Form NHTSA 2000 NHTSA 2000 Screening and Informed Consent

Assessing the Fit and Comfort of Motorcycle Safety Gear

NHTSA Form 2000 – Screening & Informed Consent

Consent Form

Paperwork Reduction Act Statement: A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number (listed below). Please send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Room W45-205, Washington, DC, 20590.

Data Collector Screening and Consent Items (Main Study)

(Read aloud by recruiter) 

“Hi, my name is __________. You are being asked to VOLUNTARILY PARTICIPATE in an anonymous research study by the National Highway Traffic Safety Administration about the fit and comfort of motorcycle protective gear. You will be asked to answer a short survey about your riding habits and gear choices, have your currently worn gear evaluated for fit, and provide opinions about examples of protective gear presented to you on a tablet. If you complete the full survey, you will receive a $50 payment. The entire study takes less than 30 minutes, and you may stop participation at any time. Again, this study is completely anonymous which means nothing can or will be directly linked to you in any way. If you would like to continue, there are a couple questions I need to ask to make sure you qualify. May we continue?” 

“I will indicate on my tablet you said”: □ YES □ NO 

1: Are you able to read and understand English? 

• Yes 

• No (not eligible) 

2: Are you at least 18 years old? 

• Did not ask (person is obviously over the age limit) 

• Yes 

• No (not eligible) 

 

If ineligible: “I’m sorry but you do not qualify to participate in the study. This sheet contains information about who we are and what the study is about. It also contains contact information if you have any questions or concerns. Thank you very much for your time. Have a great day (daytime) / night (nighttime)!” 

 

If eligible: “Congratulations! You qualify to participate in the study. You will read more information about the study on this tablet and officially decide if you want to complete all or some of the study activities.” 

(Hand tablet to participant to read Consent Form)

Consent Information

Thank you for your interest in this study. Feel free to ask the researcher questions at any time. By pressing “Yes” below, you are volunteering to participate, and data collection will begin.

Voluntary Participation

• Your participation in this study is completely voluntary.

• You are free to leave at any time.

• Full participation will take approximately 30 minutes.

Confidentiality

• This study is completely anonymous.

• Any information you provide will not be linked to you in any way.

Procedure

This study has three parts:

1. Taking a tablet survey

2. Having body measurements taken for one gear type of interest: footwear, gloves, helmets, jackets, or pants. Researchers will assess the fit and comfort of the gear type of interest you are currently wearing.

3. Being presented images of protective gear on a tablet for the gear type of interest alongside a product description and providing opinions about the gear

Survey

• Questions you will be asked are about your bike type, riding habits, preferences and beliefs about motorcyclists’ protective gear, and demographic information.

Gear Worn Assessment

• Members of the research team will need to measure your physical dimensions, similar to the measurements taken by a tailor when fitting custom-made clothing.

• The specific measurements will depend on the type of gear being fitted, such as inseam for pants or chest measurements for jackets. These measurements will be relevant only to the type of gear you are trying on.

• You have the option to request that measurements be taken by a research staff member of the sex of your choice.

• Alternatively, a research staff member can guide you through the process of taking the measurements yourself. Your comfort and privacy are important considerations throughout the process.

New Gear Assessment

• You will be shown images of various examples of one gear type of interest (footwear, gloves, helmets, jackets, or pants) and asked for your opinions about these items.

Costs/Compensation

• There is no cost to you for taking part in this study.

• You will be paid $50 cash if you complete all study activities.

Consent

I have read the above information and have received answers to any questions that I asked. I consent to take part in the study.

• YES, I consent to participate.

• NO, I do not consent to participate.

Contact Information

This study is being conducted by Dunlap and Associates, Inc. and its partners under contract from the National Highway Traffic Safety Administration.

If you have any questions about the study or your rights as a participant, you may call the study’s Principal Investigator, Dr. Matthew Romoser, at (XXX) XXX-XXXX- or email him at XXXX@XXXXX.com.

You may also contact the independent institutional review board (IRB) that reviewed this study, Advarra, at 410-884-2900 (Advarra individual Point of Contact information will be included when assigned).

The OMB control number is XXXXX. A paper copy of this information is available upon request.

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