0704-XXXX_Consent and Survey_8.4.2022

OMB CONTROL NUMBER: XXXX-XXXX

OMB EXPIRATION DATE: XX/XX/XXXX

Study Introduction/Informed Consent and Questions

For the Panel Recruitment and Design Round (Round 0)

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Three expert lens panels will be conducted on three separate topics. Depending on the panel, the header for the top of each page: will be either:

Topic A: Positive relationship behavior education and dating violence prevention for students

Topic B: Improving access to resources for domestic abuse survivors

Topic C: Domestic abuse prevention workforce strategies

Correspondingly, [Topic A/B/C] in the template below will be filled as either:

1. Age-appropriate training and education programs for elementary and secondary school students, designed to assist such students in learning positive relationship behaviors in families and with intimate partners. 

2. Means of improving access to resources for survivors who have already experienced domestic abuse, including survivors who are geographically relocating. 

3. Strategies to prevent domestic abuse by training, educating, and assigning prevention-related responsibilities to military leaders; medical, behavioral, and mental health service providers; staff from domestic abuse and related prevention programs; and others with relevant responsibilities, such as law enforcement. 

OMB Control Number 0704-0553, Expiration Date [Date]

The Research Study: The Department of Defense (DoD) is sponsoring a study to provide independent analyses and recommendations for improving domestic abuse prevention and response in the armed forces. RAND, a nonprofit, nonpartisan research organization, is conducting the study on behalf of DoD.

The Expert Panels: To help fill gaps in the scholarly literature on [Topic A/B/C], the RAND research team is creating advisory panels that brings together experts with knowledge from several relevant domains: (brackets with letters indicate which options will be displayed for which topics)

• [A] Domestic abuse prevention strategies, including school-based healthy relationship training or other age-appropriate prevention for students

• [A] Socioemotional learning in children and adolescents

• [A] DoDEA and military-affiliated school systems

• [A/B/C] Aspects of the military setting relevant for domestic abuse prevention and response

• [B] Systems that provide domestic abuse referrals such as medical, behavioral health, school, and law enforcement systems

• [B/C] Domestic abuse survivor experiences, perceptions, needs, and help-seeking barriers and pathways

• [C] Prevention workforce staffing and training

You have been identified as an expert in one or more of these categories. The purpose of this form is to determine your interest in potentially participating in the panel and to gather information relevant for designing the panel.

Participation: The selected experts will participate in a 3-round virtual interactive process through the ExpertLens platform. Additional information about ExpertLens can be found here.

Participation in this panel is completely voluntary, and does not require travel, scheduling meetings, or a DoD computer or network. Participants can connect on their own schedule within the panel’s timeframe. Volunteers may discontinue participation at any time without any penalty.

The panel is expected to run from [start date] to [end date]. Each round will be open for at least seven days so that panelists can access the online platform at their convenience to rate and post comments about the topic areas. We expect the overall time commitment to be 3-4 hours total spread out over 4-6 weeks.

Confidentiality: The information we are collecting is for research purposes only. Your personal information will not be shared outside of our project team. We will not disclose your identity, position, or characteristics to other participants during the panel process. On the expert panel discussion boards, participants will be identified only by a unique alphanumeric code.

Risks and Benefits: We anticipate no risks to you, as participation involves applying your subject matter expertise to deliberations of possible future activities. A potential benefit to you would be the satisfaction of contributing to efforts to prevent and respond to domestic abuse in the military. Another possible benefit to you is that your expertise may be further developed through the discussions with other experts on the panel.

Questions: If you have further questions concerning the study, please contact the project team at: [email protected]

If you have any technical issues using this form, please contact the ExpertLens administrator at: [email protected].

If you have any questions or concerns regarding your rights as a participant in research, please contact RAND’s Human Subjects Protection Committee at (866) 697-5620 or [email protected]. When you contact the Committee, please reference Study #2021-N0371.

Please indicate your interest in possibly serving on the voluntary expert advisory panel by answering the question below. If you indicate that you are interested, you will be asked a few questions about your background and have an opportunity to suggest strategies for the panel to discuss.

Are you interested in participating in this expert panel?

• Yes

• No

[Message if they respond “No”]:

Thank you for considering participation in this study and informing us of your decision.

[If they respond “Yes”, proceed to the Questions]:

Questions

For the Panel Recruitment and Design Round (Round 0) 

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[An asterisk denotes questions that require a response in order to proceed.]

*1. What email address should we use to contact you regarding the expert panel? This information will not be shared outside of the RAND research team managing the panel, and it will be used only for panel participation purposes.

______________________ [short open-ended text box]

*2a. Which of the following expert categories apply to you? (Select all that apply)

• Academic, scholar, or researcher

• Military counselor, medical provider, advocate, chaplain, or other support person

• Teacher, school administrator, or community member who works in schools that enroll children of military service members

• U.S. military commander or senior noncommissioned officer with experience managing domestic abuse incidents

• Domestic abuse survivor activist, lobbyist, organizer, or member of civilian advocacy or support groups

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*2b. [If they selected more than one in 2a:] You selected more than one of the following expert categories. Which one most closely reflects your greatest area of expertise related to domestic abuse prevention? (Please select only one this time)

• Academic, scholar, or researcher

• Military counselor, medical provider, advocate, chaplain, or other support person

• Teacher, school administrator, or community member who works in schools that enroll children of military service members

• U.S. military commander or senior noncommissioned officer with experience managing domestic abuse incidents

• Domestic abuse survivor activist, lobbyist, organizer, or member of civilian advocacy or support groups

[Page break]

3. Some experts have openly identified themselves as survivors of domestic abuse. Does this apply to you?

• Yes

• No

[Page break]

Please help us create a balanced expert panel by providing some additional information about yourself. This information will not be shown to other participants. It will be used only to select and describe the panel. We will not report participant characteristics associated with any individual input.

4. What is your affiliation with the U.S. military? (Select all that apply)

• Current service member

• Current service member’s spouse

• Current military civilian employee or contractor

• Former service member

• Former service member’s spouse

• Former military civilian employee or contractor

• None of the above

5. [If current or former affiliation checked above] Which U.S. military organizations have you been affiliated with? If you have worked across multiple Services, please select the one(s) reflecting your greatest level of experience and expertise. [Permit multiple selections]

• Air Force

• Army

• Marine Corps

• Navy

• Space Force

• Office of Secretary Defense

• Coast Guard (Department of Homeland Security)

[Page break]

6. In which region do you reside?

• Midwest

• Northeast

• South

• West

• U.S. territories

• None of the above/ another country)

[Page break]

7. What is your gender? ____________ [short open-ended text box]

8. Are you Spanish/Hispanic/Latino?

• No, not Spanish/Hispanic/Latino

• Yes, Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, or other Spanish/Hispanic/Latino

9. What is your race? Mark one or more races to indicate what you consider yourself to be.

• American Indian or Alaska Native

• Asian (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese)

• Black or African American

• Native Hawaiian or Other Pacific Islander (e.g., Samoan, Guamanian, or Chamorro)

• White

10. What is your age group?

• 20-29 years old

• 30-39 years old

• 40-49 years old

• 50-59 years old

• 60+ years old

[Page break]

11. How many years of experience with domestic abuse-related issues or activities do you have?

• None

• Less than 5 years

• 5-9 years

• 10-19 years

• 20 years or more

12. Please mark any of the following populations for which you have specialized expertise:

• Women

• Men

• Any other gender identities (e.g., transgender, gender fluid, agender)

• Sexual orientation minorities (e.g., lesbian, gay, bisexual)

13. Please mark any of the following racial or ethnic subgroups for which you have specialized expertise:

• Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, or other Spanish/Hispanic/Latino populations

• American Indian or Alaska Native populations

• Asian American populations (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese)

• Black or African American populations

• Native Hawaiian or Other Pacific Islander populations (e.g., Samoan, Guamanian, or Chamorro)

• White populations

14. Please mark any age groups for which you have specialized expertise:

• Preschool-aged children

• Elementary school-aged children

• Junior high-aged children

• High school aged children

• Young Adults 18-22 years old

• Adults, 23-59 years old

• Older adults, 60 years old or older

15. Are there any other subpopulations for which you have specialized expertise? If so, please list them here: (Please do not include any personally identifying information in your response.) ______________________________

If not, please proceed to the next question.

[Page break]

16. This final section will invite you to share any suggestions you have for possible strategies the expert panel members should collectively consider during the iterative process.

[Topics B and C] For this panel, “domestic abuse” refers to domestic violence or a pattern of behavior resulting in emotional or psychological abuse, economic control, or interference with personal liberty that is directed toward a person who is one or more of the following:

• Current or former spouse.

• Person with whom the alleged abuser shares a child in common.

• Current or former intimate partner with whom the alleged abuser shares or has shared a common domicile.

• An intimate partner who is or has been in a social relationship of a romantic or intimate nature with the alleged abuser.

[Page break]

We will use your suggestions to help design the expert panel discussion agenda. The RAND research team will not report to anyone outside of the team your identity linked to your suggestions, or even whether you offered any suggestions. Whether you volunteered for the panel is also confidential information.

What [Topic A/B/C] should the expert panel consider? Please do not include any personally identifying information in your response.

[Unlimited text characters box]

[Page break]

Thank you for your interest and your time responding to this request. We expect to select the panelists and follow up with volunteers in [month year].

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