0693-0078 Informed Consent: Telephone

One-year Post-Fire Field Study of the Chimney Tops 2 Fire in Sevier County, TN

Emergency Communications and Public Response Survey

Telephone Consent Script

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

Principal Investigator: Erica Kuligowski

Study Title: One-year Post-Fire Survey of Emergency Communications and Public Response to the Chimney Tops 2 Fire in Sevier County, TN

Study Site(s): Sevier County, Tennessee

Phone: May I please speak with the head of the household?

[If the head of household is available/gets on the phone, please continue with the next question]

May I please verify that you are the head of household and you are 18 years or older?

[If yes, ask the next question.]

Were you at home or in the area when the Chimney Tops 2 fire occurred in Sevier County in November, 2016?

[If the head of household says “yes, that he/she was at home or in the area”, then, please continue reading the following script to them. If the head of household says “no” to the question about being at home or in the area, then thank them for their time and end the call.]

Introduction

You are being asked to take part in a research study. Research studies include only people who choose to take part. This document is called an informed consent form. Please listen carefully to this information and take your time making your decision. The nature of the study, benefits, risks, and other important information about the study are provided below.

About Our Study

The National Institute of Standards and Technology (NIST), an agency under the U.S. Department of Commerce, is collecting information from people in Sevier County, Tennessee about their experiences and responses to the public alerts and warnings issued during the November 2016 Chimney Tops 2 Fire. The information collected in this study will help the nation better prepare for wildfire emergencies.

You have been selected as part of a sample of people asked to complete this questionnaire. If you participate in this study, you will be asked questions about the types of information that you received about the November 2016 Chimney Tops 2 Fire and what you did in response to that information. Your participation will take approximately 20 minutes, depending on your experience with the Chimney Tops 2 Fire. 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. Also, all of the information that you provide will be kept confidential to the extent permitted by law.

When we report and share our findings, we will combine the data from all participants into summary statistics and tables so no unique individual 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 the November 2016 Chimney Tops 2 Fire, so that we can learn from your experiences to help communities better prepare for similar events in the future.

The person who is in charge of this research study is Erica Kuligowski. She is the Principal Investigator and is a fire researcher at NIST. However, other research staff may be involved and can act on behalf of the person in charge. If you have questions about your rights as a participant in this study, or have complaints, concerns or issues you want to discuss with someone outside the research team, I can provide the number to the Human Subjects Protection Office at NIST. The number is (301) 975-5445.

Consent to Take Part in this Research Study

I freely give my consent to take part in this study. I understand that by saying “yes” now, I am agreeing to take part in this research study.

Thank you for taking part in this study.

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 20 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. Erica Kuligowski, NIST, 100 Bureau Drive, MS 8662, Gaithersburg, MD 20899-8662, telephone 301-975-2309, or via email:[email protected].