Development of Deployment Risk and Resilience Inventory (DRRI)

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Appendix C: Draft Consent Form

*****DO NOT PUT YOUR NAME ANYWHERE ON THIS FORM******

This questionnaire is part of a research study on Operation Enduring Freedom and Operation Iraqi Freedom veterans’ experiences before, during, and after their deployment. This is not a treatment study. You are asked to respond to a series of questions that involve your opinions and knowledge. The questionnaire should take about 60 minutes to complete. You will be compensated $30 for your time and effort. You will receive a single payment in the form of a check mailed to you following your participation in the study.

By completing this questionnaire, you are indicating that you understand the following:

1. Your responses will be combined with those of approximately 750 other veterans and kept completely confidential as required by law. Any and all identifying information (like your name or address) will be kept separate from your responses. Dr. Dawne Vogt at (617) 232-9500 ext. 45976 is responsible for the storage of research records related to your participation in this study. All received questionnaires will be stored in locked files and password-protected data files at VA Boston Healthcare System in Boston, Massachusetts. Only the researchers will have access to your responses. At the conclusion of the study all records and data, including those containing identifying information, will be destroyed to ensure anonymity.

2. In the event that the results are publicly presented, your responses and identity will remain completely confidential and will not be disclosed to anyone outside our research team unless required by law. Your participation is completely voluntary. You do not have to take part in this study, and your refusal to participate will involve no penalty or loss of rights to which you are entitled. While some questions may be personal or sensitive in nature, you are free to choose not to answer any specific questions, and you are free to withdraw at any point. While there is no specific benefit to you from participating in this study, we hope that the information we obtain can be used to prepare future military personnel for the challenges of being deployed overseas, and help us to understand how to assist veterans after their deployment. Failure to return a questionnaire will be taken as an indication that you do not wish to participate in the Deployment Experiences Project. As a result, you will no longer be considered a research participant in this study. Completion and return of a questionnaire signifies your consent to participate in the study.

3. You will be informed of any significant new findings that develop during the course of this study or information that may relate to your willingness to continue participation in this study.

4. Official government agencies such as the Department of Defense or the Department of Veterans Affairs may examine your research and medical records to fulfill their responsibilities. Should this happen, you may expect the same confidentiality from these agencies as from our research team.

5. You may find thinking and answering questions about aspects of your deployment experiences to be discomforting. Should you experience this or a previously unknown study side effect, we will be available to talk with you or refer you to other possible resources, should it become necessary. Should you have any psychological problems possibly related to this study, you may call Dr. Jeff Knight at (857) 364-5900. If you need to contact someone after regular working hours, you may contact the Medical Center Operator at (617) 323-7700 and ask for the Fellow on call for psychiatry.

6. In the event that you are injured as a result of your being in this research study, you will receive medical care, including emergency treatment. This care or treatment is governed by federal law and VA policy. You would also have the right to file any legal action, as in any instance of alleged negligence.

7. If you have any further questions about the Afghanistan and Iraq War Experiences Project or wish to withdraw from the study, please contact Dr. Dawne Vogt at (617) 232-9500 ext. 45976. If at any point you have questions about your rights as a research subject you may contact the VA Boston Healthcare System Patient Advocate at (857) 364-5295. If you want to discuss problems or obtain information you may contact the Research Compliance Officer at (857) 364-4182.