OMB Appendix Forms - Final 4/20/09

OMB_Appendix_Forms_final_04.20.09.doc

Feasibility Test for Design Phase of National Study of child Care Supply and Demand

OMB Appendix Forms - Final 4/20/09

OMB: 0970-0363

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APPENDIX


SUPPORTING FORMS:


Advance Letter (Demand Survey)

Advance Letter (Providers)

Informed Consent (In-person Parent Interviews)

Informed Consent (In-person Provider Interviews)

[DESIGN PHASE NSCCSD FEASIBILITY TEST HH DEMAND ADVANCE LETTER]

[NORC LETTERHEAD]


[DATE]


We are writing to ask for your help with an important study about how we care for children in the United States. The study is conducted by the National Opinion Research Center (NORC) at the University of Chicago on behalf of the U.S. Department of Health and Human Services (HHS). This study seeks to understand the experiences and attitudes of parents as they make decisions about child care or after-school programs for children and young teenagers. The study will also gather information about people who care for children and young teenagers. This can include formal home-based child care businesses, or it can mean people who watch relatives’ or friends’ children informally. In the next few weeks, we will call your household asking you to take part in this study for HHS.


The survey will include various questions related to child care, including the type of care used for children under age 13 in your household, the search and selection of child care, and general information about your household. We are looking to speak to parents who have children at home as well as people who regularly provide child care in their homes to children who are not their own.


Your phone number was chosen randomly by computer. It is important for us to interview every household we call to get a complete picture of the demand for and supply of child care in your area. The study is important, but you do not have to take part, or you can decide not to answer one or more questions.


You may call this toll free number at 1-877-322-4721 if you would like to take part in the study now. You can also call this number to learn more about the study and what you will be asked.


Your participation in this child care study will provide information to help the government to understand how private decisions and public policies affect the supply and demand of child and school-age care in our country. We need your help to make this study a success. We hope you will decide to take part when we call.


[SIGNED BY RUPA DATTA, DESIGN PHASE PROJECT DIRECTOR]



NORC Toll Free Number: 1-877-322-4721


You can call the NORC toll free number to take part in the study right away, learn more about the study, and hear what you will be asked.


Who sees my answers?


You will be called by a trained interviewer who enters your answers into a computer. Everyone who works on the survey must sign an oath that promises they will never give out anyone's personal information. Only a few people who work on this survey ever see any personal information. Answers that could identify you or your family in any way are separated from your other answers. Survey findings are put into summary reports that contain no names or other information that identifies you.


How do you protect my information?


Your answers are used for research purposes only. All information that you provide will be kept private to the fullest extent provided by the law.


If you have questions about your rights as a study participant, you may call Kathleen Parks, the NORC IRB Administrator, toll free, at 1-866-309-0542.



[PROVIDER ADVANCE LETTER]

[NORC LETTERHEAD]


[DATE]


Dear [DIRECTOR OF PROGRAM]:



We are writing to ask for your help with an important study about the need for and availability of child care in the United States. The study is conducted by the National Opinion Research Center (NORC) at the University of Chicago on behalf of the U.S. Department of Health and Human Services (HHS). This study seeks to create a profile of child care available to children under age 13, including before- and after-school care. In the next few weeks, we will contact your program to ask you to take part in this study for HHS.


The survey will include various questions related to early and school-age care, including the type of care your program provides for children under age 13, how you seek new children to serve, and general information about the structure of your services. [IF APPROPRIATE: We are enclosing a small gift to thank you in advance for your cooperation with our study, and to acknowledge any inconvenience you may experience while participating.]


You have been selected for participation in this study from a list of providers in your area based on geographic and program criteria. It is important for us to interview every selected provider to get a complete picture of the supply of and demand for early and school-age care in your area. The study is important, but you do not have to take part, or you can decide not to answer one or more questions.


You may call this toll free number at 1-877-322-4721 if you would like to take part in the study now. You can also call this number to learn more about the study and what you will be asked.


Your answers to this child care study will provide information to help the government understand how private decisions and public policies affect the supply and demand of child and school-age care in our country. We need your help to make this study a success. We hope you will decide to take part when we call.




[SIGNED BY RUPA DATTA, PROJECT DIRECTOR NSCCSD FEASIBILITY TEST]





NORC Toll Free Number: 1-877-322-4721


You can call the NORC toll free number to take part in the study right away, learn more about the study, and hear what you will be asked.


Who sees my answers?


You will be called by a trained interviewer who enters your answers into a survey. Everyone who works on the survey must sign an oath that promises they will never give out identifying information about a respondent. Only a few people who work on this survey ever see any personal information. Answers that could identify you or your program in any way are separated from your other answers. Survey findings are put into summary reports that contain no names or other information that identifies you.


How do you protect my information?


Your answers are used for research purposes only. All information that you provide will be kept private to the fullest extent provided by the law.


If you have questions about your rights as a study participant, you may call Kathleen Parks, the NORC IRB Administrator, toll free, at 866-309-0542.

Informed Consent for NSCCSD Design Phase In-Person Parent Interviews


Purpose of the Study

The National Opinion Research Center (NORC) at the University of Chicago is conducting a study about the experiences and preferences of parents of children under age 13 with regard to the child care or after-school programs that are available for these children. The study is being paid for by the U.S. Department of Health and Human Services. It is designed to help the government understand how private decisions and public policies affect the supply and demand of child and school-age care in our country. We would like to talk with you for approximately 30 minutes about your children under 13 and the child care that you use or would like to use for them.


This interview will include various questions related to child care, including the type of care used for children under age 13 in your household, the search and selection of child care, and general information about your household members. You may find that some of the questions we are asking make you feel uncomfortable and you may choose not to answer any question for any reason. You do not have to reveal any specific information about your own experiences unless you choose to do so. You may stop participating at any time, and there are no consequences for you if you choose to stop.


Appreciation for your time

We know that your time is very valuable. We would like to offer you $20 as a token of appreciate for your participation in this study.

Taking part is up to you.  You don’t have to answer any question you don’t want to, and you can end the interview at any time.  The interview takes a short time and any information you give me will be kept private.  There are no risks or benefits to being in this survey.  If you have any questions about this survey, I will provide a telephone number for you to call to get more information.


Risks and Benefits

While there is no direct benefit to you for participating in this survey, your responses will help policy makers better understand the availability of child care and factors influencing parents’ choice of care for their children. These policies will help the government make good decisions about helping families get quality child care for their children, including through Head Start, child care subsidies, pre-kindergarten, and tax credits for working families.


There are no known physical or psychological risks from taking part in this study. While the survey does ask about current and previous child care decisions and arrangements and collect household financial information, we will take all possible steps to protect your privacy.


Privacy of your data

You will not be identified in any reports that come from this study. Any information with identifying information will be kept in a secure location during the period of the study. This information will be used solely for the purposes of this study and will be destroyed when the study is over.


Additional Information

If you have any questions about the purpose of this study, what the data will be used for or your participation, please contact project staff at 877-322-4721.


If you have questions about your rights as a study participant, you may call Kathleen Parks, the NORC IRB Administrator, toll free, at 866-309-0542.


Recordings

We would like to audio record the interview discussion so there is an accurate record of comments made. The recording allows us to more carefully capture your response. If you agree, you may ask to stop the recording at any time, and we will turn off the machine. We will keep the recording in a locked room or in the safe keeping of a staff person. At a later time, staff from NORC who are on this project may listen to the interview. However, they will not know who you are.


Signed Consent

If you agree to participate, please sign and date the statement which follows, indicating your informed consent.


  • I have read and understood the information presented in this document, and have been given the opportunity to ask any questions. I choose to participate in the study, and understand my right to withdraw as a participant at any time.”

  • I allow NORC to audio record my interview. I also allow NORC to play my audio recording to other people working on this project.


Print name of participant:___________________________________

Date______________


Signature of participant:___________________________________

Date______________


Signature of individual obtaining consent_______________________

Date___________


Informed Consent for NSCCSD In-Person Provider Interviews


Purpose of the Study

The National Opinion Research Center (NORC) at the University of Chicago is conducting a study about the experiences and preferences of program providers of children under age 13 with regard to the child care or after-school programs that are available for these children. The study is being paid for by the U.S. Department of Health and Human Services, and is designed to help the government understand how private decisions and public policies affect the supply and demand of child and school-age care in our country. We would like to talk with you for approximately 30 minutes about the programs you provide for children under 13.


The survey will include various questions related to child care, including the type of care you provide for children under age 13, the search and selection of child care by parents, and general information about the structure of your services. You may find that some of the questions we are asking make you feel uncomfortable and you may choose not to answer any question for any reason. You do not have to reveal any specific information about your own experiences unless you choose to do so. You may stop participating at any time, and there are no consequences for you if you choose to stop.


Appreciation for your time

We know that your time is very valuable. We would like to offer you $20 as a token of appreciate for your participation in this study.

Taking part is up to you.  You don’t have to answer any question you don’t want to, and you can end the interview at any time.  The interview takes a short time and any information you give me will be kept private.  There are no risks or benefits to being in this survey.  If you have any questions about this survey, I will provide a telephone number for you to call to get more information.


Risks and Benefits

While there is no direct benefit to you for participating in this survey, your responses will help policy makers better understand the availability of child care and factors influencing parents’ choice of care for their children. These policies will help the government make good decisions about helping families get quality child care for their children, including through Head Start, child care subsidies, pre-kindergarten, and tax credits for working families.


There are no known physical or psychological risks from taking part in this study. While the survey does ask about current and previous child care decisions and arrangements and collect household financial information, we will take all possible steps to protect your privacy.


Privacy of your data

You will not be identified in any reports that come from this study. Any information with identifying information will be kept in a secure location during the period of the study. This information will be used solely for the purposes of this study and will be destroyed when the study is over.


Additional Information

If you have any questions about the purpose of this study, what the data will be used for or your participation, please contact project staff at 877-322-4721.


If you have questions about your rights as a study participant, you may call Kathleen Parks, the NORC IRB Administrator, toll free, at 866-309-0542.


Recordings

We would like to audio record the interview discussion so there is an accurate record of comments made. The recording allows us to more carefully capture your response. If you agree, you may ask to stop the recording at any time, and we will turn off the machine. We will keep the recording in a locked room or in the safe keeping of a staff person. At a later time, staff from NORC who are on this project may listen to the interview. However, they will not know who you are.


Signed Consent

If you agree to participate, please sign and date the statement which follows, indicating your informed consent.


  • I have read and understood the information presented in this document, and have been given the opportunity to ask any questions. I choose to participate in the study, and understand my right to withdraw as a participant at any time.”

  • I allow NORC to audio record my interview. I also allow NORC to play my audio recording to other people working on this project.


Print name of participant:___________________________________

Date______________


Signature of participant:___________________________________

Date______________


Signature of individual obtaining consent_______________________

Date___________




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File TitleAPPENDIX
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File Modified2009-04-20
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