Quantitative Study of Tobacco Facts Designed to Inform Youth Tobacco Prevention Messaging

Generic Clearance for the Collection of Quantitative Data on Tobacco Products and Communications

Attachment B - Invitation and Youth Assent Form

Quantitative Study of Tobacco Facts Designed to Inform Youth Tobacco Prevention Messaging

OMB: 0910-0810

Document [docx]
Download: docx | pdf

OMB Control # 0910-0810

Exp. 11-30-2018




ATTACHMENT B:

INVITATION AND YOUTH ASSENT FORM


Quantitative Study of Tobacco Facts Designed to Inform Youth Tobacco Prevention Messaging



You have been asked to take part in a study called [STUDY NAME]. The study is being led by RTI International, which is a company that does research. The online survey will ask 1500 youth ages 13-17 about several tobacco-related facts.
Your answers will help us make ads that keep kids from smoking. It will take about 20 minutes for you to complete this survey.

You will not be harmed by being in this study. There is a small chance that you might feel embarrassed or upset by the questions asked in the survey. However, you can skip any questions you don't want to answer.

If you decide to take the survey, your parent will receive ‘points’ that are about $5 in value. The points can be redeemed for items or gift cards through the GfK system. There are no additional benefits from completing the survey.

It is your choice to take part in this study. You may stop taking the survey at any time without penalty. Your identity will not be known in the results of the study. The researchers will not have access to any of your personal information (such as your name). Your answers will not be shared with your parent. The "GfK’s Privacy & Terms of Use Policy" explain the ways your information will be kept private.

If you have any questions about the study, you may contact the research team through Annice Kim of RTI at 1‑800‑334‑8571. If you have any questions about your rights as a study participant, you may call RTI’s Office of Research Protection at 1-866-214-2043.



I understand the study purpose and process.



Would you like to participate in this survey?


Yes, I want to take the survey.


No, I do NOT want to take the survey.



A copy of the form will be sent to your email address.



Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 5 minutes per response (the time to read and complete). You can send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to [email protected].


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJones, Bonnie
File Modified0000-00-00
File Created2021-01-21

© 2024 OMB.report | Privacy Policy