Appendix C - Consent forms for focus groups with mothers

Appendix C – Consent forms for focus groups with mothers

Agreement to Participate for Adult Mothers

Building Bridges and Bonds (B3)

You are invited to take part in the Building Bridges and Bonds study or B3 for short. A nonprofit organization called MDRC is running the study. The study is being done with MEF Associates, ABT SRBI, Georgetown University, University of Cincinnati Corrections Institute, and Youth Law Center. This form describes B3 and explains what it means for you to be a part of it. When you sign this form, you agree to be in the study. Your participation is voluntary. We hope you will agree to participate.

What is Building Bridges and Bonds or B3 for short?

B3 is an important project to learn about how parenting and employment services for fathers affect fathers and their families. Families are participating in the study from around the country. During the study, we hope to understand your experiences with [XX fatherhood program].

What does it mean to be a part of this study?

• You can participate in a group discussion with other mothers, also known as a focus group. It will take approximately 60 minutes.

• You will receive a $20 gift card as a “thank you” for your participation.

• Some questions involve sensitive topics and may be stressful to answer. You do not have to answer any questions that you do not want to answer.

• It is your choice to participate. If you decide not to participate, there is no penalty. Your decision will not affect the services you or others receive.

• The focus group discussions will be recorded. The recordings will be used by the research team; however any data storage has a small risk of information being seen outside of the study team in the unlikely event of a data breach (such as a breach in the computer security). However, we follow strict rules to protect your data. No reports will include your name or identifying information.

• The study team will follow strict rules to protect your personal information. The study team is trained to protect your information. The team signs a pledge.

• The information about you will be marked with a special code number, not your name. No reports will describe you in a way that would allow you to be identified.

If you have questions about your rights as someone in this study, the research team can be reached at [email protected] or INSERT PHONE. Please check and sign below:

_____ I agree to be in the focus group study.

_____ I do not agree to be in the focus group study.

Signature: _______________________________

Name (Printed): __________________________

• This evaluation is being conducted on behalf of the Administration for Children and Families (ACF). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-0XXX and the expiration date is XX/XX/XXXX