FINAL_HCS_SSA_ATTACH 4_TOOLKIT_Jan 2013

SSA ATTACHMENT 4

HEALTHY COMMUNITIES STUDY

HEATHY COMMUNITIES STUDY

FAMILY RECRUITMENT TOOLKIT

Each recruited school will receive a Toolkit with recruitment materials that can be shared with students and their families to provide them with information on the study and assist in identifying those families with children in grades K-8 that may be interested in participating in the study. The Toolkit will be available at least one month before any recruitment occurs in the school to allow time for these materials to be disseminated to families in advance of being contacted by the study team.

The Toolkit contains the following material:

1. Parent/Guardian Letter, Brochure and Interest Form: An invitation letter to the child’s parent/guardian, an informational brochure and an interest form will be sent home with children in their book bags to solicit parent’s interest in learning more about the study. The interest forms will be printed in large easy to read typeface and have limited data items to be completed by the parent/guardian, including a name, contact number, and the grade, gender and race/ethnicity of the child attending the selected school. The student will be asked to bring the completed interest form back to school. This information will be used to develop the sampling pool from which to recruit families for data collection.

2. HCS News Article: A short news article about the HCS that the school can include their PTA newsletter and/or other communications that are routinely sent, or made available, to parents of children in the schools. Two formats of the news article are provided for electronic and paper distribution.

3. Scripts for Verbal Announcements: Scripts that the school can use to provide verbal announcements to the parents/guardians (either at in-person meetings such as PTA meetings or through phone call blasts) and verbal announcements to the children informing and reminding them about the study and interest form.

To assist with the dissemination and collection of the Toolkit materials, a school liaison from amongst the professional staff at each school will be identified. This individual will also serve as the “School Champion” for the study, helping raise awareness of the study in the school and community. To successfully function in this capacity, the selected individual must be highly regarded and trusted by both students and their parents. The prime responsibility for the liaison will be to serve as the point of contact for the study to parents/guardians and the students; this includes engaging students to take the informational materials and interest form to their homes and return the completed form back to the school, and responding to questions from parents/guardians on the study. The school champion/liaison will receive an incentive of $50 for their assistance with family recruitment. Each liaison will collect the returned interest forms from students and provide these to the HCS team.

We need 81 families in our community to be in this study! Do your part to help improve children’s health! Volunteer today!

Dear Parent/Guardian,

We at [SCHOOL NAME] are lucky! We were picked to be in the Healthy Communities Study. The Healthy Communities Study is trying to find out how communities help children be healthy. We at [SCHOOL NAME] agreed to be in the Healthy Communities Study because we value the health of every child.

We are asking all [SCHOOL NAME] parents to fill out the attached Study Interest Form if they might want to be in the study. If you have more than one child, please complete one form for your family.

Being in the study is easy and FREE!

• The study will use the interest forms to select families (like a lottery).

• If they call, they will tell you more about the study.

• If you want to be in the study, a home visit will be scheduled at a time that works for you and your family.

• The study team will ask you and your child questions.

  • About the foods your child eats.

  • About the physical activities your child does.

  • Measure you and your child's height and weight.

• You will only answer questions that you want to and all information about you will be kept private.

• Your family will get gifts worth $30 to thank you for being in the study.

You can learn more by going to the study website at http://go.usa.gov/QMT. Make sure you put QMT in capital letters!

Please look at the Healthy Communities Study pamphlet for answers to your questions. Please return completed interest forms to your child’s teacher by [DATE]. Fill out your interest form today!

Sincerely,

[SIGNATURE]	[SIGNATURE]	[SIGNATURE]
LIAISON NAME [SCHOOL NAME] Healthy Communities Study Liaison	PRINCIPAL NAME [SCHOOL NAME] Principal	[OTHER COMMUNITY MEMBER NAME] [ORGANIZATION]

FAMILY BROCHURE LANGUAGE

1. What is The Healthy Communities Study?

• One of the biggest studies of children’s health

• A project that includes 268 communities and 21,500 families

• A study that looks at how communities help children be healthy

2. How will this study work?

• Schools will send information home to parents

• Families will decide if they want to be in the study

• The study will draw names of families to call – like a lottery

• Someone from the study meets with families in their homes

• The study will talk with school staff about schools

• The study will talk to community leaders

3. Will I get anything for being in the study?

• Your family will get thank you gifts worth $30

4. What are the benefits of being in the study?

• You can be proud of helping to improve children’s health

• The study results can be used to help children be healthy in your community and across the country

5. Is there a cost or risk to being in the study?

• There is no cost or risk to being in this study

• What you tell us is kept private

• You can decide if you want to be in the study

• You can stop being in the study at any time

• You do not have to answer every question

6. How will I know if my family is picked to be in the study?

• You will get a phone call from the study

7. What happens if my family is picked for the study?

• The study will call you and tell you more about the study

• If you have more than one child, only one of your children will be in the study

• If you are in the study

  • Someone from the study will come to your home

  • They will make sure to come at a time that works for your family

  • The visit will take about one and a half hours (1.5 hours)

  • They will ask about the foods your child eats and the physical activities that your child does

  • They will measure you and your child’s height and weight

  • They will ask to get your child’s medical records from the doctor to see how your child has grown

  • Some children will be asked if they want to wear an activity monitor for 8 days

    • The activity monitor is just a small plastic square on a stretchy belt

8. Why should I be in the Healthy Communities Study?

• You can help us learn how children in your community and across the country can be healthy

• Being in the study is easy and FREE!

• You don’t even have to leave your home!

To learn more, please go to our website at http://go.usa.gov/QMT . Make sure you type the QMT in capital letters!

H

Public reporting burden for this collection of information is estimated to 5minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0649). Do not return the completed form to this address.

ealthy Communities Study Interest Form

If you would like to be in the Healthy Communities Study, please fill out this form. If you have children in different schools and they both bring home a form, please fill out a separate form for each school. Return this form to your child’s teacher. What you tell us will be safe. It will NOT be shared with anyone outside the study. The study team will use the Study Interest Forms to select families to call – like a lottery.

Parent/Guardian Information:		Best time to call (check all that apply): Weekdays Evenings Weekends
Name: _______________________________	Phone #: (____) ____-______
Address: _____________________________	Other phone #: (____) ____-______
City, State: _____________________, _________
Zip: __________ years at this address: _____	Do you prefer to receive information in:  English  Spanish  Other

What school is named in the letter? _________________________________

Child Information: Please complete the following information for each child who goes to the school named in the letter.
Child first name	Grade	Gender	Do you consider child Hispanic/ Latin(o/a)?	What race do you consider your child to be? (check all that apply)
		Female Male	Yes No	White Black/ African American American Indian/Alaska Native	Native Hawaiian/ Pacific Islander Asian
		Female Male	Yes No	White Black/ African American American Indian/Alaska Native	Native Hawaiian/ Pacific Islander Asian
		Female Male	Yes No	White Black/ African American American Indian/Alaska Native	Native Hawaiian/ Pacific Islander Asian
Thank you very much for completing this form.

Public reporting burden of this collection of information is estimated at 3 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to S. Sonia Arteaga, Ph.D., project officer at [email protected]

Public reporting burden of this collection of information is estimated at 3 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to S. Sonia Arteaga, Ph.D., project officer at [email protected]

HCS NEWS ARTICLE FOR PTA E-MAIL BLASTS AND NEWSLETTERS

E-MAIL BLAST

Hey [SCHOOL MASCOT]s! [NAME OF SCHOOL] is a part of a new national study called the Healthy Communities Study!

• The Healthy Communities Study is trying to find out how community programs and local policies help children be healthy.

• We were picked to represent our community!

• We will send home more information about the study soon.

• You can also go to the study WEBSITE (click the word website) to learn more about it!

• We will send a Study Interest Form home with each child.

  • Please fill it out if you might want to be in the study.

  • Return it to your child’s teacher.

  • If you have more than one child, please fill out one form for your family.

• When the study team gets our school’s Study Interest Forms, they will draw names of families to call – like a lottery.

• If they call you, they will tell you more about the study.

• If you have more than one child, they will work with you to pick one child to be in the study.

• Then you can decide if you want to be in the study.

• If you agree to be in the study, the study team will ask you and your child some questions.

  • They will ask about the foods your child eats and the physical activities that your child does.

  • They will measure you and your child’s height and weight.

  • Your family will get gifts worth $30 to thank you for being in the study.

• Being in the study is easy and FREE!

Please fill out the Study Interest Form so you have a chance to be in the study! Contact [SCHOOL LIAISON NAME at ###-###-#### or [email protected]] if you have any questions about the Healthy Communities Study.

Thanks,

Principal [LAST NAME] and [SCHOOL LIAISON NAME]

PAPER NEWSLETTERS

Hey [SCHOOL MASCOT]s! [NAME OF SCHOOL] is a part of a new national study called the Healthy Communities Study!

• The Healthy Communities Study is trying to find out how community programs and local policies help children be healthy.

• We were picked to represent our community!

• We will send home more information about the study soon.

• You can also go to the study website at http://go.usa.gov/QMT (make sure you type QMT in capital letters) to learn more about it!

• We will send a Study Interest Form home with each child.

  • Please fill it out if you might want to be in the study.

  • Return it to your child’s teacher.

  • If you have more than one child, please fill out one form for your family.

• When the study team gets our school’s Study Interest Forms, they will draw names of families to call – like a lottery.

• If they call you, they will tell you more about the study.

• If you have more than one child, they will work with you to pick one child to be in the study.

• Then you can decide if you want to be in the study.

• If you agree to be in the study, the study team will ask you and your child some questions.

  • They will ask about the foods your child eats and the physical activities that your child does.

  • They will measure you and your child’s height and weight.

  • Your family will get gifts worth $30 to thank you for being in the study.

• Being in the study is easy and FREE!

• Please go to the study website now at http://go.usa.gov/QMT (make sure you type QMT in capital letters) to learn more about it!

Please fill out the Study Interest Form so you have a chance to be in the study! Contact [SCHOOL LIAISON NAME at ###-###-#### or [email protected]] if you have any questions about the Healthy Communities Study.

Thanks,

Principal [LAST NAME] and [SCHOOL LIAISON NAME]

SCRIPTS FOR VERBAL ANNOUNCEMENTS MADE TO PARENTS/GUARDIANS

SCRIPT FOR VERBAL ANNOUNCEMENTS MADE TO PARENTS AT MEETINGS, EVENTS, ETC.

Hi everyone! [NAME OF SCHOOL] is a part of a new study called the Healthy Communities Study! The Healthy Communities Study is trying to find out how communities help children be healthy. Please fill out the Study Interest Form if you might want to be in the study! Return the Interest Form to your child’s teacher by MM/DD/YYYY. (There are booklets at the back of the room with more information about the study.) When the study team gets our school’s interest forms, they will draw names of families to call – like a lottery. If they call you, they will tell you more about the study. If you have more than one child, the study team will work with you to pick one child to be in the study. Then you can decide if you want to be in it. If your family is in the study, they will ask about the foods your child eats. They will also ask about the physical activities that your child does. They will measure you and your child’s height and weight. Your family will receive gifts worth $30 to thank you for being in the study. Being in the study is easy and FREE! If you have any questions about the Healthy Communities Study, please see [SCHOOL LIAISON’S NAME/ME]. Thank you!

LONGER PHONE CALL BLAST

Hi [SCHOOL MASCOT]s! [NAME OF SCHOOL] is a part of a new study about children’s health called the Healthy Communities Study! Our school was selected to represent our community. We are sending home more information about the study soon. When it comes, please fill out the Study Interest Form if you might want to be in the study! Return the Interest Form to your child’s teacher by MM/DD/YYYY. The study team will draw names of families to call – like a lottery. If they call you, they will tell you more about the study. Then you can decide if you want to be in the study. Families in the study will be given a gift worth $30 as a thank you. Being in the study is easy and FREE! If you have any questions, please call [SCHOOL LIAISON’S NAME/ME] at ###-###-####. Thank you!

SHORTER PHONE CALL BLAST

Hi [SCHOOL MASCOT]s! [NAME OF SCHOOL] is a part of a new study about children’s health called the Healthy Communities Study! Our school was selected to represent our community. We are sending home more information about the study. Please fill out the Study Interest Form if you might want to be in the study! Return the Interest Form to your child’s teacher by MM/DD/YYYY. If you have any questions, please call [SCHOOL LIAISON’S NAME/ME] at ###-###-####. Thank you!

SCRIPTS FOR VERBAL ANNOUNCEMENTS MADE TO STUDENTS

FIRST ELEMENTARY SCHOOL VERBAL ANNOUNCEMENT:

Hey [SCHOOL MASCOT]s! [NAME OF SCHOOL] is lucky! We were picked to be in the Healthy Communities Study! Do you want to help our community? Do you want to help our country? Talk to your parents about being in the Healthy Communities Study! If you are in the study, staff will ask you about what you eat and the physical activities you do. They will also measure your height and weight. Your family will get gifts to thank you for being in the study. Please take the forms home with you and ask your parents to fill them out. Don’t forget to turn in your Study Interest Form to your teacher by [MM/DD/YYYY]!

FIRST MIDDLE SCHOOL VERBAL ANNOUNCEMENT:

Hey [SCHOOL MASCOT]s! [NAME OF SCHOOL] is lucky! We were picked to be in the Healthy Communities Study! Do you want to help our community? Do you want to help our country? Talk to your parents about being in the Healthy Communities Study! If you are in the study, staff will ask you about what you eat and the physical activities you do. They will also measure your height and weight. Your family will get gifts to thank you for being in the study. Please take the forms home with you and ask your parents to fill them out. Don’t forget to turn in your Study Interest Form to your teacher by [MM/DD/YYYY]!

SUBSEQUENT VERBAL ANNOUNCEMENTS:

Hey [SCHOOL MASCOT]s! Only [#] days left to return your Study Interest Form for the Healthy Communities Study! Ask your parents to fill out the form and bring it to your teacher by the end of the day on [DAY OF WEEK].

Don’t miss out! Turn in your Healthy Communities Study form by [DATE]! See [LIAISON NAME] if you have any questions.

Remember to ask your parents to fill out the Healthy Communities Study Interest Form! Turn it in to your teacher by [DATE] so you can have a chance to be in the study!