Appendix E2- Written Concent NoInc 5.14.18 - Marshallese

Appendix E2: WRITTEN CONSENT, Marshallese

PEPA IN KEJELA NAN BOK KUNAAM ILO JUON EKATAK

Taitol in Project eo: Title V Jinen im ejmour an ajri eo (MCH) Jeen in jiban ko jen MCH jerbal in etale ko

Person in Charge of Study: Caitlin Oppenheimer, Senior Vice President, Public Health Department NORC at the University eo an Chicago

Etke jej komane ekatak in? Kimij teej ie jet kajitok koi lo survey nan katak elablok kin jinen im ejnour an ajri eo. Kimij komane teej in ilo American Samoa, Federated States eo an Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico, im U.S. Virgin Islands. Mottan kein rej bed ilo Taitol V MCH prokraam in jiban ko. Prokraam ko an MCH ijo kwoj bed ie renaj kejerbal kajitok kein nan melele kin ejmour an jinen im ajri eo. Enaj jiban ir komane jet makitkit in jiban ko nan paamle ko.

1. Won eo ej bok eddo in ekatak in? prokraam in rej kolla wonen jen Health Resources im Services Administration eo.

2. Ta eo renaj kajitok bwe in komane elane inaj bed ilo ekatak in? Renaj kajitok bwe kwon uake jet kajitok ko ilo etale im renaj kajion in riiti waj nan kwe. Kajitok kein renaj nan kwe im ejmour an ajri eo nejuum. Nan wan jonok, kim naj kajitikini iok kin ajri eo ilo ien eo ear drik, wawin am kar kejbaroke, im wawin an ekatak. Kim naj barienwot kajitok kin naninmij ko kin kwe im ajri eo nejuum, takto ro kwe ak ajri ro nejuum rej komij etal iben, melele kin ro iloan mweo, im kain kajitok ko jet.

3. Wawin ej nan ro rej monono in bok kunaier: Kwojab aikuij in bed ilo ekatak in. Komaron kelet bwe kwon bok kunaam ilo ekatak in kio im ukot am lomnak tokelik. Kwojab aikuij uake jabrewot kajitok ko im kwojab konan uake. Lomnak eo am nan jab uake kajitok kein ak bojrak jen am uake kajitok ko ejamin ukot jabrewot.

4. Inebata im uota: Ejelok uata ilo uake kajitok kein ilo survey in, einwot wawin ko rej walok nan kij iloan juon ran. Jet ian kajitok kein rej kin ejmour, uno ko ak kejerbal dren ko rekajuur, ak elane lomnak kein rej nan kwe wot im naj koman menin am inebata.

5. Jiban ko: Ejamin iwoj jiban ko nan kwe ilo am bok kunaam ilo uake kajitok kein ilo survey in, uak kein am remaron jiban kin melele ko remanlok nan jiban kokmanmanlok wawin ejmour an jinen im ajri eo nejin ilo air bed iumwin Taitol V MCH prokraam in jiban ko.

6. Ewi toan ao naj bed ilo prokraam in ekatak in? enaj bok jonan in 40 miniit nan uake kajitok ko.

7. Tenkwadrik/Ittino: Armij eo wot enaj loe uak ko am ej armij eo enaj jerbal ilo ekatak in im armij eo enaj jiron kim bwe kimin komane ekatak in ilo juon ien eo emokaj. Etam ejamin bed ilo survey in iben uak ko am. Kim naj kejerbal code nomba ko nan lale uak ko am, ejab etam.

Survey eo eban kajitok kin jorren ko nan ajri eo ak elane kwojab kejbaroke. Elane kim naj loe je eor wawin jorren kein ak jab kejbarok ko im rej walok kio ak etto an walok, kim naj jironlok ro tellokier.

Uak ko am renaj jei ilo pepa ko. Kape in survey in enaj ilok nan opiij eo am ilo Chicago, Illinois kejerbal computer ko. Kim naj kajion lale bwe melele ko am ren tenkwadrik im bed ilo ittino, ak ejelok juon emaron kalimuur bwe uak ko jilikinok ilo Internet renaj bed ilo tenkwadrik ak ittino. Ien eo wot renaj jilikinlok uak ko am, kim naj temakili pepa eo am im uak ko ie. Jabrewot pepa eo eor uak ko am ie renaj kakoni ilo cabinet ko emoj laaki nan ien eo renaj temakili.

Elane kwonaj bojrak mokta jen an jemlok survey eo, komaron kajitok bwe kimin juuloki kajitok ko am.

8. Pepa in kamol ikijen jerbal in tenkwadrik ak ittino: Kim ar kajitok iben U.S. Department eo an Health im Human Services (DHHS) bwe ren komane bwe pepa in bwe en wor kakien nae, im rej naetan pepa in kamol ikijen jerbal in tenkwadrik ak ittino. Melelein bwe rejab maron komane jabrewot ekatak im leto-letak uak ko nan jabrewot jikin ekajet. Kim naj leto-letak melele kein elane enaj lon melim jen kwe.

• Ekatak ko einwot in remaron in lale jen kein eo an United States. Elane enaj walok wawin in, kimij jab v maron in kejerbal pepa in kamol ikijen jerbal in tenkwadrik ak ittino nan kejbaork uak ko am jen ri-jerbal ro

rej etale.

9. Jimwe nan am kajitikini: Jouij im kirlok Clare Davidson ilo[tnomba in toll ejelok onen] ak [email protected] kin kajitok ko am, melele ak wawin ko kin katak in. Elane eor am kajitok ak enjake ko kin jimwe ko am einwot juon eo ej bok kunaan ilo ekatak in, jouij im kirlok NORC Institutional Review Board Menija eo ilo toll-free telpoon nomba eo ilo (866) 309-0542.

Kwoj aikuij bwe kwon 18 am iio ak rittolok nan am maron bok kunaam ilo ekatak in.

Elane kwoj erre ilo am naj bok kunaam ilo ekatak in, jouij im jaini etam im je rainin.

Renaj lewaj juon am kape in form in bok melele bwe en bed ilo rekoot ko am. Jouij im likit form in ilo rekoot ko am nan naj etale ko.

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Jain an eo enaj bok kunaan Allin/ran/iio

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Jain an eo ej kajitok kin maron kein Allin/ran/iio

Peij 2 in 2