Form
Approved
OMB No. 0910-0753
Exp. Date xx/xx/xxxx
[PARENT FNAME] [PARENT LNAME] [Date]
[Address1]
[Address2]
[City], [State] [Zip]
Dear [PARENT FNAME] [PARENT LNAME]:
The U.S. Food and Drug Administration is conducting the first follow-up survey of the FDA Health and Media Study. Your child, [Child’s first name], is one of approximately 2,000 youth taking part in this study. We thank you and your child for your continued help in this important study.
Your child’s participation is important and will contribute to valuable research related to youth attitudes toward health, health behaviors, and advertisements they may have seen on TV, online, and/or heard on the radio. We will offer your child $25 if they complete the survey through the website on or before [Early Bird Data], or $20 after [Early Bird Date], as a token of appreciation for participating. If your child does not complete by this date, one of our professional interviewers will contact you to schedule a time to complete the survey in person.
More information about the study is provided in the enclosed fact sheet. To complete the survey via a website on a personal computer, laptop, or tablet (the questionnaire cannot be accessed on a phone):
In your web browser type the study website address: [RUSTEC SURVEY WEBSITE]
On the login screen, type your username and password exactly as shown below:
Username: [Case ID]
Password: [Password]
Once you’ve typed in your username and password, you will see instructions for completing this round of the study. A parent or legal guardian must follow the steps to provide permission for the child to complete the survey.
Your help with this round of the study is voluntary. You can refuse to answer any and all questions. All information provided by you 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.
For more information about the study, you can call our project assistance line toll-free at (866) 214-2039, or email us at mediastudy@rti.org. 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 this study’s success. Thank you for your cooperation.
Sincerely,
Dr. Matthew Farrelly, PhD
RTI International
OMB No: 0910-0753 Expiration Date: xx/xx/xxxx
Paperwork Reduction Act Statement: The public reporting burden for this collection of information has been estimated to average 2 minutes per response. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRAStaff@fda.hhs.gov.
File Type | application/msword |
Author | Taylor, Nathaniel |
Last Modified By | PR* |
File Modified | 2016-06-01 |
File Created | 2016-06-01 |