Informed Consent Form

0704-XXXX_WIT Main Study Consent (Follow Up).docx

Wingman Intervention Training (WIT) Program Evaluation Survey

Informed Consent Form

OMB: 0704-0627

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Study Title: Wingman Intervention Training (WIT) Program Evaluation

Principal Investigator: Bruce Taylor

Participant Informed Consent Form


The following information is provided to inform you about the Wingman Intervention Training (WIT) Program Evaluation and your participation in it. Please read this form carefully.


  1. Purpose of the study:

You are being asked to participate in this anonymous Survey because the survey is designed for Airman/Guardian in the United States Department of the Airforce. The purpose of this study is to evaluate SAPR (Sexual Assault Prevention and Response) activities in the DAF.


  1. Procedures and approximate time requirements:

You will be asked to complete two online surveys, a baseline survey now, and a follow-up survey in about six months. Each survey will take about 15-20 minutes. The survey includes some questions about you and how you think about sexual harassment and assault.

Your participation in this research is voluntary. There is no penalty to you if you choose not to respond. You can skip any question and you can stop the survey at any time. Because it is an anonymous survey, it needs to be completed in one session. You will need to begin again (using the anonymous link from [email protected] or accessing the survey link at www.xxx.norc.org if you exist unexpectedly.

You can complete the survey using a personal device (e.g., laptop, tablet, or mobile phone) in a private location of your choice. We recommend using a device with a larger screen for better viewing.


  1. Anonymity:

This study is anonymous. No one in your chain of command or anyone outside the research team will ever see your responses. Demographic responses will be recoded to prevent anyone from figuring out your identity based on unique characteristics.


  1. Compensation for participation:

If you are eligible and choose to take the survey today, NORC will email you an additional $15 Amazon gift code.


  1. Benefits and risks:

There are no direct benefits to you. However, benefits to future Airmen/Guardians may include better prevention programming and less sexual harassment and sexual assault at DAF. Your voice is important to us, therefore, we will all benefit by having your voice heard.

Completing this survey is not expected to involve any risk or discomfort to you. Respondents who have experienced sexual harassment or sexual assault may experience strong emotions while completing this survey. Helpful resources are provided below.


  1. Resources:

If you are a victim of sexual assault, or a person who wishes to prevent or respond to a crime, you may want to contact a Sexual Assault Response Coordinator (SARC) or Victim Advocate (VA). To reach the DoD Safe Helpline 24/7 for restricted/unrestricted reporting and established DoD Sexual Assault Services, call the hotline number:


DoD Safe Helpline

Toll-Free: 877-995-5247

Worldwide: https://www.safehelpline.org/

If you are a victim of sexual harassment, or a person who wishes to prevent or respond to it, you may want to contact a DAF resource, below.

Air Force Discrimination and Sexual Harassment Hotline

https://www.af.mil/Equal-Opportunity/


Available 24 hours a day. You can reach the hotline by calling 1-888-231-4058. Air National Guard members can also contact the National Guard EO hotline at 703-607-5462 or 1-800-371-0617.


DAF SAPR Response Line (24/7): 1-800-616-3775


  1. Data security:

Data will be secured on dedicated servers, and access to sensitive data will be restricted to authorized users. All NORC systems reside within secure facilities with controlled physical access with restricted hours of access. Systems are in a data center with boundary protection utilizing network firewalls, Intrusion Prevention Systems (IPS) and security monitoring using a unified situational platform. The IT environment is documented and managed utilizing NIST 800-53 Revision 4 security framework and is audited by third party auditors on a regular basis. The aggregated results of this anonymous survey may be shared with the DAF leadership, USAF Wingman Intervention Training (WIT) staff, and DoD SAPR staff, without any personally identifiable information.


  1. Contact information:

This research is being conducted by Bruce Taylor, Ph.D., a Senior Fellow at NORC at the University of Chicago with over 25 years of experience conducting research in the social sciences. He may be reached at [email protected] or 1-xxx-xxxx for questions or to report a research-related problem. You may contact the NORC IRB Office at xxx-xxx-xxxx or Air Force SAPR Research Program Manager Major Leah Pound [email protected] if you have questions or comments regarding your rights as a participant in the research. This research has been reviewed according to the DAF’s procedures governing your participation in this research.


STATEMENT BY PERSON AGREEING TO PARTICIPATE IN THIS ANONYMOUS STUDY

I have read this informed consent document. I understand each part of the document and I freely and voluntarily choose to participate in this anonymous study. I can choose to withdraw from the NORC Survey at any time without penalty.


Click NEXT if you agree to participate in this anonymous study.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePARTICIPANT INFORMED CONSENT FORM
AuthorOctavia Powell
File Modified0000-00-00
File Created2022-02-02

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