UNIVERSITY OF WASHINGTON
PARENTAL CONSENT FORM
Investigators:
Mike Crandall, Senior Lecturer, The Information School, (206) 897-1798, [email protected]
Karen Fisher, Associate Professor, (206) 543-6238, [email protected]
Chic Naumer, PhD Student, (206) 543-6238, [email protected]
Carol Landry, PhD Student, (206) 543-6238, [email protected]
Samantha Becker, MLIS Student, (206) 543-6238, [email protected]
Jack Baur, MLIS Student, (206) 543-6238, [email protected]
Ellie Bair, MLIS Student, (206) 543-6238, [email protected]
Sherry Edwards, MLIS Student, (206) 543-6238, [email protected]
Elizabeth Mitchell, MLIS Student, (206) 543-6238, [email protected]
*Please note that we cannot guarantee the confidentiality of information sent via e-mail
Researchers’ Statement
We are asking your permission for your child to be in a research study. The purpose of this consent form is to give you the information you will need to help you decide whether to allow them to be in the study or not. Please read the form carefully. You may ask questions about the purpose of the research, what we would ask your child to do, the possible risks and benefits, your child’s rights as a volunteer, and anything else about the research or this form that is not clear. When we have answered all your questions, you can decide if you want to allow your child to be in the study or not. This process is called ‘informed consent.’ We will give you a copy of this form for your records.
PURPOSE OF THE STUDY
We want to know more about how people use the computers and the Internet in public libraries. In a focus group with 3-4 other people between the ages of 14 and older, we would like to talk with your child about his or her experiences with using the Library’s freely accessible computers to obtain information.
PROCEDURES
If you choose to have your child participate, we would like your child to be part of a focus group at the Public Library. The focus group will take place during the time that your child regularly attends the Library. Snacks and non-alcoholic beverages may be provided to each participant.
The focus group will last about 20-30 minutes and will focus on the different library services that he or she has tried. For example, I will ask you your child “What types of services have you tried using library computers?” “What skills you have you learned?” “How has the computers and the Internet you? and, “How do you think the computers and the Internet at the library could be made better? You do not have to answer every question.
During the focus group, your adolescent may refuse to answer any question. Each focus group session will be audio recorded and transcribed. The audio recording of his or her voice will be destroyed within 6 weeks of being recorded. Only members of the research team listed above will have access to this potentially sensitive information.
RISKS, STRESS, OR DISCOMFORT
Some people do not want to take part in research.
ALTERNATIVES TO TAKING PART IN THIS STUDY
Taking part in this study is voluntary. If you decline, I will not interview your child for this study.
BENEFITS OF THE STUDY
Although we think this research is valuable to society as a whole, your child may not benefit directly from participation in this study.
OTHER INFORMATION
Being in this study is voluntary. Your child can stop at any time. Allowing your child to be in the study, or not allowing your child to be in the study, will not affect your child’s involvement in any activities at the Library. Information about your child is confidential. We will assign pseudonyms to individuals. A pseudonym is a fictitious name to conceal your child’s identity. We will keep the link between pseudonyms and names in a separate, secured location until May 2009. Then we will destroy the list of names. If we publish the results of this study, we will not use your name, the name of your child, the names of people your child tells us about or any other identifying information. Your child will receive $20 after the focus group.
Government or university staffs sometimes review studies such as this one to make sure they are being done safely and legally. If a review of this study takes place, your records may be examined. The reviewers will protect your privacy. The study records will not be used to put you at legal risk of harm.
Although the research team will take precautions to safeguard your child’s privacy, we cannot guarantee that all of the focus group participants will not repeat information presented during the focus group. However, we will do our best to protect your child’s privacy throughout their involvement in our research project.
If you have any questions about this research study, please contact Karen Fisher at the telephone number or e-mail listed above. If you have any questions about your child’s rights as a research subject, please contact the University of Washington Human Subjects Division: 206-543-0098.
Printed Name of Researcher Signature of Researcher Date
Participant’s statement
This research study has been explained to me. I allow my child to take part in this research. I have had a chance to ask questions. If I have questions later about the research, I can ask one of the researchers listed above. If I have questions about my child’s rights as a research subject, I can call the Human Subjects Division at (206) 543-0098. I will receive a copy of this consent form.
____ I give my permission for the researcher to audio record and interview my child in a focus group.
____ I do NOT give my permission for the researcher to audio record and interview my child in focus group.
Printed Name of Participant’s Parent/Guardian Signature of Participant’s Parent/Guardian Date
___________________________
Minor parental focus group consent form - modified August 5, 2008
File Type | application/msword |
File Title | SAMPLE FORMAT |
Author | H. McGough |
Last Modified By | llanga |
File Modified | 2008-09-04 |
File Created | 2008-09-04 |