Appendix B: Client consent

Appendix B

Client Consent

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Appendix B.1.

Parent consent form for HM youth focus groups and interviews

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OMB#: 0970-0630

Expiration Date: 03/31/2027

Voluntary Parent/Guardian Consent for Youth to Participate in a Focus Group or Interview about Healthy Marriage and Relationship Education Surveys

Study description and purpose

Healthy Marriage and Relationship Education for teenagers and adults are classes that teach teenagers skills needed for healthy relationships and marriages. These classes can be in schools, such as part of a health class, or other places, like places of worship or community centers. The teenagers in these classes take surveys, and the information from the surveys is used to improve the classes.

Because your child takes these classes, we invite your child to join a study to help make the surveys better for Healthy Marriage and Relationship Education programs. We want to know how well the questions in these surveys reflect the experiences, values, and beliefs of people from different backgrounds, races, ethnicities, and cultures. We also want to learn if the survey questions are clear and easy to understand and if your child thinks there are important topics missing or better ways to ask the questions.

Mathematica, an independent research firm, is conducting this study for the Administration for Children and Families (ACF). ACF is an agency in the federal government within the U.S. Department of Health and Human Services that supports the health and well-being of people.

What will my child do?

This is a permission form with information to help you decide if your child can participate in a focus group or interview. More information about the study activities is described next.

• If you give your permission, your child will (1) complete a 5-minute survey about their personal characteristics, such as their gender identity and their race and ethnicity, and (2) participate in a 60-minute focus group session to discuss people’s opinions about the surveys. Your child will be asked to share their name in the focus group. In some cases, your child may be asked to instead join one individual interview session. Your child would be invited to one focus group or one interview, but not both.

• The focus group will include a small group of youth who participated in a Healthy Marriage and Relationship Education program. The group may include others from your child’s class and others from different classes.

• If your child is asked to join an individual interview instead of a focus group, the interview would be conducted with your child alone. Your child would be invited to one focus group or one interview, but not both.

• The focus group or interview will be led by a researcher from Mathematica.

• In the focus group or interview, youth will be asked for their feedback on surveys that have questions about their opinions and experiences with relationships and their opinions on teen sexual behavior.

• We are not interested in your child’s answers to the survey questions. Instead, we want to know if the questions were easy or hard to understand, how the questions can be improved, and what your child thinks about the process of taking the surveys.

• The feedback your child provides will be combined with feedback from other youth and will be used to make the survey questions better. Your child’s name or feedback will not be disclosed or used in identifiable form.

What are the risks and benefits to participating?

• There are no known risks associated with this research. Some people might feel uncomfortable or embarrassed talking about relationships, sex, and relationship violence. Your child does not need to answer any questions or talk about any topics that make them uncomfortable.

• The focus group is a group discussion. There is a chance others might share information from the discussion with people who did not participate. We ask all participants to respect the privacy of others in the group by not discussing specifics with others outside the group, but we cannot guarantee that all members of the group will follow that guidance.

• Your child’s participation is entirely voluntary. Even if you give permission for them to participate, they can choose for themselves whether they want to participate or not. There are no consequences if you or your child decides not to participate in this research study.

• If your give permission and your child chooses to participate, they will receive $75 as a thank you for helping us improve the surveys.

How will my child’s privacy be protected?

• The discussion will be video-recorded so that the study team can review the recording later to make sure their notes are accurate. No one will hear the recording except for the study team. We will store the recording in a secure location, and our study team will destroy it at the end of the project.

• We will keep any notes from our conversation in a secure location for the study team to use, and we will destroy the notes at the end of the project.

• We are required by law to report your child’s name to authorities if:

• We suspect child abuse or neglect.

• Your child says something that suggests they are likely to harm themselves, harm another person, or that someone is likely to harm them.

How will the information from the discussion be used?

The study team will write a report for ACF that summarizes the findings across all focus groups and interviews. The study team might also write a report for the public that could include summaries of feedback we hear during the focus groups and interviews. Your child’s name will not be shared outside of the research team and your child’s feedback will not be used in a way that could identify them (for example, we would not include their name or a combination of information that could identify them, such as age, gender identity, race and ethnicity, and location).

Who can I contact for more information?

The Health Media Lab Institutional Review Board has approved this work. If you have any questions or concerns, please contact [study point of contact to be inserted].

Agreement to participate

• By checking the boxes and signing your name below, you agree that your child may participate in either the youth focus group or interview to gather feedback on the Healthy Marriage and Relationship Education surveys.

• If you agree, then your child will decide on their own whether to participate. They will sign their own agreement form.

• Your signature below indicates that your questions have been answered and that you have read and understood the information provided above.

I accept the terms described above and give permission for my child to participate voluntarily in the Healthy Marriage and Relationship Education study:

___________________________________________________________________________

Print Child’s Name

Please check the boxes below to let us know which study activity your child can join.

☐ My child only has permission to participate in a focus group.

☐ My child only has permission to participate in an interview.

☐ My child has permission to participate in either the focus group or the interview.

____________________________________ _______________________

Parent/Guardian Signature Date

This page has been left blank for double-sided copying.

Appendix B.2.

Youth assent form for HM youth focus groups or interviews

This page has been left blank for double-sided copying.

OMB#: 0970-0630

Expiration Date: 03/31/2027

Voluntary Youth Participation Agreement Form for a Focus Group or Interview about Healthy Marriage and Relationship Education Surveys

Study description and purpose

Healthy Marriage and Relationship Education for teenagers are classes that teach teenagers skills needed for healthy relationships and marriages. These classes can be in schools, such as part of a health class, or other places, like places of worship or community centers. The teenagers in these classes take surveys, and the information from the surveys is used to improve the classes.

Because you take these classes, we invite you to join a study to help make the surveys better for Healthy Marriage and Relationship Education programs. We want to know how well the questions in these surveys reflect the experiences, values, and beliefs of people from different backgrounds, races, ethnicities, and cultures. We also want to learn if the survey questions are clear and easy to understand and if you think there are important topics missing or better ways to ask the questions.

Mathematica, an independent research firm, is conducting this study for the Administration for Children and Families (ACF). ACF is an agency in the federal government within the U.S. Department of Health and Human Services that supports the health and well-being of people.

What will I do?

This is a permission form with information to help you decide if you want to participate in a focus group or interview. Your parent or guardian has already provided permission for you to participate, but you can now decide for yourself. More information about the study activities is described next.

• If you agree to participate, you will (1) complete a 5-minute survey about your personal characteristics, such as your gender identity and your race and ethnicity, and (2) participate in a 60-minute focus group session to discuss people’s opinions about the surveys. You will be asked to share your name in the focus group. In some cases, you may be asked to instead join one individual interview session.

• The focus group will include a small group of youth who participated in a Healthy Marriage and Relationship Education program. The group may include others from your class and others from different classes.

• If you are asked to join an individual interview instead of a focus group, a researcher will meet virtually with only you. You would be invited to one focus group or one interview, but not both.

• The focus group or interview will be led by a researcher from Mathematica.

• In the focus group you will be asked for your feedback on surveys that have questions about your opinions and experiences with relationships and your opinions on teen sexual behavior.

• We are not interested in your answers to the survey questions. Instead, we want to know if the questions were easy or hard to understand, how the questions can be improved, and what you think about the process of taking the surveys.

• The feedback you provide will be combined with feedback from other youth and will be used to make the survey questions better. Your name or feedback will not be shared or used in identifiable form.

What are the risks and benefits to participating?

• There are no known risks associated with this research. Some people might feel discomfort or embarrassment talking about relationships, sex, and relationship violence. You do not need to answer any questions or talk about any topics that make you uncomfortable.

• The focus group is a group discussion. There is a chance others might share information from the discussion with people who did not participate. We ask all participants to respect the privacy of others in the group by not discussing specifics with others outside the group, but we cannot guarantee that all members of the group will follow that guidance.

• If you choose to participate, you will receive $75 as a thank you for helping us improve the surveys.

Do I have to participate?

No. You can choose to participate or not participate in this research study. Even if you decided to participate now, you can change your mind later and decide to not participate, or skip any questions, without any consequences.

How will privacy be protected?

• The discussion will be video recorded so that the study team can review the recording later to make sure their notes are accurate. No one will hear the recording except for the study team. We will store the recording in a secure location and our study team will destroy it at the end of the project.

• We will keep any notes from our conversation in a secure location for the study team to use, and we will destroy the notes at the end of the project.

• Nothing will be shared with your parents or any other people outside of the study team conducting this study. However, we are required by law to report your name to authorities if:

  • We suspect child abuse or neglect.

  • You say something that suggests you are likely to harm yourself, harm another person, or that someone is likely to harm you.

How will the information from the discussion be used?

The study team will write a report for ACF that summarizes the findings across all focus groups and interviews. The study team might also write a report for the public that could include summaries of feedback we hear during focus groups and interviews. Your name will not be shared outside the research team and your feedback will not be used in a way that could identify you (for example, we would not include your name or a combination of information that could identify you, such as age, gender identity, race and ethnicity, and location).

Who can provide more information about this study?

• The Health Media Lab Institutional Review Board has approved this work.

• If you have any questions or concerns, please contact [study point of contact to be inserted].

Agreement to participate

• By signing below, you agree to participate in either the youth focus group or an interview to give feedback about the Healthy Marriage and Relationship Education surveys.

• Your signature means that your questions have been answered, and that you have read and understood the information provided above.

I accept the terms described above and will voluntarily participate in the Healthy Marriage and Relationship Education focus group or interview.

________________________________________________________

Print your name

____________________________________ _______________________

Your Signature Date

This page has been left blank for double-sided copying.

Appendix B.3.

Adult consent form for HM and RF focus groups and interviews

This page has been left blank for double-sided copying.

OMB#: 0970-0630

Expiration Date: 03/31/2027

Voluntary Consent to Participate in a Focus Group or Interview about [Healthy Marriage and Relationship Education/Responsible Fatherhood] Surveys

Study description and purpose

We invite you to join a study to help make surveys better for [Healthy Marriage and Relationship Education/Responsible Fatherhood] programs. We want to know how well the questions in these surveys reflect the experiences, values, and beliefs of people from different backgrounds, races, ethnicities, and cultures. We also want to learn if the survey questions are clear and easy to understand and if you think there are important topics missing or better ways to ask the questions.

Mathematica, an independent research firm, is conducting this study for the Administration for Children and Families (ACF). ACF is an agency in the federal government within the U.S. Department of Health and Human Services that supports the health and well-being of people.

What’s involved?

This form provides information to help you decide if you want to participate in this study. Most people who participate will join a focus group, however, in some cases, you may be asked to join an individual interview with a researcher instead of joining a focus group. More information about the study activities is described next.

• Participants will (1) complete a 5-minute survey about your personal characteristics, such as your gender identity and your race and ethnicity, and (2) participate in a 60-minute focus group session to discuss people’s opinions about the surveys. You will be asked to share your name in the focus group. In some cases you may be asked to join one individual interview instead of a focus group.

• The focus group will include a small group of adults who participated in a [Healthy Marriage/Responsible Fatherhood] program. The group may include others from your class and others from different classes.

• If you are asked to participate in an individual interview, a researcher will meet virtually with only you. You would be invited to one focus group or one interview, but not both.

• The focus group or interview will be led by a researcher from Mathematica. You will be asked for your feedback on surveys that have questions about your opinions and experiences with relationships and marriage, parenting and co-parenting, economic stability, and personal development.

• We are not interested in your answers to the survey questions. Instead, we want to know if the questions were easy or hard to understand, how the questions can be improved, and what you think about the process of taking the surveys.

• The feedback you provide will be combined with feedback from other people and will be used to improve the surveys.

What are the risks and benefits to participating?

• There are no known risks associated with this research. Some people might feel discomfort or embarrassment talking about relationships. You do not need to answer any questions or talk about any topics that make you uncomfortable.

• The focus group will have a group discussion. There is a chance others might share information from the discussion with people who did not participate. We ask all participants to respect the privacy of others in the group by not discussing specifics with others outside the group, but we cannot guarantee that all members of the group will follow that guidance.

• Your participation is entirely voluntary. You can choose to participate or not participate in this research study. Even if you decided to participate now, you can change your mind later and decide to not participate without consequence.

• If you choose to participate you will receive $75 for helping us improve the surveys.

How will my privacy be protected?

• These discussions will be video-recorded so that the study team can review the recording later to make sure their notes are accurate. We will store the recording in a secure location, and our study team will destroy it at the end of the project. Only the study team will have access to and hear the recordings.

• We will keep any notes from our conversation in a secure location for the study team to use, and we will destroy the notes at the end of the project.

• We are required by law to report your name to authorities if:

  • We suspect child abuse or neglect.

  • You say something that suggests you are likely to harm yourself, harm another person, or that someone is likely to harm you.

How will the information from the discussion be used?

The study team will write a report for ACF that summarizes the findings across all focus groups and interviews. The study team might also write a report for the public that could include summaries of feedback we hear during focus groups and interviews. Your name will not be shared outside the research team and your feedback will not be used in a way that could identify you (for example, we would not include your name or a combination of information that could identify you, such as age, gender identity, race and ethnicity, and location).

Who can provide more information about this study?

• The Health Media Lab Institutional Review Board has approved this work.

• If you have any questions or concerns, please contact [study point of contact to be inserted].

Agreement to participate

• By signing below, you agree to participate in this study to give feedback about the [Healthy Marriage and Relationship Education/Responsible Fatherhood] surveys.

• Your signature below means that your questions have been answered and that you have read and understood the information provided above.

I accept the terms described above and will voluntarily participate in the [Healthy Marriage and Relationship Education/Responsible Fatherhood] focus group or individual interview.­­­­­­­­­­­­­­­­­­­­­­­­­

_____________________________________________________________________________________

Print Your Name

____________________________________ _______________________

Your Signature Date