Appendix B Consent Form

Appendix B: SILJ Pretest Consent Form

Survey of Inmates in Local Jails

Consent to Participate in Research (Standard) – 1^st person

Introduction

The Survey of Inmates in Local Jails (SILJ) is a research study done by the Bureau of Justice Statistics and Abt Associates. The purpose is to learn about trends in inmate characteristics, criminal justice practices, and physical and mental health status of inmates and detainees in the United States.

As part of this study, we need to test our survey questions with inmates to find out if they make sense. We are testing the questions in ten jails with a total of approximately 360 inmates randomly chosen to take part. Your participation is voluntary, but we would like to know about your experiences. Let me tell you about the study and you can decide if you want to take part.

Description of the Study

This interview will take about 60 minutes. I will ask about your:

• education, work, and family background, including citizenship status,

• current charges and prior criminal history,

• prior physical and sexual abuse,

• physical and mental health conditions and treatment received,

• drug and alcohol use before admission to jail, and

• experiences in jail and use of jail programs.

I will enter your answers into a tablet computer.

We will only use this information for research purposes. Your information will be combined with the information from all other inmates in the study for use by other authorized researchers. Your name will never be associated with your responses.

Confidentiality

There is a law that protects confidentiality of your answers, 34 U.S.C. § 10231. This study is also covered by the privacy certification requirements of 28 C.F.R. § 22.23. This means that your answers and any personally identifiable information we collect will be kept private and confidential. I will not ask you questions if I think someone can overhear your answers. We will not share your answers with anyone at this jail, a supervision officer, employer, or anyone else from the community. Nothing you tell me during the interview can be used in any legal action. All information will be kept secure and your answers will be combined with other participants in the study for research purposes. The only exceptions to our promise of confidentiality include if you tell me that you plan to seriously harm yourself or a specific person, plan to commit a future crime, or have had sexual contact with another inmate or correctional staff. In these cases, I may need to inform officials at this jail or authorities outside the jail who are responsible for protecting jail inmates.

[[If allowed by the facility] To thank you for your time participating in the study, we will provide you with a snack to eat before you leave this room.]

Possible Risks or Discomforts

Some of the questions are personal or ask about past behaviors that may have been illegal. These questions may make you feel uncomfortable or upset. You can skip any question you do not want to answer or you can stop the interview at any time. If you want to speak with a counselor at any point during or after the interview, we will contact the appropriate person(s) to make sure you can speak to someone right away.

Benefits

You will not receive any direct benefits for participating in this study, but the information collected through the study may be used by policymakers to improve how jails across the nation address different issues such as veterans in jail, women in jail, and mental health conditions among jail inmates across the nation, as well as those who will be released. If you do not take part, you will not lose any benefits or services that you now receive or might receive in the future. Your participation will have no effect on your status in the criminal justice system.

Further Questions

If you have any questions about the project, you may write to the Survey of Inmates in Local Jails at Abt Associates, 10 Fawcett Street, Cambridge, MA 02138. If you have questions about your rights as a project participant, you can call the Institutional Review Board Administrator at Abt Associates toll free at (877) 520-6835.

Refusal Conversion Script

INTERVIEWER:

AFTER READING THE CONSENT FORM:

Do you have any questions about the study at this time? RESPOND IN ACCORDANCE WITH TRAINING.

If you agree to take part, I’ll begin the interview.

IF AGREES, CODE CONSENT STATUS IN CASE MANAGEMENT SYSTEM, PROVIDE RESPONDENT WITH STANDARD CONSENT FORM, ASK QUESTIONS C1 BELOW.

C1. The full study asks respondents to agree to allow the Bureau of Justice Statistics to combine study participant’s answers with information other government agencies already have about their criminal record.

Would you agree to this if you were participating in the full study?

Yes

No

Blind D or R

IF YES, Skip to C3 ONLY IF BJS/Census observing in facility

Ask if C1= NO, D or R:

C2. Would you still agree to participate in the interview only?

Yes

No

Blind D or R

C3. [ONLY If BJS/Census observing in facility] We also have staff from the Bureau of Justice Statistics and the US Census Bureau with us today to observe some of the interviews. While, there are representatives from both agencies here today, they won’t be observing the same interviews. They are only here to observe the interview process, not to record your responses. Do you agree to allow them to observe our interview? You can participate in the interview whether or not you agree to let them observe.

Yes

No

BEGIN INTERVIEW

IF INITIAL REFUSAL:

ASK IF THE INMATE HAS ANY QUESTIONS OR CONCERNS. ANSWER THE INMATE’S QUESTIONS AND/OR ATTEMPT TO ADDRESS THE CONCERNS USING STANDARD SILJ CONVERSION TECHNIQUES. IF STANDARD SILJ TECHNIQUES ARE SUCCESSFUL, CODE CONSENT STATUS IN CASE MANAGEMENT SYSTEM AND ASK QUESTIONS C1 BELOW. PROVIDE RESPONDENT WITH STANDARD CONSENT FORM.

C1. The full study asks respondents to agree to allow the Bureau of Justice Statistics to combine study participant’s answers with information other government agencies already have about their criminal record.

Would you agree to this if you were participating in the full study?

Yes

No

Blind D or R

IF YES, Skip to C3 ONLY IF BJS/Census observing in facility

IF NO, D or R:

C2. Would you still agree to participate in the interview only?

Yes

No

Blind D or R

C3. [ONLY If BJS/Census observing in facility] We also have staff from the Bureau of Justice Statistics and the US Census Bureau with us today to observe some of the interviews. While there are representatives from both agencies here today, they won’t be observing the same interviews. They are only here to observe the interview process, not to record your responses. Do you agree to allow them to observe our interview? You can participate in the interview whether or not you agree to let them observe.

Yes

No

BEGIN INTERVIEW

IF REFUSES, CODE REFUSAL STATUS IN CASE MANAGEMENT SYSTEM AND THANK INMATE (DO NOT BEGIN INTERVIEW).