your answers?

Yes___

No___ Please explain:__________________________________________________

3. Did you complete a computer practice session that showed you how to enter your answers in the computer?

Yes___ No___

4. Were you paid for your participation?

Yes___ No___

If yes, how much were you paid? $_____

5. Was the interviewer professional and polite?

Yes___

No___ Please describe how our interviewer could improve his/her behavior: _____________________

_________________________________________________________________________

A stamped, pre-addressed envelope is included for you to return this form. Thank you for your help.

Sincerely,

National Field Director

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

[PARENT NAME] [Date]

[Address]

[Address #2]

[City, State, Zip]

Dear Parent,

The U.S. Food and Drug Administration’s (FDA’s) Center for Tobacco Products is conducting the next round of the Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT). Your child is one of more than 8,000 youth who took part in the first round of this study. We thank you and your child for your help in this important study.

This study will provide FDA, policy makers, and researchers important information about youth exposure to public education messages on the health risks of smoking or using other tobacco products. The information collected by this study will also improve our understanding of how public education campaigns affect youth’s attitudes, beliefs, and behaviors toward tobacco use. FDA has hired RTI International, a not-for-profit survey research organization, to conduct the study.

By taking part in this round of the study, your child will have a unique opportunity to contribute to valuable research related to youth awareness, exposure, and receptivity to campaign messages. Because your contribution is important, we will offer your child an incentive of $20 for completing this round of interviews.

More information about the study is provided in the enclosed fact sheet. A professional RTI interviewer will try to call you to schedule the interview. If you and your child would rather complete this round of the study via a website, you can complete the following steps:

Open your interview browser and type in the study website address: http://XXXXXXX.rti.org
Once you have reached the study website, type in the username and password exactly as shown below:

Username: USERNAME

Password: PASWORD

Once you’ve typed in your username and password, you will see instructions for completing this round of the study. Before your child can begin answering the survey questions, a parent or legal guardian must follow the steps to provide permission for her or him to complete the survey.

Your help with this round of the study is voluntary, but greatly appreciated. All information provided by your child will be kept private to the fullest extent allowable by law and used only for statistical purposes. You or your household will never be identified in any analysis, reports, or publications, and no one will try to sell you anything.

If you have any more questions about this study, you can call RTI’s National Field Director, Jennifer Keeney, at (800) 334-8571, extension 23525. If you have a question about your rights as a study participant, you can call RTI’s Office of Research Protection toll-free at (866) 214-2043.

Your help is very important to the success of this study, and I thank you in advance for your help.

Sincerely,

Dr. Matthew Farrelly, PhD

RTI International

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Email Invitation for Follow-Up Interviews

From: Project Email Account

To: Respondent Email address

This study will provide FDA, policy makers, and researchers with important information about youth exposure to public education messages on the health risks of smoking or using other tobacco products. The information collected by this study will also improve our understanding of how public education campaigns affect youth’s attitudes, beliefs, and behaviors toward tobacco use. FDA has hired RTI International, a not-for-profit survey research organization, to conduct the study.

By taking part in the survey, you and your child will have a unique opportunity to contribute to valuable research related to youth awareness, exposure, and receptivity to campaign messages. Because your contribution is important, we will offer your child an incentive of $20 for completing this round of interviews.

For this round of interviews, you may complete the survey online by following the steps below:

Click on the study website link. The website address is http://XXXXXXX.rti.org
Once you have reached the study website, type in the username and password exactly as shown below:

Username: USERNAME

Password: PASWORD

Once you’ve typed in your username and password, you will see instructions for completing this round of the study. Before your child can begin answering the survey questions, a parent or legal guardian must follow the steps to provide permission for her or him to complete the survey.

If you have any problems with the survey, please contact Jennifer Keeney at (800) 334-8571, extension 23525, for help. If you do not complete the survey via web, an RTI interviewer will try to call you to schedule and complete the interview at your home.

Your help with this round of the study is voluntary, but greatly appreciated. All information provided by your child will be kept private to the fullest extent allowable by lawand used only for statistical purposes. You or your household will never be identified in any analysis, reports, or publications, and no one will try to sell you anything.

If you have any more questions about this study, you can call the RTI National Field Director, Jennifer Keeney, at (800) 334-8571, extension 23525. If you have a question about your rights as a study participant, you can call RTI’s Office of Research Protection toll-free at (866) 214-2043.

Your help is very important to the success of this study, and I thank you in advance for your help.

Sincerely,

Dr. Matthew Farrelly, PhD

RTI International

OMB No. 0910-xxxx

Exp. Date xx/xx/xxxx

Controlled Access Letter

[DATE]

[NAME], [TITLE]

[COMPLEX/COMMUNITY NAME]

[ADDRESS]

[CITY], [STATE] [ZIP]

Dear [MR./MS.] [NAME]:

Recently, one of our field interviewers, [FIRST & LAST NAMES], tried to contact specific residences within [COMPLEX/COMMUNITY NAME] that were randomly chosen to participate in a national study conducted by RTI International for the U.S. Food and Drug Administration. So far, [MR./MS.] [LAST NAME] has been unable to [GAIN ACCESS/GAIN FULL ACCESS] to [NAME OF COMPLEX/COMMUNITY], and we are asking for your help.

We understand your responsibility to protect your residents and want to provide you with more information about the study:

We are not selling anything. This is not a marketing survey.
The Evaluation of the Public Education Campaign on Teen Tobacco (ExPECTT) provides valuable information about important health-related issues, including experiences with and opinions about media awareness and tobacco use among youth.
A limited number of household addresses were randomly chosen to take part. We do not have any information about the residents other than an address.
The RTI interviewer only needs a few minutes of the residents’ time to see if someone in the household will be asked to participate in an interview. If selected, those completing the interview receive a cash incentive.
All information provided is kept completely confidential.

By helping our interviewer access the selected households in [NAME OF COMPLEX/COMMUNITY], you will make a direct contribution to this important research effort. [FIRST & LAST NAMES], our supervisor in your area, will contact you soon to address any questions, or you may call [HIM/HER] toll-free at [TOLL FREE NUMBER].

Your assistance is very important to the success of this study, and I thank you in advance for your help.

Sincerely,

National Field Director, RTI

File Type	application/msword
File Modified	2013-10-29
File Created	2013-10-28