Participant Letters

Attachment 3

Letters

Advance letter to NIS households

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

From the Director of the National Center for Health Statistics:

I am asking for your help with an important study conducted by the Centers for Disease Control and Prevention (CDC) called the National Immunization Survey (NIS). This survey tells us which vaccines people in the U.S. have received and about other important health topics. Results from the NIS are used to help health officials in their efforts to improve health care programs. In the next few weeks, (INSERT CONTRACTOR NAME) will call your household to take part in this study for CDC.

For this study, we need to ask about vaccinations and about children’s health. Some households also may be asked questions about the health services their children need or use. If you have a child between 18 and 35 months of age, it would be helpful to have your child’s immunization records handy when answering our questions. However, you can also answer these questions without the records.

Your phone number was chosen randomly by computer. It is important for us to interview every household we call to get a complete picture of your area’s immunization rates and key factors that might affect them. The study is important, but you do not have to take part, or you can decide not to answer one or more questions.

You may call this toll free number at 1-866-999-3340 if you would like to take part in the study now. You can also call this number to learn more about the study and what you will be asked. For more information, turn this letter over or go to the study’s web site: http://www.cdc.gov/nis.

Your answers to the NIS will provide information to help improve the nation’s health now and in the years ahead. We need your help to make this study a success. We hope you will decide to take part when we call.

Thank you for your cooperation. I am grateful for your help.

Sincerely,

Edward J. Sondik, Ph.D.

Director, National Center for Health Statistics

Centers for Disease Control and Prevention

Advance letter to NIS households – back

(INSERT CONTRACTOR NAME) Toll Free Number: 1-866-999-3340

You can call (INSERT CONTRACTOR NAME) toll free number to take part in the study right away, learn more about the study, and hear what you will be asked.

Who sees my answers?

You will be called by a trained interviewer who enters your answers into a computer. Everyone who works on the survey must sign an oath that promises they will never give out anyone’s personal information. Only a few people who work on this survey ever see any personal information. Answers that could identify you or your family in any way are separated from your other answers. Survey findings are put into summary reports that contain no names or other information that identifies you.

How do you protect my information?

Your answers are used for health research purposes only. We conduct this survey under the Public Health Service Act. It and other strict U.S. laws require that we protect your family’s information and keep it confidential. If you would like to know more about how we protect your answers, these laws are described in detail at www.cdc.gov/nchs/about/policy/confiden.htm.

If you want to know more about your rights as a study participant you may call 1-800-223-8118, toll free. This is the number for the Research Ethics Review Board at CDC. You will be asked to leave a message. Say you are calling about Protocol 2009-04.

How do I find more about immunizations and places to get them?

You may call toll free 1-800-CDC-INFO (1-800-232-4636) for more information about vaccinations or to get the phone number of a doctor or clinic near you.

If you prefer to use a TTY

Please call the AT&T Relay Service at 1-800-855-2880 and request that (INSERT CONTRACTOR NAME) be called at 1-866-999-3340.

NS-CSHCN augmentation sample advance letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

Dear Resident,

In the next few weeks, the Centers for Disease Control and Prevention (CDC) will call your household to participate in a study about the health of children and teenagers. This survey asks about the health services used by children and teenagers. Local, state, and federal health authorities depend on the results of this study to measure the status of children’s health care across the country.

Your telephone number was picked at random from lists of phone numbers. It is important that we talk to your household to learn about the health of children in your community. When we call you, we will ask a few questions to see if your household is eligible for this study.

You do not have to take part in this study, but we hope you will. If you do, you can choose not to answer any questions you do not wish to answer.

To learn more about the study or to take part right away, call 1-888-990-9986, toll-free. CDC has hired (INSERT CONTRACTOR NAME) to conduct the survey. Our website shows how we have used the data from the 2005 survey - www.cdc.gov/nchs/slaits.htm.

On the back of this letter are answers to questions you might have about the study.

Thank you very much for your help with this important research.

Sincerely,

Edward J. Sondik, Ph.D.

Director, National Center for Health Statistics

Centers for Disease Control and Prevention

If you prefer to use TTY

P lease call the AT&T Relay Service at 1-800-855-2880 and request that 1-888-990-9986 be called. The call is toll free.

NS-CSHCN augmentation sample advance letter (back)

National Survey of Children with Special Health Care Needs

Frequently Asked Questions

What is the purpose of this study?

This survey is designed to count the number of children with special health care needs in each state, to describe the types of services that they need and use, and to identify any problems they have in getting care. People have very different experiences with their children’s health and health care. In order to improve children’s health and well-being, it is important that we learn about how children use health care services and about any problems that they have in getting care that they need.

Does this study apply to me?

The CDC is interested in talking with all households. We need your information to get a complete picture of your area’s special health needs. It will take a few minutes or less to determine if you are eligible for the study.

How will you protect my privacy?

We are bound by law to maintain strict confidentiality standards. Your information and the child’s information will never be associated with any results.

If you would like more information about the confidentiality of the research, the federal laws that ensure the protection of your information have been described in detail at: www.cdc.gov/nchs/about/policy/confiden.htm. If you want to know more about your rights as a study participant you may call 1-800-223-8118, toll free. This is the number for the Research Ethics Review Board at CDC. You will be asked to leave a message and say you are calling about Protocol 2009-04.

How will this information be used?

Maternal and child health agencies in your state will use this information to improve health care services for children and their families. The federal government will also use this information to learn about the types of support services that states need for children’s health care.

You may visit http://www.cdc.gov/nchs/slaits.htm to find general information about the study. To find results from the last time the survey was done, please visit http://mchb.hrsa.gov/cshcn05/.

(INSERT CONTRACTOR NAME) Toll Free Number: 1-888-990-9986

You can call (INSERT CONTRACTOR NAME) toll free number to take part in the study right away, learn more about the study, and hear what you will be asked.

Refusal conversion letter—no monetary incentive offer

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

Dear Parent or Guardian,

The CDC needs your help!

Recently, your family was asked to take part in the National Survey of Children with Special Health Care Needs, but we have not been able to complete the survey yet. We hope you will reconsider our request. Information about your child and other children will help the U.S. Department of Health and Human Services develop programs to promote the health of children in your state and throughout the United States.

We hope you will share this important information with us by phone when an interviewer calls to ask you to take part in the study. If you would like to participate right away, please call the toll-free telephone number 1-866-999-3340.

Your household is very important to the study because it has been scientifically selected and cannot be replaced. All information collected for this study is confidential and protected by federal law. The back of this letter provides answers to some questions you might have and ways to get more information about the survey.

Thank you very much for your help with this important research.

Sincerely,

Edward J. Sondik, Ph.D.

Director, National Center for Health Statistics

Centers for Disease Control and Prevention

(back)

Why is this study being conducted?

The Centers for Disease Control and Prevention is committed to improving children’s health and well-being. State and federal health authorities are depending on the results of this study to help them understand how best to meet children’s needs.

How will this information be used?

Maternal and Child Health Agencies in your state will use this information to improve programs and services for children and their families. The federal government will also use this information to learn about the types of support services that states need for children’s health and well-being.

You may visit http://www.cdc.gov/nchs/slaits.htm to find general information about the study. To find results from the last time the survey was done, please visit http://mchb.hrsa.gov/cshcn05/.

How do I know that my information will remain private?

As required by law, we will take all possible steps to protect your privacy. The collection of information in this survey is authorized by Section 306 of the Public Health Service Act. The Public Health Service Act is Volume 42 of the US Code, Section 242k. The confidentiality of your responses is assured by Section 308(d) of this Act as well as by the Confidential Information Protection and Statistical Efficiency Act (CIPSEA).

Information that you provide is used for statistical research only. The results of this research are published only in the form of summary statistics. Your name and your child’s name are never associated with any published information.

Participation in the study is voluntary. You may choose not to answer any question that you do not wish to answer or to end your participation at any time.

How can I find out more about this survey?

If you have any questions about this research study, please call 1-866-999-3340.

If your questions are about your rights as a participant in this research study, you may also call the office of the Research Ethics Review Board at the National Center for Health Statistics, toll free, at 1-800-223-8118. Please leave a brief message with your name and phone number. Say that you are calling about Protocol #2009-04. Your call will be returned as soon as possible.

Refusal conversion letter—$5 + $10 monetary incentive offer

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

Dear Parent or Guardian,

The CDC needs your help!

Recently, your family was asked to take part in the National Survey of Children with Special Health Care Needs, but we have not been able to complete the survey yet. We hope you will reconsider our request. Information about your child and other children will help the U.S. Department of Health and Human Services develop programs to promote the health of children in your state and throughout the United States.

We hope you will share this important information with us by phone when an interviewer calls to ask you to take part in the study. If you would like to participate right away, please call the toll-free telephone number 1-866-999-3340.

Your household is very important to the study because it has been scientifically selected and cannot be replaced. All information collected for this study is confidential and protected by federal law. The back of this letter provides answers to some questions you might have and ways to get more information about the survey.

Thank you very much for your help with this important research.

Sincerely,

Edward J. Sondik, Ph.D.

Director, National Center for Health Statistics

Centers for Disease Control and Prevention

P.S. In appreciation for your time and effort, we have enclosed $5. We will send an additional $10 in cash once you complete the survey.

(back)

Why is this study being conducted?

The Centers for Disease Control and Prevention is committed to improving children’s health and well-being. State and federal health authorities are depending on the results of this study to help them understand how best to meet children’s needs.

How will this information be used?

Maternal and Child Health Agencies in your state will use this information to improve programs and services for children and their families. The federal government will also use this information to learn about the types of support services that states need for children’s health and well-being.

You may visit http://www.cdc.gov/nchs/slaits.htm to find general information about the study. To find results from the last time the survey was done, please visit http://mchb.hrsa.gov/cshcn05/.

How do I know that my information will remain private?

As required by law, we will take all possible steps to protect your privacy. The collection of information in this survey is authorized by Section 306 of the Public Health Service Act. The Public Health Service Act is Volume 42 of the US Code, Section 242k. The confidentiality of your responses is assured by Section 308(d) of this Act as well as by the Confidential Information Protection and Statistical Efficiency Act (CIPSEA).

Information that you provide is used for statistical research only. The results of this research are published only in the form of summary statistics. Your name and your child’s name are never associated with any published information.

Participation in the study is voluntary. You may choose not to answer any question that you do not wish to answer or to end your participation at any time.

How can I find out more about this survey?

If you have any questions about this research study, please call 1-866-999-3340.

If your questions are about your rights as a participant in this research study, you may also call the office of the Research Ethics Review Board at the National Center for Health Statistics, toll free, at 1-800-223-8118. Please leave a brief message with your name and phone number. Say that you are calling about Protocol #2009-04. Your call will be returned as soon as possible.

Refusal conversion letter—reminder of $5 monetary incentive offer

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

Dear Parent or Guardian,

The CDC needs your help!

Recently, your family was asked to take part in the National Survey of Children with Special Health Care Needs, but we have not been able to complete the survey yet. We hope you will reconsider our request. Information about your child and other children will help the U.S. Department of Health and Human Services develop programs to promote the health of children in your state and throughout the United States.

We hope you will share this important information with us by phone when an interviewer calls to ask you to take part in the study. If you would like to participate right away, please call the toll-free telephone number 1-866-999-3340.

Your household is very important to the study because it has been scientifically selected and cannot be replaced. All information collected for this study is confidential and protected by federal law. The back of this letter provides answers to some questions you might have and ways to get more information about the survey.

Thank you very much for your help with this important research.

Sincerely,

Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics
Centers for Disease Control and Prevention

P.S. In appreciation for your time and effort, we will send $5 in cash once you complete the survey.

(back)

Why is this study being conducted?

The Centers for Disease Control and Prevention is committed to improving children’s health and well-being. State and federal health authorities are depending on the results of this study to help them understand how best to meet children’s needs.

How will this information be used?

Maternal and Child Health Agencies in your state will use this information to improve programs and services for children and their families. The federal government will also use this information to learn about the types of support services that states need for children’s health and well-being.

You may visit http://www.cdc.gov/nchs/slaits.htm to find general information about the study. To find results from the last time the survey was done, please visit http://mchb.hrsa.gov/cshcn05/.

How do I know that my information will remain private?

As required by law, we will take all possible steps to protect your privacy. The collection of information in this survey is authorized by Section 306 of the Public Health Service Act. The Public Health Service Act is Volume 42 of the US Code, Section 242k. The confidentiality of your responses is assured by Section 308(d) of this Act as well as by the Confidential Information Protection and Statistical Efficiency Act (CIPSEA).

Information that you provide is used for statistical research only. The results of this research are published only in the form of summary statistics. Your name and your child’s name are never associated with any published information.

Participation in the study is voluntary. You may choose not to answer any question that you do not wish to answer or to end your participation at any time.

How can I find out more about this survey?

If you have any questions about this research study, please call 1-866-999-3340.

If your questions are about your rights as a participant in this research study, you may also call the office of the Research Ethics Review Board at the National Center for Health Statistics, toll free, at 1-800-223-8118. Please leave a brief message with your name and phone number. Say that you are calling about Protocol #2009-04. Your call will be returned as soon as possible.

Thank you letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

Dear Respondent:

Thank you for participating in the National Survey of Children with Special Health Care Needs. The information you provided about your child’s health and health care will be used to develop and evaluate programs for children across the country. In appreciation for the time and effort you spent answering our questions, we are enclosing $XX.

If you have any questions, you can call the study staff toll-free at X-XXX-XXX-XXX, or you can visit the study's web site at http://www.cdc.gov/nchs/about/major/slaits/XX.htm.

Thank you again for your help.

Sincerely,

Edward J. Sondik, Ph.D.

Director, National Center for Health Statistics

Centers for Disease Control and Prevention