Women's Health Needs STUDY_SCREENER

Attachment F7. Women’s Health Needs Informed Consent Form (Oromo translations)

Women’s Health Needs Study Informed Consent to be a Research Participant

My name is _______________and I am working with NORC and the Centers for Disease Control and Prevention on this study.

Why we are doing this study? We are trying to find out about the health care needs of women age 18 to 49 years in your community. We plan on interviewing about 2,000 women for this study.

Who is funding this study? This study is funded by the Centers for Disease Control and Prevention.

What would I be asked to do if I am in this study? The interview will take you about 45 minutes. We will read you the questions in your preferred language. We will be asking you some questions to see if you are eligible to be in the study. These will be about things like where you and your family are from, what languages you speak, and if you have lived in certain countries. If you are eligible, give consent, and then choose to enroll in the study, then we will be asking you questions such as how long you have been in the US, if you have had a medical exam, your childbirth experiences, and what you and your family thinks about female circumcision and your experiences with female circumcision. Some of the study questions may make you feel uncomfortable. You can skip any question. Your answers are completely private and only results from the whole group of women will be included in any report.

How long will it take for me to participate in this study? For this study you will do one interview that will take about 45 minutes to complete. This will end your time in the study.

Are there any risks for me if I decide to participate? The risks to participating in this research are minimal. However, some of the questions are personal and might make you uncomfortable. You are free to skip or not answer any questions. You can stop at any time. I have community resources available for you if you need help finding support or services in your community.

If you choose to do the survey whether you complete the survey or not, you will not lose access to any services that you would otherwise be eligible for. Your answers will be kept private to the extent allowed by law and will be used only for research. The study has a Certificate of Confidentiality and a Privacy Certificate, so no one outside the study, even an official of the court, the government or law, can request your information. However, if interviewers and other study staff learn of immediate plans to have your minor daughter circumcised they may be legally obligated to report this as child abuse to state or local authorities The study does not ask you about circumcision in your daughter.

Employees of CDC, or experts and contractors working for CDC, may review information sent through computer networks to assess security. We will not collect your name or other information that identifies you during this interview. When results from this research are presented, we will not include any information that might be used to figure out who you are.

Are there any benefits for me if I decide to participate? There is no direct benefit to you for participating in the study. We believe the answers you provide will help us better understand the health care needs of women in your community.

Payment for participation: If you agree to be in this study we will give you $25 for your travel and/or child care expenses. In addition, if you recruit another women to be in this study, we will give you $10 for cell phone calls and/or transportation. You may recruit up to 3 women and receive $10 for each woman you recruit. You may need to contact these 3 women with our study invitation card or information. You will be able to receive a total of $55 reimbursement for expenses you may need to participate in the study and for recruiting up to three women.

A unique passcode will let us know which women you helped recruit so that we can reimburse you. Your name will not be collected at any time during this study.

Do I have to be in this study? No you do not. If you choose to be in this study, you can stop at any time and you are also free to skip or not answer any questions.

What happens if I would like to stop this interview? If you start the interview and decide to stop, that is perfectly OK. You will still receive the $25 for your travel and/or any child care expenses you may have during this interview. We will be able to keep and use the information you have shared up until that point. If you do not want your responses to be included, let us know and we will destroy your information.

Right to Ask Questions: Please contact the WHNS Study contact number with questions, complaints or concerns about this research at the toll-free phone number (866) 315-7130. If you have any questions or concerns about your rights as a research participant, please contact the NORC IRB Manager by toll-free phone number at (866) 309-0542. An Institutional Review Board (IRB) operates under Federal regulations and they review research involving human subjects to ensure the ethical, safe, and equitable treatment of study participants.

Do you have any questions about this study? If you have any questions or concerns regarding this study please ask. If you think of them later, contact the WHNS Study number at 866-315-7130.

What if I do not want to be in this study? If you do not wish to participate, we sincerely thank you for your time.

If you would like to participate: You must be 18 to 49 years of age to take part in this research study.

Participation in this study implies that you have reviewed and understand what is being asked of you for this study and that you are voluntarily willing to take part of this study. Your answers will be private and you can stop at any time.

Would you like a copy of this form?

Waliigaltee hirmaata Qorannon Fadhii Fayyaa Dubartootaa ta’uu

Maqaaan kiyyaa_______________dha, NORC fi Gidduu-gala Dhukkubaa Too’achuu fi Ittiisuu wajjiiniin qorannoo kana irrattii hojjeechaa jira.

Maaliif qorannoo kan gochaa jirraa? Fadhii Fayyaa Dubartii waggaa 18 hanga 49 kan hawaasa keessaniiti baruuf yaalaa jirra. Qorannoo kanaaf dubartoota 2,000 aff-gaaffii godhuuf karoorfannee.

Qorannoo kanaaf deeggarsa maallqaa eenyuutu godha? Qorannoo kana mallaqaan kan deeggaru Gidduu-gala Dhukkubaa Too’achuu fi Ittiisuu ti.

Yoon qorannoo kana keessa jiraadhee maal godhuutu narraa eeggama? Af-gaaffiin kan sitti fudhatuu toora daqiiqaa 45. Afaan isiin filattaniin gaaffiilee isiniif duubbisna. Qoranno kana kessatti qoratamuuf akka gahoo taatan ilaaluuf gaaffiilee muraasa isiin gaafanna. Waantoota akka maatiin keessanii fi isiin essaa akka dhuftanii, afaan kam akka dubbatan, akkasumas biyyoota murtaa’aa jirattanii faa dha of keessa qaba. Yoo gahoo taatan, hayyama keennaati qorannoo kana keessattii galmaa’aa san booda Ameeriika keessa hangam takka akka turtan, qorannon fayyaa yoo isiin mudaatee turee, muxannoo dahuumsa daa’imaa keessanii fi waan isinii fi maatiin keessan waa’ee dhaqna-qabaa dubartoota yaaddan akkasumas muxannoo keessan kan dhaqna-qabaa dubartoota isiin gaafanna. Gaaffiileen qorannoo muraasni isinitti toluu dhabuu mala. Gaaffii kamiyyuu bira darbuu ni dandeessan. Deebiim keessan gutumaa-gututtii iccitii dha akkasumas gabaasa kamiyyuu keessattii kan dabalamuu bu’aa garee dubartoota hundaa ti.

Qorannoo kana keessattii hirmaachuudhaaf hangam takka natti fudhata? Qorannoo kanaaf aff-gaffii tokko kan xumuruudhaaf daqiiqaa 45 fudhatuu gaggeessita. Kuni yeeroo kee kan qorannoo keessaa ni xumura.

Yooniin hirmaachuuf murteesse rakkiinni na mudatu ni jiraa? Rakkiinni qorannoo kana keessaattii hirmaachuu waa xiqqoo. Ta’ullee gaaffiileen muraasni kan dhuunfaati akkasumas isinitti toluu dhabuu mala. Gaaffilee kammiyyuu bira darbuu yookiin deebisuu dhabuudhaaf isiin bilisa. Yeroo kamuu dhaabuu ni dandeessan. Deeggarsa hawaasa yookiin tajaajiloota argachuudhaaf gargaarsa yoo barbaaddan qabeenyaa hawaasaa kan isiniif argamuun qaba.

Qorannoo godhuuf yoo filattan, qorannoo xumurtanis xumuruu baattanis, tajaajilaa isiin argachuudhaaf gahoo ta’uu dandeessan kamiyyuu hin dhabdan. Hanga seeraan hayyamaama ta’ee tokkoo deebiin keessan icciitiin qaba akkasumas qorannoo qofaaf itti fayyadamna. Qorannoon waraqaa ragaa iccitii qabuutii fi warqaa ragaa iccitii dhunfaati qaba, kanaaf namni tokkollee kan qorannoo kanan alaa angawootanni mana murtii, mootummaan yookiin seerrii odeeffannoo keessan gaafachu danda’an. Ta’ullee, gaafataa fi hajjeettootnnii qorannoo biroo yoo karooraa ariitii keessan kan in tanlaa keessan xiqqoo dhaqna-qabuu yoo beekan kana akka miidhaa daa’imaattii gara mootummaattii yookiin angawoota naannoottii gaabsuuf seeraan dirqamuu danda’an. Qorannoon waa’ee dhaqna-qabaa intalaa keessanii irraa isin hin gaafatu.

Hojjattoonni CDC, yookiin ogeessootaa fi hojjattootaa qacaramanii CDC dhaaf hojjatan nageenyaa too’achuuf odeeffannoo gara netiwoorkii kompitaraatin ergamuu madaaluu danda’uu. Waytii qorannoo kanaa maqaa keessan yookiin odeeffannoo eenyummaa keesan adda baasuu hin sassaabnuu. Yeroo bu’aawwan qorannoo kanaa dhihaatan, odeeffannoo kamiyyuu kan eenyummaa keessan saaxiluuf tajaajilu itti hin daballuu.

Yoo hirmaachuuf murteessee bu’aan inni naaf qabuu ni jira? Qorannoo kana irrattii hirmaachuu keessaniif bu’aa kallatiin argattan hin jiru. Deebisaan isiin nuuf kennitaan akka caalatti fadhii eegumsa fayyaa dubartoota hawaasa keessanii hubannuuf nu gargaara janne amaanna.

Kaffaltii hirmaachuudhaaf: Yoo qoranno kana keessattii hirmaachuuf waliigaltan $25 imlaa keessaniitii fi/yookiin baasii daa’ima keessaniitiif isiniif kenninaa. Dabalataan, akka dubartoonni biroo qorannoo kan irrattii hirmaataaniif qacartan taa’ee baasii bilbilaatii fi/yookiin imalaatiif $10 isiniif kennina. Hanga dubartii 3 qacartanii tokkoon-tokkoo dubartii qacartaniitiif $10 argachuu ni dandeessan. Tarii dubartii 3n kana kaardii afeerraa qorannoo keenyaatii wajjiin isaan qunnamuun isinirraa jiraachuu danda’a. Baasii qorranoo irratti hirmaachuu fi hanga dubartii 3 qacaruuf barbaachisuu kan baastan kaffaltii deebisuu walumaagalattii $55 ni argattuu.

Akka nutii maallaqaa isiinif deebisuu dandeenyuuf koodiin-darbii addaa dubarii kam akka qacaramaniif isiin gargaartan akka beeknu nu taasisa. Yeroo kamiyyuu waytii qorannoo kanaa keessattii maqaan keessan hin sassaabamu.

Qorannoo kana keessattii argamuun qaba? Lakkii hin qabdu. Yoo qorannoo kan keessa jiraachuu filattan, yeroo kamiyuutti dahbuu ni dandeessan akkasumas isiin gaaffiilee kamiyyuu bira darbuu yookiin deebisuu dhisuudhaaf bilisa.

Yooniin aff-gaaffii kana dhaabuu barbaade maaltuu ta’aa? Yoo aff-gaaffii kana jalqabdee dhaabuu barbaade, san sirriiti gaariidha. Ammallee $25 baasii waaytii qorannoo kanaatiif baastan kan imlaa keessanii fi/yookiin baasii daa’ima keessaniitiif ni argattan. Hangaa qabxii sanattii odeeffanoo isiin nuuf qooddaan qabachuudhaan fayyadamuu ni dandeenya. Akka deebiin keeessan itti dabalamuu yoo hin barbaa nuttii himaa, odeeffannoo keessan ni balleessina.

Mirgaa Gaaffiileen gaafachuu: Gaaffiileen, komiiwwaniin yookiin dhimmootaa waa’ee qorannoo kanatii wajjiin maaloo lakkoofasa bilbilaa bilisaa Qorannoo QFFD kana (866) 315-7130 irrattii qunnama. Yoo gaaffiilee yookiin dhimmoota kamiyyuu kan waa’ee mirgaa keessanii akka hirmaata qorannoottii maaloo hoogganaa NORC IRB lakkoofasa bilbilaa bilisaa kana (866) 309-0542 irrattii qunnama. Boordiin qorqoruu dhaabbatichaa (IRB) seeraa fedaraalaa irratti hundaa’uudhaan hojeeta akkasumas isaan namusa hirmanna qorannoo, nageenyaa fi kunuunsa haqaa/madaalawaa hirmaattoota qorannoo ni too’atan.

Waa’ee qorannoo kanaa gaaffii kamiyyuu ni qabdanii? Yoo gaaffiilee yookiin dhimmoota qorannoo kana ilaalchisee qabaattan maaloo gaafadhaa. Yoo gulana isaan yaaddee, miseensa Qorannoo QFFD lakkoofasa kanaan 866-315-7130 qunnami.

Yoo qorannoo kan keessatti hirmaachuu hin barbaannee maali? Yoo hirmaachuu hin barbaannee, kabaajaa wajjiin yeroo keessaniif isin galatoomffanna.

Yoo hirmaachuu barbaaddan: Qorannoo kana irrattii hirmaachuudhaaf waggaa 18-49 ta’uu qabdan.

Hirmannan keessan kan qorannoo kanaa irrattii isiin qorannoo kanaaf maal akka gaafatamtan madaaluu fi hubaachuudhaan akka isiin feedhinnaa keessaniin qorannoo kanarraattii hirmaachuuf hayyamamaa taatan agarsiisa. Deebiin keessan ichiitii dha akkasumas yeroo kamuu dhaabuu ni dandeessan.

Garagalchaa unka kana ni barbaaddanii?