Attachment MICS-3_Study Description_Final_9-12-22

Follow-up Study
Description

You have been selected for a follow-up study to the National Survey on Drug Use and
Health. This study, sponsored by the U.S. Department of Health and Human Services,
will ask questions about mental health and consists of one interview.
If you decide to participate in the follow-up interview, your first name, telephone
number, and email address will be collected so we can contact you about your interview.
To schedule an interview appointment, you can either select a date and time through the
study’s online scheduling system or when speaking to the interviewer who contacts you.
The interview should take about 60 minutes to complete. Your participation is voluntary,
you can refuse to answer any questions you do not want to answer, and you can stop the
interview at any time. The interview will be conducted using Zoom. You can be in your
home, office, or another private location when you complete the interview. You will be
asked for permission to record the interview to ensure the interviewer administered the
interview properly. You can still be interviewed even if you do not allow the interview to
be recorded. Your interview recording may be used for quality or training purposes. If
you agree to complete the interview, you will receive $30.
Federal law requires us to keep all of your answers private and confidential. Any data you
provide will only be accessed by authorized personnel for statistical purposes according
to the Confidential Information Protection and Statistical Efficiency Act of 2002. The only
exceptions to this promise of confidentiality are if you tell the interviewer that you intend
to seriously harm yourself or someone else, or if a child has been or will be seriously
harmed. In this situation, the interviewer may need to notify a mental health professional
or other authorities.
If you have questions about the study, call the Project Representative at 1-800-8484079. 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).
Thank you for your cooperation and time.
Your confidentiality is protected by the 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 10/31/24.