Attachments 3, 4, 6, 18

Redesign Field Test_PDF 1_Attachments 3 4 6 18.pdf

2019-20 National Survey on Drug Use and Health (NSDUH) - CVS and FT

Attachments 3, 4, 6, 18

OMB: 0930-0110

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2020 NSDUH Redesign Field Test
Attachment FT-3 – Lead Letter

UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES
ROCKVILLE, MD 20857

«NAME COUNTY/PARISH/DISTRICT» Resident at:
«ADDR1»
«ADDR2»
«CITY», «STATE» «ZIP»

Dear «NAME County/Parish/District» Resident:
We are writing to ask for your help with a nationwide study sponsored by the U.S. Department of
Health and Human Services called the National Survey on Drug Use and Health (NSDUH). Since 1971,
local, state and national agencies have used the study findings to develop education, prevention, and
treatment programs. This study asks questions about use or non-use of alcohol, tobacco, other
substances, as well as questions about mental health and other health-related topics. Soon, an
interviewer will be in your area to give you more information and answer any questions you may have.
•

Your address was randomly chosen, through scientific methods, and it cannot be replaced.
Across the country, about 200,000 other addresses were also randomly chosen.

•

The interviewer will first ask a few general questions. This will take just a few minutes.


•

Next, someone from your household might be selected and invited to complete the
interview. Either 0, 1, or 2 residents will be selected. Each person who completes the
full interview will receive <$30/$50> in cash.

•

By Federal law*, all answers are kept confidential and used only for statistical purposes.
This means that everyone’s answers are combined. No individual data are reported.

RTI International, a nonprofit organization, conducts this study. The interviewer will have an ID card
like the example shown below.
Please share this information with others in your household. To learn more about the study, go to
https://nsduh.rti.org or you may call [FT TOLL FREE NUMBER].
Your help is very important to this study’s success.
Thank you for your cooperation.

Sincerely,

Grace E. Medley
National Study Director, HHS

Ilona S. Johnson
National Field Director, RTI

You will be
contacted by: ______________________________________
Interviewer Name

*Confidentiality protected by the Confidential Information Protection and Statistical Efficiency Act of 2002 (PL 107-347). Authorized by the U.S. Congress as
part of Section 505 of the Public Health Service Act (42 USC 290aa4). Approved by the Office of Management and Budget (OMB Approval No. 0930-0110).

2020 NSDUH Redesign Field Test
Attachment FT-4 – Contact Cards – Sorry I
Missed You and Appointment Cards

Contact Cards
Interview Appointment Card

Front:

Interview Appointment

Back:

Interview Appointment
Just a reminder: I appreciate you taking time for this important study
and look forward to our appointment to complete the interview.
You will receive <$30/$50> in cash upon completion of the interview!
I have you scheduled for the following:

Day: _____________ Date: _____________ Time: ___________
Interviewer: ___________________________________________
RTI International
Research Triangle Park, NC 27709-2194
1-800-848-4079
https://nsduh.rti.org

Contact Cards
Sorry I missed You (SIMY) Card

Front:

Sorry I Missed
You…
Inside:

Dear Resident:
I stopped by today to talk to you about an
important research study being conducted by RTI
International. You should have received a letter
explaining the study.
I am sorry that I did not find you at home. I will
return to talk with you soon.
Thank you in advance for your participation.

Contact Cards
Field Interviewer Business Card

Front:

Back: Blank/White

2020 NSDUH Redesign Field Test
Attachment FT-6 – Study Description

Study Description

Your address is one of several in this area randomly chosen for the 2020 National
Survey on Drug Use and Health (NSDUH). This study, sponsored by the U.S. Department of

Health and Human Services, collects information for research and program planning by asking about:
• tobacco, alcohol, and drug use or non-use,
• knowledge and attitudes about drugs,
• mental health, and
• other health issues.

Your privacy is important to us. To make sure we protect it, we never share your address. Your

address will never be connected to your answers. Answers from all participants are only reported as
overall statistics. Federal law requires us to keep all of your answers confidential. Any answers that you
provide will only be used by authorized personnel for statistical purposes according to the Confidential
Information Protection and Statistical Efficiency Act of 2002.*

First, we will ask a few general questions, which will take just a few minutes.

 If anyone is selected, the
interview will take about an hour. You can refuse to answer any questions, and you can quit at any time.
Each person who is selected and completes the interview will receive <$30/$50> in cash.

If you have questions about the study, call the Project Representative at [FT TOLL FREE

NUMBER]. If you have questions about your rights as a study participant, call RTI International’s Office of
Research Protection at 1-866-214-2043 (a toll-free number). You can also visit our project website:
https://nsduh.rti.org for more information.

Thank you for your cooperation and time.
Peter Tice, Ph.D.
Project Director, National Survey on Drug Use and Health
Substance Abuse and Mental Health Services Administration, HHS
* Confidential Information Protection and Statistical Efficiency Act of 2002. (CIPSEA, PL 107-347). Any project staff or
authorized data user who violates CIPSEA may be subject to a jail term of up to 5 years, a fine of up to $250,000, or both.
NOTICE: Public reporting burden for this collection of information is estimated to average 60 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 aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports
Clearance Officer, Paperwork Reduction Project (0930-0110), Center for Behavioral Health Statistics and Quality; Room
15E57B; 5600 Fishers Lane, Rockville, MD 20857. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control
number for this project is 0930-0110, expiration date 3/31/22.

2020 NSDUH Redesign Field Test
Attachment FT-18 – Federalwide Assurance

http://ohrp.cit.nih.gov/search/IOrgDtl.aspx


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Authorgmchenry
File Modified2019-09-09
File Created2019-09-09

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