Document 11224470

advertisement
BOSTON COLLEGE
Department of Psychology
Research Study: Transitions from Foster Care
Researcher Name: [insert PI Name here]
Sample FOCUS GROUP CONSENT FORM: Adult Participation in a focus Group
What is the Research?
You have been asked to take part in a research study about being a parent of a foster child.
The purpose of this study is to find out the best ways foster parents can help teens prepare for adult life.
Why have I been asked to take part?
You are a foster parent with a teen aged child
We would like you to take part in a discussion on how to prepare teens for adult life with other foster
parents.
We will talk about how you helped your child switch from foster care to family life.
Voluntary Participation
This discussion is voluntary—you do not have to take part if you do not want to.
If you do not take part, it will have no effect on your child’s services with the agency.
If any questions make you feel uncomfortable, you do not have to answer them.
You may leave the group at any time for any reason.
Risks
We do not think any risks are involved in taking part in this study.
This study may include risks that are unknown at this time.
Benefits
There are no benefits for taking part in this research. We hope to learn more about how to help foster
children prepare for adult life.
Privacy
Your privacy will be protected.
Your name will not be used in any report that is published.
The discussion will be kept strictly confidential.
The other parents in the group will be asked keep what we talk about private, but this cannot be assured.
Rev. 4/12/10
Subject’s Initials ______
If a BC researcher finds out during the talk that that child abuse or neglect is suspected, the BC
researcher is required by law to report suspected child abuse or neglect to state officials as required by
Massachusetts State law .
Regulators, sponsors or Institutional Review Board Members that oversee research may see research
records to make sure that the researchers have followed regulatory requirements
If the tape recorder is used, it will only be used to remind staff what parents said.
All research data will be stored in a locked file cabinet and the tapes will be destroyed the talk has been
studied.
Audiotape Permission
I have been told that the discussion will be tape recorded only if all participants agree.
I have been told that I can state that I don’t want the discussion to be taped and it will not be. I can ask
that the tape be turned off at any time.
I agree to be audio taped ___Yes ___No
Payment
I will receive a $15 gift card as a token of appreciation for taking part in the focus group.
Questions
I have been given the opportunity to ask any questions I wish regarding this evaluation. If I have any
additional questions about the evaluation, I may call ______________.
If I have any questions about my rights as a research subject, I may contact the Boston College Office for
Research Protections at (617) 552-4778 or [email protected] I have received (or will receive) a copy of this
form.
Please write your name below and check yes or no. If you want to take part Sign your name at the
bottom.
__________________________________________
NAME
_____ Yes, I would like to take part in the focus group.
_____ No, I would not like to participate in the focus group.
SIGNATURE
Rev. 4/12/10
DATE
Subject’s Initials ______
Download