Consent Script

0693-0078_ConsentScript_LumbertonHouseholdSurvey.docx

NIST Generic Clearance for Community Resilience Data Collections

Consent Script

OMB: 0693-0078

Document [docx]
Download: docx | pdf

One-Year Post-Hurricane Matthew Field Study in Lumberton, North Carolina

Housing/Household Recovery Survey

Consent Script

OMB CONTROL NO. 0693-0078 Expiration date: 07/31/2019


Hello, my name is (interviewer name) and I am a researcher from (name of university or National Institute of Standards and Technology) in the (department name/Engineering Laboratory). We are conducting a research study on recovery following the flooding that occurred in Lumberton, N.C. in the days following Hurricane Matthew in early October last year. We would like to speak with you about how this event affected your household. In particular, we are interested in learning about the process of recovering from the flooding.

 

This study is part of a larger project led by Center of Excellence for Risk-Based Community Resilience Planning at Colorado State University. This project is led by Drs. John van de Lindt and Bruce Ellingwood, both Professors from the Civil and Environmental Engineering Department and is funded by the National Institute of Standards and Technology (NIST).

 

We would like to ask you some brief survey questions about your household’s experience after the flood as well as some details about your home during this time. Participation will take approximately ten minutes, depending on the experience of your household with Hurricane Matthew. Your participation is voluntary. If you decide to participate in the study, you may withdraw your consent and stop participation at any time without penalty.

 

We will be collecting information about the damage to your home, the process of making repairs, and how the flood disrupted your household’s living arrangements and daily routines, such as going to work and school. When we report and share our findings, we will combine the data from all participants into summary statistics and tables so no unique individual or household can be identified. There are NO KNOWN RISKS or direct benefits to you. We hope to gain more knowledge on how you and others were affected by Hurricane Matthew and the flooding so that we can learn from your experiences to help communities better prepare for similar events in the future.

 

So again, we would like to speak with an adult member of the household that was here at the time of Hurricane Matthew and the flooding OR someone who knows about what happened to the household around that time. Would that person be you and would you be willing to participate? 


This collection of information contains Paperwork Reduction Act (PRA) requirements approved by the Office of Management and Budget (OMB). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the PRA unless that collection of information displays a currently valid OMB control number. For this collection, the OMB Control number is:0693-0078 with an expiration date: July 31, 2019. Public reporting burden for this collection is estimated to be 10 minutes per survey, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any aspect of this collection of information, including suggestions for reducing this burden, to the National Institute of Standards and Technology, Attn: Dr. Jennifer Helgeson, NIST, 100 Bureau Drive, MS 8603, Gaithersburg, MD 20899-1710, telephone 301-975-6133, or via email:[email protected].

Privacy Act Statement

Authority: The Paperwork Reduction Act of 1980 (Pub. L. No. 96-511, 94 Stat. 2812, codified at 44 U.S.C. §§ 3501–3521).


Purpose: The National Institute for Standards and Technology (NIST) conducts Community Resilience research and surveys through the Generic Paperwork Reduction Act Clearance, OMB CONTROL NO. 0693-0078 Expiration date: 07/31/2019.


Routine Uses: NIST will use this information to conduct a systematic process evaluation of the NIST Community Resilience Planning Guide implementation. This is not a Privacy Act system of Records, therefore there is no System of Records Notice associated with this collection.


Disclosure: Furnishing this information is voluntary. When you submit the form, you are indicating your voluntary consent for NIST to use of the information you submit for the purpose stated.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorDillard, Maria (Fed)
File Modified0000-00-00
File Created2021-01-20

© 2024 OMB.report | Privacy Policy