Appendix D Consent Form

Appx D CLR Consent Form_9_18_23.docx

Consumer Labeling Research Focus Groups

Appendix D Consent Form

OMB: 0583-0188

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Appendix D: Consumer Labeling Research Focus Groups
Consent Form





Cooking Focus Group Consent Form

Purpose:

  • The U.S. Department of Agriculture, Food Safety and Inspection Service (USDA, FSIS) contracted with RTI International to conduct this study to get your response on potential new labelling on raw meat and poultry products.

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 12 focus group discussions.

  • The discussion will take up to 90 minutes.

  • We will ask you some questions to get your impressions and feedback on potential new labels for raw meat and poultry products.

  • 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.

  • The results of this study may be used in reports, presentations, and publications and may also be used in future studies, but your name will not be used.

  • 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, email address) 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.

    • 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 Principal Investigator, Sheryl Cates, at
    919-541-6810.


You will receive a $75 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 consumer needs for information on safely preparing raw meat and poultry and to assess their response to the draft label designs presented during the discussions. These results will be used to refine and draft label designs.


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 gift card and a gift.





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 1.1, 4/20/2023



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleConsent Form
AuthorHAGERTY-HELLER_T
File Modified0000-00-00
File Created2023-10-26

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