Attachment 6_Verbal Informed Consent for Interviews

Attachment 6_Verbal Informed Consent for Interviews.doc

An Assessment of the Sustainability and Impact of Community Coalitions Once Federal Funding Has Expired

Attachment 6_Verbal Informed Consent for Interviews

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Attachment X: Informed Consent for Telephone Interviews


The Assistant Secretary for Planning and Evaluation is conducting an assessment of the community coalitions formerly funded by the Community Access Program (CAP)/ Healthy Communities Access Program (HCAP) to learn about their sustainability and impact post-federal funding. This project provides the opportunity to gather information about the experience of coalitions that have been built around grant funding once that funding no longer exists.


We are asking you to contribute to this study by participating in a telephone interview. Completing the interview will take no longer than 60 minutes. There are no foreseeable risks to your participation. Your participation in this study is completely voluntary. You do not have to answer all of the questions, and are welcome to stop at any time. Whether or not you choose to participate the interview will not affect you in any way.


NORC would like to audio record the interview in order to help us to take comprehensive notes of this discussion. We will not share the audio tape with any other party, and all tapes will be destroyed after we have reviewed them. All data collected during the interview will remain completely confidential.  We are not collecting your name or any other potentially identifying information. Findings from the interview may be used in a final report to ASPE.


If you have questions about your rights as a participant in this research project, please call the NORC Institutional Review Board Administrator, Kathleen Parks, at (866) 309-0542.


Do you have any questions?


Do you agree to participate in the interview?


Do you agree to be recorded?



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File Typeapplication/msword
File TitleIntroductory Script for Users and Informed Consent
AuthorSinger-Rachel
Last Modified Byinfante-alycia
File Modified2010-04-01
File Created2010-04-01

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