Cognitive Interview Screener (telephone and mail)

OMB Control No. 0910-0345 Expiration Date: xx/xx/xxxx

Dear Resident:

The U.S. Food and Drug Administration (FDA) is conducting an important study about food and nutrition in the United States. The study is a telephone survey that will ask for your opinions about food and nutrition. FDA will use the results to develop food and nutrition educational materials and to provide critical up-to-date information for our food and nutrition programs.

We hope you take the time to respond to the survey when the interviewer calls. The survey is brief and only takes about 15 minutes to complete. If the call comes at a bad time, the interviewer will be glad to make an appointment at a time that works for you.

Your telephone number was randomly generated by a computer to be called for this study. An interviewer will call your house within the next several weeks to ask an adult (age 18 or over) to participate in this study.

• Your response is critically important to the accuracy of the study. Your household was randomly selected for the survey and will represent thousands of others.

• Because you represent so many others like you, your opinions are very important.

• If you have caller ID on your phone, you will know we are calling when you see “US FDA” appear on your caller ID. The interviewer will be calling from Westat, which is an independent research firm we are using to conduct the study.

Your participation is voluntary. The information you give us will be kept secure to the extent permitted by law. Furthermore, FDA will not receive any information that identifies you because your phone number is removed from the survey responses Westat sends to FDA.

If you have questions about the study or would like to set up a time to complete the telephone survey, please call toll-free 1-888-XXX-XXXX.

We thank you in advance for taking part in this important study.

Sincerely,

Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0910-0345. The time required to complete this information collection is estimated to average 20 minutes per response, 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 other aspects of this collection of information, including suggestions for reducing burden to [email protected].