Adults 18 and older in the United States - Screener and Consent Process- second post-test outcome survey

Attachment 5: Parental consent and adolescent assent

Introduction for Parents or Guardians Evaluation of the Fresh Empire Campaign on Tobacco (EFECT)

FIRST, READ THE PARENTAL SCRIPT BELOW AND OBTAIN PERMISSION FROM THE PARENT

Your (AGE) year-old child has been selected to be in this study. Your child’s participation is voluntary. This interview asks about tobacco use, media use, and illegal behaviors. All of your child’s answers will be kept private to the fullest extent allowable by law and used only for statistical purposes. Since your child will answer most of the questions on the computer, I will never see the answers, and you are not allowed to see them either. If it is all right with you, we’ll get started.

(Can we find a private place to complete the interview?)

THEN, READ THE BOXED INFORMATION BELOW BEFORE STARTING EVERY INTERVIEW WITH YOUTH AGE 11-16

We are interviewing about 2,100 youth across the nation. You have been randomly chosen to take part. You will represent young people in this country who are similar to you. You may choose not to take part in this study, but no one else can take your place. We will offer you an incentive of $25 when you finish the interview.

GIVE STUDY DESCRIPTION TO RESPONDENT IF YOU HAVE NOT ALREADY DONE SO.

This study is designed to collect data from youth about tobacco use, media use, and illegal behaviors. It takes about [30 minutes for the pre-campaign survey; 45 minutes for the post-campaign survey] to complete. You will answer most of the questions on the computer, so I will not see your answers. Your answers will never be seen by your parent or guardian. We are only interested in the combined responses from those selected to participate, not just one person’s answers. RTI may contact you by phone or mail to ask a few questions about the quality of my work. This is why we ask for your phone number and mailing address at the end of the interview.

While the interview has some personal questions, federal law keeps your answers private. We hope that protecting your privacy will help you to give accurate answers. You can quit the interview at any time and you can refuse to answer any questions.

If it is all right with you, let’s get started.

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