Understanding RR Study Participant Consent Form

Understanding Rapid Re-housing Study
Participation Consent Form

I would like to invite you to participate in a study of households in rapid re-housing programs like [PROGRAM NAME]. Abt Associates is conducting this study for the U.S. Department of Housing and Urban Development (HUD). If you participate, you will help HUD learn more about what types of housing assistance and services help people who experience homelessness.

Participating in this study is voluntary. You do not have to participate if you do not want to. If you decide to participate, you will be one of 28 households that will be helping to inform how rapid re-housing programs work and what type of assistance is provided. You will also help us to understand how this program could be improved. Participating in this study will not affect your participation or change any of the services you receive. You can continue to use all services and assistance that you are currently using.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 2528-XXXX. The time required to complete this information collection is approximately

5 minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

What do I need to do to participate in this study?

To participate in this study, you will need to review and sign this Participation Agreement. It explains more about the study and what is required of participants.

What happens once I agree to participate?

If you decide to participate, someone from the study team will contact you to ask to schedule and complete one interview. The interview will take up to 2 hours. The interview will ask you questions about the different places you have lived since you were a child, your current housing situation, the types of assistance offered by the rapid re-housing program, your current financial situation, and your health and well-being. You can choose not to answer any question. All information you provide will be kept confidential to the extent allowed by law. You will receive $50 as a token of our appreciation for completing the interview.

If I sign the participation agreement, what else am I agreeing to do?

Agreeing to participate in the study means that you give us permission to proceed with scheduling and conducting this interview. It also means that we will get records from the program on the assistance you have received.

Who will see the information I provide?

All the information you provide is confidential. Your information will be protected to the extent allowed under the law as part of the Privacy Act.¹ This means, for example, that we may need to notify someone if keeping the information confidential could put you or others at risk of harm. Only the interviewer and a small number of staff authorized to work on this research project will see your interview responses. No one at the shelter or at the rapid re-housing program that you are participating in [PROGRAM NAME] will see the information that you share with us. Your name will never be used in any report. The study team may quote some of your responses but will not identify you by name.

Are there any risks to me if I participate in this study?

The risks to you of participating in this study are minimal. However, if you join, there are some potential risks. Risks could include the possibility that:

• You might be uncomfortable or even upset answering some of the questions in the interview. If you feel that way, you can choose not to answer any of the questions. You can also stop the interview at any time.

• There is some risk that your information could be released to people other than the researchers doing this study. The study has strict procedures in place to protect the information you provide and to prevent this from happening. However, if that were to happen, we would contact you to let you know that this occurred.

Questions About Participation

If you have questions regarding this study please contact the Abt Associates Inc. Project Director, Ms. Lauren Dunton at (301) 634-1779. You may also contact Ms. Mindy Ault at the U.S. Department of Housing and Urban Development at (202) 402-3116. These phone numbers are not toll-free.

If you have any questions about your rights as a participant in this study, you can call Ms. Teresa Doksum, the IRB Administrator at Abt Associates toll-free at (877) 520- 6835.

Consent by Participant

By signing this participation agreement, I confirm that I have read and understand the information presented in it. The information in this form has also been explained to me. I have had the opportunity to ask questions. I understand that my participation is voluntary, and I can ask to be withdrawn from the study at any time. I understand that I will be given a signed copy of this consent form to keep. I voluntarily agree to take part in this study of rapid re-housing programs.

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Participant’s Name – PLEASE PRINT

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Participant’s Signature Date