Workforce ICR - Appendix I_Supervisor Consent

Supervisor Consent

National Survey of Child and Adolescent Well-Being (NSCAW)

NSCAW

The Administration for Children and Families (ACF), an agency within the U.S. Department of Health and Human Services, provides funding for activities that support the well-being of children and families. ACF hired RTI International (RTI), a research company in North Carolina, to conduct a national survey of children and families in the child welfare system and to collect information about the child welfare workforce serving these families. RTI works with researchers from the University of North Carolina at Chapel Hill and Washington University in St. Louis to carry out the study.

Selection of Agency Supervisors

RTI has selected over 170 supervisors within participating NSCAW agencies to take part in a research study about their work experiences. You were randomly selected for participation from a list of supervisors provided by your agency’s director/administrator.

Purpose of the Study

The purpose of this study is to gain a better understanding of the characteristics and activities of the current workforce in public child welfare agencies, including the strengths of the workforce and challenges they may face. ACF will use information from this study to improve child welfare programs and policies.

Types of Questions for Supervisors

This one-time survey takes about 35 minutes to complete. The survey covers topics like your roles and responsibilities as a supervisor, your educational background and skills, training and professional development, job satisfaction, your relationship with the caseworkers you supervise, and how the COVID-19 pandemic may have impacted your work.

.

Your Rights

You can decide to take part in the study or not and your participation is strictly voluntary. Your decision to take part will not affect you or your job. You have the right to stop the survey at any time, and if you do participate, you can refuse to answer any questions.

Risks

To the best of our knowledge, the things you will be doing have no more risk of harm than you would experience in everyday life.

Benefits

Taking part in this research study presents no direct benefits to you. Your input will help us learn more about the characteristics and activities of the current workforce in public child welfare agencies across the nation.

Privacy

We keep your responses private to the extent permitted by the law. We do not identify you by name. We will combine your answers with other supervisors who respond to this survey and report the information in summary form. All staff involved in this research signed a Privacy Pledge.

This research is covered by a federal protection called a Certificate of Confidentiality. This means the researchers cannot share the information they gather that may identify you. The Certificate prevents researchers from revealing this information even if it is subpoenaed by a court. However, the Certificate does allow researchers to share information in some situations. For example, the agency that funds this research (ACF) is permitted to access information to confirm that the research is being conducted properly.

We may use or share your research data for future research studies, but it will be deidentified, which means that it will not contain your name or other information that can directly identify you. We will not ask for your additional informed consent for these studies. We may also share this deidentified data with other researchers here, at other institutions in the United States or around the world.

We or other researchers may contact you in the future to offer you participation in additional research activities. If you decide to participate in any future studies, you will be asked to sign a separate consent form.

Questions

If you have questions, please call Jennifer Keeney at RTI, 1-800-334-8571 extension 23525 (toll-free number). If you have questions about your rights as a study participant, please call RTI's Office of Human Research Protection at 1-866-214-2043 (a toll-free number).

You will receive a $20 gift card as a thank you for your input. If you should stop participating before the study is over, you will still receive the gift card.

You will receive a copy of this consent form to keep.

We use a laptop quality control (QC) system for this study. The system runs on the computer and may record what you and I say to each other. You and I will not know when the computer records our conversation. RTI project staff review the recordings to monitor my work. We will not use the recordings for any other purpose and will keep them private. We will destroy the files at the end of the study after data have been cleaned and analyzed. Those project staff who listen to the recording will know who I am but will not know who you are. Do we have your permission to run this system during your survey?

Check one box.

	Yes, I consent to having parts of this survey recorded by the computer for quality reviews.
	No, I do not want any part of this survey recorded.

The above information has been explained to me. My signature below indicates I give consent for my survey.

____________________________ __________________________ _________________

Supervisor Printed Name Supervisor Signature Date

____________________________ ________________________

Interviewer Signature Date

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number and expiration date for this collection are OMB #: 0970-0202, Exp: XX/XX/XXXX. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Dr. Melissa Dolan; 230 W. Monroe Street, Suite 2100 Chicago, IL 60606.

The Federal Government has issued a Certificate of Confidentiality (authorized by the Public Health Service Act Section 301(d), 42 U.S.C Section 241 (d), 1988) to the researchers who are conducting this study which authorizes us to protect the privacy of individuals who participate. 

Page 3 of 3 June 2020