Consent Forms

Attachment C. Consent Forms

Surveys (Information Sheet)

Project Title	Leveraging the Emerging Field of Disaster Citizen Science to Enhance Community Resilience and Improve Disaster Response
Purpose of the Study	This is a research project being conducted by Drs. Ramya Chari and Lori Usher-Pines at the RAND Corporation. This study is funded by the Centers for Disease Control and Prevention (CDC) within the Department of Health and Human Services (DHHS). You are invited to participate in this project because you represent a local health department in the United States. The purpose of this research project is to understand how citizen science activities and data can be used to increase community resilience, enhance participation in preparedness and response activities, and improve preparedness efforts. Citizen science is a broad term that covers many different types of activities. It has also been called “public participation in scientific research,” “community science,” and “participatory research.” At its core, citizen science is the engagement of members of the public in research processes.
Procedures	Participants will complete the following survey by [INSERT DATE] electronically. Surveys will be completed remotely, at the respondent’s convenience. Participants include representatives of local health departments in the United States. Completing this survey should take approximately 30 minutes. We will not collect personally identifiable information, and your answers cannot be linked back to you. This survey contains questions related to your local health department’s experiences with and perceptions of citizen science. Question types include multiple choice (single and multi answer options) and fill in the blank questions. You can skip any questions on the survey that you do not want to answer. Completing the questions to the best of your ability, or based on minimal information searching, is acceptable for this survey.
Potential Risks and Discomforts	There are no identifiable risks associated with this survey. All information will be kept secure. Your name will not be collected or linked to the data you provide at any time. The researchers will provide an electronic copy of this written consent directly to all research participants prior to conducting the survey.
Potential Benefits	This research is not designed to help you personally, but the results may help local health departments cultivate citizen science activities with the intent of strengthening community resilience. We hope that, in the future, individuals and communities might benefit from this study through improved understanding of this phenomenon.
Token of Appreciation	You will receive a $10.00 gift card as a token of appreciation for completing this survey.
Data security	We will not collect any identifiable information, thus security will be maintained. Should you choose not to participate in the study, information on your refusal to participate will not be released to the organization sponsoring this research project and/or your employer. The data collected through this survey will be summarized in aggregate form, grouped with data others provide for reporting and presentation. Survey responses will be securely stored on the investigators’ password protected computers and password protected shared drive. Any hard copies of the data will remain in the possession of the principal investigator at her locked office. All data will be destroyed (i.e., shredded or erased) when their use is no longer needed but not before minimum of five years after data collection.
Right to Withdraw and Questions	Your participation in this research is completely voluntary. You may choose not to take part at all. If you decide to participate in this research, you may stop participating at any time. If you decide to stop taking part in the study, if you have questions, concerns, or complaints, or if you need to report an injury related to the research, please contact the RAND Corporation’s Human Subjects Protection Committee (HSPC) toll free at (866)-697-5620 or by emailing hspcinfo@rand.org.
Participant Rights	If you have questions about your rights as a research participant or wish to report a research-related injury, please contact: RAND Corporation Human Subjects Protection Committee 1776 Main Street Santa Monica, California, 90401 E-mail: hspcinfo@rand.org Telephone: (866)-697-5620 If possible, when you contact the Committee, please reference Study #2016-0861. This research has been reviewed according to the RAND Corporation HSPC and CDC procedures for research involving human subjects.
According to the Paperwork Reduction Act of 1995, information collection exercises must display a valid OMB control number. The valid OMB control number for this information collection is [INSERT NUMBER]. The time required to complete this information collection is estimated to average 30 minutes per response, including the time to review instructions and complete and review the information collection.

Interviews (Information Sheet)

Project Title	Leveraging the Emerging Field of Disaster Citizen Science to Enhance Community Resilience and Improve Disaster Response
Purpose of the Study	This is a research project being conducted by Drs. Ramya Chari and Lori Usher-Pines at the RAND Corporation. This study is funded by the Centers for Disease Control and Prevention (CDC) within the Department of Health and Human Services (DHHS). You are invited to participate in this research project because you are citizen scientist or an end-user of citizen science data (e.g. health departments, policymakers) in the United States. The purpose of this research project is to understand how citizen science activities and data can be used to increase community resilience, enhance participation in preparedness and response activities, and improve preparedness efforts. Citizen science is a broad term that covers many different types of activities. It has also been called “public participation in scientific research,” “community science,” and “participatory research.” At its core, citizen science is the engagement of members of the public in research processes.
Procedures	We will ask questions related to your experiences with and perceptions of citizen science. Interviews will be completed either by phone or in person by [INSERT DATE]. Participants include adults (18+) who are citizen scientists or end-users of citizen science data in the United States. Completing an interview should take approximately 60 minutes. You can skip any questions during the interview that you do not want to answer.
Potential Risks and Discomforts	The risk to participation in this study is minimal. In any written reports of the data obtained from this interview, your responses will be combined with others and reported together. If quotations are used in any reports, they will not be connected to an individual or organization. Identifiable information that you provide will not be shared with anyone outside of the RAND project staff without your permission, except as required by law. At the end of the study, we will destroy any information that identifies you as a participant. The researchers will provide an electronic copy of this written consent directly to all participants prior to conducting the interview.
Potential Benefits	This research is not designed to help you personally, but the results may help community groups and local health departments cultivate citizen science activities with the intent of strengthening community resilience. We hope that, in the future, individuals and communities might benefit from this study through improved understanding of this phenomenon.
Data security	We will keep personally identifying information (PII) separated from interview responses, thus security will be maintained. Should you choose not to participate in the study, information on your refusal to participate will not be released to the organization sponsoring this research project and/or your employer. The data collected through your interview will be summarized in aggregate form, grouped with data others provide for reporting and presentation. Interviews will be recorded, transcribed, and securely stored on the investigators’ password protected computers and password protected shared drive. Any hard copies of the data will remain in the possession of the principal investigator at her locked office. All data will be destroyed (i.e., shredded or erased) when their use is no longer needed but not before minimum of five years after data collection.
Token of Appreciation	You will receive a $25.00 gift card as a token of appreciation for completing this interview.
Right to Withdraw and Questions	Your participation in this research is completely voluntary. You may choose not to take part at all. If you decide to participate in this research, you may stop participating at any time. If you decide to stop taking part in the study, if you have questions, concerns, or complaints, or if you need to report an injury related to the research, please contact the RAND Corporation’s Human Subjects Protection Committee (HSPC) toll free at (866)-697-5620 or by emailing hspcinfo@rand.org.
Participant Rights	If you have questions about your rights as a research participant or wish to report a research-related injury, please contact: RAND Corporation Human Subjects Protection Committee 1776 Main Street Santa Monica, California, 90401 E-mail: hspcinfo@rand.org Telephone: (866)-697-5620 If possible, when you contact the Committee, please reference Study #2016-0861. This research has been reviewed according to the RAND Corporation HSPC and CDC procedures for research involving human subjects.
According to the Paperwork Reduction Act of 1995, information collection exercises must display a valid OMB control number. The valid OMB control number for this information collection is [INSERT NUMBER]. The time required to complete this information collection is estimated to average 60 minutes per response, including the time to review instructions and complete and review the information collection.