informed consent

Informed Consent

Purpose of Research: Thank you for volunteering to participate in this study. This study provides an opportunity to examine the many factors that can lead to motorcycle-related crashes and affect the severity of the injury outcome. This research is funded by the US Department of Transportation, National Highway Traffic Safety Adminsitration (NHTSA)/Federal Highway Administation, and the motorcycle industry.

Research Procedures: Trained researchers will collect data on police-reported, motorcycle-involved crashes. Information will be collected for each rider, passenger and driver of involved vehicles, along with vehicle and environmental characteristics. Data include interviews, examinations of vehicle condition, and measurement and diagrams of environmental characteristics and photographing vehicle and scene information. Researchers will also ask for information regarding specific injuries sustained by crash victims. We are including your crash as part of the study so that the survey will cover all crash types and severities.

We would like to ask you a series of questions about the crash circumstances, your current health status, and your riding/driving experience. All information will be kept strictly confidential, and you can refuse to answer any question. The entire interview will last approximately 30 minutes. We also may need your permission to examine and cdocument the damage to your vehicle. You will also be provided with a consent form that we can submit to the hospital in order to oibtain specific information about your injuries (if applicable).

Foreseeable Risk: All data will be collected from a safe location and at your convenience. No personal identifiers are included in our forms, and all information is used strictly for statistical purposes by the federal government.

Benefits of the Research: The number and severity of motorcycle crashes has risen greatly in recent years. There has been no comprehensive study of motorcycle crash causation for more than 30 years. Our objective is just to gain some insight into the causes of such crashes, and what can be done to prevent them or reduce their severity. The federal government may eventually use this information when making rules, or developing strategies and design changes to improve motorcyclist safety.

Confidentiality: We will be asking you for some basic descriptive information about yourself. This includes your age and certain questions about physical status and health. We will also ask about your riding/driving experience and the circumstances leading to this crash This information is confidential, and no published reports of the research will identify any participants. Likewise, all information collected during the study is confidential and will not be presented in any form that identifies individuals. All data will be treated with anonymity; your crash will be assigned a number and all identifying information will be separated from the data you provide.

Voluntary Withdrawal from the Survey: Your cooperation in this study is entirely voluntary. Refusal to participate will involve no penalty. You may discontinue participation at any time.

Contact Person: If you have any questions about the research or the rights of research participants contact Ms. Frances D. Bents (240) 314-7557, at Westat, 1650 Research Blvd., Rockville Maryland 20850.

Authorization: By signing this form you certify that you understand that your participation in this study is voluntary and that you consent to be interviewed and allow access to your vehicle for inspection.

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I have read (or heard) the above information and recognize the risks of this study. I agree to be a participant in the research. I understand that participation is voluntary and I may withdraw from the study at any time.

Participant: _______________________ Date:___________

Investigator:_________________________Date:___________

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