Attachment E Focus Group Consent revised-clean

OMB Control #0970-0356, Expiration Date 01/31/2015

Attachment E: Focus Group Consent

COLLEGE OF ARTS AND SCIENCES
Department of Sociology

201 Benton Hall
P.O. Box 880623
Lincoln, NE 68588-0623
(402) 472-5562

SOP Data Collection Project [Focus Group]

FAX: (402) 472-4983
Toll Free: 1-888-567-5285

University of Nebraska-Lincoln
Les Whitbeck, Principal Investigator
201 Benton Hall
Lincoln, NE 68588-0623
Phone: 402-472-5562
Fax: 402-472-4983

E-mail: [email protected]

PARTICIPANT INFORMED CONSENT FORM
This study is sponsored by money from the Family and Youth Services Bureau and is being
conducted by _______________in cooperation with the University of Nebraska-Lincoln.
The goal of this study is to find out how we can best help runaway and homeless young people. We want to
know what kind of experiences homeless young people have had. We will use this information to identify
the services that will best help young people who do not have a regular place to live. If you are between the
ages of 14 and 21 and don’t have a regular place to live right now, we would like to ask you to be part of our
study. Whether you say yes or no will not make any differences in the services you can get from any service
agency.
If you want to participate in this study, we will want you to be part of a focus group. The focus group will
consist of a group of four to six young people & two group organizers. The focus group will last
approximately 1.0 – 1.5 hours. During the focus group, the organizers will ask the group questions. You can
share as much or as little as you want for each question. The focus groups will be tape- recorded so the
conversations can be transcribed, or typed. The recording will be stored on a server at UNL and destroyed
after the study is finished. You will be given a $20 gift card for participating in the focus group.
During the focus group you will be asked questions about where you have been staying, why you left home,
what has happened to you since you haven’t had a regular place to live, and your daily activities. I will ask
you about the types of services and supports you have used while you don’t have a regular place to stay.
Some of the questions may bring back bad memories or make you feel sad, but you don’t have to answer
questions that you don’t want to. You can leave the focus group at any time, but you won’t receive the $20
gift card unless you participate in the focus group for most of the session (for at least 30 minutes). If you
withdraw from this study, any of the information collected up to the point of withdrawal may still be used in
order to protect the integrity of the information collected.

Privacy
Everything you say during the focus group will be kept private by agency staff & UNL. By agreeing to be part
of the study, you and the other young people in the focus group agree to not discuss with anyone else things
said during the focus group after the focus group ends. We cannot guarantee that someone attending the focus
group will not share your answers, so only share what you are comfortable telling others. The people who will
see the transcription of the focus group will not know your name. Any forms you sign, like this consent form,
will be kept in a locked file away from the focus group transcriptions. Although the information you provide
will be private, there are three things that the interviewer is required to tell someone else about, including your
caretaker and/or public agencies.
1. Any case of suspected physical or sexual abuse and/or neglect of children must be reported to
Child Protective Services. This may be yourself or a sibling or someone you know that you tell us
about.
2. If you tell me you are going to hurt yourself badly, or I think you might try to kill yourself, I will
get help for you. If the researchers have very serious concerns, they will need to report the
situation to the appropriate authorities.
3. If you say that you are aware of serious harm that may be done to someone else, the interviewer is
required to take steps to protect that person, which includes reporting the situation to the
appropriate authorities.

Risks and Benefits
Some questions may make you feel upset during or after a focus group. If that happens, please let one of the
organizers know and he or shee will contact a staff person at the agency to help you. The benefits from participating
in this study are: 1) You will be providing important information that will help agencies develop and sustain
programming specific to homeless youths’ needs, 2) You will be able to share your life experiences, 3) You will
be able to provide information about the needs of homeless youth in your area, 4) Interviewers will provide you
with an information card for services available in the area.

Contact Information
This study is completely voluntary. You decide whether or not you would like to be involved. You may ask
any questions concerning this research and have those questions answered before agreeing to participate or
anytime. If you have any additional questions of concerns, you may call the principal investigator, Les
Whitbeck, at (888) 567-5285. If you have questions about your participation in this study that have not been
answered by this individual, or to report any concerns, you may contact the UNL Institutional Review Board,
at (402) 472-6965.
Focus Group Informed ConsentSOP Homeless Youth Project
Your signature on this form indicates the following:
I agree to participate in the SOP Homeless Youth Project.
I agree to have my discussions in the focus group audio recorded for this study.
I understand that I will receive a $20 gift card for completing the focus group.
I agree to respect the privacy of the other focus group participants, and not discuss their answers
after the focus group ends.
I understand that all information I provide will remain private and the audio recordings will be
destroyed after the study has ended.
I understand that participation is voluntary and I may leave the focus group at any time.
I understand that if I stop the interview, the services I may be receiving will not be affected.
I know that if I have any questions about this study I can talk with someone at the agency where the
focus group was conducted and they will answer my questions.
I agree to the study’s purpose and my involvement.
I do not give up any of my legal rights by signing this form.
If you are not sure you understand everything we just read, I will be happy to answer any questions you have
now, or I can give you some time to talk to agency staff before you decide. Please feel free to ask me any
questions about the study before you sign the consent. You will be given a copy of this consent form to keep.

Participant’s Printed Name

Date

Participant’s Signature
I was present when this was read and I think that he/she understood everything and has agreed to participate
in the study.

Staff Signature

Date