Focus Group Informed Consent Form

Focus Group Participant Informed Consent Form
National Survey on Drug Use and Health (NSDUH)
The Substance Abuse and Mental Health Services Administration (SAMHSA) has contracted with RTI
International to complete a large drug and health study called the National Survey on Drug Use and
Health (NSDUH). Each year, almost 70,000 people from across the United States are interviewed for
this important study. In association with this project, RTI has been asked to conduct virtual focus
groups like this one with adults to evaluate materials used on NSDUH.
Your participation in this focus group will involve answering questions about the content and design of
the letter sent to households inviting a household member to participate. We will ask how we can
improve these letters to increase study participation. There may be up to 6 people in each focus group.
You are one of approximately 54 people discussing the content of these letters in virtual focus groups.
There are no right or wrong answers; we just want your opinions.
Your participation in this group discussion is voluntary and you may withdraw at any time. Your
involvement and any comments you make will be kept private and confidential. Responses from all
focus group participants will be combined in a summary report that will not identify any individual or
their answers. We ask that you show consideration for others and refrain from sharing information
after leaving this focus group. This focus group will take about an hour.
Your personal information will not be connected to your remarks in any way. We will be recording this
focus group, to more easily prepare our summary report. The recording will be destroyed after the
report has been submitted. You will receive a $75 gift card as a token of our appreciation.
There are no physical risks to you from participating in this focus group other than those associated
with everyday living. You do not have to answer any questions that you do not want to. There are no
direct benefits to you from participating in this focus group.
We may be joined by observers from our project team that are here to help take notes.
If you have any questions about this focus group, please ask your group moderator. If you have any
questions about your rights as a study participant, you can call RTI's Office of Research Protection at
1-866-214-2043 (a toll-free number). For any other questions about the study, you can call Doug
Currivan of RTI at 1-800-334-8571, extension 23334.

At the beginning of the focus group, the moderator will ask for your verbal confirmation that this
information was provided to you, and you give your consent to participate in this focus group and
allow recording.

NOTICE: Public reporting burden for this collection of information is estimated to average 60 minutes. 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 (0930-0290), 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 0930-0290, expiration date
04/30/23.