7. CAPE-Youth PD Study Interview Consent Form final IRB approved

Center for Advancing Policy on Employment for Youth (CAPE-Youth) Data Collection

7. CAPE-Youth PD Study Interview Consent Form final IRB approved

OMB: 1230-0015

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OMB Control No: 1230-0NEW

Expiration Date: XX/XX/20XX


Cornell University Consent Form—Interviews


Project Title: Professional Development Study


Principal Investigator:


Kimberly Osmani, Ph.D., Cornell University, Yang-Tan Institute on Employment and Disability


You are invited to take part in the second phase of the research study to strengthen and align professional development across the many systems serving youth and young adults with disabilities. This study, titled “Professional Development Study,” is a research initiative of the Center for Advancing Policy on Employment for Youth (CAPE-Youth), supported by the Office of Disability Employment Policy (ODEP). In this part of this study, you will be asked to participate in a follow-up interview. The purpose of this study is to explore best practices, challenges, and strategies for improving professional development efforts and the subsequent capacity of youth serving professionals including supervisors, and frontline staff within the workforce system, education system and other systems supporting transitioning youth and young adults with disabilities as in attaining their employment goals.

Through these processes, we will:

  • Gather information regarding current professional development opportunities and credentialing of youth serving professionals; and

  • Identify themes and gaps will inform:

    • A cross-systems rubric of evidence-based practices; and

    • The recommended staff development strategies necessary to elevate the transition and employment outcomes of youth and young adults with disabilities.

These interviews will include questions and discussions about identified gaps from phase 1’s Group Concept Mapping (GCM) in terms of importance, presence, and ease of access, factors affecting access to meaningful professional development, barriers to professional development, and identified strategies to help fill the gap. We hope to develop a snapshot of what youth serving professionals across a multitude of systems need to increase their skill capacity to effectively support youth and young adults with disabilities as they transition to employment. Our overall goal with this project is to develop a cross-systems rubric of evidence-based practices to be used by policymakers for planning and selecting professional development and to provide technical assistance to policymakers and those preparing and supporting youth serving professionals.


Taking part in this study is voluntary. You may refuse to participate before the study begins, discontinue at any time, or skip any questions/procedures that may make you feel uncomfortable, with no penalty, and no effect on the compensation earned before withdrawing, or on your academic standing, record, or relationship with the university or other organization or service involved with the research.


The interview poses no risks greater than those encountered in day-to-day life. All of your responses will be kept confidential and reporting of results will be done in aggregate form only. In order to keep the information confidential, it is important you do not share information discussed with others outside of the interview. The interview will be recorded for transcription purposes. De-identified data from this study may be shared with the research community at large to advance science and health. We will remove or code any personal information identifying you before sharing files with other researchers to ensure, by current scientific standards and known methods, no one will be able to identify you from the information we share. Despite these measures, we cannot guarantee anonymity of your personal data.


The interviews will take up to 1 hour and 30 minutes. You have the right to not answer a question or end your participation at any point. Please note: there are no “right” or “wrong” answers to any of the questions. You can choose whether or not to participate in the interview, and you may stop at any time during the course of the study. Not all participants from the GCM have been selected to participate in the interviews. You have been selected to participate in interviews, and, at the end of your participation, you will be compensated with a $25 gift card.


The main researcher conducting this study is Dr. Kimberly Osmani, an Extension Associate at Cornell University. Please ask any questions you have now. If you have questions later, you may contact Kimberly Osmani at [email protected] . If you have any questions or concerns regarding your rights as a subject in this study, you may contact the Institutional Review Board (IRB) for Human Participants at 607-255-5138 or access their website at http://www.irb.cornell.edu. You may also report your concerns or complaints anonymously through Ethicspoint online at www.hotline.cornell.edu or by calling toll free at 1-866-293-3077. Ethicspoint is an independent organization that serves as a liaison between the University and the person bringing the complaint so that anonymity can be ensured.


Written electronic consent: Please indicate your decision regarding whether or not to participate in the described research and follow-up interviews by selecting yes or no in the online questionnaire platform.


According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays an Office of Management and Budget (OMB) control number. The valid OMB Control Number for this information collection is xxxx-xxxx. The time required to participate in the interview is estimated to average 90 minutes, including the time to review instructions, search existing data resources, gather the data needed and complete and review the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to US Department of Labor, Office of Disability Employment Policy, 200 Constitution Ave., N.W. Washington, DC 20210 and reference the OMB Control Number xxxx-xxxx.




Privacy Act Statement
Collection and Use of Personal Information




The following statement is made in accordance with the Privacy Act of 1974 (5. U. S. C. 552a). Information collected will be handled and stored in compliance with the Freedom of Information Act and the Privacy Act of 1974, as amended (5 U.S.C. 552a). Furnishing the data requested is voluntary.


We will use the data you provide for the CAPE-Youth Research Project, funded by The United States Department of Labor, Office of Disability Employment Policy. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. Per the Federal Cybersecurity Enhancement Act of 2015, Federal information systems are protected from malicious activities through cybersecurity screening of transmitted data.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKimberly Osmani
File Modified0000-00-00
File Created2021-09-14

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