Field Materials - English

19_Field_Data_Collection_Materials.pdf

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Field Materials - English

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Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Attachment 19 - English
PATH Study
Field Data Collection Materials
June 26, 2014

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Table of Contents
Section

Page

Attachment 19. PATH Study Field Data Collection Materials
AM2 – Study Brochure ......................................................................................
RS3 – SIMY Card ...............................................................................................
RS3a – SIMY Doorhanger ................................................................................
RS4 – PATH Interviewer ID Badge ................................................................
RS5 – Interviewer Authorization Letter..........................................................
RS7b-A – Refusal Conversion Letter: Too Busy - Adult .............................
RS7b-E – Refusal Conversion Letter: Too Busy – Emancipated
Youth ......................................................................................................
RS7b-P – Refusal Conversion Letter: Too Busy – Parent ...........................
RS7b-T – Refusal Conversion Letter: Too Busy – Emancipated
Youth Turning Adult ............................................................................
RS7f-A – Refusal Conversion Letter: General - Adult .................................
RS7f-E – Refusal Conversion Letter: General – Emancipated
Youth ......................................................................................................
RS7f-P – Refusal Conversion Letter: General – Parent................................
RS7f-T – Refusal Conversion Letter: General – Emancipated
Youth Turning Adult ............................................................................
RS7g-A – Refusal Conversion Letter: Worried About
Confidentiality - Adult..........................................................................
RS7g-E – Refusal Conversion Letter: Worried About
Confidentiality – Emancipated Youth ...............................................
RS7g-P – Refusal Conversion Letter: Worried About
Confidentiality – Parent .......................................................................
RS7g-T – Refusal Conversion Letter: Worried About
Confidentiality – Emancipated Youth Turning Adult .....................
RS7h-A – Refusal Conversion Letter: Max Calls - Adult .............................
RS7h-E – Refusal Conversion Letter: Max Calls – Emancipated
Youth ......................................................................................................
RS7h-P – Refusal Conversion Letter: Max Calls – Parent ...........................
RS7h-T – Refusal Conversion Letter: Max Calls – Emancipated
Youth Turning Adult ............................................................................
RS7i-A – Refusal Conversion Letter: Non-User - Adult ..............................
RS7i-E – Refusal Conversion Letter: Non-User – Emancipated
Youth ......................................................................................................
RS7i-P – Refusal Conversion Letter: Non-User – Parent ............................
RS7i-T – Refusal Conversion Letter: Non-User – Emancipated
Youth Turning Adult ............................................................................

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Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Contents (continued)

Section

Page

Attachment 19. PATH Study Field Data Collection Materials
RS7k – Refusal Conversion Letter: Gatekeeper/No Solicitation................
RS7m-A – Refusal Conversion Letter: Anti Survey - Adult.........................
RS7m-E – Refusal Conversion Letter: Anti Survey –
Emancipated Youth ..............................................................................
RS7m-P – Refusal Conversion Letter: Anti Survey – Parent .......................
RS7m-T – Refusal Conversion Letter: Anti Survey –
Emancipated Youth Turning Adult ...................................................
RS8a – Urine Collection Instructions ..............................................................
RS9 – PATH Blood Collection Brochure (Hooper Holmes) ......................
RS10 – Adult Payment Receipt ........................................................................
RS10a – Youth Payment Receipt .....................................................................
RS10b – Parent Payment Receipt.....................................................................
RS11 – How to Get Help Brochure ................................................................
RS12 – Interviewer Appointment Card ..........................................................
RS13 – Health Professional Appointment Card ............................................
RS14 – Debit Card Carrier ................................................................................

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50

How can I get more information about the
PATH Study?
The PATH Study interviewer can answer any
questions you have about the study.
Also, for additional information on the study, you can
go to the PATH Study website at www.pathstudyinfo.
nih.gov (if you have a smartphone, you can scan the
QR code below to visit the website) or call toll-free at
1-888-311-1819.

Will I get anything for being in the
PATH Study?

New
National Study
on Tobacco
and Health

Yes. As a thank you, each adult household member
selected for the PATH Study will be offered up to $85
for fully participating in both of two home visits.

38215.0713.8954020204

Each selected youth will be offered $25 for completing
an interview. Parents will be offered $10 for completing
an interview about the youth.

www.pathstudyinfo.nih.gov

Welcome to the PATH Study!
Your household and thousands of others have been
selected to be in one of the most important national
health studies ever done in the United States.

Why was my household selected?

Why should I be part of this study?

The PATH Study selected your address by chance
from a list of addresses. Whether or not to participate
is up to you. However, the study results will be much
more complete and useful if your household agrees to
participate.

You should be part of the PATH Study because the
results may help to improve the health of millions of
Americans.

What happens next?

Whether or not you use tobacco, you will be an
important part of what is learned about tobacco
products and how they may affect health. Your
participation can make a difference.

In the next few weeks, one of the PATH Study
interviewers will visit your home. The interviewer
would like to talk to an adult and ask questions about
the people who live in your household. We will use
the answers to select people to participate in the study.

• If an adult in your household is selected for the
study, we will ask him or her to take part in an
interview. The person can decide whether or not to
be part of the study. If you are selected, we hope
you will agree to participate.

• If a person 12 to 17 years old is selected, we will
What is the PATH Study?
The National Institutes of Health (NIH), in partnership
with the Food and Drug Administration (FDA), is
sponsoring an exciting new study on tobacco and
health, called the PATH Study. This study will include
people age 12 and older, whether or not they use
tobacco.
The study will teach us about why and how people
are using–or not using–different types of tobacco
products (not just cigarettes) and how use may affect
health. Because we want to know why people do not
use tobacco products, including tobacco non-users is
critical. The goal is to interview about 59,000 people
at their homes, making the PATH Study the largest of
its kind ever done.
The information we collect will be used for research
purposes only. The study will keep this information
private; it will only be seen by individuals working on
the study.

interview him or her only if a parent or guardian
gives permission, and the youth agrees to
participate.

How will you protect my privacy?
All the information you give to the PATH Study will
be kept private.

• Your answers will not be connected with
your name.

• We will identify your answers by a number only.
• Your name and contact information will be kept
separately in secure computer files.

Sorry I Missed You!

Hello _______________________________________________

I visited today to talk with you about the Population Assessment of Tobacco and Health

(PATH) Study. This study will look at tobacco use and how it may affect the health of

people in the United States. It will include both people who use tobacco and those who

don’t. This study is being conducted by Westat for the National Institutes of Health (NIH),

in partnership with the Food and Drug Administration (FDA).

I’m sorry that I didn’t find you at home. In the next few days, I’ll try to contact you again.

Thank you for your cooperation.

Sincerely,

Interviewer Name ____________________________________

Date _______________________________________________

Over

Date _______________________________________________

Sorry I Missed You!

Hello _______________________________________________

Over

I visited today to talk with you about the Population Assessment of Tobacco and Health

(PATH) Study. This study will look at tobacco use and how it may affect the health of

people in the United States. It will include both people who use tobacco and those who

don’t. This study is being conducted by Westat for the National Institutes of Health (NIH),

in partnership with the Food and Drug Administration (FDA).

I’m sorry that I didn’t find you at home. In the next few days, I’ll try to contact you again.

Thank you for your cooperation.

Sincerely,

Interviewer Name ____________________________________

Date _______________________________________________

Over

Date _______________________________________________

Over

Contact Information

If you want more information about this study or to schedule an appointment at

a convenient time, please call our toll-free number, 1-888-311-1819, weekdays

between 9:00 a.m. and 5:30 p.m. Eastern Time.

You may also visit the PATH Study website at www.pathstudyinfo.nih.gov.

If you have a smartphone, you can scan the QR code to visit the website.

38201.0513.8954.02.02.04

Contact Information

If you want more information about this study or to schedule an appointment at

a convenient time, please call our toll-free number, 1-888-311-1819, weekdays

between 9:00 a.m. and 5:30 p.m. Eastern Time.

You may also visit the PATH Study website at www.pathstudyinfo.nih.gov.

If you have a smartphone, you can scan the QR code to visit the website.

38201.0513.8954.02.02.04

Sorry I Missed You!

Hello

I visited today to talk with you about the
Population Assessment of Tobacco and
Health (PATH) Study. This study will look
at tobacco use and how it may affect the
health of people in the United States. It will
include both people who use tobacco and
those who don’t. This study is being conducted by Westat for the National Institutes
of Health (NIH), in partnership with the
Food and Drug Administration (FDA). I’m
sorry that I didn’t find you at home. In the
next few days, I’ll try to contact you again.

Thank you for your cooperation.

Sincerely,

Printed Name

Date

Date
Over

Over

If you want more information about this
study or to schedule an appointment at a
convenient time, please call our toll-free
number, 1-888-311-1819, weekdays between
9:00 a.m. and 5:30 p.m. Eastern Time.

You may also visit the PATH Study website
at www.pathstudyinfo.nih.gov

If you have a smartphone, you can scan
the QR code below to visit the website.

38201.0513.8954.02.02.04

Contact Information

38201.0513.8954.02.02.04

Contact Information

38201.0513.8954.02.02.04

Contact Information

38201.0513.8954.02.02.04

Contact Information

<><>
<>
Expires: 9-30-2017

Issued by: Westat Project Director, David Maklan, Ph.D.
1- 888 -311-1819 · www.pathstudyinfo.nih.gov

To reach the PATH Support Desk, field staff should call

1-855-811-7284

To Whom It May Concern:
The bearer of this letter, [INTERVIEWER NAME], is a professionally trained interviewer who
works for Westat, an independent research firm. Westat is conducting the Population Assessment of
Tobacco and Health (PATH) Study. This study is sponsored by the National Institutes of Health
(NIH), in partnership with the Food and Drug Administration (FDA). The study will look at
tobacco use and how it may affect the health of people in the United States. What we learn will help
improve the health of millions of Americans.
About 47,000 individuals will be asked to participate in this study. The study will include people
who use tobacco and those who don’t.
The interviewer named in this letter is doing interviews for the PATH Study. He or she carries a
Westat identification badge. The interviewer needs to speak to someone at the selected address and
other addresses in the area.
If you have any questions about the study or this interviewer’s role, call Westat’s toll-free number, 1888-311-1819, weekdays between 9:00 a.m. and 5:30 p.m. Eastern Time. You can also visit the
PATH Study website at www.pathstudyinfo.nih.gov (if you have a smartphone, you can scan the
QR code below to visit the website).
Thank you in advance for your cooperation.
Sincerely,

Kevin P. Conway, Ph.D.
PATH Study, NIH Project Officer

www.pathstudyinfo.nih.gov

«MailDate»
«Name»
«ADDR1»
«CITY», «ST» «ZIP»

RS7b-A - Refusal Conversion Letter: Too Busy - Adult

Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you were too busy to participate. As the PATH
Study Survey Director, I want to ask you personally to think about it again.
I understand that you are busy and have many demands on your time and energy. But doing an
interview for the PATH Study is very important to our Nation’s health. You can help researchers
understand why and how Americans are using – or not using – different types of tobacco products
(not just cigarettes) and how use affects health. Whether or not you use tobacco, you can make a
difference by doing an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. It should only
take about an hour. We can do it when it is convenient for you. We will offer you $35 as a thank
you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR
code below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration
(FDA), is sponsoring the PATH Study

www.pathstudyinfo.nih.gov

RS7b-A_V0

RS7b-E - Refusal Conversion Letter: Too Busy – Emancipated Youth
«MailDate»
«Name»
«ADDR1»
«CITY», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you were too busy to participate. As the PATH
Study Survey Director, I want to ask you personally to think about it again.
I understand that you are busy and have many demands on your time and energy. But doing an
interview for the PATH Study is very important to our Nation’s health. You can help researchers
understand why and how Americans are using – or not using – different types of tobacco products
(not just cigarettes) and how use affects health. Whether or not you use tobacco, you can make a
difference by doing an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. It should only
take about an hour. We can do it when it is convenient for you. We will offer you $25 as a
thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR
code below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration
(FDA), is sponsoring the PATH Study.

www.pathstudyinfo.nih.gov

RS7b-E_V0

RS7b-P - Refusal Conversion Letter: Too Busy - Parent
«MailDate»
«Name»
«ADDR1»
«CITY», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer let us know you were too busy to participate this year with
your child. As the PATH Study Survey Director, I want to ask you personally to think about it again.
I understand that you are busy and have many demands on your time and energy. But doing an
interview for the PATH Study is very important to our Nation’s health. You can help researchers
understand why and how Americans are using – or not using – different types of tobacco products
(not just cigarettes) and how use affects health. Whether or not you use tobacco, you and your child
can make a difference by doing an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. It should only
take about an hour. We can do it when it is convenient for you. We will offer your child $25 as
a thank you for completing the interview. We will offer you $10 as a thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR
code below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration
(FDA), is sponsoring the PATH Study.

www.pathstudyinfo.nih.gov

RS7b-P_V0

RS7b-E - Refusal Conversion Letter: Too Busy – Emancipated Youth Turning Adult
«MailDate»
«Name»
«ADDR1»
«CITY», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you were too busy to participate. As the PATH
Study Survey Director, I want to ask you personally to think about it again.
I understand that you are busy and have many demands on your time and energy. But doing an
interview for the PATH Study is very important to our Nation’s health. You can help researchers
understand why and how Americans are using – or not using – different types of tobacco products
(not just cigarettes) and how use affects health. Whether or not you use tobacco, you can make a
difference by doing an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. Because you are
now 18 years old, you are eligible to participate in the Study as an adult. The visit should take
between 40 and 90 minutes. We can do it when it is convenient for you. We will offer you up to
$85 as thank you for fully participating in two home visits. I have enclosed a study brochure to help
answer your questions.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR
code below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration
(FDA), is sponsoring the PATH Study.

www.pathstudyinfo.nih.gov

RS7b-T_V0

RS7f-A Refusal Conversion Letter: General - Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that, although you agreed to be interviewed last year, you do not want
to have the follow-up visit this year. As the PATH Study Survey Director, I want to ask you personally to
think about it again.
I understand how busy people are these days. But, by doing the follow-up interview for the PATH Study,
you can help researchers understand why and how Americans are using – or not using – different types of
tobacco products (not just cigarettes) and how use affects health. Whether or not you use tobacco, you
can make a difference by doing another interview.
I have asked a PATH Study interviewer to contact you again to set up the interview. It should only take
about an hour. We can do it when it is convenient for you. We will offer you $35 as a thank you for
participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit
our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to
visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.

www.pathstudyinfo.nih.gov

RS7f-A_V1

RS7f-E Refusal Conversion Letter: General – Emancipated Youth
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that, although you agreed to be interviewed last year, you do not want
to have the follow-up visit this year.. As the PATH Study Survey Director, I want to ask you personally to
think about it again.
I understand how busy people are these days. But, by doing the follow-up interview for the PATH Study,
you can help researchers understand why and how Americans are using – or not using – different types of
tobacco products (not just cigarettes) and how use affects health. Whether or not you use tobacco, you
can make a difference by doing the interview.
I have asked a PATH Study interviewer to contact you again to set up the interview. It should take about an
hour. We can do it when it is convenient for you. We will offer you $25 as a thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit
our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to
visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.

www.pathstudyinfo.nih.gov

RS7f-E_V1

RS7f-P Refusal Conversion Letter: General - Parent
«Parent FName LName»
«Addr1»
«City», «ST» «ZIP»
Dear «Parent FName LName>>,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that, although you and your child agreed to the interview last year, you
do not want to have the follow-up visit this year. As the PATH Study Survey Director, I want to ask you
personally to think about it again.
I understand how busy people are these days. But, by doing the follow-up interview for the PATH Study,
you both can help researchers understand why and how Americans are using – or not using – different types
of tobacco products (not just cigarettes) and how use affects health. Whether or not you use tobacco, you
can make a difference by doing another interview.
I have asked a PATH Study interviewer to contact you again to set up the interview. It should take about an
an hour. We can do it when it is convenient for you and your child. We will offer your child $25 as a
thank you for completing an interview. We will offer you $10 as a thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit
our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to
visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.

www.pathstudyinfo.nih.gov

RS7f-P_V1

RS7f-T Refusal Conversion Letter: General – Emancipated Youth Turning Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that you did not want to continue in the Study a second year. As the
PATH Study Survey Director, I want to ask you personally to think about it again.
I understand how busy people are these days. But, by doing a follow-up interview for the PATH Study,
you can help researchers understand why and how Americans are using – or not using – different types of
tobacco products (not just cigarettes) and how use affects health. Whether or not you use tobacco, you
can make a difference by doing another interview
I have asked a PATH Study interviewer to contact you again to set up the interview for this year. Because
you are now 18 years old, you can participate in the Study as an adult. Your interview should take about an
hour and a half. We can do it when it is convenient for you. The PATH Study will offer you up to
$85 as a thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit
our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to
visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.

www.pathstudyinfo.nih.gov

RS7f-T_V1

RS7g-A Refusal Conversion Letter: Worried about Confidentiality - Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that you had concerns about the privacy of your information.
As the PATH Study Survey Director, I am writing to you personally to let you know that we are totally
committed to protecting your information. Here are some of the things we do to protect you.


We do not link your answers to your name, address, or any other information that can identify
you. For example, if I were in the Study, none of my answers would have my name on them. Instead,
they would have a number, such as 0021.



We combine your answers with answers given by thousands of others. Study reports will show only
totals of combined answers. Reports from the Study will not say anything about individual
people.



All researchers must sign a written pledge to protect your confidentiality. Anyone who violates your
privacy could lose their job and get in trouble with the law.



The Study has a Certificate of Confidentiality from the U.S. Department of Health and Human
Services. This means that no authority can force us to share your information. Your interviewer has a
copy of this certificate and can show it to you.



You may change your mind about being in the Study and leave at any time. Also, you may refuse to
answer any question even if you’ve agreed to be in the Study.

I have asked a PATH Study interviewer to contact you again to set up a time for an interview. It should take
about an hour. We can do it when it is convenient for you. We will offer you $35 as a thank you for
your participation.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit our
website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to visit
the website.
Thank you in advance for your help.
Sincerely,
www.pathstudyinfo.nih.gov

Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.
RS7g-A_V1

RS7g-E Refusal Conversion Letter: Worried about Confidentiality – Emancipated Youth
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that you had concerns about the privacy of your information.
As the PATH Study Survey Director, I am writing to you personally to let you know that we are totally
committed to protecting your information. Here are some of the things we do to protect you.




We combine your answers with answers given by thousands of others. Study reports will show only
totals of combined answers. Reports from the Study will not say anything about individual
people.



All researchers must sign a written pledge to protect your confidentiality. Anyone who violates your
privacy could lose their job and get in trouble with the law.



The study has a Certificate of Confidentiality from the U.S. Department of Health and Human
Services. This means that no authority can force us to share your information. The interviewer has a
copy of this certificate and can show it to you.



You may change your mind about being in the Study and leave at any time. Also, you may refuse to
answer any question even if you have agreed to be in the Study.

I have asked a PATH Study interviewer to contact you again to set up a time for an interview. It should take
about an hour. We can do it when it is convenient for you. We will offer you $25 as a thank you for
participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit our
website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to visit
the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director

www.pathstudyinfo.nih.gov

The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.
RS7g-E_V1

RS7g-P Refusal Conversion Letter: Worried about Confidentiality - Parent
«MailDate»
«SP_ID»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and Health
(PATH) Study. Our interviewer said that you had concerns about the privacy of your information and your
child’s information.
As the PATH Study Survey Director, I am writing to you personally to let you know that we are totally
committed to protecting your information and your child’s. Here are some of the things we do to
protect you.


We do not link your answers or your child’s answers to your names, address, or any other
information that can identify you. For example, if I were in the Study, none of my answers would
have my name on them. Instead, they would have a number, such as 0021.



We combine your answers and your child’s answers with answers given by thousands of others. Study
reports will show only totals of combined answers. Reports from the Study will not say anything
about individual people.



All researchers must sign a written pledge to protect your confidentiality. Anyone who violates your
privacy or your child’s privacy could lose their job and get in trouble with the law.



You and your child may change your minds about being in the Study and leave at any time. Also, you
and your child may refuse to answer any question even if you’ve agreed to be in the Study.

I have asked a PATH Study interviewer to contact you again to set up a time for an interview. It should take
about an hour. We can do it when it’s convenient for you and your child. We will offer your child $25
as a thank you for completing the interview. We will offer you $10 as a thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study, visit our
website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code below to visit
the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director

www.pathstudyinfo.nih.gov

The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the PATH
Study.
RS7g-P_V1

RS7g-T - Refusal Conversion Letter: Worried about Confidentiality – Emancipated
Youth Turning Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of
Tobacco and Health (PATH) Study. Our interviewer said that you had concerns about the
privacy of your information.
As the PATH Study Survey Director, I am writing to you personally to let you know that we
are totally committed to protecting your information. Here are some of the things we do
to protect you.


We do not link your answers to your name, address, or any other information
that can identify you. For example, if I were in the Study, none of my answers would
have my name on them. Instead, they would have a number, such as 0021.



We combine your answers with answers given by thousands of others. Study reports
will show only totals of combined answers. Reports from the study won’t say
anything about individual people.



All researchers must sign a written pledge to protect your confidentiality. Anyone who
violates your privacy could lose their job and get in trouble with the law.



The Study has a Certificate of Confidentiality from the U.S. Department of Health
and Human Services. This means that no authority can force us to share your
information. Your interviewer has a copy of this certificate and can show it to you.



You can change your mind about being in the Study and leave at any time. Also, you
may refuse to answer any question even if you have agreed to be in the Study.

I have asked a PATH Study interviewer to contact you again to set up a time for an
interview. Because you are now 18 years old, you can participate in the Study as an adult.
The interview should take about an hour and a half. We can do it when it is convenient
for you. We will offer you up to $85 as a thank you for fully participating in two home
visits. I have enclosed a Study brochure to help answer your questions.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888311-1819, weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about
the PATH Study, visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone,
you can scan the QR code below to visit the website.
Thank you in advance for your help.
Sincerely,

www.pathstudyinfo.nih.gov

Tammy Cook
PATH Study Survey Director

The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is
sponsoring the PATH Study.
RS7g-T_V0

RS7h-A Refusal Conversion Letter: Max Calls - Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
One of our interviewers has been trying to contact you about the Population Assessment of Tobacco
and Health (PATH) Study. The PATH Study is an important study of tobacco use and health. We
would like you to continue being in it. As the PATH Study Survey Director, I am writing to ask you
personally to think about it again,
I understand how busy people are these days. But, by doing a follow-up interview for the PATH Study,
you can help researchers understand why and how Americans are using – or not using – different types
of tobacco products (not just cigarettes) and how use affects health. Whether or not you use
tobacco, you can make a difference by doing another interview.
I have asked a PATH Study interviewer to contact you again to set up the second year’s interview. It
should take about an hour. We can do it when it is convenient for you. We will offer you $35 as a
thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7h-A_V1

RS7h-E Refusal Conversion Letter: Max Calls – Emancipated Youth
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
One of our interviewers has been trying to contact you about the Population Assessment of Tobacco
and Health (PATH) Study. The PATH Study is an important Study of tobacco use and health. We
would like you to continue being in it. As the PATH Study Survey Director, I am writing to ask you
personally to think about it again.
I understand how busy people are these days. But, by doing a follow-up interview for the PATH Study,
you can help researchers understand why and how Americans are using – or not using – different types
of tobacco products (not just cigarettes) and how use affects health. Whether or not you use
tobacco, you can make a difference by doing another interview.
I have asked a PATH Study interviewer to contact you again to set up the second year’s interview. It
should take about an hour. We can do it when it’s convenient for you. We will offer you $25 as a
thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7h-E_V1

RS7h-P Refusal Conversion Letter: Max Calls - Parent
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
One of our interviewers has been trying to contact you about the Population Assessment of Tobacco
and Health (PATH) Study. The PATH Study is an important Study of tobacco use and health. We
would like you and your child to continue being in it. As the PATH Study Survey Director, I am
writing to ask you personally to think about it again.
I understand how busy people are these days. But, by doing an interview for the PATH Study, you can
help researchers understand why and how Americans are using – or not using – different types of
tobacco products (not just cigarettes) and how use affects health. Whether or not you use tobacco,
you can make a difference by doing an interview.
I have asked a PATH Study interviewer to contact you again to set up the second year’s interview. It
should take about an hour. We can do it when it is convenient for you and your child. We will
offer your child $25 as a thank you for completing the interview. We’ll offer you $10 as a thank you
for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH
Study, visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR
code below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7h-P_V1

RS7h-T Refusal Conversion Letter: Max Calls – Emancipated Youth Turning Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
One of our interviewers has been trying to contact you about the Population Assessment of Tobacco
and Health (PATH) Study. The PATH Study is an important Study of tobacco use and health. We
would like you to continue being in it. As the PATH Study Survey Director, I am writing to ask you
personally to think about it again.
I understand how busy people are these days. But, but by doing a follow-up interview for the PATH
Study, you can help researchers understand why and how Americans are using – or not using –
different types of tobacco products (not just cigarettes) and how use affects health. Whether or not
you use tobacco, you can make a difference by doing an interview.
I have asked a PATH Study interviewer to contact you again to set up the second year’s interview.
Because you are now 18 years old, you can participate in the Study as an adult. The interview should
take about an hour and a half. We can do it when it is convenient for you. The PATH Study will
offer you up to $85 as a thank you for participating in two home visits. I have enclosed a Study
brochure to help answer your questions.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7h-T_V0

RS7i-A Refusal Conversion Letter: Non-User - Adult

«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,

Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you were uncertain about begin in the Study because
you do not use tobacco. As the PATH Study Survey Director, I want to ask you personally to think
about it again.
We need to get information from people who do not use tobacco, as well as those who do.
Having you in the Study would help us learn more about tobacco use in America. You will be
performing an important public service if do an interview.
I have asked a PATH Study interviewer to contact you again to arrange a time for an interview. It
should take about an hour. We can do it when it is convenient for you. We will offer you $35 as a
thank you for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is
sponsoring this important study of tobacco use and its effects on the health of all Americans.

www.pathstudyinfo.nih.gov

RS7i-A_V1

RS7i-E Refusal Conversion Letter: Non-User – Emancipated Youth
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you are uncertain about being in the Study because
you do not use tobacco. As the PATH Study Survey Director, I want to ask you personally to think
about it again.
We need to get information from people who do not use tobacco, as well as those who do.
Having you in the Study would help us learn more about tobacco use in America. You will be
performing an important public service if you do an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. It should take
about an hour. We can do it when it is convenient for you. We will offer you $25 as a thank you
for participating.
If you want to ask questions or schedule an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7i-E_V1

RS7i-P Refusal Conversion Letter: Non-User - Parent

«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,

Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you and your child are uncertain about being in the
Study because you do not use tobacco. As the PATH Study Survey Director, I want to ask you
personally to think about it again.
We need to get information from people who do not use tobacco, as well as those who do.
Having you and your child in the Study would help us learn more about tobacco use in America. You
and your child will be performing an important public service if you do an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. It should take
about an hour. We can do it when it is convenient for you and your child. We will offer your
child $25 as a thank you for completing the interview. We will offer you $10 as a thank you for
participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7i-P_V1

RS7i-T - Refusal Conversion Letter: Non-User – Emancipated Youth Turning Adult
«MailDate»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about the Population Assessment of Tobacco and
Health (PATH) Study. Our interviewer said that you were uncertain about being in the Study because
you do not use tobacco. As the PATH Study Survey Director, I want to ask you personally to think
about it again.
We need to get information from people who do not use tobacco, as well as those who do.
Having you in the Study would help us learn more about tobacco use in America. You will be
performing an important public service if you do an interview.
I have asked a PATH Study interviewer to contact you again to set up an interview. Because you are
now 18 years old, you can participate in the Study as an adult. The interview should take about an hour
and a half. We can do it when it is convenient for you. We will offer you up to $85 as a thank you
for fully participating in two home visits. I have enclosed a study brochure to help answer your
questions.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

www.pathstudyinfo.nih.gov

RS7i-T_V0

Attn: Community Management

Dear Management,
I am writing to request your help with an important study, the Population Assessment of Tobacco
and Health (PATH). The National Institutes of Health (NIH), in partnership with the Food
and Drug Administration (FDA), is sponsoring this study of tobacco use and its effects on the
health of all Americans. We are conducting the second set of annual visits to participants for the
study under Public Law 11-31 of the 111th Congress, the Family Smoking Prevention and Tobacco
Control Act (FSPTCA). Researchers and policymakers will use the information collected in the
PATH Study to help improve the Nation’s health.
Several addresses in the community or building you manage were selected last year, and the
residents agreed to participate in the PATH Study. The study goes for several years, and each
year the participants have a follow-up visit. We are now contacting participants to schedule their
annual interview. We are not soliciting or selling anything.
I am requesting your permission to allow our interviewer to enter to
speak with residents who are participants in the PATH Study. We recognize that you have
responsibility for security. Our interviewers wear photo ID badges and are trained on privacy,
confidentiality, and ethical practices in research. We monitor them closely. They carry a Certificate
of Confidentiality from the U.S. Department of Health and Human Services and can show
this to you. We respectfully ask that you give the residents the opportunity to have their follow-up
visit.
If you have questions, or to discuss arrangements for our interviewer to contact the selected
addresses in , please call our toll-free number, 1-888-311-1819, weekdays
between 9:00 a.m. and 5:30 p.m. Eastern Time. You can also visit our website at
www.pathstudyinfo.nih.gov (if you have a smartphone, you can scan the QR code below to visit the
website).
On behalf of the PATH Study, thank you in advance for your help.
Sincerely,

Tammy Cook
PATH Study Survey Director

RS7k_V1
www.pathstudyinfo.nih.gov

Frtfrt2CCCCC
[Type text]
[Type text]

RS7m-A Refusal Conversion Letter: Anti Survey - Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about your follow-up visit for the Population
Assessment of Tobacco and Health (PATH) Study. Our interviewer said that you have changed your
mind about participating in this survey. As the PATH Study Survey Director, I am asking you
personally to reconsider.
The PATH Study is very important to our Nation’s health. Whether or not you use tobacco, you will
be performing an important public service if you do another interview.
The results from the PATH Study will be better if you continue to be in it. We chose you last year to
represent thousands of other people like you. By doing the follow-up interview, you will be helping
researchers understand tobacco use and how it affects Americans’ health.
I have asked a PATH Study interviewer to contact you again to set up the interview. It should take
about an hour. We can do it when it is convenient for you. We will offer you $35 as a thank you
for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is
sponsoring the PATH Study.

www.pathstudyinfo.nih.gov

RS7m-A_V1

RS7m-E Refusal Conversion Letter: Anti Survey – Emancipated Youth
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about your follow-up visit for the Population
Assessment of Tobacco and Health (PATH) Study. Our interviewer said that you have changed your
mind about participating in this survey. As the PATH Study Survey Director, I am asking you
personally to reconsider.
The PATH Study is very important to our Nation’s health. Whether or not you use tobacco, you will
be performing an important public service if you do another interview.
The results from the PATH Study will be better if you continue to be in it. We chose you last year to
represent thousands of other people like you. By doing the follow-up interview, you will be
helping researchers understand tobacco use and how it affects Americans’ health.
I have asked a PATH Study interviewer to contact you again to set up the interview. It should take
about an hour. We can do it when it is convenient for you. We will offer you $25 as a thank you
for participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director

www.pathstudyinfo.nih.gov

The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

RS7m-E_V1

RS7m-P Refusal Letter: Anti Survey--Parent
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about your follow-up visit for the Population
Assessment of Tobacco and Health (PATH) Study. Our interviewer said that you and your child have
changed your minds about participating in this survey. As the PATH Study Survey Director, I am
asking you personally to reconsider.
The PATH Study is very important to our Nation’s health. Whether or not you use tobacco, people in
the study are performing an important public service.
The results from the PATH Study will be better if you and your child continue to be in it. We chose
you both last year to represent thousands of other people like you. By doing the follow-up interview,
you will be helping researchers understand tobacco use and how it affects Americans’ health.
I have asked a PATH Study interviewer to contact you again to set up the interview. It should take
about an hour. We can do it when it’s convenient for you and your child. We will offer your child
$25 as a thank you for completing the interview. We will offer you $10 as a thank you for
participating.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
On behalf of the PATH Study, thank you in advance for your help.
Sincerely,
www.pathstudyinfo.nih.gov

Tammy Cook
PATH Study Survey Director
The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

RS7m-P_V1

RS7m-T Refusal Conversion Letter: Anti Survey – Emancipated Youth Turning Adult
«MailDate»
«Name»
«Addr1»
«City», «ST» «ZIP»
Dear «Name»,
Recently, you spoke with one of our interviewers about your follow-up visit for the Population
Assessment of Tobacco and Health (PATH) Study. Our interviewer said that you have changed your
mind about participating in this survey. As the PATH Study Survey Director, I am asking you
personally to reconsider.
The PATH Study is very important to our Nation’s health. Whether or not you use tobacco, you will
be performing an important public service if you do another interview.
The results from the PATH Study will be better if you continue to be in it. We chose you last year to
represent thousands of other people like you. By doing the follow-up interview, you will be
helping researchers understand tobacco use and how it affects Americans’ health.
I have asked a PATH Study interviewer to contact you again to set up the interview. Because you are
now 18 years old, you can participate in the Study as an adult. The interview should take about an hour
and a half. We can do it when it is convenient for you. We will offer you up to $85 as a thank you
for fully participating in two home visits. I have enclosed a study brochure to help answer your
questions.
If you want to ask questions or set up an interview, please call our toll-free number, 1-888-311-1819,
weekdays between 9:00 a.m. and 9:00 p.m. Eastern Time. To find out more about the PATH Study,
visit our website at www.pathstudyinfo.nih.gov. If you have a smartphone, you can scan the QR code
below to visit the website.
Thank you in advance for your help.
Sincerely,
Tammy Cook
PATH Study Survey Director

www.pathstudyinfo.nih.gov

The National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA), is sponsoring the
PATH Study.

RS7m-T_V0

URINE

Collection Instructions

As part of the PATH study, we ask you to collect a sample of your urine. Please follow these instructions.
1

Wash your hands with soap and water.

Lay the paper towel in the kit on a flat surface. Take
the lid off of the collection container and place it on the
paper towel. The inside of the lid should be placed face
down on the paper towel.

Don’t touch the inside of the lid or the inside of the
collection container. Don’t allow the inside of the lid or
the inside of the collection container to come in contact
with any part of your body, clothing, or bathroom surfaces.

Urinate directly into the container. Collect all of your
urine; don’t let any of it go into the toilet unless the
container is full.

Replace the lid on the collection container immediately
so that the urine is only briefly exposed to the air.

Use the paper towel to wipe any urine from the outside
of the container.

Wash your hands with soap and water after collecting
the sample.

Give the collection container back to the interviewer.

If you have any questions, please ask the interviewer.
Thank you for providing this sample!

38208.0513.8954020204

URINE

Collection Instructions

As part of the PATH study, we ask you to collect a sample of your urine. Please follow these instructions.

Wash your hands with soap and water.

Lay the paper towel in the kit on a flat surface. Take
the lid off of the collection container and place it on the
paper towel. The inside of the lid should be placed face
down on the paper towel.
Don’t touch the inside of the lid or the inside of the
collection container. Don’t allow the inside of the lid or
the inside of the collection container to come in contact
with any part of your body, clothing, or bathroom surfaces.

Urinate directly into the container. Collect all of your
urine; don’t let any of it go into the toilet unless the
container is full.

Replace the lid on the collection container immediately
so that the urine is only briefly exposed to the air.

Use the paper towel to wipe any urine from the outside
of the container.

Wash your hands with soap and water after collecting
the sample.

Give the collection container back to the interviewer.

If you have any questions, please ask the interviewer.
Thank you for providing this sample!

38208.0513.8954020204

Thank you for agreeing to provide a
blood sample for the PATH Study.

This study is sponsored by the
National Institutes of Health (NIH),
in partnership with the
Food and Drug Administration (FDA).

www.pathstudyinfo.nih.gov

38199.1013.8954030202–RS9–V1

Blood Collection

Frequently Asked Questions
Why are you collecting blood?

Who is Hooper Holmes?
• Hooper Holmes is a national provider of in-home blood collection services.
• For the PATH Study, Hooper Holmes health professionals will visit homes
to collect blood samples from consenting adults.

• All health professionals are trained and certified to draw blood.

The blood collection is critical to the success of the PATH Study.
Researchers will conduct tests on the blood that will help us to understand
how tobacco affects the body. We are collecting samples from adults who
use tobacco and those who do not.
How much blood will you take?

We’ll collect six tubes of blood that equal about three tablespoons.
The body makes blood daily and replaces this amount of blood within
24 hours.
Is it safe?

What Should I Expect?
Step 1
A Hooper Holmes health professional will call you 1 to 2 days before your
scheduled appointment. The health professional will confirm:

• The date of your appointment,
• The time of your appointment, and
• Your address.

Yes. All PATH Study health professionals have done more than
150 successful blood collections and have been trained and certified on
PATH Study collection procedures. The supplies used for blood collection
are completely sterile and are used only once. You can’t be infected by
any bloodborne disease, such as hepatitis or AIDS, through this blood
collection.
Will I receive the results of the tests?

No. The results of the tests will be used for research purposes only, so we
won’t send individual test results to you.

Step 2
A Hooper Holmes health professional will come to your home on
the appointed date and time. The health professional will do the following:

• Show a driver’s license and PATH Study identification,
• Collect information about your recent use of tobacco, and
• Complete the blood collection in your home.
Step 3

Whom do I contact if I have questions about the blood collection?

• Ask the interviewer or health professional any questions you may have about
the blood collection or

• Call the PATH Study toll-free number, 1-888-311-1819, weekdays between
9:00 a.m. and 9:00 p.m. Eastern Time.
Whom do I contact if I want to change or confirm my appointment?

As a thank you for participating in the health professional visit, $25 will be
added to your debit card within 3 business days after sample collection.

Safe, Easy, and at Your Convenience!

Call the Hooper Holmes Scheduling Coordinator toll-free number,
1-888-326-1688, weekdays between 9:00 a.m. and 10:00 p.m. Eastern Time
and weekends between 10:00 a.m. and 7:00 p.m. Eastern Time.

RS10 – Payment Receipt
Population Assessment of Tobacco and Health (PATH) Study
Adult Payment Receipt
Print Participant’s Name: __________________________________________________
The National Institutes of Health (NIH) and the Food and Drug Administration (FDA) appreciate
your participation in the PATH Study. Please accept the following payment(s) as a thank you for
participating.
Adult Participant
 Payment of $35 on a debit card will be made to you for the adult interview.
 Payment of $25 on a debit card will be made to you for providing a
urine sample at an interviewer visit.
 Payment of $25 on a debit card will be made to you for providing a blood sample at
a health professional visit.
By signing below, you acknowledge receipt of a debit card that you will use for this study. Each time
you participate in an interview or give a sample, we will make additional payments to you.
Remember that participating in all or any part of the study is fully voluntary.
Participant’s Signature:

Interviewer’s Signature:

_________________________________

________________________________

______ / ______ / ______
Month
Day
Year

Note: Please allow 3 business days for your debit card to be activated. Your card will be active for 36
months. After 2 months, if any money is still on the card, a $3 fee will be deducted from it
each month. You will be charged $1 for each bank teller cash withdrawal; you will be charged $1
each time you get cash back from a debit purchase.
Please call our toll-free number, 1-888-311-1819, weekdays between 9:00 am and 9:00 pm Eastern
Time, if you have concerns or questions.

RS10 V1

YOUTH

Participant Name:__________________________________________________________________________

The National Institutes of Health (NIH) and the Food and Drug Administration (FDA)
appreciate your participation in the PATH Study. Please accept the following payment(s)
as a thank you for participating.

Youth Participant

Payment Receipt

❍ Payment of $25 on a debit card will be made to you for the youth interview.

By signing below, you acknowledge receipt of a debit card that you will use for this study.
Each time you participate in an interview, we will make additional payments to you.
Remember that participating in all or any part of the study is fully voluntary.

Participant’s Signature

__________________________________

Interviewer’s Signature

__________________________________

Interviewer’s Signature

__________________________________

______ / ______ / ______

Month

Day

Year

Day

Year

Day

Year

Day

Year

Note: Please allow 3 business days for your debit card to be activated. Your card will be active for
36 months. After 2 months, if any money is still on the card, a $3 fee will be deducted from it each
month.You will be charged $1 for each bank teller cash withdrawal; you will be charged $1 each time
you get cash back from a debit purchase.

Please call our toll-free number, 1-888-311-1819, weekdays between 9:00 a.m. and 5:30 p.m. Eastern Time,
if you have concerns or questions.

38206.0713.8954020204

YOUTH

Participant Name:__________________________________________________________________________

Youth Participant

Payment Receipt

❍ Payment of $25 on a debit card will be made to you for the youth interview.

Participant’s Signature

__________________________________

Interviewer’s Signature

__________________________________

Interviewer’s Signature

__________________________________

______ / ______ / ______

Month

Day

Year

Day

Year

Day

Year

Day

Year

Note: Please allow 3 business days for your debit card to be activated. Your card will be active for
36 months. After 2 months, if any money is still on the card, a $3 fee will be deducted from it each
month.You will be charged $1 for each bank teller cash withdrawal; you will be charged $1 each time
you get cash back from a debit purchase.

Please call our toll-free number, 1-888-311-1819, weekdays between 9:00 a.m. and 5:30 p.m. Eastern Time,
if you have concerns or questions.

38206.0713.8954020204

PARENT/GUARDIAN

Participant Name:__________________________________________________________________________

Parent/Guardian Participant

Payment Receipt

❍ Payment of $10 on a debit card will be made to you for the parent interview.

Participant’s Signature

__________________________________

Interviewer’s Signature

__________________________________

Interviewer’s Signature

__________________________________

______ / ______ / ______

Month

Day

Year

Day

Year

Day

Year

Day

Year

Note: Please allow 3 business days for your debit card to be activated. Your card will be active for
36 months. After 2 months, if any money is still on the card, a $3 fee will be deducted from it each
month.You will be charged $1 for each bank teller cash withdrawal; you will be charged $1 each time
you get cash back from a debit purchase.

Please call our toll-free number, 1-888-311-1819, weekdays between 9:00 a.m. and 5:30 p.m. Eastern Time,
if you have concerns or questions.

38206.0713.8954020204

PARENT/GUARDIAN

Participant Name:__________________________________________________________________________

Parent/Guardian Participant

Payment Receipt

❍ Payment of $10 on a debit card will be made to you for the parent interview.

Participant’s Signature

__________________________________

Interviewer’s Signature

__________________________________

Interviewer’s Signature

__________________________________

______ / ______ / ______

Month

Day

Year

Day

Year

Day

Year

Day

Year

Note: Please allow 3 business days for your debit card to be activated. Your card will be active for
36 months. After 2 months, if any money is still on the card, a $3 fee will be deducted from it each
month.You will be charged $1 for each bank teller cash withdrawal; you will be charged $1 each time
you get cash back from a debit purchase.

Please call our toll-free number, 1-888-311-1819, weekdays between 9:00 a.m. and 5:30 p.m. Eastern Time,
if you have concerns or questions.

38206.0713.8954020204

Information on Substance Abuse Resources
SAMHSA’s Treatment Referral Routing Service
Website: http://www.samhsa.gov/treatment/natHelpFAQs.aspx
Telephone: 1-800-662-HELP (1-800-662-4357)
This treatment and referral system is a confidential, free, 24-hour-a-day,
365-days-a-year information service in English and Spanish for individuals and
family members facing substance abuse and mental health issues. The service
provides referrals to local treatment facilities, support groups, and communitybased organizations. Callers can also order free publications (many are available for download) and other print information on substance abuse and mental
health.
Parent Hotline

How to Get Help

Website: http://parenthotline.net
Telephone: 1-800-840-6537
Parent Hotline has a website dedicated to helping families who are in a crisis. It
lists behaviors for parents to be aware of, including drug use, and how to determine if a child is in need of intervention.

Libraries are an excellent source of information about these and other health
concerns. Bookstores also often have relevant materials in their “diet and
health” sections.
In addition, many websites have information related to these issues. Some
are better than others. Knowing if the information on a website comes from
sources you can trust is important. Be careful about sharing or exchanging
information online, as some websites will not keep information private.

www.pathstudyinfo.nih.gov

38198.0513.8954020204

This study is sponsored by the National Institutes of Health (NIH), in partnership with the
Food and Drug Administration (FDA).

In today’s visit, you expressed interest in learning
about resources for one of these topics:

Information on Mental Health Resources

• Smoking or other tobacco use,

National Hopeline Network

• Mental health, or

Website: www.hopeline.com
Telephone: 1-800-SUICIDE (1-800-784-2433)

• Substance abuse.
Below is a list of telephone numbers and websites where you can get help
and information on these topics. The list is not meant to be complete. You
may also wish to first contact your family physician or your private health
insurance provider for advice and referral.

Information on Smoking/Other Tobacco Use Resources

The Hopeline connects people in immediate distress to a crisis center. Calls
are answered by certified counselors 24 hours a day, 7 days a week. When the
system is fully operational, your call should be routed to a center nearest your
home. A trained counselor should answer within two or three rings, or in about
20 to 30 seconds from the moment you dial 1-800-SUICIDE.

Smokefree.gov

1-800-THERAPIST

Website: www.smokefree.gov
Telephone: 1-877-44U-QUIT (1-877-448-7848)

Website: www.1-800-THERAPIST.com
Telephone: 1-800-843-7274

Smokefree.gov is a website created by the National Cancer Institute (NCI).
The site offers the following information:

This is a toll-free number, and it’s a free referral service. You can talk to a referral resource counselor during normal business hours. You must leave a message
and someone will return your call. After an initial telephone evaluation, you
can be referred to a full range of clinicians, including a psychiatrist, psychologist, marriage or family therapist, clinical social worker, licensed professional
counselor, or nurse.

• Step-by-step quit guide,

• Tools to help you quit, and

• Talk to a smoking cessation expert

• Topics related to quitting.

at 1-877-448-7848,
1-800-QUIT-NOW

National Institute of Mental Health (NIMH) Public Inquiries

Telephone: 1-800-QUIT-NOW (1-800-784-8669)

Website: www.nimh.nih.gov
Telephone: 301-443-4513

When you call 1-800-QUIT-NOW, you’ll have access to many types of information and services about quitting smoking. They include the following:

• Free support and advice from an
experienced counselor,

• A personalized quit plan and selfhelp materials,

• Social support and coping strategies
to help you deal with cravings,

• The latest information about medications to help people quit smoking.

QuitNet
Website: www.quitnet.com
QuitNet is an online group of smokers and ex-smokers. Support comes from
other people who share similar experiences in the effort to quit smoking.
This approach is designed to help people help each other quit smoking using
forums, chats, emails, and testimonials.

The public inquiries line is a toll call and is staffed by trained information
specialists Monday through Friday, 8:30 a.m. to 5:00 p.m. (Eastern Time).
Information is available on NIMH mental health research programs and on
symptoms and treatment for emotional problems. NIMH does not provide
referrals to health care providers or counsel people on specific problems. A list
of NIMH publications, including several in Spanish, is available on the NIMH
website at www.nimh.nih.gov. Single copies of these are free and may be
requested by telephone at 301-443-4513, by fax at 301-443-4279, or by writing
to NIMH Public Inquiries, 6001 Executive Boulevard, Room 8184 MSC 9663,
Bethesda, MD 20892-9663. Also, you can download publications directly from
the website.

INTERVIEWER
Appointment Reminder

Just a reminder: I appreciate you taking time for this important study.
I look forward to our appointment.

I have you scheduled for the following:
Day/Date

Time

a.m.

p.m.

Field Interviewer ______________________________________
We will call you to confirm the appointment.
Over

CONTACT
PATH Study Information
1-888-311-1819
www.pathstudyinfo.nih.gov

This study is sponsored by the National Institutes of Health (NIH),
in partnership with the Food and Drug Administration (FDA).

38203.0713.8954020204

If you have a smartphone, you can scan the QR code to visit the website.

HEALTH PROFESSIONAL

Just a reminder: I appreciate you taking time for this important study. As a thank you,

we’ll give you $25 for providing a blood sample.

I have you scheduled for the following:

Appointment Reminder

Day/Date

Time

Appointment Reminder

a.m.

Day/Date

p.m.

Time

a.m.

p.m.

Over

HEALTH PROFESSIONAL

Just a reminder: I appreciate you taking time for this important study. As a thank you,

we’ll give you $25 for providing a blood sample.

I have you scheduled for the following:

Appointment Reminder

Day/Date

Time

Appointment Reminder

a.m.

Day/Date

p.m.

Over

Time

a.m.

p.m.

Over

Hooper Holmes

Scheduling Coordinator

1-888-326-1688

PATH Study Information

1-888-311-1819

www.pathstudyinfo.nih.gov

If you have a smartphone, you can scan the QR code to visit the website.

This study is sponsored by the National Institutes of Health (NIH),
in partnership with the Food and Drug Administration (FDA).

CONTACT

Hooper Holmes

Scheduling Coordinator

1-888-326-1688

PATH Study Information

1-888-311-1819

www.pathstudyinfo.nih.gov

If you have a smartphone, you can scan the QR code to visit the website.

This study is sponsored by the National Institutes of Health (NIH),
in partnership with the Food and Drug Administration (FDA).

38200.0513.8954020204

CONTACT

This study is sponsored by the National Institutes of Health (NIH),
in partnership with the Food and Drug Administration (FDA).

38200.0513.8954020204

Hooper Holmes

38200.0513.8954020204

CONTACT

38200.0513.8954020204

CONTACT

*1820-0000*
1820-0000

*10134*
PATH 1820
Westat

000001-py0722ZUX15303nl

1600 Research Boulevard
Rockville, MD 20850
United States of America

Dear PATH Study Participant,
We are pleased to present your new PATH Study debit card! You will receive your PATH Study payments on this card.
Here’s some information on the debit card, which is a MasterCard® card issued by Payoneer.
o

Please allow 3 business days for your card to be activated. Your card will be valid for 36 months. After 2 months, if any money is still on the
card, a $3 fee will be deducted from it each month.
o Use your card for purchases anywhere on/offline that Debit MasterCard® is
accepted.
o If you are asked, you may select “credit” at the register and sign for your
purchase.
o If you would like to use a personal identification number (PIN), for debit
features such as cash back for purchases, you may call the toll-free number
located on the back of the card and follow the prompts to set a PIN.
o If you are asked for an address or zip code when making a purchase, please
use the following address: 1600 Research Boulevard, Rockville, MD 20850.
o For gas purchases, give your card to the cashier; the card cannot be used to
pay-at-the-pump.
o Your card cannot be used to access cash at an ATM.
o When making a purchase for an amount greater than your available balance,
instruct the merchant to charge an amount equal to your available balance
and then pay the remainder using another form of payment.
Keep your card, even if the balance is $0. Future payments for your participation in the PATH Study will be transferred to this card.

If you have any questions about use of the card, including your balance or a lost/stolen card, please contact PATH Study support toll-free at (888)
311-1819. (This number is also printed on the front of your card.)

Sincerely,
The PATH Study Team

Fee Schedule
Description
Fee
Purchase Transaction
Free
Bank Teller Cash Withdrawal / Cash Back with PIN Purchase
$1.00
ATM Transaction (Note: Your card cannot be used to withdraw cash at an ATM)
N/A
Card Replacement
Free
Live Agent Customer Service
Free
Monthly Maintenance Fee *
$3.00
Foreign Transaction Processing
Up to 5%
* After 2 months, if any money is still on the card, this fee will be deducted from it each month.

Use of this card constitutes agreement and acceptance of the Cardholder Agreement and Terms and Conditions. A copy of the Terms and Conditions is available upon
request.
The Payoneer Prepaid MasterCard is issued by First Covenant Bank, member FDIC, pursuant to a license by MasterCard International Incorporated. Payoneer is a
registered MSP of First Covenant Bank. MasterCard is a registered trademark of MasterCard International Incorporated.
A copy of Payoneer’s Privacy Policy for cardholders is available upon request.

paymc-FCB-Westat

File Type	application/pdf
Author	Carolyn Gatling
File Modified	2014-07-22
File Created	2014-06-25