PD Interview_Consent and Script

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Evaluation of Programs to Provide Services to Persons Who Are Homeless with Mental and /or Substance Use Disorders

PD Interview_Consent and Script

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Attachment 5: Project Director Telephone Interview Scripts & Verbal Consent


Consent to Participate in an Evaluation Study


Substance Abuse and Mental Health Services Administration (SAMHSA)

National Evaluation of SAMHSA’s Homeless Programs


Project Director Telephone Interview:

Scripts and Verbal Consent

Script for Informed Consent Verbal Agreement

To interviewers/document reviewers:

The following questions will be used to develop a profile of each SAMHSA Homeless Program grantee. The process for completing the questions will include a combination of evaluation staff data extraction, grantee staff review, and telephone interviews to verify and complete any missing information. SAMHSA Homeless Program RTI team evaluation staff will extract data and information from documents, including grant applications, progress reports, and technical assistance (TA) site visit reports. This information will be imported from the document extraction to the Project Director Telephone Interview form. SAMHSA Homeless Program grantee project directors will be sent an email requesting their participation, copying their government project officer (GPO) per direction of SAMHSA. If the project director agrees, and once an interview is scheduled, they will be asked to review the preliminary information extracted from grantee documents and entered on the follow-up form by the RTI team evaluation staff. A telephone interview as follow-up to the document extraction will be scheduled between each grantee project director and an RTI evaluation team member to review, verify, and update information on the form. Please read the consent and if verbal agreement is attained for the interview, proceed with the interview per your training.

Email to Project Directors

Dear (Project Director),


I am writing to request your assistance in an upcoming national evaluation effort to describe the implementation, effectiveness and sustainability of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT) Homeless Programs throughout the country. SAMHSA’s Homeless Programs include CSAT Grants for the Benefit of Homeless Individuals (GBHI) General, Services in Supportive Housing (SSH) and Cooperative Agreements to Benefit Homeless Individuals (CABHI) grants, CMHS SSH grants and CMHS Projects for Assistance in Transition from Homelessness (PATH) grants. The goals of this evaluation are to 1) identify challenges and successes in implementing and sustaining a program for homeless individuals who have substance abuse and mental health problems, 2) understand which service models are delivered with what outcomes, for which populations, and with what resulting comparative effectiveness and cost-effectiveness, and 3) to provide recommendations to SAMHSA useful for monitoring performance and implementation of its Homeless Programs and to add to the evidence base on effective programs for homeless populations.


A member of the RTI evaluation team will be calling you in the next two weeks to request your participation in a 3.5 hour telephone interview; if you prefer we can schedule the interview over two telephone calls, each lasting about 1.5 hours at times that are convenient for you during your work week.  We will send you the interview questions ahead of time in which we have pre-filled some of the answers based on our review of your grant application and other materials you submitted to SAMHSA. We will update that information during our call. However, where possible, we wanted to reduce the burden of this interview by pre-filling in responses. We are very interested in learning about your experiences and professional opinions about various aspects of your [Insert Project Name] project. 


I thank you in advance for your thoughtful consideration of this request and opportunity to share information about your [Insert Project Name] project.


[Signature/Name]


National Evaluation of SAMHSA’s Homeless Programs

RTI International

121 West 27th Street, Suite 1001

New York, NY 10001



Script-Verbal Consent via Telephone:

Introduction

Hello, my name is ______________ and I work for RTI International. RTI International (RTI) is an independent non-profit research company in Research Triangle Park, North Carolina. RTI is studying the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT) Homeless Programs, which include CSAT Grants for the Benefit of Homeless Individuals (GBHI) General, Services in Supportive Housing (SSH) and Cooperative Agreements to Benefit Homeless Individuals (CABHI) grants, CMHS SSH grants and CMHS Projects for Assistance in Transition from Homelessness (PATH) grants. The questions in this survey are asked as part of a national evaluation of SAMHSA’s Homeless Programs that RTI is conducting for the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) CMHS and CSAT. I would like to talk to you about participating in the evaluation study.


About the Study

This interview is part of the data collection for a national evaluation effort to describe the implementation, effectiveness and sustainability of SAMHSA’s Homeless Programs throughout the country. The evaluation will examine the effects of SAMHSA Homeless Program project activities on client outcomes, treatment services, treatment systems and cost-effectiveness and identify challenges and successes in implementing and sustaining a project for homeless or housed individuals who have substance abuse and mental health problems.


This telephone interview is a follow-up to our review of [your grant application, final report, Technical Assistance site visit report, etc.]. We are contacting project directors to get their perspectives on their local SAMHSA Homeless Program project and services to help SAMHSA improve their GBHI, GBHI-CABHI, SSH and PATH Homeless Programs and the supports they offer to clients and grantees. You are one of 158 Project Directors who may participate in this study. The following questions ask about your project, [Program Name], which was implemented in [county/city] by [agency name] in [Year], funded by SAMHSA [CSAT’s GBHI/CSAT’s GBHI-CABHI/CMHS’ SSH/CMHS’ PATH] program. These questions are about background information about your agency, the services provided by your agency and your Homeless Programs project, your partners and project stakeholders, the target population of clients/consumers of focus for your project, your experience implementing, evaluating, and sustaining your project, and lessons learned; these questions were approved by DHHS SAMHSA CMHS and CSAT.

Voluntary Participation and Privacy

Your participation in this interview is completely voluntary. You can refuse any part of the study and you can stop participating at any time. You can refuse to answer any question.


All the information you provide in this interview will be kept private and will not be shared with anyone from your agency or directly with SAMHSA. We will not divulge your individual responses to your employer or anyone else outside of the research team. The interviewer will be entering your responses directly into a computer that will be password protected and encrypted with Point Sec to prevent any unauthorized access. You will be assigned a participant ID number and your name will not appear on this form; the information linking your name and agency ID will be kept separately from this consent and your responses in a password protected and Point Sec-encrypted folder only accessible to the Project Director and Project Manager.


Risks and Benefits of the Study

There is little risk of participation in this telephone follow-up interview to our review of your agency’s submitted documents and reports to SAMHSA. In addition to the privacy protections described above, we will reduce the risk of inadvertent disclosure by associating your responses with a unique identifier and not your name.


There are no immediate benefits of participation. No incentive for participation is provided. Information from Project Directors and other key staff like yourself will be aggregated and the results will help stakeholders, practitioners, policy makers, researchers and funders learn more about the efforts of local SAMHSA CMHS and CSAT Homeless Program Initiatives, factors contributing to their success and help inform SAMHSA and future programs about what works.


Duration


This interview will take about three and a half hours of your time including the time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information that has been pre-filled by the research team.


Questions

You are welcome to contact our office any time if you have questions about the survey. Please call Dr. Nahama Broner, the SAMHSA Homeless Programs Cross-Program Evaluation Project Director, toll free at 1-877-353-3422 and leave a message. You can also email Dr. Broner at [email protected] or write to her at RTI International, 121 West 27th Street, Suite 1001, New York, NY, 10001.


If you have any questions about your rights as a research study participant, you may call the RTI International Office of Research Protection toll-free at 1-866-214-2043; or you can write to them at RTI International Office of Research Protection, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, North Carolina, 27709-2194.



Participant Agreement

By verbally agreeing to participate in this evaluation, you are not giving up any of your legal rights. Verbally agreeing to participate indicates that you have been read the information provided above, have received answers to your questions, and have freely decided to participate. Do you give your verbal consent to participate in this evaluation?

Date Yes—Participant Agrees



No—Participant Does Not Agree



I certify that the nature and purpose, potential benefits, and possible risks associated with participating in this evaluation have been explained to the above-named individual.


Date Signature of Person Obtaining Consent


Printed Name of Person Obtaining Consent

_________Participant ID

_________Agency ID


Consent to Participate in an Evaluation Study


Substance Abuse and Mental Health Services Administration (SAMHSA)

National Evaluation of SAMHSA’s Homeless Programs


Project Director Telephone Interview


About the Study

This interview is part of the data collection for a national evaluation effort to describe the implementation, effectiveness and sustainability of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT) Homeless Programs throughout the country. The evaluation covers SAMHSA’s Homeless Programs: CSAT Grants for the Benefit of Homeless Individuals (GBHI) General, Services in Supportive Housing (SSH) and Cooperative Agreements to Benefit Homeless Individuals (CABHI) grants, CMHS SSH grants and CMHS Projects for Assistance in Transition from Homelessness (PATH) grants. Specifically, the evaluation aims to identify the effect of program activities on client outcomes, treatment services, treatment systems and cost-effectiveness and identify challenges and successes in implementing and sustaining a program for homeless or housed individuals who have substance abuse and mental health problems. RTI International is conducting the cross-program evaluation for SAMHSA CMHS and CSAT; these questions were approved by the Department of Health and Human Services SAMHSA CMHS and CSAT.


This telephone interview is a follow-up to our review of [your grant application, final report, TA site visit report]. We are contacting project directors to get their perspectives on their local [grant name] project and services to help SAMHSA improve the Homeless Programs and the supports it offers to clients and grantees. You are one of 158 Project Directors who may participate in this study. The following questions ask about your project, [Project Name], which was implemented in [county/city] by [agency name] in [Year] and funded by SAMHSA [CSAT’s GBHI/CSAT’s GBHI-CABHI/CMHS’ SSH/CMHS’ PATH] program. These questions are about background information about your agency, the services provided by your agency and your Homeless Programs project, your partners and project stakeholders, the target population of clients/consumers of focus for your project, your experience implementing, evaluating, and sustaining your project, and lessons learned.

Voluntary Participation and Privacy

Your participation in this interview is completely voluntary. You can refuse any part of the study and you can stop participating at any time. You can refuse to answer any question.


All the information you provide in this interview will be kept and will not be shared with anyone from your agency or directly with SAMHSA. We will not divulge your individual responses to your employer or anyone else outside of the research team. The interviewer will be entering your responses directly into a computer that will be password protected and encrypted with Point Sec to prevent any unauthorized access. You will be assigned a participant ID number and your name will not appear on this form; the information linking your name and agency ID will be kept separately from this consent and your responses in a password protected and Point Sec-encrypted folder only accessible to the Project Director and Project Manager.


Risks and Benefits of the Study

There is little risk of participation in this telephone follow-up interview to our review of your agency’s submitted documents and reports to SAMHSA. In addition to the privacy protections described above, we will reduce the risk of inadvertent disclosure by associating your responses with a unique identifier and not your name.


There are no immediate benefits of participation. No incentive for participation is provided. Information from Project Directors and other key staff like yourself will be aggregated and the results will help stakeholders, practitioners, policy makers, researchers and funders learn more about the efforts of local SAMHSA CMHS and CSAT Homeless Program Initiatives, factors contributing to their success and help inform SAMHSA and future programs about what works.


Duration


This interview will take about three and a half hours of your time including the time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information that has been pre-filled by the research team.


Questions

You are welcome to contact our office any time if you have questions about the survey. Please call Dr. Nahama Broner, the SAMHSA Homeless Programs Cross-Program Evaluation Project Director, toll free at 1-877-353-3422 and leave a message. You can also email Dr. Broner at [email protected] or write to her at RTI International, 121 West 27th Street, Suite 1001, New York, NY, 10001.


If you have any questions about your rights as a research study participant, you may call the RTI International Office of Research Protection toll-free at 1-866-214-2043; or you can write to them at RTI International Office of Research Protection, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, North Carolina, 27709-2194.



Participant Agreement

By verbally agreeing to participate in this evaluation, you are not giving up any of your legal rights. Verbally agreeing to participate indicates that you have been read the information provided above, have received answers to your questions, and have freely decided to participate. Do you give your verbal consent to participate in this evaluation?

Date Yes—Participant Agrees




No—Participant Does Not Agree



I certify that the nature and purpose, potential benefits, and possible risks associated with participating in this evaluation have been explained to the above-named individual.


Date Signature of Person Obtaining Consent


Printed Name of Person Obtaining Consent




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleConsent to Participate in an Evaluation Study
Authornbroner
File Modified0000-00-00
File Created2021-01-28

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