consent form recall

Appendix E_Consent Form_Recall_1-13-21.docx

Focus Group Research to Inform Consumer Food Safety Education and Outreach

consent form recall

OMB: 0583-0184

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Appendix E: Food Recall Focus Group
Consent Form



Food Recall Focus Group Consent Form

Purpose:

  • The U.S. Department of Agriculture contracted with RTI International to conduct this study to learn about how people understand and respond to food recalls.

What Is Involved:

  • You are one of about 8 people being asked to be part of a focus group discussion. We are conducting a total of 8 focus group discussions.

  • The discussion will take up to 90 minutes.

  • We will ask you some questions about your experience with and understanding of food recalls. We will show you messages from USDA and ask for your feedback.

  • We will audio- and video-record the discussions, and the recordings will be used to make sure we get good notes. Study staff may be viewing the focus groups in person (behind a one-way mirror) or remotely (via live video streaming). Only first names will be used during the discussion.

  • Your participation in this study is voluntary. No one will be upset if you choose not to participate.

  • Even if you decide to be part of the study, you can stop participating at any time. Also, you do not have to answer any questions that you do not want to. You will receive a token of appreciation after you complete the study even if you choose not to answer some questions. However, consent to be in the study implies consent to being audio- and video-recorded during the discussions.

Confidentiality and Risks:

  • We do not expect that any of the topics discussed during the focus group will make you uncomfortable or upset you; however, if they do, you do not have to participate in that part of the discussion.

  • Nothing you say will be connected with your name. We will be writing a report on all of the focus groups and may use quotes from you in our report but will not use your name.

  • You will not be identified in any published or presented materials. Your data will only be used for this study, and not for other studies.

  • RTI will take several steps to keep your participation secure to the extent provided by law. Even with these steps, there is still a small risk that your privacy could be breached.

    • RTI and USDA will not receive any record of your full name or contact information. This means that your personal information (name, address, phone number) will not be linked to any of your responses.

    • All data collected for the focus group will be kept secure to the extent provided by law. The study team will not disclose your name or any of your responses.

    • All data collected for the focus group will be stored in a locked file cabinet or on a password-protected computer for a period of 5 years, after which they will be destroyed.

    • When we analyze the results, your information will be separated from the information that identifies you, and it will be combined with information from other people taking part in the study.

Benefits:

  • There are no direct benefits to you for participating in this study.

  • Your thoughts and experience will be helping with an important research project.

Questions:

  • If you have questions about the study, you may call the RTI Project Manager, Jenna Brophy, at
    919-541-8881.

  • If you have questions about your rights as a study participant or concerns about how you are treated in the study, you may contact RTI’s Office of Research Protection at 1-866-214-2043.


You will receive a $75 Visa gift card and a gift as a token of appreciation for your time and participation in the discussion.




Privacy Act Notice


Authority: The USDA is generally authorized to collect information to support its mission under: Title 7, Chapter 55-2205 (7 U.S.C 2204) (which authorizes the Secretary of Agriculture to collect information and employ any sampling or other statistical method deemed appropriate); 21 U.S.C. 679c(a)(1)-(3) (which expressly authorizes the Secretary to give high priority to enhancing the ability of FSIS to conduct its mission); the Federal Meat Inspection Act (FMIA) (21 U.S.C. 601, et seq.), the Poultry Product Inspection Act (PPIA) (21 U.S.C., et seq.), the Egg Products Inspection Act (EPIA) (21 U.S.C. 1031, et seq.), and the Humane Methods of Livestock Slaughter Act of 1978 (7 U.S.C. 1901- 1906).


Purpose: Findings from these focus groups will provide information on how FSIS communication programs and materials affect consumer understanding of recommended safe food handling practices and insight into how to effectively inform consumers of recommended practices. The results of this research will be used to enhance communication programs and materials to improve consumers’ food safety behaviors and help prevent foodborne illness. Additionally, this research will provide useful information for tracking progress toward the goals outlined in the FSIS Fiscal Years 2017–2021 Strategic Plan.


Routine Uses: Not applicable.


Disclosure: Responses to any, and all, questions are completely voluntary. Participants selected to participate in this research can choose to not answer any questions asked by the focus group moderator. If participants do not answer a question, they will not be penalized and will still receive the $75 incentive.





If you agree to participate, please sign below. You will be given a copy of this consent form to keep.





I understand what the study involves, and my questions so far have been answered. I understand that my participation in this research study is voluntary. I consent to participate in this focus group.



____________________________________ _________________________________

Participant’s signature Date





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 0583-0xxx and the expiration date is 0x/xx/20xx. The time required to complete this information collection is estimated to average 1.5 hours 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.


Draft Version 3.0, 12/17/2020


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleConsent Form
AuthorHAGERTY-HELLER_T
File Modified0000-00-00
File Created2021-01-22

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