Thank you for your interest in this research study. I will ask you some questions to determine if your child is eligible for this study. If your child does not participate, we will not keep your answers to any of these questions.
How old is your child? [Convert to months if given in years]
[Require 18 to 71]
Does your child have normal physical development?
[If no concerns expressed, continue.]
Can he/she participate in normal physical activities, such as running and playing on playground equipment?
[Require yes]
In this study, we will ask your child to push and pull very hard with his/her hands and feet, and climb up on laboratory equipment between 4 and 18 inches above a padded floor. Does that sound like something your child would be able to do?
[Require yes]
Does he/she currently have any illness or injury that would make it difficult for your child to participate?
[Require no]
Is your child able to follow spoken instructions in English at a level appropriate for his/her age?
[Require yes]
Are you able to read English well? [Require yes, for consent form]
[If no]: We’ll need a caregiver who understands English well.
I’ll explain a bit more about the study so you can see if you’re interested.
We are conducting a study for the U.S. Consumer Product Safety Commission to gather data on child strength and climbing behavior related to furniture tip-over. These data are useful for ensuring the products are safe for children. We will ask your child to push and pull on handles while standing and sitting. We will encourage them to push or pull as hard as possible, because we want to record the greatest force they can exert. We will also ask your child to climb up on a laboratory apparatus between 4 and 18 inches above a padded floor.
During the testing, we will record video of your child. The video is necessary so that we can understand the postures your child uses when pushing and pulling. We will maintain the confidentiality of the videos. We will blur your child’s face and any other identifying characteristics if we share the videos outside the study team.
Do you have any questions?
Are you interested in having your child participate?
Is it OK for us to record video of your child?
[If yes, schedule for consent and installation visit.]
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Child Climbing Study/Focus Group - OMB Package |
| Author | 558022 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |