UNIVERSITY OF WASHINGTON CONSENT FORM
Institute of Museum and Library Services & University of Washington Information School
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
We are asking you to be in a research study being conducted by the University of Washington’s Information School and sponsored by the US government’s Institute for Museum and Library Services. The purpose of this consent form is to give you the information you will need to help you decide whether or not to be in the study. Please read the form carefully. You may ask questions about the purpose of the research, what we would ask you to do, the possible risks and benefits, your rights as a volunteer, and anything else about the research or this form that is not clear. When all your questions have been answered, you can decide if you want to be in the study or not. This process is called ‘informed consent.’
PURPOSE OF THE STUDY
We want to better understand how people use free access to computers and the Internet in their public libraries for improving their educational, English literacy, and information technology job skills. We would like to interview local community business staff about their experiences using or working with people who use the library’s public access computing services.
If you choose to be in this study, I would like to interview you about your experiences with using the library computers and the Internet. The interview will last about 30 minutes and will focus on how you use the free access to the library and the Internet. For example, I will ask you “Do you use the library’s free computer services?” “What for?” “Have you referred customers to the library’s free access to the computers and the Internet?” and “How have people benefited from using computer and Internet services at the Library?”
During the interview, you may refuse to answer any question. The interview will be audio recorded and transcribed. The audio recording of your 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 feel that providing information for research is an invasion of privacy. I have addressed concerns for your privacy in the section below.
ALTERNATIVES TO TAKING PART IN THIS STUDY
Taking part in this study is voluntary. If you decline, I will not interview you for this study.
BENEFITS OF STUDY
We hope the results of this study will help us better understand how free access to computers and the Internet at libraries helps people and their communities. You may not directly benefit from taking part in this research study.
Taking part in this study is voluntary. You can stop at any time. Information about you is confidential as provided by except law. I will code the study information. I will keep the link between your name and the code in a separate, secured location until May 2009. Then I will destroy the link. If the results of this study are published or presented, we will not use your name without your permission.
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.
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 rights as a research subject, please contact the University of Washington Human Subjects Division: 206-543-0098.
______________________________________________________________________________
Signature of investigator Printed Name Date
Subject’s statement
This study has been explained to me. I volunteer to take part in this research. I have had a chance to ask questions. If I have questions later on about the research I can ask one of the investigators listed above. If I have questions about my rights as a research subject, I can call the University of Washington Human Subjects Division at (206) 543-0098. I will receive a copy of this consent form.
____ I give permission for the researcher to audio record my interview.
____ I do not give permission for the researcher to audio record my interview
______________________________________________________________________________
Signature of subject Printed name Date
Copies to: Investigator’s file
Subject
Local Community Business Staff Interview Consent January 19, 2009
| File Type | application/msword |
| File Title | SAMPLE FORMAT |
| Author | H. McGough |
| Last Modified By | Samantha Becker |
| File Modified | 2009-01-19 |
| File Created | 2009-01-19 |