Pre-Interview Letter

Appendix C

Pre-interview letter sent to

potential respondents

PRE-INTERVIEW LETTER FOR POTENTIAL SUBJECTS

U.S. CONSUMER PRODUCT SAFETY COMMISSION

BETHESDA, MD 20814

March 04, 2011

«Title». «FirstName» «LastName»

«Address1»

«Address2»

«City», «State» «PostalCode» Re: «Taskno»

Dear «Title». «LastName»:

All injuries seen in the Emergency Room at «HospName» are reported to the Consumer Product Safety Commission (CPSC). The CPSC and the Centers for Disease Control and Prevention (CDC) are using these reports for a research study to tell us if people would report work-related injuries. We will also find out why people decide to report or not to report an injury. We are writing you because we need your help. We would like to ask you for more information about your injury. All follow-up is being done by phone.

CPSC records show that you were treated on <<Treatment date>> in the <<HospName>> Emergency Room for an injury. Someone from CPSC may call you. During the phone call we will ask questions about the injury event, the treatment you received, the injury outcome, and other related issues. You will also be asked if you would tell your employer about future injuries. If you agree to take part in this phone interview, it should take about half an hour. There is no payment or direct benefit to you for taking part in this study.

Your decision to take part in this study is voluntary. If you do decide to take part, you may decide to end the study at any time without penalty. If you do not want to be in this study, call CPSC at (800) 638-8095, extension 7431, and leave a message within 10 days of getting this letter. Please leave your name and the project number that is at the top of this letter.

Your name and number will only be used to get in touch with you for this study. Your name and number will be kept no more than 60 days and will be erased before 60 days if the interview is finished or you refuse to take part.

Your answers to the questions will be kept private to the extent allowed by law. Other facts that might point to you indirectly will not be reported or published. The answers you give us will be a part of the CDC Privacy Act System (Systems of Records Notice 09-20-0136). It may be given to contractors working with us on this study or other researchers who plan to do further studies.

A loss of privacy that may lead to mental stress is the only known danger to taking part in this study. Physical injury or harm is not likely. If you are harmed, medical care will not be provided. If you are harmed because of any actions of an interviewer contracted by CPSC, you could file a claim against the contractor. If you are harmed because you took part in this study, call Larry Jackson, CDC project officer at the National Institute for Occupational Safety and Health (NIOSH), at (304) 285-5980. You may also call Mark Toraason, Chair of the CDC/NIOSH Human Subjects Review Board, at (513) 533-8222.

The Occupational Safety and Health Act of 1970 authorizes the collection of data for this study. If you have questions about this study, call Larry Jackson, CDC/NIOSH project officer, at (304) 285-5980. If you have questions about your rights as a part of this study, call Mark Toraason, Chair of the CDC/NIOSH Human Subjects Review Board, at (513) 533-8222.

Thank you for your time.

Respectfully,

Tom Schroeder

Statistician, Division Director

Division of Hazard and Injury Data Systems

U.S. Consumer Product Safety Commission

Flesch-Kincaid grade level: 8.1