Protocol Title: Assessment of Community Use of the NIST Community Resilience Planning Guide for Buildings and Infrastructure Systems
Informed Consent Version #: 2
Date: XX-XX-20XX
Principal Investigator: Maria Dillard
Study Title: Assessment of Community Use of the NIST Community Resilience Planning Guide for Buildings and Infrastructure Systems
Study Site(s): NIST Gaithersburg, MD; online; phone
Introduction
You are being asked to take part in a research study. Research studies include only people who choose to take part. This document is called an informed consent form. Please read this information carefully and take your time making your decision. Ask the researcher or study staff to discuss this consent form with you, please ask him/her to explain any words or information you do not clearly understand. The nature of the study, risks, inconveniences, discomforts, and other important information about the study are listed below.
The person who is in charge of this research study is Maria Dillard. This person is called the Principal Investigator. However, other research staff may be involved and can act on behalf of the person in charge.
You
are invited to take part in a study about communities that have used
or are currently using the NIST
Community Resilience Planning Guide for Buildings and Infrastructure
Systems. The purpose of this study
is to assess communities’ experience using the NIST Guide to:
1) inform the next generation of guidance on community resilience
planning including Version 2.0 of the NIST
Community Resilience Planning Guide
and accompanying tool development, 2) better understand the process
of resilience planning, and 3) identify additional resources that
communities need for resilience planning. The study will be conducted
through a series of web based surveys, though you are also welcomed
to request the survey by phone or on paper. The modules will
be administered in phases, with Phase 1 consisting of between 1-3
survey modules within a one year timeframe.
Why are you being asked to take part?
We are asking you to take part in this research study because you are a representative of a community that has used or is currently using the NIST Community Resilience Planning Guide as part of resilience planning. You have a valuable perspective on the process of resilience planning for the community you represent.
If you take part in this study, you will be asked to:
Complete between one and three surveys online at your computer, on paper, or over the phone. Your participation will require approximately 15 minutes per survey. The surveys will be administered over several months’ time, in relation to the completion of the steps (1-2) of the NIST Guide.
The survey will ask general background questions about you and the community you represent and then will ask about your community’s experience of the NIST Guide and resilience planning. You can choose not to answer any question on the survey.
If your community is working through the remaining steps (3-6) of the NIST Guide, you may be asked to participate in Phase 2 of the study.
Your responses will be kept strictly confidential, and digital data will be stored in secure computer files. Any report of this study that is made available to the public will not include your name or any other individual information by which you could be identified. The report will include aggregate results from you and other respondents along with the name of the community that you represent.
About 100 individuals per year will take part in this study at NIST.
You do not have to participate in this research study. You should only take part in this study if you want to volunteer. You should not feel that there is any pressure to take part in the study. If you choose to participate in the study, you can withdraw at any time without adversely affecting your relationship with anyone at NIST. There will be no penalty or loss of benefits you are entitled to receive if you stop taking part in this study.
The potential benefits of participating in this research study include:
guidance and tools better tailored for your community’s needs;
a shared understanding of barriers to resilience planning and identification of potential solutions;
and improved technical support for resilience planning.
This research is considered to be minimal risk. That means that the risks associated with this study are the same as what you face every day. There are no known additional risks to those who take part in this study. There is also a small risk that someone who is not authorized could get access to the data we have stored about you. However, we describe how we will protect your confidentiality in a later section of this consent form.
You will receive no payment or other compensation for taking part in this study.
It will not cost you anything to take part in the study.
We will keep your study records private and confidential. Certain people may need to see your study records. Anyone who looks at your records must keep them confidential.
These individuals include:
The research team, including the Principal Investigator, study coordinator, and all other research staff. [Research Social Scientist, Economist, Research Environmental Engineer]
Certain government people who need to know more about the study, and individuals who provide oversight to ensure that we are doing the study in the right way.
Any agency of the federal, state, or local government that regulates this research. [Office for Human Research Protection (OHRP)]
Your identity will be protected to the extent permitted by law, including the Freedom of Information Act. We may publish what we learn from this study. If we do, we will not include your name. We will not publish anything that would let people know who you are.
In addition to the general study records, the NIST research team will maintain a master list that links the id code assigned to each respondent (e.g., random number) with the respondent’s personal identifiers (e.g., name, contact information). The Research Team Leads and the IT Security Officer for NIST Engineering Laboratory are the only individuals who will have access to this file.
All personally identifiable information (PII) will be stored and used in compliance with NIST policies. The identification code and respondent names will be stored in a secure file with two step verification.
The file will be stored in an encrypted file share folder on a secure NIST server. Further, the file will be password protected. Only the PI, Co-PI, and NIST Engineering Laboratory Information Technology Security Officer (ITSO) will have password access to this file.
Any data collected through the SurveyMonkey web tool is password protected with limited access to the researchers on this project and to the Engineering Laboratory ITSO. The data will be downloaded and stored in an encrypted file share folder on a secure NIST server. Only the NIST Research Team and the Engineering Laboratory ITSO will have access to the survey data.
NIST will maintain the data in accordance with standards of information security and will keep personally identifiable data only as long as is absolutely necessary to complete the survey modules relevant for the community represented by the respondent. For example, if a community is completing all steps of the NIST Guide, respondents from Phase 1 will be asked to participate in Phase 2 which will consist of surveys addressing Steps 3-6.
Following final analysis of the data collected during Phases 1 and 2 of this study, the dataset will be archived but made non-discoverable (i.e., the dataset will not be publicly accessible in a raw form where individual responses can be viewed). Instead, the data will be made available through reports in aggregated form, where responses are statistically summarized for the communities represented by the respondents.
NIST researchers plan to use the data to inform future edits to the NIST Community Resilience Planning Guide and the development of accompanying tools. Therefore, maintaining access to the original data is essential.
At a future time, the data may provide a basis for interpretation of an anticipated Phase 3 of this study focused on the evaluation of outcomes of resilience planning.
Respondents who are actively being surveyed in future phases of this study will receive a verbal review of the informed consent process before the new phase begins.
If you have any questions, concerns or complaints about this study, or experience an unanticipated problem call Maria Dillard at (301) 975-4953.
If you have questions about your rights as a participant in this study, or have complaints, concerns or issues you want to discuss with someone outside the research, call the Human Subjects Protection Office at (301) 975-5445.
You will receive a copy of this signed consent form.
I freely give my consent to take part in this study. I understand that by signing this form I am agreeing to take part in research. I have received a copy of this form to take with me.
_____________________________________________ ____________
Signature of Person Taking Part in Study Date
_____________________________________________
Printed Name of Person Taking Part in Study
I have carefully explained to the person taking part in the study what he or she can expect from their participation. I confirm that this research subject speaks the language that was used to explain this research and is receiving an informed consent form in their primary language. This research subject has provided legally effective informed consent.
______________________________________________ ____________
Signature of Person obtaining Informed Consent Date
______________________________________________
Printed Name of Person Obtaining Informed Consent
Version # 2
NIST Approval Date: Page
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Subject | USF IRB Form, informed consent, template, adult, social, behavioral |
| Author | California Family Health Council, John Arnaldi, Norma Epley |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |