Att E-Consent to Participate in Focus Group Session

Att E-Consent to Participate in Focus Group Session.docx

CDC and ATSDR Health Message Testing System

Att E-Consent to Participate in Focus Group Session

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Attachment E. Consent form.


Consent to Participate in Focus Group Session



What am I being asked to do?

We are asking you to participate in a focus group session or group discussion in support of a future Centers for Disease Control (CDC) communication campaign. The purpose of the group discussion is to get your thoughts and opinions on different ways of managing children’s behaviors. We also want your opinions on some messages and materials that we have.


What will I be doing?

A focus group is a special group discussion that includes the research staff from CDC and about six or seven other parents participating in the CDC project. We will meet with a small group of parents like you in a private room to be able to talk about this topic. We will ask you what you think about ways that parents manage children’s behaviors. We will also ask you what you think of some videos and books about managing children’s behaviors.


We will record the discussion and take notes during the group meeting in order to get all your opinions accurately. We will destroy our focus group notes as soon as we complete our project report. Our job is to ask you questions, to keep the group focused on the topic we want to discuss, and to make sure we don’t run out of time. We really want you to feel free to talk together as a group, so if everyone is talking about the questions we asked, we will mostly just listen to your ideas and take notes. Our discussion will take about one and a half hours to complete.


Do I have to do this?

No, you don’t. Your participation in this focus group is voluntary. You can say that you don’t want to participate in the focus group and that is fine. Your choice will not affect your status here at (Facility where group is conducted). You are also free to stop participating at any time without consequences. It is important that you feel comfortable answering the questions honestly. You do not have to answer any questions that you do not want to answer.


How will my privacy be protected?

To protect your privacy, we will not ask you to introduce yourself by name and we will not write down your name on any of the notes we take during the focus group. Answers to the focus group questions will be kept separate. This information and our notes from group discussion will be locked in our research offices in Atlanta.


Although we value your participation in this focus group, we understand that you may not be comfortable telling the entire group what you have to say out loud. In these cases, if you prefer, you can write down your ideas or thoughts. We will give you several sheets of paper and a pencil so that you can write down any ideas that you do not feel like sharing with the entire group. When you are finished writing down your idea you can put your paper in an envelope that we will give you and seal/close the envelope. Feel free to write down all of your ideas that you do not want to share with the entire group on the provided paper. You do not have to put your name or initials anywhere on the paper or the envelope. At the end of the focus group, you will turn in your envelope to the researcher. No one else will be able to see your idea except for the researchers. We will take steps to insure that the paper documents/envelopes are kept secure in the CDC offices. At the end of each focus group, we will collect any envelopes and place them into a larger manila envelope. We will review and analyze the contents of the envelopes at our office in Atlanta and once completed we will seal the envelopes in the larger manila envelope and secure that in a locked filing cabinet in the Principal Investigator’s (Dr. Joanne Klevens) office.


What are the risks?

Because you will be speaking with us in a group with other parents, there is the possibility that your co-participants in the focus group meeting will tell other people about your participation. Group members may repeat what you have said during the meeting to other people. However, we will ask everyone in the group to keep what is said in the group confidential that is to not share anything said in the discussion with anyone after the discussion has ended. We hope you will feel comfortable enough to be open and honest in your responses to our questions.


Are there any benefits to participating?

There are no direct benefits to participating in this research study. However, you may benefit from knowing that your participation has the potential to help future parents manage children’s behaviors.


Will I receive compensation?

As a token of appreciation of the time and effort of being interviewed, each person in the project will be given a $50 gift card after the discussion is completed.

What will be done with the results of this Focus Group?

We will analyze information from the Focus Group session to identify common opinions. This information will be shared with CDC’s Communication Team. We will never write the names of parents participating in any reports. We will be careful not to include information that could be used to identify those who participated in the focus group. Only general themes and some direct things you say will be included in our final report. In the event that we use something you said directly, we will only describe those words as coming from “a parent in <site name>” instead of using any names.



OTHER INFORMATION

Participation in the Focus Group is completely voluntary. If you decide to not participate or to withdraw from the session at any time, there will be no penalties or consequences. Please keep a copy of this information sheet for your records. If you have any questions about this study, you may contact Joanne Klevens at 770-488-1386 or via e-mail at jklevens@cdc.gov. The investigators are also willing to answer any questions or concerns that might arise after the discussion and are willing to provide referral information if you would need assistance related to parenting. You may also contact the CDC’s Institutional Review Board Office (IRB Manager, toll-free at 1-###-###-####). We look forward to working with you. We do not anticipate any foreseeable risks to you and we think that our research will be helpful in designing better messages and materials to improve parenting.

By signing below, I am indicating that:

___ I have read and understand the information above and voluntarily agree to participate in this focus group discussion.


___ I understand what has been read to me, and I agree to take part in the study in this focus group discussion.

___ I know that I have a choice to be in the study or not, and can stop at any time during the study.





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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKlevens, Joanne (CDC/ONDIEH/NCIPC)
File Modified0000-00-00
File Created2021-01-22

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