Youth 1st, 2nd, and; 3rd (Male, Rural Smokeless) follow up questionnaire

Attachment 35_R: Panel Maintenance Email - 18

Form Approved

OMB No. 0910-0753

Exp. Date 09/30/2019

CASEID

Date, 2017

Please forward this email to [CHILD’S FIRST NAME OR INTIALS]

Dear [CHILD’S FIRST NAME OR INTIALS]:

You have previously participated in an interview for the FDA Health and Media Study. The purpose of the study is to learn more about youth attitudes and beliefs towards health and health behaviors, their media use, and their awareness of recent public education campaigns. The Health and Media Study is longitudinal, that is, the study will follow the same youth over a period of time.

We are now preparing to conduct the next round of interviews beginning in the Spring of 2017. You will be able to participate in this round by accessing a website and completing the survey online. Or, for those who do not complete online, a professional interviewer will call to schedule the interview.

For this study to be successful, it is important that we interview as many of the youth as we can. We are writing you now to make sure that we still have your correct name, address telephone number and e-mail address. Please review your information below. If the name, address, telephone number on the form are correct, please respond to this email letting us know our information is correct. If your information needs to be updated, please respond to this email with your new information so we can update our records. If you expect to move soon and know your new address and telephone number, please provide that information along with the date you plan to move.

Thank you for taking time to provide us with this information. We would appreciate receiving your response in the next 2 weeks.

If you have any questions about the study, please contact us toll-free at 1-866-214-2039 to speak with a project team member.

CURRENT CONTACT INFORMATION:

Participant Name

Address1 Address2

City, State Zip

Telephone

E-mail address

Sincerely,

Melissa Helton,

National Field Director

RTI International

1-866-214-2039

mediastudy@rti.org

OMB No: 0910-0753 Expiration Date: 09/30/2019

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.

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