Parent Of Youth Baseline Survey Participants

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

Attachment 10_R. Lead Letter (male rural smokeless)

Parent Of Youth Baseline Survey Participants

OMB: 0910-0753

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ATTACHMENT 10_R: LEAD LETTER (MALE RURAL SMOKELESS FOLLOW-UP)


Form Approved

OMB No. 0910-0753

Exp. Date 09/30/2019

RIHSC No. 15-101CTP


The Parents of [CHILD’S FIRST NAME OR INITIALS] [Date]

[Address1]

[Address2]

[City], [State] [Zip]


[CASE ID]

Dear Parents of [CHILD’S FIRST NAME OR INITIALS]:


The U.S. Food and Drug Administration is conducting the third follow-up survey of the FDA Health and Media Study. Your child, [CHILD’S FIRST NAME OR INITIALS], is one of approximately 2,200 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, or heard on the radio. We will offer your child a check for $25 if he completes the survey through the website on or before [Early Bird Date], or a check for $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. Your child will receive $20 in cash if he completes 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, phone, or tablet, a parent or guardian must follow all three steps below:


  1. In your web browser type the study website address: [RUSTEC WEBSITE]

  2. On the login screen, type your username and password exactly as shown below:

Username: [Case ID]

Password: [Password]

  1. 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 child’s help with this round of the study is voluntary. Your child can refuse to answer any and all questions. All information provided by you and your child will be kept private to the fullest extent allowable by law and used only for statistical purposes. Your child or your household will never be identified in any analysis, reports, or publications, and no one will try to sell you or your child 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 child’s rights as a study participant, you can call RTI’s Office of Research Protection toll-free at (866) 214-2043.


Your child’s help is very important to this study’s success. Thank you for your cooperation.


Sincerely,



Matthew Farrelly, PhD

RTI International


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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