CHATS Attachment W_revised_02272012

ATTACHMENT W

Refusal Letters

ATTACHMENT W1

General Refusal Letter

GENERAL REFUSAL CONVERSION LETTER

[DATE]

[Parent Name]

[STREET ADDRESS]

[CITY], [STATE] [ZIPCODE]

Dear [Parent Name],

Recently, an interviewer from RTI International came to your home and asked permission for your child to take part in the Children’s Health after the Storms (CHATS) study. This study is supported by the Centers for Disease Control and Prevention (CDC). At that time, you did not wish for your child to take part in the study. I am writing to tell you more about the study and hope you will reconsider.

The purpose of the Children’s Health after the Storms Study is to find out about the health of children in the Gulf Coast after Hurricanes Katrina and Rita.  This is so that we can better understand the effects of the living conditions—such as storm damaged housing, FEMA-supplied trailers,  and housing unaffected by the storms—on children in this area.

Your participation is critical to the success of our study. A small number of children were randomly selected to represent children living on the Gulf Coast. Your child cannot be replaced. If your child does not take part in the study, the health experiences of children like yours will not be heard. By participating in this study, your child will help us record the experiences, symptoms and illnesses among these children.

We understand that the privacy of your family is important, and we will keep all information your family provides strictly private. You and your child can skip or refuse to answer any questions you do not want to answer. Any services you and your family may receive will not be affected as a result of your participation. All answers and data collected for CHATS will be combined with other interviews and provided to the public in summary form only and your names will not be included in these reports.

In addition, RTI has obtained a Federal Certificate of Confidentiality from the Department of Health and Human Services which prevents the release of your names or other identifying characteristics to anyone not connected with the CHATS study, even if in a court of law, unless you say it’s okay.  There is an important exception: If the CHATS interviewer or nurse feels that a participant’s life or health is in danger, they will inform the appropriate county or state agency.

As a thank you for your time, your household could receive up to $135 depending on the age of your child and the study parts in which your family qualifies.

I have included with this letter a brochure with more information about CHATS. I hope that after reading it you will agree to have your child take part in this important study. You and your child can make a difference, but only if you participate. One of our interviewers will call on you again soon. If you have any questions or concerns, or would like to set up an appointment, please call me toll-free at 1-800-334-8571, ext. 5628 from 9 am - 5 pm CST. Thank you very much for your time.

S incerely,

Diane Wagener, PhD

Project Director

Children’s Health after the Storms

ATTACHMENT W2

Anti-Government Refusal Letter

REFUSAL LETTER – ANTI-GOVERNMENT

[DATE]

[Resident]

[STREET ADDRESS]

[CITY], [STATE] [ZIPCODE]

Dear Community Member,

Recently, an interviewer from RTI International came to your home and asked your household to take part in the Children’s Health after the Storms (CHATS) study. At that time, you were concerned about your family participating in a study sponsored by the federal government. I am writing to tell you more about the study and hope you will reconsider.

CHATS is supported by the Centers for Disease Control and Prevention (CDC). RTI International, a not-for-profit research organization, is carrying out the study on CDC’s behalf. The purpose of the Children’s Health after the Storms Study is to find out about the health of children in the Gulf Coast after Hurricanes Katrina and Rita. This is so that we can better understand the effects of the living conditions—such as storm damaged housing, FEMA-supplied trailers, and housing unaffected by the storms—on children in this area.

Your participation is critical to the success of our study. A small number of households were randomly selected to represent the children living on the Gulf Coast. Your household cannot be replaced. If your household does not take part in the study, the health experiences of children like yours will not be heard. By participating in this study, you will help us to record the experiences, symptoms and illnesses among these children.

We understand that the privacy of your family is important, and we will keep all the information your family provides strictly private. You can skip or refuse to answer any questions you do not want to answer. Any services you and your family may receive will not be affected as a result of your participation. The CDC will not receive your names or address nor will any other government agency. All answers and data collected for CHATS will be combined, all published information about the study will be in summary form only and your names will not be included in these reports. All RTI employees are required by law to safeguard and protect the information collected for the CHATS study.

In addition, RTI has obtained a Federal Certificate of Confidentiality from the Department of Health and Human Services which prevents the release of your names or other identifying characteristics to anyone not connected with the CHATS study, even if in a court of law, unless you say it’s okay.  There is an important exception: If the CHATS interviewer or nurse feels that a participant’s life or health is in danger, they will inform the appropriate county or state agency.

As a thank you for your time, your household could receive up to $135 depending on the age of your child and the study parts in which your family qualifies.

I have included with this letter a brochure with more information about CHATS. I hope that after reading it you will agree to take part in this important study. Your household can make a difference, but only if you participate. One of our interviewers will call on you again soon. If you have any questions or concerns, or would like to set up an appointment, please call me toll-free at 1-800-334-8571, extension 5628 from 9 am - 5 pm CST. Thank you very much for your time.

S incerely,

Diane Wagener, PhD.

Project Director

Children’s Health after the Storms

Refusal Letters W-1