OMB CONTROL NUMBER: XXXX-XXXX
Date of OMB Expiration: XX/XX/XXXX
Consent before Interviews
Hello, my name is [name] and on the call with me today is [name]. We are from RAND and are working on a research study to evaluate the DoD Peer Caregiver Forums. We really appreciate your taking the time to speak with us today to share information about the program as well as your views and experiences about working with military caregivers. The interview should last approximately 45 minutes.
We are particularly interested in learning about your experiences with the PEER Forums for military caregivers, to include any role you have in designing, implementing, or evaluating the forums. We are also interested in your impressions of how well the PEER Forums are working to address the needs of military caregivers and how the program might be improved.
This study is sponsored by the Office of Military Family and Community Policy within the Office of the Secretary of Defense.
Your participation is completely voluntary and you are under no obligation to discuss anything that you do not feel comfortable discussing with me/us. We will keep all information you provide during the discussion confidential. We will not share the names of our interview participants with anyone outside of the RAND study team. The information you provide will help us understand how the PEER Forums are designed to address the needs of military caregivers. The information you provide will be combined with that collected from other interviews about the program and presented collectively in a final report that we will present to DoD and release publically.
We will be taking notes on our call today to ensure that we accurately capture your comments, but we will not identify you by name in these notes nor in our final report. We would also like to record our conversation to make sure we don’t miss anything important that you say. The recordings, as well as our interview notes, will be reviewed only by those at RAND working on the project and they will be destroyed following the completion of the report.
Are you comfortable participating in this interviews? [If yes….]Do you have any questions for me before we begin? [If no, thank them for their time and end discussion]
Are you comfortable with me recording this conversation? [If yes, turn on recorder. If no, continue on to interview]
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information is estimated to average 60 minutes 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, East Tower, Suite 03F09, Alexandria, VA 22350-3100 (0704-XXXX). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
File Type | application/msword |
File Title | __MENTAL HEALTH CONSEQUENCES OF VIOLENT VICTIMIZATION |
Author | Unknown |
Last Modified By | Kaitlin Chiarelli |
File Modified | 2017-01-05 |
File Created | 2017-01-05 |