Attachment H_Intro and Informed Consent

INTRODUCTION AND INFORMED CONSENT FOR

INTERVIEW RESPONDENTS AGE 18+

INTRODUCE YOURSELF AND STUDY AS NECESSARY: Hello, I’m ________, and I’m working on a nationwide study sponsored by the U.S. Department of Health and Human Services. You should have received a letter about this study. (SHOW LEAD LETTER, IF NECESSARY.)

READ THE BOXED INFORMATION BELOW

BEFORE STARTING EVERY INTERVIEW

This year, we are interviewing about 70,000 people across the nation. You have been randomly chosen to take part. You will represent over 4,500 other people who are similar to you. You may choose not to take part in this study, but no one else can take your place. We will give you $30 when you finish the interview.

GIVE STUDY DESCRIPTION TO R IF YOU HAVE NOT ALREADY DONE SO.

This study asks about tobacco, alcohol, and drug use or non-use, knowledge and attitudes about drugs, mental health, and other health issues. It takes about an hour. You will answer most of the questions on the computer, so I will not see your answers. We are only interested in the combined responses from all 70,000 people, not just one person’s answers. This is why we do not ask for your name and we keep your answers separate from your address. RTI may contact you by phone or mail to ask a few questions about the quality of my work. This is why we ask for your phone number and current address at the end of the interview.

You may consider some of the questions to be sensitive in nature and some questions may also make you feel certain emotions, such as sadness. For example, the interview asks questions about criminal history, depression, suicide and other topics. If you become upset during the interview and wish to speak to a mental health professional about how you are feeling, I can provide you with a toll-free helpline number.

While the interview has some personal questions, federal law keeps your answers private. We hope that protecting your privacy will help you to give accurate answers. You can quit the interview at any time and you can refuse to answer any questions.

If it is all right with you, let’s get started.

(Can we find a private place to complete the interview?)

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INTRODUCTION AND INFORMED CONSENT FOR

INTERVIEW RESPONDENTS AGE 12-17

Your (AGE) year-old child has been selected to be in this study. Your child’s participation is voluntary. This interview asks about tobacco, alcohol, and drug use or non-use, knowledge and attitudes about drugs, mental health, and other health related issues.

Your child may consider some of the questions to be sensitive in nature and some questions may also make your child feel certain emotions, such as sadness. For example, the interview asks questions about criminal history, depression, suicide and other topics. Your child can refuse to answer any questions and can stop the interview at any time. If your child becomes upset during the interview and wishes to speak to a mental health professional about how they are feeling, I can provide you with a toll-free helpline number.

All of your child’s answers will be confidential and used only for statistical purposes. Since your child will answer most of the questions on the computer, I will never see the answers, and you are not allowed to see them either. If it is all right with you, we’ll get started.

(Can we find a private place to complete the interview?)

READ THE SCRIPT BELOW AND OBTAIN PERMISSION FROM THE PARENT/GUARDIAN

Once parental permission has been given, confirm the parent/guardian or another adult will be present for the duration of the interview

THEN, READ THE BOXED INFORMATION ON THE NEXT PAGE BEFORE STARTING EVERY INTERVIEW WITH A 12-17 YEAR OLD

INTRODUCTION AND INFORMED CONSENT FOR

INTERVIEW RESPONDENTS AGE 12-17 (CONTINUED)

READ THE BOXED INFORMATION BELOW BEFORE STARTING EVERY INTERVIEW WITH A 12-17 YEAR OLD

This year, we are interviewing about 70,000 people across the nation. You have been randomly chosen to take part. You will represent over 1,000 young people in this country who are similar to you. You may choose not to take part in this study, but no one else can take your place. We will give you $30 when you finish the interview.

GIVE STUDY DESCRIPTION TO R IF YOU HAVE NOT ALREADY DONE SO.

This study asks about tobacco, alcohol, and drug use or non-use, knowledge and attitudes about drugs, mental health, and other health issues. It takes about an hour. You will answer most of the questions on the computer, so I will not see your answers. Your answers will never be seen by either your parents or your school. We are only interested in the combined responses from all 70,000 people, not just one person’s answers. This is why we do not ask for your name and we keep your answers separate from your address. RTI may contact you by phone or mail to ask a few questions about the quality of my work. This is why we ask for your phone number and current address at the end of the interview.

You may consider some of the questions to be sensitive in nature and some questions may also make you feel certain emotions, such as sadness. For example, the interview asks questions about criminal history, depression, suicide and other topics. If you become upset during the interview and wish to speak to a mental health professional about how you are feeling, I can provide you with a toll-free helpline number.

While the interview has some personal questions, federal law keeps your answers private. We hope that protecting your privacy will help you to give accurate answers. You can quit the interview at any time and you can refuse to answer any questions.

If it is all right with you, let’s get started.