Att 11_NON-DISCLOSURE AGREEMENT

Att 11_NON-DISCLOSURE AGREEMENT.doc

Pre-Evaluation Assessments of Nutrition, Physical Activity and Obesity Programs and Policies

Att 11_NON-DISCLOSURE AGREEMENT

OMB: 0920-0927

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Non-Disclosure Agreement for Data Collection Contractors/Site Visitors


Pre-Evaluation Assessments of Nutrition, Physical Activity, and Obesity Programs and Policies


Because of concerns about protecting participant privacy and fostering an atmosphere of respect for the participants, it is important for all persons who intend to act as site visitors for the Pre Evaluation Assessments of Nutrition, Physical Activity, and Obesity Programs and Policies project accept the following in respect of participants’ privacy:

  • Site visitors should not discuss the identity of participants or what was said by individual participants with others, with the exception of the other site visitor assessing the same program or policy and the ICF Macro coordinating center.

  • During data collection in the field, site visitors will maintain data collection materials (handwritten notes) in their possession or in secured storage at all times until the data are sent to the ICF Macro coordinating center in your written reports. The notes are to be shared ONLY with the co-site visitor.

  • Site visitors will ensure the computers used to enter and store site visit data are protected with current antivirus software.

  • Site visitors will report immediately to the ICF Macro coordinating center any loss of site visit documents or the corruption of computer files containing site visit data.

  • Participants’ names will only be noted in the site visit report as part of the methods section listing of those who participated in the visit. Site visitors will not include individual identifying information in the topline report, site visit report, or subsequent publications (without the express written permission of the participant for each usage).

  • Site visitors are not to use the collected site visit data for any purpose other than the work associated with this research project.

Your signature below indicates that you understand and accept these conditions.

Site visitor (print name)


site Visitor Signature


Date



WITNESS (print name))


WITNESS SIGNATURE


Date



File Typeapplication/msword
AuthorKari Cruz
Last Modified ByKari Cruz
File Modified2011-10-24
File Created2011-10-24

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