Caregivers of Former WIC Children (Individuals/Households)

Site #

OMB Approval No. 0584-0580

Approval Expires: XX/XX/20XX

Appendix A1 - Year 9 Study Consent Form – English

Feeding My Baby - A National WIC Study

Year 9 Study Extension Consent Form

Background

Westat, along with our partners at the Public Health Foundation WIC Program, the University of California Davis Nutrition Policy Institute, is carrying out The Feeding My Baby Study for the Food and Nutrition Service (FNS) of the U.S. Department of Agriculture. The study is being done to learn more about the choices WIC families make in feeding their children. FNS has extended the study to follow children enrolled in the study at age 9. We would like you to help by agreeing to participate in the study until your child is 9 years old, and allowing us to hear more about you, your family, and the choices you make in feeding your child.

What Would I Do in the Study?

Take Part in Telephone Interviews

If you agree to participate in the extension of this study, we will contact you when your child is 9 years old. The interview will ask you about your background, your household, your health and your child’s health, the choices you make about how and what to feed your child, your beliefs about feeding children, and your family’s and child’s behavior and eating habits. This final interview will take about 60 minutes.

Allow Us to Seek Information on Your Child’s Height and Weight

When your child turns 9, we will ask you either to return to a WIC office or to go to your child’s doctor to have your child weighed and measured.

Provide your Contact Information

We will ask you to provide your current contact information periodically until the interview.

What Are the Risks of Being In This Study?

We expect that your time in the study will be interesting and pleasant, and will not cause you discomfort. There is, however, a small risk to privacy since you are entrusting us with personal information. We will continue to take many steps and precautions to protect your privacy. Your name and your child’s name will not be used in any research reports. We will assign a study ID to your information, and only a small number of study staff will have access to the connection between study IDs and actual names. All study information will be stored on secure computer servers at Westat. We will not share personal information about you with WIC or with anyone else who is not on the study staff, unless otherwise required by law.

What Are the Benefits of Being In This Study?

There are no direct benefits or penalties to you for taking part in this study. The information collected during the study will help the FNS better understand how WIC participation may impact the health and nutrition trajectories of school-aged children who previously received program benefits. They will then use this information to continue to improve WIC services for everyone.

Will I Receive Incentives For Participating In This Study?

As a token of our appreciation, we will provide you with a $70 gift card for the 9 year-old interview (or $80 if using your own cell phone). We will provide you with an $80 gift card at age 9 for taking your child to a WIC office or your child’s doctor to be measured and returning the measurement card to us. We will provide you with a $10 check each time for completing our request for contact information.

What Are My Rights As a Participant In the Study?

Participation in this study is completely voluntary. Giving consent means that you have read the information and that you agree to take part in this study. If you do not want to answer a question during the interview, you may choose not to do so. If you decide to take part in the study and then change your mind, you can stop at any time. Again, there is no penalty to stop participating in the study or in parts of the study, and any WIC services or other benefits you receive will not be affected.

Who Should I Call if I Have Questions?

If you have questions about the study, a member of our study team can help you. For those questions, please contact Terry Aranda at 888-987-4926.

If you have a problem that the study team member couldn’t help you resolve, please call Janice Machado at 1-800-937-8281, x2801.

If you have questions about your rights and welfare as a research participant, please call the Westat Human Subjects Protections office at 1-888-920-7631. Please leave a message with your full name, the name of the research study that you are calling about (the Feeding My Baby Study), and a phone number beginning with the area code. Someone will return your call as soon as possible.

By signing below, I am saying that I have read the information presented here, and I agree to take part in the extension of the Feeding My Baby Study.

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