Att 5_ Informed Consent

Attachment 5

Formative PD Evaluation Electronic Informed Consent

Form Approved

OMB No. 0920-0840

Expiration Date: XX/XX/XXXX

Formative Evaluation of Professional Development Resources

Attachment 5

Informed Consent

Public reporting burden of this collection of information is estimated to average 2 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-0840)

CONSENT. Purpose of the survey: The Division of Adolescent and School Health (DASH) at the Centers for Disease Control and Prevention (CDC) is working with an independent evaluation consulting firm, ICF, to learn more about what resources school districts are using to provide professional development (PD) to their middle school and high school teachers and other school staff.

As someone who works on these issues at the district level, you are being asked to help us learn about resources your school district is using to provide PD. We are specifically interested in face-to-face trainings, conferences, webinars, self-paced e-learning opportunities, observations, etc. that you use to prepare your staff to implement effective practices related to:

1. Classroom management

2. Supporting lesbian, gay, bisexual, and transgender (LGBT) students

3. Sexual health education

Additionally, we will ask you some questions about what kinds of training or resources you may need related to providing health services to students, including sexual and reproductive health services.

A total of 475 school districts are being asked to participate in this survey.

What you will do: You will use a computer to fill out a Web-based survey. The question will indicate whether to select only one or more than one answer. You will not be asked to provide your personal information, and your survey responses will not be linked with your personal information.

Time needed: The survey should take about 20 minutes to complete.

Possible risks: Completing this survey will cause little to no risk to study participants. The survey is voluntary and you may choose to discontinue at any time for any reason. We will not use your name, and when summarizing results, the evaluation team will take care to ensure that all data is presented in aggregate in a manner that is not identifiable to a specific school district. It should take no longer than 20 minutes to complete.

Benefits: Answering these questions will give you the chance to share information about PD resources being used in school districts as well as common characteristics of these resources. This information can promote broader use of effective PD resources and can inform development of new materials and adaptation of programs to enhance impact.

Deciding not to take the survey: Taking this survey is completely voluntary. You can choose to take it or not to take it. If you choose to take the survey, you can stop the survey at any time. If you decide not to take the survey, or decide to stop answering the questions at any point during the survey, it will not be held against you in any way. Other staff and administrators in your district will have no knowledge of your decision to participate or not participate.

Contacting the evaluator: You may call Catherine Lesesne at (404) 592-2230 if you have questions about this study. If you have questions about your rights related to this study you can call the ICF Review Board at (877) 556-2218.

Clicking “yes” below means that you agree to take the survey. If you wish to stop at any time, click the “exit” button at the bottom of the screen. Thank you.

1 Yes - I have read the informed consent statement and agree to participate in the survey