0990-PBHCI Attach 11 Consent Protocol Site Visit Interviews

0990-PBHCI Attach 11 Consent Protocol Site Visit Interviews.doc

Evaluation of SAMHSA Primary Care Behavioral Health Integration Grant Program

0990-PBHCI Attach 11 Consent Protocol Site Visit Interviews

OMB: 0990-0371

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ATTACHMENT 11


Informed Consent Protocol

Evaluating the Primary Care Behavioral Health Integration Program

Site Visit Interviews with PBHCI Grantees


RAND is a non-profit research organization based in Santa Monica, California, and we also have an office in Pittsburgh. Researchers in our Santa Monica and Pittsburgh office are performing an evaluation to learn more about whether locating primary care services in community mental health centers improves the physical and emotional health of the people you serve.

RAND’s work is being funded by the Assistant Secretary of Planning and Evaluation (ASPE) and the Substance Abuse and Mental Health Services Administration (SAMHSA) of Health and Human Services. We are interested in learning how a select number of programs have implemented the primary care-behavioral health integration program, both globally and with respect to specific required features of the program, such as screening/referral, registry/tracking, care management and wellness/prevention. We are also interested in learning about barriers and facilitators to implementation of the program. This interview is an important part of our study because it gives us an opportunity to learn from the people directly involved in the delivery of integrated services.


RAND will use the information you provide during this group interview for research purposes only. You do not have to participate in the interview, and if you participate, you should feel free to decline to discuss any topic that we raise. Don't worry about having a different opinion than someone else, and please respect others' opinions.


RAND will keep private the identities of those who participate in the interview and will not attribute any comments to any specific individuals. In the notes from the interview, we will not record individuals’ names associated with comments made. RAND requests that each of you also protect the confidentiality of others in the group. Please do not use the name or other identifying information of anyone as you talk about them, and do not repeat anything that is said here in a way that is attributable to particular people. However, RAND cannot guarantee that everything you say during this discussion will be kept confidential by all the participants, so please do not say anything that you do not want anyone else to know.


And finally, we're tape recording the session because we don't want to miss any of your comments. If anyone is uncomfortable with the idea of being taped, just say so and we won't use it. Again, remember that we will not be able to connect the taped information with your name or anything that identifies you.


Do you have any questions about the study?


Do you agree to participate in our research interview?


We are providing you a copy of this explanatory statement, which includes information about how to contact the principle investigator or a third party at RAND in case you have any questions or concerns about the study or your participation in it.

WHO TO CONTACT ABOUT THIS RESEARCH:


Audrey Burnam

Principal Investigator

RAND

1776 Main Street

PO Box 2138

Santa Monica, CA 90407

Telephone: 310-393-0411

FAX: 310-393-4818

Email: [email protected]



James Tebow, Ph.D.
Human Subjects Protection Committee

RAND
P.O. Box 2138
Santa Monica CA 90407-2138

Telephone: 310-393-0411 x7173
FAX: 310-393-4818
Email: [email protected]

File Typeapplication/msword
File TitleRecruitment and Informed Consent Protocol
AuthorCSD
Last Modified ByIST
File Modified2011-01-20
File Created2011-01-18

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