Consent to Participate
The Learning Office within CDC’s Office of Public Health Preparedness and Response has personally invited you to participate in "Ready CDC," an educational intervention aimed at improving the personal preparedness of the CDC workforce. Thank you for taking the time to learn about this research study and determine whether you would like to participate.
What is the purpose of this
study?
The
purpose of this study is to assess whether our designed intervention
changes any (and/or your family’s) behaviors associated with
preparedness for a disaster or emergency.
How long will you need
me?
The
intervention includes one, in-person, 60-minute workshop on November
18 from 11:00 AM - 12:00 PM at CDC's Roybal Campus in Atlanta.
Subject matter experts in preparedness will be available for 30
minutes afterward for optional questions and discussion. Before and
after the workshop, you will be asked to complete a pre and follow-up
surveys that will take no longer than 20 minutes each (20 minutes for
the pre-workshop survey and 10 minutes for the follow-up survey).
What do you want me to do
if I decide to be in this study?
If
you decide to be in this study, you will be asked to participate in
one, in-person training workshop related to personal preparedness.
This workshop will include learning about personal preparedness from
local, subject matter experts, starting or refining a family disaster
plan, and discussion with local experts and classmates. You will also
be asked to complete a brief evaluation after the workshop.
Are there any risks to me
if I decide to be in this study?
Risks
from participating in this research study are unlikely. All questions
in the assessments include an option to not disclose information, if
you so choose. However, if you have experienced an
emergency/disaster, there may be some distress that could occur if
the content discussed in the training workshops triggers negative
emotions.
Are there any benefits from
being in this study?
There
are many benefits from participating in this study. You and your
family may be better prepared to handle an emergency or disaster
situation because you have accurate, localized information. If you
and your family are better prepared, CDC may benefit from you being
more willing to help on behalf of your Agency during an event. Your
community may also benefit from you and your family being better
prepared in that you are likely to need less help from responders and
can potentially assist neighbors or friends.
Will the information I give
you be kept private?
Yes,
the information we collect over the course of the study will be kept
private and confidential. All results will be reported in the
aggregate; no individual results will be accessible to anyone other
than the primary investigators on this project. You will be assigned
an identification number so that results of your assessment will not
be linked to your name.
Who should I contact if I
have questions about this study?
If
you have questions about this study, contact Victoria Harp at
[email protected] or 404.639.4929. She is the study coordinator for this
project.
Who should I call if I have
a question about my rights as a research volunteer?
If
you have any questions about your rights as a participant in this
study, please contact CDC/ATSDR’s Acting Deputy Associate
Director for Science at 1-800-584-8814. Leave a message with your
name, phone number, and refer to CDC protocol #6472, and someone will
call you back.
Do I have to be in this
study?
Participation
is completely voluntary.
By signing and dating this form, you agree to be in the study.
Signature Print your name Date (MM/DD/YYYY)
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | CDC User |
File Modified | 0000-00-00 |
File Created | 2021-01-27 |