Perform Formative Research to Test Messages Developed to Help Communicate 2015 Dietary Guidelines Recommendations

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APPENDIX D-1 CNPP ONLINE SURVEY CONSENT FORM - ENGLISH

CNPP Online Survey Participation

Consent Form - English

You are being invited to participate in a research study on behalf of the United States Department of Agriculture (USDA) Center for Nutrition Policy and Promotion (CNPP) to inform them about how Americans make food choices and think about health-related issues.

If you agree to take part in this study, you will be asked to complete an online survey. This survey will take you approximately 15 minutes to complete.

You may not directly benefit from this research; however, we hope that your participation in the study may help the USDA determine how to best communicate ways that Americans can make healthier decisions about what they eat and drink. You may also receive customary number of points from the panel provider.

To the best of our ability, your answers in this study will remain private. By agreeing to participate in this survey, you are allowing the USDA to use the information from this study. The information collected is for research only, and your name will not be shared with anyone outside of this study, except as otherwise required by law. Any results that come from this study will be presented as an aggregate and your name will not be identified with any statements you made.

Your participation in this study is completely voluntary and you can stop at any time. You are free to skip any question that you choose. There will not be any penalties if you refuse to participate in this study or refuse to answer any questions.

If you have questions about this project or if you don't understand something, you may contact Alec Ulasevich, PhD at [email protected] or at 240-403-1641.

By clicking “I agree” below you are indicating that you are at least 18 years old, have read and understood this consent form and agree to participate in this research study. Please print a copy of this page for your records.

I Agree

I Do Not Agree