SPI consent form track changes and clean versions

Attachment E – 2016 SPI Consent_Track Changes_Clean

Bureau of Justice
Statistics

OMB No. 1121- 0152: Approval Expires 08/31/2018

Survey of Prison Inmates
Consent to Participate in Research
Introduction
The Survey of Prison Inmates is a research study being done by the Bureau of Justice Statistics and RTI
International. The purpose of this research is to collect information on the conditions and experiences
oflearn about prison inmates in the United States. Interviews will be conducteddone at 350 prisons for this
study and you . You are one of about 30,000 inmates in the nation being asked chosen to take part. Your
participation in this project is voluntary. But you were chosen at random, or by chance, to This means that
you represent thousands ofall the other inmates across the nation whothat were not selected. We
cannot replace you with anyone else, so yourchosen to take part. Your participation is important
ifvoluntary, but we arewould like to accurately describe all inmates across the nation. After you have
heard the informationknow about your experiences. Let me tell you about the study, and you can decide if
you want to participate in the studytake part.

Description of the Study
This interview will take about 55 minutes. I will ask questions about your criminal:






education, work, and family background,
current and prior offense history,
physical and mental health, and treatment received,
drug and alcohol use before you were incarcerated, and any treatment you may have received. I
will also ask questions about your admission to prison, and
experiences at this facility, some background questions about your family, your education and
your work history. in prison and use of prison programs.

I will enter your answers directly into the laptop computer.
At some point overWithin the next 5 years, the Bureau of Justice Statistics may also combine your survey
answers with data frominformation other government agencies already have about you. This might
include information about your :


employment, and income, participation in various
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Attachment E – 2016 SPI Consent_Track Changes_Clean



criminal records, and
benefits you might have gotten from government programs, and criminal records. This.

Adding this information will allow for additional research without taking up morecut down on the number
of your time with questions. It I ask today. We will only be useduse this information to produce statistics
that will combine your. Your information will be combined with that ofthe information from all other
inmates in the study. It will also help identify ways to improve the services, education, and training
available to inmates in the future, including inmates who return to the community.

Confidentiality
There is a law that protects the privacy of your answers, Title 42, United States Code, Section 3789g. This
study is also covered by a Privacy Certificate which. This means that your answers and information we
will treat everything you say during the interview and all information about you ascollect is kept private
and confidential. I will not ask you questions if I think someone can overhear your answers. It also means
that we We will not share your answers with anyone at this prison or with anyone from the community
such as, a supervision officer or, employer, or anyone else from the community. Nothing you tell me
during the interview can be used in any legal action. To protect your confidentiality, allAll information
will be handled in akept secure manner and your answers will always be combined with those of all other
inmatesparticipants in the study to produce the study results. The procedures to protect your privacy are
required by law, Title 42, United States Code, Section 3789g, There is, however, anfor statistics. The only
exceptions to our promise of confidentiality include . Iif you tell me that you intend plan to seriously
harm yourself, or a specific person, or plan to commit a future crime, or know about any sexual contact
between inmates or correctional staff. In these cases, I may need to inform correctional staffofficials at
this prison.
[To thank you for participating in the study, we will provide you with a snack to eat before you leave this
room.]

Possible Risks or Discomforts
Some of the survey questions are personal andor ask about past behaviors that may behave been illegal.
These questions may make you feel uncomfortable or upset. You can skip any questionsquestion you do
not want to answer. orI will not ask you questions if I think someone can overhear your answers. If you
become upset for any reason, you can stop the interview. at any time.

Benefits
You will not receive any direct benefits for participating in this study. However,But the results of thisthe
study may help to improve the condition and well-being ofthings for prison inmates in facilities across the
nation, as well as those who reenter the community.will be released. If you do not participatetake part,
you will not lose any benefits or services that you now receive or might receive in the future. Your choice
to participateparticipation will have no effect onnot affect your legal status or any decisions regarding
your release.

Further Questions
If you have any questions about the project, you may write to the Survey of Prison Inmates at RTI
International, P.O. Box 12194, Research Triangle Park, NC 27709-2194. If you have questions about
your rights as a project participant, you can write to RTI's Office of Research Protection at the same
address.

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Attachment E – 2016 SPI Consent_Track Changes_Clean
Refusal Conversion Script
INTERVIEWER:

AFTER READING THE CONSENT FORM:
Do you have any questions about the study at this time? RESPOND IN ACCORDANCE WITH
TRAINING.
If you agree to take part, I’ll begin the interview.
IF AGREES, CODE CONSENT STATUS IN CASE MANAGEMENT SYSTEM, PROVIDE
RESPONDENT WITH STANDARD CONSENT FORM, AND BEGIN INTERVIEW.

IF INITIAL REFUSAL:
ASK IF THE INMATE HAS ANY QUESTIONS OR CONCERNS. ANSWER THE INMATE’S
QUESTIONS AND/OR ATTEMPT TO PERSUADEADDRESS THE CONCERNS USING
STANDARD SPI CONVERSION TECHNIQUES FROM TRAINING/EXPERIENCE.. IF
STANDARD SPI TECHNIQUES ARE SUCCESSFUL, CODE CONSENT STATUS IN CASE
MANAGEMENT SYSTEM AND BEGIN INTERVIEW. PROVIDE RESPONDENT WITH
STANDARD CONSENT FORM.
IF STANDARD TECHNIQUES ARE NOT SUCCESSFUL, AS FINAL EFFORT TO
PERSUADEELICIT PARTICIPATION, OFFER OPT-OUT OPTION.
I understand that you don’t want to take part in the study as I’ve described it. Because you represent
thousands ofmany other inmates, it’s important to learn what we can about your experiences. And if
you would be willing to participate in just part of the study, you can still help us identify ways to
improve things for inmates in the future and those who return to the community.
If you agree, you can do the interview and allow us to combine your answers with just your current
criminal record to save time. And I can promise that we will not review your future criminal records
or get information about you from any other government agencies for additional research purposes.
If you agree to that, I can begin the interview.
IF AGREES, CODE CONSENT STATUS IN CASE MANAGEMENT SYSTEM, PROVIDE
RESPONDENT WITH OPT-OUT CONSENT FORM, AND BEGIN INTERVIEW.
IF REFUSES, CODE REFUSAL STATUS IN CASE MANAGEMENT SYSTEM AND THANK
INMATE (DO NOT BEGIN INTERVIEW).

3

Attachment E – 2016 SPI Consent_Track Changes_Clean
OMB No. 1121- 0152: Approval Expires 08/31/2018

Survey of Prison Inmates
Consent to Participate in Research
Introduction
The Survey of Prison Inmates is a research study done by the Bureau of Justice Statistics and RTI
International. The purpose is to learn about prison inmates in the United States. Interviews will be done at
350 prisons. You are one of about 30,000 inmates chosen to take part. This means that you represent all
the other inmates that were not chosen to take part. Your participation is voluntary, but we would like to
know about your experiences. Let me tell you about the study and you can decide if you want to take part.

Description of the Study
This interview will take about 55 minutes. I will ask about your:






education, work, and family background,
current and prior offense history,
physical and mental health and treatment received,
drug and alcohol use before admission to prison, and
experiences in prison and use of prison programs.

I will enter your answers into the laptop.
Within the next 5 years, the Bureau of Justice Statistics may combine your answers with information
other government agencies already have about you. This might include information about your:




employment and income,
criminal records, and
benefits you might have gotten from government programs.

Adding this information will cut down on the number of questions I ask today. We will only use this
information to produce statistics. Your information will be combined with the information from all other
inmates in the study.

Confidentiality
There is a law that protects the privacy of your answers, Title 42, United States Code, Section 3789g. This
study is also covered by a Privacy Certificate. This means that your answers and information we collect is
kept private and confidential. I will not ask you questions if I think someone can overhear your answers.
We will not share your answers with anyone at this prison, a supervision officer, employer, or anyone else
from the community. Nothing you tell me during the interview can be used in any legal action. All
information will be kept secure and your answers will be combined with other participants in the study for
statistics. The only exceptions to our promise of confidentiality include if you tell me that you plan to
seriously harm yourself, a specific person, commit a future crime, or know about any sexual contact
between inmates or correctional staff. In these cases, I may need to inform officials at this prison.
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Attachment E – 2016 SPI Consent_Track Changes_Clean
[To thank you for participating in the study, we will provide you with a snack to eat before you leave this
room.]

Possible Risks or Discomforts
Some of the questions are personal or ask about past behaviors that may have been illegal. These
questions may make you feel uncomfortable or upset. You can skip any question you do not want to
answer or you can stop the interview at any time.

Benefits
You will not receive any direct benefits for participating in this study. But the results of the study may
help to improve things for prison inmates across the nation, as well as those who will be released. If you
do not take part, you will not lose any benefits or services that you now receive or might receive in the
future. Your participation will not affect your legal status or any decisions regarding your release.

Further Questions
If you have any questions about the project, you may write to the Survey of Prison Inmates at RTI
International, P.O. Box 12194, Research Triangle Park, NC 27709-2194. If you have questions about
your rights as a project participant, you can write to RTI's Office of Research Protection at the same
address.

5

Attachment E – 2016 SPI Consent_Track Changes_Clean
Refusal Conversion Script
INTERVIEWER:
AFTER READING THE CONSENT FORM:
Do you have any questions about the study at this time? RESPOND IN ACCORDANCE WITH
TRAINING.
If you agree to take part, I’ll begin the interview.
IF AGREES, CODE CONSENT STATUS IN CASE MANAGEMENT SYSTEM, PROVIDE
RESPONDENT WITH STANDARD CONSENT FORM, AND BEGIN INTERVIEW.

IF INITIAL REFUSAL:
ASK IF THE INMATE HAS ANY QUESTIONS OR CONCERNS. ANSWER THE INMATE’S
QUESTIONS AND/OR ATTEMPT TO ADDRESS THE CONCERNS USING STANDARD SPI
CONVERSION TECHNIQUES. IF STANDARD SPI TECHNIQUES ARE SUCCESSFUL, CODE
CONSENT STATUS IN CASE MANAGEMENT SYSTEM AND BEGIN INTERVIEW.
PROVIDE RESPONDENT WITH STANDARD CONSENT FORM.
IF STANDARD TECHNIQUES ARE NOT SUCCESSFUL, AS FINAL EFFORT TO ELICIT
PARTICIPATION, OFFER OPT-OUT OPTION.
I understand that you don’t want to take part in the study as I’ve described it. Because you represent
many other inmates, it’s important to learn what we can about your experiences. And if you would be
willing to participate in just part of the study, you can still help us identify ways to improve things for
inmates in the future and those who return to the community.
If you agree, you can do the interview and allow us to combine your answers with just your current
criminal record to save time. And I can promise that we will not review your future criminal records
or get information about you from any other government agencies for additional research purposes.
If you agree to that, I can begin the interview.
IF AGREES, CODE CONSENT STATUS IN CASE MANAGEMENT SYSTEM, PROVIDE
RESPONDENT WITH OPT-OUT CONSENT FORM, AND BEGIN INTERVIEW.
IF REFUSES, CODE REFUSAL STATUS IN CASE MANAGEMENT SYSTEM AND THANK
INMATE (DO NOT BEGIN INTERVIEW).

6