Form 1600 Informed Consent Form

OMB Control Number: 2127-NEW

Expiration Date: xx/xx/xxxx

CONSENT TO TAKE PART IN A RESEARCH STUDY

Under the Paperwork Reduction Act, a Federal agency may not conduct or sponsor, and a person is not required to respond to collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control number. The OMB Control Number for this information collection is 2127-xxxx (expiration date: xx/xx/xxxx). The average amount of time to complete the informed consent is 5 minutes. Your participation and all your responses to this collection of information are voluntary. The purpose of this research study is to examine public attitudes toward motor vehicle safety and relationships between attitudes, behaviors, and demographics. The information collected will be summarized in a report to support future countermeasure development. If you have comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden send them to Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590.

Sponsor / Study Title:	National Highway Traffic Safety Administration “Examination of News Reports of Car Crashes”
Protocol Number:	TA2020_NewsCrash_Full
Principal Investigator:	Lawrence E. Decina, MS, BS
Telephone:	215-538-3820, x 102 (office) 610-999-9954 (cell)
Additional Contact(s): (Study Staff)	Kathy Lococo
Address:	TransAnalytics, LLC 345 West Broad St. Quakertown, PA 18951

Please read this form carefully. Reading this form may help you decide whether to take part in this study or not. You may call the number shown above to ask the study staff as many questions about the study as you would like to help you decide whether to take part in this study. Your participation in this study is voluntary. If you decide to take part in this study, you must electronically sign your consent at the end of this form and date it. You cannot take part in this research study until you sign and date this form.

KEY INFORMATION

The purpose of this research study is to examine public attitudes toward motor vehicle safety and relationships between attitudes, behaviors, and demographics. You will read a short newspaper story about a car crash. You will then (electronically) answer 40 multiple-choice questions about what you read, your opinions about certain highway safety issues, and demographics (such as your age, race/ethnicity, education). The time estimated to read the news report and answer the questions is 20 minutes. If you decide to participate and complete the study, you will receive points in your Schlesinger account equal to $3.00, which you can use toward the purchase of gift cards.

This project is sponsored by the National Highway Traffic Safety Administration (NHTSA), an operating mode of the U.S. Department of Transportation. The study will be carried out by a Pennsylvania firm, TransAnalytics, LLC. TransAnalytics has a long track record in conducting traffic safety and behavior science research for NHTSA. The Study Investigator, Mr. Lawrence E. Decina, has worked for TransAnalytics for 19 years.

This study has been reviewed by an institutional review board (IRB), which is a committee that has reviewed this research study to help ensure that your rights and welfare as a research participant are protected and that the research study is carried out in an ethical manner.

If you decide to participate, your responses will remain anonymous to the researchers (TransAnalytics), to Schlesinger (the marketing research company that provided you with the invitation to participate), and to NHTSA. When you enter the study, your Schlesinger participant ID will be used instead of your name, so that the researchers (TransAnalytics) will not know your identity. TransAnalytics will not provide your responses to the Schlesinger Group. Therefore, your name will never be associated with your responses. Your Schlesinger Group ID number is being collected to confirm your participation in the study. The Schlesinger Group will add points to your Schlesinger account following your submission of the completed study. TransAnalytics will replace your Schlesinger ID in the final dataset with an ID number from 1 to 1,500.

Your responses will be summarized in tables and graphs along with that of other study participants. In other words, no individuals’ identities will be revealed in study reports.

INTRODUCTION to the research study

You are being asked to take part in a research study. Your participation is voluntary. You may refuse to join, or you may withdraw your consent to be in the study at any time, for any reason.

Research studies are designed to obtain new knowledge. This new information may help people in the future. You may not receive any direct benefit from being in the research study, other than the payment you will receive from the marketing research company. There are no risks to you for participating in this study.

The study you are being asked to join is described below. It is important that you understand this information so that you can make an informed choice about being in this research study. You may contact the Study Investigator named above, or study staff members who may assist him, about any questions you have about this study, at any time.

information about THE STUDY

If you decide to participate, you will be one of 1,500 people in this research study. You are eligible to participate in this study if the following apply:

• You are age 18 or older in all States except Nebraska, Alabama, or Mississippi.

  • If you live in Nebraska or Alabama, you are age 19 or older.

  • If you live in Mississippi, you are age 21 or older.

• You have driven a car, van, SUV, or pickup truck at least once in the past month.

• You do not ride a motorcycle as your main form of transportation.

• You are a United States resident.

• You can read and write in English fluently.

what will happen during the study

If you agree to take part in this study, you will first provide your consent by clicking first a “YES” button that states that you read this form and understand its contents and, second, another “YES” button that states that you agree to be in this research study for the purposes described in this informed consent document. These buttons will appear at the end of this document. You will be automatically directed to the study website where you will read a news report and then answer the 40 questions. Your responses will be stored in a secure database. The database manager will provide a spreadsheet containing responses from all 1,500 participants to the researcher (TransAnalytics) for analysis. Upon your submission of your completed study, Schlesinger Group will receive notice of your study completion using your study ID, allowing them to add the points worth $3.00 to your Schlesinger account. TransAnalytics will analyze the data and present the findings in a report to NHTSA, the study sponsor, as well as a copy of the dataset without the Schlesinger ID.

Your role in the study

You do not have any special responsibilities as a study participant, beyond participating in the study using your personal computer and answering the questions to the best of your ability.

RISKS of the study

There are no risks associated with your participation in the study.

costs of being in thE study

There will be no costs for being in the study, other than the 20 minutes of your time to read the news report and answer the questions.

Your Payment for being in the study

You will receive bonus points in your Schlesinger account towards gift cards equaling $3.00. These points will show up in your Schlesinger account after all 1,500 participants complete the study. This will be approximately within two weeks of your completion of this study.

ALTERNATIVES TO PARTICIPATION

This research study is for research purposes only. The only alternative is to not participate in this study.

study staff Payment

The National Highway Traffic Safety Administration, an operating administration of the U.S. Department of Transportation, is paying for all aspects of this study.

HOW WILL YOUR PRIVACY BE PROTECTED?

Individual participants will not be identified in any report or publication about this study. Data will be analyzed and reported only at the group (not individual) level.

The study staff at TransAnalytics who are carrying out this research for NHTSA have completed a course in human research ethics, and have been performing similar research for more than 20 years.

The information collected will be transferred to the researchers at TransAnalytics in Pennsylvania and will be stored on a computer for analysis along with all the other study participants’ information. To ensure that your information collected for this study will be kept private, the researchers will not have any access to your personal identification. Your Schlesinger ID will be recoded as a number from 1 to 1,500.

A copy of the study data will be delivered to NHTSA; these data will reference study participants only by ID number (1 to 1,500).

It is possible that the Department of Health and Human Services and an authorized Institutional Review Board (IRB) may view this study’s collected data for auditing purposes. An IRB is responsible for the oversight of the protection of human subjects involved in research.

being a study volunteer

Entering a research study is voluntary.

• You may always say no. You do not have to take part in the study.

• If you start a study, you may stop at any time without penalty or loss of benefits to which you are otherwise entitled. You do not need to give a reason.

STATEMENT of consent

I have read this form and understand its contents.

____YES

____NO

I agree to be in this research study for the purposes listed above (select one).

____YES

____NO

(Only those who select YES to both statements will be directed to the study website.)

NHTSA Form No. 1600