Study of the ESEA Title VI Indian Education LEA Grants Program

Appendix B

Informed Consent

Informed Consent – Interview

Study of the ESEA Title VI Indian Education LEA Grants Program

Purpose

SRI International (SRI) and Policy Studies Associates (PSA), under contract with the Policy and Program Studies Service (PPSS) of the U.S. Department of Education, are conducting a study of the implementation of the Elementary and Secondary Education Act (ESEA) Title VI Indian Education Local Education Agency (LEA) Grants Program, in partnership with Arizona State University’s (ASU) Center for Indian Education and the University of Alaska Anchorage’s (UAA) Center for Alaska Education Policy. The purpose of the study is to describe nationwide operations of and strategies used by Title VI grantees to provide culturally responsive services and activities and help Native students meet challenging state academic standards; align and leverage program-funded services with those funded by other federal, state, and local sources; identify eligible American Indian and Alaska Native (AI/AN) students; establish and implement project priorities with parent, community, and tribal involvement; and measure progress towards Title VI project objectives. The study is intended to gather information about the overall program and not to evaluate individuals in their capabilities or performance.

If you agree to participate in this study, we will invite you to participate in a brief in-person interview that takes about 45-60 minutes.

Risks and Discomfort

There are few anticipated or known risks in participating in this study.

Benefits

While you personally may not benefit directly from the study, your participation in the study will contribute to our understanding of Title VI Indian Education program implementation and the supports needed to increase access and positive outcomes for AI/AN students. A report summarizing the findings from the study will be made publically available on the Department’s website at www.ed.gov in 2018.

Participation

Participation in this study is voluntary. You may choose not to respond to certain questions or discontinue the interview at any time.

Privacy

All information will be kept confidential, except as required by law. Safeguards will be put in place to protect the privacy and confidentiality of all respondents, and all information will be reported in the aggregate so will not reveal your or your project’s identity. Only SRI/PSA/ASU/UAA research staff will have access to personally identifiable information.

More Information

If you have any questions about this study, please contact the study team at 800-XXX-XXXX or XX@XX. If you wish to share concerns or ask questions about the study and your rights as a research participant to someone other than the researchers, please contact SRI’s Institutional Review Board by calling 650 859-4022 or emailing IRB@SRI.com. Please reference case number XXXX-XXXX.

CONSENT: I understand that participation in this interview is voluntary and I may decline to answer or skip any question that makes me uncomfortable.

If you agree to participate in this interview, please sign below.

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Printed Name Grantee Name

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Signature Date