Cog Interview Informed Consent

Appendix C

2023 Census of Medical Examiner and Coroner Offices

Cognitive Testing Informed Consent

C-1: CMEC Informed Consent Form for Participants

C-2: CMEC Informed Consent Form for Interviewers

Appendix C-1: CMEC Informed Consent Form for Participants

2023 Census of Medical Examiner and Coroner Offices

Cognitive Testing Informed Consent

What is the purpose of the interview? The interview is part of a research study that is being conducted by the Bureau of Justice Statistics (BJS). The purpose of the interview is to receive feedback on the 2023 Census of Medical Examiner and Coroner Offices (CMEC).

What will happen during the testing? The interview will take approximately 60 minutes. You will be asked to read through the CMEC survey as if you were completing it on your own. During the survey I will stop you and ask you some questions about the survey and whether the questions make sense and are easy to answer. The interview will also involve recording your comments for later analysis. The recording will only be heard by authorized project staff and your name will never be used. You can choose not to be recorded. If the interview is conducted via Zoom you are welcome to have your camera on or off, whatever you are most comfortable with.

Why was I chosen? You were chosen because you are either a medical examiner, coroner justice of the peace, or key member of their staffs . Participants represent the types of people who will take part in the 2023 CMEC Survey.

Are there risks? There is no expected risk to participating in this study. Any information that is learned during this discussion will not be shared with anyone outside the CMEC project staff.

Are there benefits? There are no expected direct benefits to you for participating in this study.

What will I get for participating? By participating you will make an important contribution to the understanding of the nation’s medicolegal death investigation system.

Do I have to participate? Participation in this interview is entirely voluntary. You can stop the interview at any time. You can also refuse to answer any question on any form.

Will this be kept private? Participants’ names and other identifying information will not be used in any report or publication. Everything we learn will be kept private by BJS and RTI to the fullest extent of the law. Only project team members from RTI and BJS will be allowed access to this information or observe any of the interviews. You can choose not to be audio recorded or observed.

Whom do I call if I have questions? If you have any questions about the study, you can call the project director, Hope Smiley-McDonald. Her number is 919-485-5743. If you have any questions about your rights in taking part in this study, you can call RTI's Office of Research Protection at 1-866-214-2043 (this is a toll-free call).

By participating in this interview, you consent to BJS and RTI using your answers to inform the survey. You are also acknowledging receipt of this consent form. If there is any part of this form that is not clear to you, be sure to ask about it before you consent.

Appendix C-2:CMEC Informed Consent form for Interviewers

2023 Census of Medical Examiner and Coroner Offices

Cognitive Testing Informed Consent

What is the purpose of the interview? The interview is part of a research study that is being conducted by the Bureau of Justice Statistics (BJS). The purpose of the interview is to receive feedback on the 2023 Census of Medical Examiner and Coroner Offices (CMEC).

What will happen during the testing? The interview will take approximately 60 minutes. You will be asked to complete the CMEC. During the survey I will stop you and ask you some questions about the survey and whether the questions make sense and are easy to answer. The interview will also involve recording your comments for later analysis. The recording will only be heard by authorized project staff and your name will never be used. You can choose not to be recorded. If the interview is conducted via Zoom you are welcome to have your camera on or off, whatever you are most comfortable with.

Why was I chosen? You were chosen because you are either a medical examiner or coroner. Participants represent the types of people who will take part in the 2023 CMEC Survey.

Are there risks? There is no expected risk to participating in this study. Any information that is learned during this discussion will not be shared with anyone outside the CMEC project staff.

Are there benefits? There are no expected direct benefits to you for participating in this study.

What will I get for participating? By participating you will make an important contribution to the understanding of the nation’s medicolegal death investigation system.

Do I have to participate? Participation in this interview is entirely voluntary. You can stop the interview at any time. You can also refuse to answer any question on any form.

Will this be kept private? Participants’ names and other identifying information will not be used in any report or publication. Everything we learn will be kept private by BJS and RTI to the fullest extent of the law. Only project team members from RTI and BJS will be allowed access to this information or observe any of the interviews. You can choose not to be audio recorded or observed.

Whom do I call if I have questions? If you have any questions about the study, you can call the project director, Hope Smiley-McDonald. Her number is 919-485-5743. If you have any questions about your rights in taking part in this study, you can call RTI's Office of Research Protection at 1-866-214-2043 (this is a toll-free call).

By participating in this interview, you consent to BJS and RTI using your answers to inform the survey. You are also acknowledging receipt of this consent form. If there is any part of this form that is not clear to you, be sure to ask about it before you consent.

Do you have any questions?

Do we have permission to continue with the interview?

 Yes

 No

Do we have your permission to audio record this discussion?

 Yes

 No

IF OBSERVER: Do you agree to have an observer sit in on this interview?

 Yes

 No

I certify that the nature, purpose, and privacy policy associated with participating in this research have been explained to the participant and the participant has given their consent to participate in this cognitive interview. Decisions whether or not to record or allow observers were the decisions of the participant.

Signature of Interviewer Date