Quantitative
Study of Tobacco Facts Designed to Inform Youth Tobacco Prevention
Messaging
[FIRST
SCREEN]
Dear KnowledgePanel participant,
Your
[INSERT CHILD’S AGE] year-old SON/DAUGHTER is invited to
complete a survey being conducted by RTI International. The
survey will ask approximately 1,500 youth ages 13-17 about their
perceptions of tobacco-related facts. Your
child’s answers will help inform messaging for future youth
tobacco prevention campaigns. It
will take about 20 minutes for HIM/HER to complete. The [STUDY
NAME] survey will be quite similar to the kinds of surveys your
child may have already been involved in as a KnowledgePanel
Member.
The
potential risk to respondents from completing the survey is
minimal. Some questions might make him or her feel uncomfortable,
but they have the right to skip any questions they don't want to
answer. Participation is completely voluntary and your child may
withdraw HIS/HER consent or discontinue participation at any time
without penalty. If your child decides to take the survey, you
will receive ‘points’ with approximate value of $5 for
their participation. The points can be redeemed for items or gift
cards through the GfK system.
[SECOND
SCREEN]
As always, his or her identity will be unknown in all
data resulting from the study. The researchers will not have
access to any of your child’s identifying information (such
as his or her name). All of the conditions and terms described in
the "GfK’s Privacy & Terms of Use Policy"
document that you received when you got your recruitment packet
are in effect for this study. If you have any questions about the
study, you may contact the research team through Annice Kim of RTI
at 1‑800‑334‑8571.
If
you have any questions about your child’s rights as a study
participant, you may call RTI’s Office of Research
Protection at 1-866-214-2043.
I have read and understand this information, and the study purpose
and process are clear to me.
Do
you give your consent to GfK for your child to complete this
survey?
Yes No
If
“Yes”, please provide your child’s email address
so we can send him/her a link to the survey:
__________________________________________ (Child’s email
address)
A
copy of the form will be sent to the email address that GfK has
for you on file.
Paperwork Reduction Act
Statement: The
public reporting burden for this information collection has been
estimated to average
5 minutes per response (the time to read
and complete). You can send comments regarding this burden estimate
or any other aspects of this information collection, including
suggestions for reducing burden, to PRAStaff@fda.hhs.gov.