OMB
No. XXXX-xxxx
Exp. Date xx/xx/xxxx
Study Description of the Evaluation of the Fresh Empire Campaign on Tobacco (EFECT)
Your address is one of several in this area randomly chosen for the Evaluation of the Fresh Empire Campaign on Tobacco (EFECT). This study, sponsored by the U.S. Food and Drug Administration’s Center for Tobacco Products, is collecting information from youth across the United States about tobacco use and media use.
You and your child cannot be identified by any of the information you give to us. Your name and address will never be connected to your answers. Also, federal law requires that we keep all of the responses private to the fullest extent allowable by law. Any data provided will only be used for statistical purposes and reported in aggregate form.
The interview itself will take approximately [30 minutes for the pre-campaign survey; 45 minutes for the post-campaign survey] to complete. The questions are about your child’s experiences at home and at school, as well as about his/her knowledge and attitudes about tobacco. Your child can refuse to answer any questions, and can quit at any time. Your child will be offered an incentive of $25 upon completing the interview.
If you have any questions about the study, please contact the project representative [CONTACT NAME HERE], at [CONTACT NUMBER HERE] extension [CONTACT EXTENSION HERE]. If you have questions about your rights as a study participant, call toll-free: RTI’s Office of Human Research Protections at 1-866-214-2043.
Thank you for your cooperation and time.
Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 1 minute per response to review the study description (the time estimated to read and review). Send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to [email protected].
File Type | application/msword |
File Modified | 2015-04-01 |
File Created | 2015-03-19 |