Participant Info Sheet

ATT E Participant Info Sheet.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Participant Info Sheet

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ATTACHMENT E: Radiation Dose Tool Participant Information Sheet


U. S. Department of Health and Human Services

CDC Study

Radiation Dose Tool (Interview)


Information for Participants


Purpose of this Survey

You are being asked to participate in an interview being held by UserInsight. The project will focus on gathering feedback on a tool created by the Centers for Disease Control and Prevention (CDC) with the assistance of Oak Ridge Associated Universities (ORAU). During the interview, you will be asked your opinions and practices regarding some information about a tool for radiation emergencies that might be provided to other people like you. Your answers can help efforts to provide accurate, helpful information to the public during a radiation emergency.


Procedures:

We have asked you to participate in an interview. The interview will take place in a professional research facility or in your home. During the interview, you will be asked your opinions and practices regarding some information about a tool for radiation emergencies that might be provided to other people like you. A trained person will lead the interview. The total time involved in the interview, including instructions, will be no more than 60 minutes.

Please remember that:

You choose to participate.

You are not required to answer the questions.

This session should last about 60 minutes.

The session will not be video or audio recorded.

You will receive a token of appreciation for participating in the discussion.

You are free to leave at any time without penalty, and you will still receive the token of appreciation.


Risks

The risks of your participation are expected to be minimal. This means that the risks are not expected to be greater than the risks persons may normally find in their daily life.


Benefits

You may be better informed about a public health issue.

You may have a sense of satisfaction from contributing.

Your comments may help improve the information the public receives.


We will keep the information you give us private to the extent allowed by law. Your name will not be used in the final report. No statement you make will be linked to you by name. Only members of the research staff will be allowed to look at the records. When we present this study or publish its results, your name or other facts that point to you will not show or be used.






Persons to Contact

If you have questions about this session, or taking part in it, you may call: Carol McCurley 770-488-3800 at the Centers for Disease Control and Prevention, Atlanta, GA.

If you need more information about your rights as a study participant, you may contact:

Oak Ridge Site-Wide Institutional Review Board at [email protected].




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