Various Demographic Pretesting Activities

Participant Informed Consent

Focus Groups or Interviews

You are invited to participate voluntarily in this research, which is being sponsored by the U.S. Census Bureau. The purpose of this research is to learn about difficulties associated with collecting census data from non-English speaking households and about language barriers and sociocultural factors affecting non-English speaking respondents’ knowledge of and reaction to census enumeration. Your answers will help us make future censuses better.

The discussion or interview will take approximately 60 minutes. There are no right or wrong answers to the questions we ask—we just want to ask your opinions about the issues under discussion. In appreciation for your participation in this project, you will receive $40.00.

Your participation in this study is voluntary, and you may stop at any time. Even if you choose not to participate, you will not lose any benefits or services that you may be receiving from any governmental agency. Also, you may choose not to answer any question. You will be paid $40 in appreciation for your time, even if you decide to stop the interview. We will not be asking about your legal or immigration status. Your participation will be kept confidential by the Census Bureau and the information you give us will be combined with the responses of others in a summary report that does not identify you as an individual. We will not share any information you give us during the interview with any person outside the project staff. There are no expected risks to participating in this study. Your identifying information is protected by Title 13 of the United States Code.

______________________________________________________________________________

The above document describing the benefits, risks and procedures for this research study has been explained to me. I agree to participate.

Signature of participant________________________________ Date _______

Printed name of participant_____________________________

I certify that the nature and purpose, the potential benefits, and possible risks associated with participating in this research have been explained to the above individual.

Signature of Person Who Obtained Consent_______________________________ Date______

Audio-taping the interview:

In order to make best use of our findings, we also request that you allow the interview to be audio-taped, through the use of a tape recorder or laptop computer. The audio-tape will only be heard by people who are working on this project. The only purpose of audio-taping is to allow us to review the interview as we document our findings. We will destroy the tapes upon completion of the project. If you would rather that your interview not be audio-taped, or if any time during the interview you decide that you would like the audio-taping to be stopped, please tell the interviewer and we will stop taping.

______________________________________________________________________________

I agree to allow the interview to be audio-taped and to be listened to by others who are working on this project:

Signature of participant ________________________________ Date _______

Printed name of participant_____________________________