Youth 1st, 2nd, 3rd and 4th (Male, Rural Smokeless) follow up questionnaire

Evaluation of the Food and Drug Administration's General Market Youth Tobacco Prevention Campaign

Attachment 25_R. Lead Letter 18 (male rural smokeless) FU4

Youth 1st, 2nd, 3rd and 4th (Male, Rural Smokeless) follow up questionnaire

OMB: 0910-0753

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Attachment 25_R: Lead Letter 18

Form Approved

OMB No. 0910-0753

Exp. Date 09/30/2019

RIHSC No. 15-101CTP

Lead Letter 18+: FDA Health and Media Study


[CHILD’S FIRST NAME OR INITIALS] [Date]

[Address1]

[Address2]

[City], [State] [Zip]


[CASE ID]

Dear [CHILD’S FIRST NAME OR INITIALS]:


The U.S. Food and Drug Administration is conducting a follow-up survey of the FDA Health and Media Study. You are one of approximately 2,200 youth and young adults taking part in this study. We thank you for your continued help in this important study.


Your participation is important and will contribute to valuable research related to youth attitudes toward health, health behaviors, and advertisements they may have seen on TV, online, or heard on the radio. We will offer you a check for $25 if you complete the survey through the website on or before [Early Bird Date], or a check for $20 after [Early Bird Date], as a token of appreciation for participating. If you do not complete by this date, one of our professional interviewers will contact you to schedule a time to complete the survey in person. You will receive $20 in cash if you complete the survey in person.


More information about the study is provided in the enclosed fact sheet. To complete the survey via a website on a personal computer, laptop, phone, or tablet, you must follow all three steps below:


  1. In your web browser type the study website address: [RUSTEC WEBSITE]

  2. On the login screen, type your username and password exactly as shown below:

Username: [Case ID]

Password: [Password]

  1. Once you’ve typed in your username and password, you will see instructions for completing this round of the study.


Your help with this round of the study is voluntary. You can refuse to answer any and all questions. All information provided by you will be kept private to the fullest extent allowable by law and used only for statistical purposes. You or your household will never be identified in any analysis, reports, or publications, and no one will try to sell you anything.


For more information about the study, you can call our project assistance line toll-free at (866) 214-2039, or email us at mediastudy@rti.org. If you have a question about your rights as a study participant, you can call RTI’s Office of Research Protection toll-free at (866) 214-2043.


Your help is very important to this study’s success. Thank you for your cooperation.


Sincerely,


Matthew Farrelly, PhD

RTI International


OMB No: 0910-0753 Expiration Date: 09/30/2019

Paperwork Reduction Act Statement: The public reporting burden for this collection of information has been estimated to average 5 minutes per response. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRAStaff@fda.hhs.gov.

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