Evaluation of the Canned, Frozen, or Dried Fruits and Vegetables Pilot Project in the FFVP
Appendix E.1c1 Telephone Script – Verbal Consent (ENGLISH)
OMB Control No: 0584-XXXX
Expiration date: XX/XX/XXXX
CALLING: Hello, could I please speak with [PARENT/GUARDIAN NAME]?
WHEN SPEAKING WITH THE PARENT: Hello, my name is ___________ and I am calling from Mathematica Policy Research on behalf of the U.S. Department of Agriculture, Food Nutrition Service, about an important study that [SCHOOL] is participating in. This study will help us learn more about the free fruit and vegetable snacks at your child’s school. Your child, [CHILD NAME], should have brought home a parent permission form to participate in the study. We are calling to make sure that you’ve gotten the permission form and to answer any questions you might have about the study.
IF PARENT ASKS WHAT DOES THE CONSENT FORM LOOKS LIKE: It is one page, two sides – the first side is a letter with the permission form to sign and the second side has information about the study. The letter has Mathematica Policy Research on the top.
IF PARENT SAYS DID NOT RECEIVE PACKET: I would like to tell you about the study. [READ EXCERPTS FROM LETTER] Could I have your verbal consent for [CHILD] to participate in the study?
YES GO TO PAGE 2 VERBAL YES CONSENT PROCEDURES
NO GO TO PAGE 2 VERBAL NO /DON’T KNOW PROCEDURES
IF PARENTS ASKS FOR ANOTHER COPY: Yes, we will mail a new packet to your home address, or we will make sure the teacher gives your child another one to take home for you. Which would you prefer? (COLLECT ADDRESS IF REMAIL DESIRED)
IF PARENT ASKS HOW TO RETURN THE CONSENT: You can return the permission form with your child to the school, and ask your child to give it to the teacher. If you have the postage paid business reply envelope, you could mail it directly to us. In the meantime, could I have your verbal consent for [CHILD] to participate in the study?
YES GO TO PAGE 2 VERBAL YES CONSENT PROCEDURES
THANK YOU: We would like to thank you for helping with this study.
IF YOU CANNOT REACH ANYONE ON YOUR FOURTH ATTEMPT, LEAVE MESSAGE ON ANSWERING MACHINE: Hello, my name is ____________, and I’m calling from [Mathematica Policy Research]. Recently your child, [CHILD NAME] should have brought home from school a permission form to participate in a study on the free fruits and vegetables snacks at school, sponsored by the U.S. Department of Agriculture, Food Nutrition Service. We have not yet received your completed permission form. Please return the form to your child’s teacher as soon as possible. If you have any questions or need another copy of the form, please call (800) 232-8024. Thank you.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
VERBAL YES (AGREE TO PARTICIPATE) CONSENT PROCEDURES
READ CONSENT FORM, ASK FOR QUESTIONS AND AGREEMENT AND THEN SAY “I need to have [SECOND INTERVIEWER (WITNESS)] confirm that you agree to let [CHILD NAME] participate”
SECOND INTERVIEWER (WITNESS): I understand that you have agreed to allow your child [CHILD NAME] to participate in the study about the fruit and vegetable snacks provided at your child’s school. Is that correct?
FILL IN THE CONSENT FORM BY WRITING ON THE LINE FOR THE PARENT SIGNATURE, “[INTERVIEWER NAME] RECEIVED VERBAL AGREEMENT FROM [PARENTS NAME]” AND HAVE SECOND INTERVIEWER (WITNESS) COUNTERSIGN UNDERNEATH
We will mail you a copy of the consent form showing that you have verbally agreed to allow your child to participate. What address should we mail that form to?
VERBAL NO /DON’T KNOW PROCEDURES
Maybe I can address your concerns. Do you have any questions about this study that I could try and answer to help you make a decision about your child’s participation?
FIND APPROPRIATE QUESTION AND RESPONSE ON THE “FFVP-CFD STUDY” Questions Parents May Ask SHEET.
SAY “I need to have [SECOND INTERVIEWER (WITNESS)] confirm that you Do Not want [CHILD NAME] participate”
SECOND INTERVIEWER (WITNESS): I understand that you Do Not want [CHILD NAME] to participate in the study of the Fresh Fruit and Vegetable Program, Is that correct?
FILL IN THE CONSENT FORM BY WRITING ON THE LINE FOR THE PARENT SIGNATURE, [INTERVIEWER NAME] RECEIVED VERBAL DECLINE TO PARTICIPATE FROM [PARENT NAME]” AND HAVE SECOND INTERVIEWER (WITNESS) COUNTERSIGN UNDERNEATH
Information about the Study for Parents and Students
What is the Purpose of the Study?
The U.S. Department of Agriculture’s (USDA) Food and Nutrition Service (FNS) is funding a study to learn how schools provide free fruit and vegetable snacks in the Fresh Fruit and Vegetable Program and how schools’ implementation of the program affects students’ diets and satisfaction with the free fruit and vegetable snacks. The USDA FNS has contracted with Mathematica Policy Research, an independent research firm, to conduct the study.
What does it mean to participate in the study?
Students will be asked to fill out a short diary to keep track of the foods they eat in school for one day. We will choose about 12 students per classroom to fill out the food diary. If chosen, each student will be given instructions orally and in writing by a member of the Mathematica study team on how to fill out the food diary for all foods eaten during the school day.
Also, students will be asked to complete a brief survey that will ask some questions about themselves and about how often they eat the free fruit and vegetable snacks offered at school and what they like or dislike about them. The student interview will take about 20 minutes to complete. Mathematica staff will also observe the distribution of fruit and vegetable snacks during the school day.
Parents will be asked to answer some brief questions about the free fruit and vegetable snacks provided at school and what they like or dislike about the program. The parent questionnaire will take no more than five minutes to complete. Parents will receive a $5 gift card for completing and returning the brief survey. Students that completed diaries will receive a $5 gift card as reimbursement for the time associated with being in the study. A small number of students will be asked to record their food and beverage intake for a second day and be given another $5 gift card for a completed food diary and dietary interview.
What are the Risks and Benefits?
Completing the questionnaires is voluntary. There are no penalties for refusing to participate. Students are not required to be in the study in order to continue to be in any school program. Being part of this study will not hurt students or parents in any way. If any parent or student feels uncomfortable at any time during the study, they may decide not to participate.
Will it be Confidential?
Mathematica has strict procedures to store data securely and to ensure the confidentiality of the names of students and parents by removing names before data are analyzed. Names will not be written in any report or given to anyone other than the study team. Teachers, school staff, program staff and parents will not be allowed to see any of the information from the questionnaires.
What if I Have Questions? If you have any questions about the study, please contact Rhoda Cohen, Mathematica Survey Director or her staff at (800) 232-8024 or email at [email protected].
E.1c1.
| File Type | application/msword |
| File Title | Fall 2004 |
| Author | schutlj |
| Last Modified By | Lynnette Thomas |
| File Modified | 2014-07-08 |
| File Created | 2014-07-08 |