Workforce ICR - Appendix H_Agency Director Consent

Appendix H_Agency Director Consent_June 2020_clean_v2.docx

OPRE Study: National Survey of Child and Adolescent Well-Being Second Cohort (NSCAW III): Data Collection [Longitudinal Study]

Workforce ICR - Appendix H_Agency Director Consent

OMB: 0970-0202

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Agency Director Consent

National Survey of Child and Adolescent Well-Being (NSCAW)

NSCAW

The Administration for Children and Families (ACF), an agency within the U.S. Department of Health and Human Services, provides funding for activities that support the well-being of children and families. ACF hired RTI International (RTI), a research company in North Carolina, to conduct a national survey of children and families in the child welfare system and to collect information about the child welfare workforce serving these families. RTI works with researchers from the University of North Carolina at Chapel Hill and Washington University in St. Louis to carry out the study.


Selection of Agency Directors/Administrators

RTI is asking over 60 agency directors/administrators within participating NSCAW agencies to provide context about their agencies and workforce. You were selected for participation based on your position within the agency.


Purpose of the Study

The purpose of this study is to gain a better understanding of the characteristics and activities of the current workforce in public child welfare agencies, including the strengths of the workforce and challenges agencies may face. ACF will use information from this study to improve child welfare policies and programs.


Types of Questions for Agency Directors/Administrators

This one-time survey takes about 35 minutes to complete. The survey covers topics like the general characteristics and structure of your agency, the partnerships your agency may have with other private agencies, your agency’s recruitment and hiring practices, training provided to your staff, your agency’s workforce policies, and impacts on your agency related to the COVID-19 pandemic.


Your Rights

You can decide to take part in the study or not and your participation is strictly voluntary. Your decision to take part will not affect you or your job. You have the right to stop the survey at any time, and if you do participate, you can refuse to answer any questions.


Risks

To the best of our knowledge, the things you will be doing have no more risk of harm than you would experience in everyday life.



Benefits

Taking part in this research study presents no direct benefits to you. Your input will help us learn more about the characteristics and activities of the current workforce in public child welfare agencies across the nation.


Privacy

We keep your responses private to the extent permitted by the law. We do not identify you by name. We will combine your answers with the other agency directors who respond to this survey and report the information in summary form. All staff involved in this research signed a Privacy Pledge.


This research is covered by a federal protection called a Certificate of Confidentiality. This means the researchers cannot share the information they gather that may identify you. The Certificate prevents researchers from revealing this information even if it is subpoenaed by a court. However, the Certificate does allow researchers to share information in some situations. For example, the agency that funds this research (ACF) is permitted to access information to confirm that the research is being conducted properly.


We may use or share your research data for future research studies, but it will be deidentified, which means that it will not contain your name or other information that can directly identify you. We will not ask for your additional informed consent for these studies. We may also share this deidentified data with other researchers here, at other institutions in the United States or around the world.

We or other researchers may contact you in the future to offer you participation in additional research activities. If you decide to participate in any future studies, you will be asked to sign a separate consent form.

Questions

If you have questions, please call Jennifer Keeney at RTI, 1-800-334-8571 extension 23525 (toll-free number). If you have questions about your rights as a study participant, please call RTI's Office of Human Research Protection at 1-866-214-2043 (a toll-free number).


You will receive a copy of this consent form to keep.

Shape1

The above information has been explained to me. My signature below indicates I give consent for my survey.







____________________________ __________________________ _________________

Agency Director (or Proxy) Printed Name Agency Director (or Proxy) Signature Date



____________________________ ________________________

Interviewer Signature Date



An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number and expiration date for this collection are OMB #: 0970-0202, Exp: XX/XX/XXXX. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Dr. Melissa Dolan; 230 W. Monroe Street, Suite 2100 Chicago, IL 60606.

The Federal Government has issued a Certificate of Confidentiality (authorized by the Public Health Service Act Section 301(d), 42 U.S.C Section 241 (d), 1988) to the researchers who are conducting this study which authorizes us to protect the privacy of individuals who participate. 


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleCaseworker Informed Consent
Authorafg
File Modified0000-00-00
File Created2022-05-19

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