Informed Consent Applicant

Form Approved

OMB Control No. 1290-XXXX

Expiration Date X/XX/2020

CONSENT FORM FOR PARTICIPATION IN THE

CASCADES JOB CORPS COLLEGE AND CAREER ACADEMY RESEARCH STUDY

You are invited to take part in a study about the Cascades Job Corps College and Career Academy. The study is being run by a company called Abt Associates and its partners, MDRC and Abt SRBI. The study is paid for by the U.S. Department of Labor. The study is about how well the Cascades Academy helps people complete their education and find jobs. This form gives information about the study and your role in the study. At the end of the form, you can tell us whether or not you will give us your permission to be in the study.

As part of the study, everyone applying to the Cascades Academy will be assigned to one of two groups. (1) A group that is allowed to join the Cascades Academy, or (2) a group that cannot join the Cascades Academy. If you are assigned to the group that cannot join the Cascades Academy you may still enroll in another Job Corps center. We will use a computerized lottery to assign people to the two groups in a fair way. Because space in Cascades Academy is limited, using a lottery makes sure everyone is treated fairly. The decision about who is assigned to which group is random. It has nothing to do with anything about you like your age or race.

Your participation in the study is completely up to you. If you decide not to be a part of the study, you may still apply to another Job Corps center. However, you will not be able to join in the Cascades Academy. You may quit the study at any time without penalty. If you are in the group that can join the Cascades Academy and you quit the study, you may still participate in the Cascades Academy. If you are in the group that cannot join the Cascades Academy and you quit the study, you will still not be able to join the Cascades Academy for five years.

What does it mean to be in the study?

To have a chance to join the Cascades Academy, we will ask you to do several things. You will first have to provide some information about yourself. You will also have to be part of the lottery that determines who will join the Cascades Academy and who will not. Everyone who enters the lottery will be in the study. If you choose not to be in the study, you cannot join the Cascades Academy. You can still enroll in other Job Corps centers or services available elsewhere.

If you agree to be in the study, the researchers will collect information about you. This information will help them to understand how well the program is working. This information will be collected whether or not you are placed in the group that can join the Cascades Academy.

1. You will be asked to complete a survey before you are entered into the lottery. You will be asked to provide your contact information, including your name, date of birth, and Social Security Number. You will be asked to provide your social media contact information. You will also be asked about your and your family’s education and work histories. You will be asked about your criminal history. You will be asked other personal questions including thoughts about your views and goals. The answers you provide on this survey will not affect which group the computer selects you into.

2. The researchers will contact you over the next two to five years to complete a few contact updates (for example, in case you have a new phone number) and one or more follow-up surveys. You can select to be contacted by mail, text, phone, or email. You may be contacted to complete a contact update every 3 months. You may complete the contact update by phone, mail, or over the internet. About a year and a half after the lottery, you may be asked to complete a survey by phone or in person. This survey will last about 30-45 minutes. You may be asked to complete another survey even later (up to five years from now). These surveys will be on the education and training and credentials you may have received, your employment, your opinions about yourself, and other topics. You may receive a small cash payment for your time spent completing the contact updates and each survey. You can refuse to participate in the contact updates and/or surveys. You can also refuse to answer any question you do not want to answer.

3. The researchers will collect information about you from government sources. To do this, researchers will use your name, date of birth, and/or Social Security Number. Information collected will include your education, employment and earnings history. This information will come from sources such as the National Student Clearinghouse and the National Directory of New Hires.

4. The researchers will view the information Job Corps collects about you. This will include what you provide in your Job Corps application, your test scores, the results of your drug test, and other information. If you are assigned to the group that can join the Cascades Academy, this will also include information about your time in the Cascades Academy. Information such as your time in the program, the courses you took, your grades and certificates you received will be collected. To collect this information, researchers will use your name, date of birth, and/or Social Security Number.

5. If you are in the group that can join the Cascades Academy, the researchers may ask you to participate in an in-person group interview. It will last about one hour. You will be asked questions about why you applied to Cascades Academy, your experiences while there, and other topics. You may refuse to participate in a group interview.

Risks and Benefits of Participation

The information learned from the study will help improve programs for young adults like you. The researchers will keep your personal information private, as much as the law allows. Only select people from the research team will be able to see individual responses that can be linked to you. There is a small risk of a loss of privacy. However, the researchers have many safety measures to prevent this from happening. Any piece of paper that includes your name will be kept in a locked storage area and will be destroyed after the study ends. Any computer files with your name will be protected by a password and will be stored on a secure network. Your name will never be used in any public document or data file created as part of the study. About 2,200 people will be in this study. When we write a report, the information you give us will be combined with information from all the other people in the study. Data files will be shared with the Department of Labor and other researchers at the end of the study. Data files will only be shared after study team members have removed information that directly identifies you. The Department of Labor may publish this de-identified file online. There is a very small risk that someone could guess your identity based on other information collected during the survey. Before giving any data files to the Department of Labor, the researchers will take steps to minimize the risk that someone could guess your identity.

To help protect your privacy, the researchers have received a Certificate of Confidentiality. The certificate is issued by the National Institutes of Health. It adds special protection to your information. It is important to understand what the Certificate can and cannot do. Because the researchers have this Certificate, they can:

1. legally refuse to give information that may identify you in any federal, state, or local proceedings. This includes if there is a court subpoena.

2. resist any demands for information that would identify you.

In other words, because of the Certificate, the researchers do not have to tell anyone who you are or that you are in the study.

However, even with the Certificate, the researchers may:

1. tell state or local authorities if they find out that you or someone else could be hurt or in danger.

2. not resist a request from the study’s funder (the Department of Labor) to view the study data to audit the project or evaluate the program.

Also, you should know that, at any time, you, or your family, may tell someone about your involvement in this research. The Certificate does not prevent this. Also, if you give someone your written consent to receive research information, such as an employer, then the researchers will not use the Certificate to withhold that information.

Questions

If you have questions about this study, call the researchers at (301) 634-1782 (not a toll-free call). For questions about your rights in the study, call Katie Speanburg at Abt Associates. You can call her at 877-520-6835 (a toll-free call).

Consent to Participate

This agreement is effective from the date you sign it until the end of research on the Cascades Academy. If you choose to quit the study this agreement will end at that time. You may choose to quit the study at any time. If you do quit the study, researchers will continue to use information collected during the time before you quit. To quit the study, please call the Abt study hotline toll-free at XXX-XXX-XXXX.

Statement

“I agree to participate in the Cascades Job Corps College and Career Academy research study. I agree to allow the researchers to use my information as described above.”

Print Your Name Above Date

Sign Your Name Above JOB CORPS ID—For Study Use Only

Abt Associates IRB Approval No. XXXX

Public Burden Statement. Persons are not required to respond to this collection of information unless it displays a currently valid OMB Control Number. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the [Contact Name; Contact Address] (Paperwork Reduction Project Control No.1290-xxxx).

Abt Associates Participant Consent Form  ▌pg. 2