Developing Brand & Creative Concepts Designed to Prevent AI/AN Youth Tobacco Use

Developing Brand and Creative Concepts Designed to Prevent
AI/AN Youth Tobacco Use
INFORMATION PACKET MATERIALS
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II.
III.

Information Packet Cover Page (Parent / Guardian Opt-Out)
Information Packet Cover Page (Parent / Guardian Permission)
Reading Levels of Assent and Parent / Guardian Opt-Out and Permission Forms

Discussion Group Information Packet
Thank you for your interest in the discussion group!
We will let you know within a few days if you are picked for the group.
Discussion groups will take place at​ [LOCATION]​ on ​[DATE RANGE]​.
Discussion groups are 90 minutes.
If you qualify and participate in the discussion group, you will receive ​$25​!
An adult who brings you will also get paid!

Make sure to text or call us back if we contact you! If you are invited, there
are 3 things we will need before you can participate:
1. Read the form called “​PARTICIPANT ASSENT FORM​“ and sign it on the last page if
you want to participate.
2. Give your parent or guardian the form in this packet called “​PARENT / GUARDIAN
OPT-OUT FORM​.”​ ​They should read it over and contact us only if they ​do not ​want
you to participate​.
3. Bring the ​signed​ PARTICIPANT ASSENT FORM to the discussion group!

If you or your parent(s)/guardian(s) have any questions about this study,
please call or email Samantha Jacobs at Rescue (619-231-7555 x 153;
sjacobs@rescueagency.com).

OMB# 0910-0796 Exp. 07/31/2021

Discussion Group Information Packet
Thank you for your interest in the discussion group!
We will let you know within a few days if you are picked for the group.
Discussion groups will take place at​ [LOCATION]​ on ​[DATE RANGE].
Discussion groups are 90 minutes.
If you qualify and participate in the discussion group, you will receive ​$25​!
An adult who brings you will also get paid!
Make sure to text or call us back if we contact you! If you are invited, there
are 3 things we will need before you can participate​:
1. Read the form called “​PARTICIPANT ASSENT FORM​“ and sign it on the last page if
you want to participate.
2. Give your parent or guardian the form in this packet called “​PARENT / GUARDIAN
PERMISSION FORM​.” They should read it over and ​sign the last page ​if they ​agree​ to
let you take part in the discussion group.
3. Bring both ​signed​ forms to the discussion group!

If you or your parent(s)/guardian(s) have any questions about this study,
please call or email Samantha Jacobs at Rescue (619-231-7555 x 153;
sjacobs@rescueagency.com​).

OMB# 0910-0796 Exp. 07/31/2021

Reading Levels of Assent and Parent / Guardian Opt-Out and Permission Forms

Form

Flesch-Kincaid
Reading Level

Parent/Guardian Permission Form
Parent/Guardian Opt-Out Form
Participant Assent Form

9.4
9.4
9.0