Form 0920-0822 Att S_Advance Letters_English

Attachment S: Advance Letters (English)

Phase 1 Advance Letter

Form Approved
OMB No: 0920-0822
Exp. Date: xx/xx/xxxx

[CountyName] Resident [mailing address] [city], [state] [zip code + 4]

Keep the $5 as a thank you for your help.

Dear [CountyName] Resident:

Help the CDC learn about health and injuries across our nation and receive up to $25. Results from this study will be used to inform and guide national prevention efforts. Opportunities to participate come in two separate steps.

Step 1: Tell us a little about your household

Online [TBD URL] Enter code: [unique login code]		By Phone Talk with one our friendly staff members.		By Mail Answer questions in the paper survey we included.
Answer questions online by [Month Day]	OR	[study’s toll-free number TBD] by [Month Day]	OR	Mail the survey back by [Month Day]
Get $10 After you answer questions online.		Get $5 After you answer questions over the phone.		Get $5 After you answer questions on paper.

In Step 2, a randomly chosen adult in your household can complete a survey and get another $15.

All steps in this study are voluntary. All answers you choose to provide will be kept private and confidential.

If you have any questions about this study, please call [study’s toll-free number TBD]. We look forward to hearing from you.

Sincerely, Arlene Greenspan, DrPH, MPH, PT Associate Director for Science National Center for Injury Prevention and Control Centers for Disease Control and Prevention

To learn more, visit [TBD URL]. You can also call CDC-Info at 1-800-232-4636 or email cdcinfo@cdc.gov. Please mention that you are calling about the Health and Injury Study.

Frequently Asked Questions

What is the goal of the study?

The goal of the survey is to learn more about health and injuries among adults in the U.S. Results from this study will be used to inform and guide national prevention efforts.

Who is sponsoring the study?

The study is sponsored by the Centers for Disease Control and Prevention (CDC). CDC is the nation’s leading public health agency and is part of the U.S. federal government. If you have additional questions, you can contact CDC-Info at 1-800-232-4636 or cdcinfo@cdc.gov. For the Disability Information and Access Line (DIAL), call 1-888-677-1199 or email DIAL@n4a.org. Please mention that you are calling about the Health and Injury Survey.

Will you keep my answers confidential and safe?

The information you provide will be kept private and will not be linked to your name. This research is covered by a Certificate of Confidentiality from the Centers for Disease Control and Prevention. The researchers with this Certificate cannot disclose the information or documents to anyone else who is not connected with the research. It may not be disclosed in any federal, state, or local civil, criminal, administrative, legislative, or other action, suit, or proceeding. The only exception is if there is a federal, state, or local law that requires disclosure (such as to report child abuse) or if you report plans to harm yourself or others.

Am I required to participate?

Your participation is voluntary and you may refuse to answer any question or leave the study at any time. However, the study collects information which may be used to help CDC and others to improve population health and prevent injuries.

Will I ever be identified?

Your name and contact information will not be linked to your answers in the survey. No information that could personally identify you will be given to the CDC or anyone else. Your answers will be combined with responses from others who are in the study.

Who is RTI International?

RTI International is a nonprofit research institute that conducts the Health and Injury Study on the behalf of CDC. For more information, please visit rti.org or call [RTI’s toll-free number for this study].

Public reporting burden of collection of information is estimated at 1 minute, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road, NW, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-0822).