Consent

Att2 NPIN Eval Survey Consent Form-5-3-2018.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

Consent

OMB: 0920-1027

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Thank you for your interest in the 2018 NPIN Evaluation. Before you decide whether to agree to be in this study (survey), please read this form and provide your consent below.



Introduction: This study is being conducted by Schlesinger Group. The Centers for Disease Control and Prevention (CDC) is sponsoring this information collection.



What is the purpose of this study? The purpose of this effort is to learn about your awareness, perceptions, and use of NPIN services from public health professionals like you who use the platform. We want to hear your views and opinions on NPIN in order to make it a stronger service and to better meet your prevention resource needs.



Why am I being asked to be in this study? We are asking you to be in this study because you work in public health and have engaged with NPIN. We want to get feedback from public health professionals like you who engage with NPIN.



How long will you need me? If you are asked to take the survey we expect it will be 20-30 minutes.



What is going to happen during the study? You will complete a survey. For the survey, you will be asked to answer several questions about NPIN.



What do you want me to do if I decide to be in this study? If you are asked to complete a survey, we would like for you to respond to the questions in the survey. We will ask about your needs for prevention resources for HIV/AIDs, viral hepatitis, STDs, TB, and adolescent sexual health.



Are there any risks to me if I decide to be in this study? There is low risk to you if you decide to be in this study. You may feel uneasy or have some concerns in providing negative opinions about NPIN. You do not have to respond to any questions you do not want to in the survey.



Are there any benefits from being in this study? By being in this study you will help CDC’s NPIN to improve how it provides prevention resources and services to public health professionals who work the disease areas of HIV/AIDs, viral hepatitis, STDs, TB, and adolescent sexual health information.



Will the things I tell you be kept private? What you tell us will be kept private to the extent allowed by law. We will safeguard your identity and information that you supply.



What will you do with the responses to the surveys? The survey findings will be used to inform NPIN’s strategy for supporting public health professionals that work in the areas of HIV/AIDs, viral hepatitis, STDs, TB, and adolescent sexual health. We will develop reports that will be used at CDC. We will share our findings with the people working on NPIN. These people will review the survey findings to help us understand what we have found. At no time, will anyone be able to know what you said or that you were in this study from anything that we write. We will also share our findings with you if you would like. You may also have a copy of any of the reports by getting in touch with us or giving us a number where we can call you.



Is there any cost if I take part in this study? The only cost to you for being in this study is your time for coming here today.



Is there any payment if I take part in this study? If you participate in a survey you will receive a token of appreciation of $10.



Who should I call if I have questions about this study or think I may have gotten sick or been harmed by this study? If you have any questions about this study or your rights for being in this study, you may call Dr. Leigh Willis, 404-639-8447, or the CDC Institutional Review Board at 1- 800-584-8814.



Do I have to be in this study? You do not have to be in this study, it is up to you if you want to or not. You can stop being in this study at any time without any penalty or loss of benefits.



Please always use the button located at the bottom of the screen to move through the survey.

Your opinion is very important to us. Please make sure to read each question thoroughly and provide thoughtful and honest responses.



Please enter your initials in the box below to give your consent for participation.



Thank you for your participation.



Click "Continue" to start the survey.

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AuthorEverett L. Long
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File Created2021-01-21

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