Youth 1st, 2nd, 3rd and 4th (Male, Rural Smokeless) follow up questionnaire

Attachment 32_R: Panel Maintenance Letter - 18

Form Approved

OMB No. 0910-0753

Exp. Date 09/30/2019

RIHSC No. 15-101CTP

Panel Maintenance Letter: FDA Health and Media Study

CASEID

[Date], 2018

[CHILD’S FIRST NAME OR INTIALS]

STREET ADDRESS

STREET_ADDRESS_2

CITY, STATE ZIPCODE

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 and young adult 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 and young adults over a period of time.

We are now preparing to conduct the next round of interviews beginning in Fall of 2018. 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 youth and young adults 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 and return the enclosed form in the postage-paid envelope provided. If the name, address, and telephone number on the form are correct, please check the “Contact Information Correct” box. If your information needs to be updated, please cross out the old information, write your new information on the form. 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 contact information form 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.

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 5 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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