Teacher Consent

RELSW 5.1.6.4 PRISMS_OMB_Appendix A4_Teacher Informed Consent Form v3.docx

Providing Reading Interventions for Students in Middle School Toolkit Evaluation

Teacher Consent

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Appendix A4: Informed Consent for Teachers to Participate in the PRISMS Toolkit Evaluation Project

Funded by the U.S. Department of Education’s Institute of Education Science, Regional Educational Laboratory (REL) Southwest is developing a toolkit with resources that supports the implementation of effective grade 6–8 literacy intervention based on the evidence-based recommendations in the Providing Reading Interventions for Students in Grades 4–9 Educator’s Practice Guide. The Providing Reading Interventions for Students in Middle School (PRISMS) Toolkit includes resources for teachers, school leaders, and literacy leaders to understand all four recommendations from the practice guide and how to implement those recommendations.

REL Southwest is conducting an evaluation to examine the implementation and impact of the toolkit on teacher and student outcomes. The data collection for the evaluation focuses on grade 6–8 English language arts (ELA) and reading intervention teachers and students in grades 6–8 who are identified as below grade level in reading. It begins in spring 2025 and ends in summer 2026. As a grade 6–8 ELA and/or reading intervention teacher, you are being asked to provide insight into the implementation and effectiveness of the toolkit by participating in the following data collection activities conducted by REL Southwest:

Online teacher surveys: A baseline survey in spring 2025 and a survey in spring 2026. The surveys will be used to collect data on teacher attitudes, knowledge and practice, and implementation of and perceptions about the toolkit resources. Each survey will take approximately 30 minutes to complete. They can be done on your own time or during normal contract hours if allowed by your school district.

Instructional log. An online instructional log to be completed by each teacher for 10 days in spring 2025 and 2026.

Interviews. A small number of teachers will be selected to participate in a 30-minute virtual interview with the evaluation team in spring 2026.

Compensation. REL Southwest will offer teachers a $30 gift card for completing the survey and/or participating in an interview. Teachers will receive up to $150 for completion of the instructional logs ($7.50 per log).

Risks. There are no risks associated with this study. Your participation in the study is voluntary. You can decide not to participate or discontinue your participation at any time without penalty.

Confidentiality. The research team will protect the confidentiality of all information collected for the study and will use it for research purposes only. Only the evaluation team members with training in how to deal with sensitive and confidential data will be allowed access.

In reporting the study’s results, no information that identifies you or your organization will be reported. The researchers conducting this study follow the confidentiality and data protection requirements of the U.S. Department of Education’s Institute of Education Sciences (The Education Sciences Reform Act of 2002, Title I, Part E, Section 183). The reports prepared for the study will summarize findings across the sample and will not associate responses with a specific district, school, institution, or individual. All information you provide will be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required by law (20 U.S.C. §9573 and 6 U.S.C. §151).

Questions? If you have any questions or concerns about participation in the data collection activities for the research study, please contact the project director, Jill Bowdon, at [email protected]. If you have concerns or questions about your rights as a research participant, contact the American Institutes for Research’s (AIR’s) Institutional Review Board (IRB), which is responsible for the protection of project participants, at [email protected], toll free at 1-800-634-0797, or c/o IRB, 1400 Crystal Drive, 10th Floor, Arlington, VA 22202-3289. 

Statement of consent:

You are being asked to participate in the data collection for the evaluation of the PRISMS Toolkit. Involvement entails participating in the data collection activities described above. Please check one of the boxes below:

  • YES, I have read and understand the above and give my consent to participate in the data collection activities for the PRISMS Toolkit Evaluation Project.

  • NO, I have read and understand the above, but I do not give my consent to participate in the data collection activities for the PRISMS Toolkit Evaluation Project.



Your name (please print): _____________________________________________________



Your signature: ________________________________________



Date: ______________________________________________


Regional Educational Laboratory Southwest Toolkit Evaluation 1


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