The University of New Mexico Health Sciences Center Consent and Authorization to Participate in a Research Study
Dear Prospective Participant,
Researchers at the University of New Mexico are inviting you to take part in in virtual interviews and focus groups about factors that create good and poor health. This study is interviewing community members and thought leaders on your ideas about what creates good and poor health and the actions that can be taken to produce good health outcomes. By doing this study, we hope to learn ways to talk to the community about how behavior, healthcare, and social and economic factors contribute to health and actions that may be taken at the community level to yield good health. Your participation in this research will last about 90 minutes.
WHAT ARE THE KEY REASONS YOU MIGHT CHOOSE TO VOLUNTEER FOR THIS STUDY?
Although you may not get personal benefit from taking part in this research study, your responses may help us understand more about how to empower community groups to achieve good health by acting upon a range of factors including behavior and socioeconomic issues.
WHAT ARE THE KEY REASONS YOU MIGHT NOT CHOOSE TO VOLUNTEER FOR THIS STUDY?
There are no known risks to participating in this study. There are no costs to you for participating. You should meet the following criteria:
- Older than 18 years of age
- Lived in New Mexico for three years or more
- English speaking
- Not a current substance user
- Access to the internet, a smart phone, laptop or computer
- An informed community member who attends local meetings and contributes to civic decision-making.
You should be aware that in one-to-one interviews or small groups some questions may cover personal or confidential information about issues such as income, food security, or housing status. Occasionally some people feel uncomfortable because of the personal nature of questions. Additionally, because of the small number of participants, approximately 3 to 12, sometimes identity might be discerned; therefore, only limited confidentiality can be guaranteed. However, your privacy will be protected to the maximum extent allowable by law. Again, we will make all possible efforts to maintain data confidentiality. Further, you are not required to answer questions that make you feel uncomfortable and may decline to answer those questions. In the case of a focus group, if you are uncomfortable, we can arrange for a one-to-one interview.
Your responses from the interview will be kept confidential to the extent allowed by law. When we write about the study and its results you will not be identified. Again, there are some circumstances in which we may have to show your information to other people because of legal or safety regulations. For example, the law may require us to share your information with the following agencies and for the following reasons:
- The law requires us to share your information with authorities if you report information about a child being abused.
- If you pose a danger to yourself or someone else.
- A court or agencies, if you have a reportable disease or condition.
- Authorities, if you report information about a child being abused, if you pose a danger to yourself or someone else.
To ensure the accuracy of the data audio, visual, and photos will be collected. Data will be kept on a password protected computer of the PI and cloud storage. Electronic records will be stored on the “N:\ Research-Studies network drive. The data will be kept only during the data collection phase up to two years then destroyed. Only the PI will access the data.
You can choose to leave the study at any time. You will not be treated differently if you decide to stop taking part in the study. If you choose to leave the study early, your interview data collected until that point will remain in the study database and may not be removed. Note, there is the possibility that investigators conducting the study may need to remove you from the study. This may occur for several reasons. You may be removed from the study if:
- You are not able to follow the directions.
- We find that your participation in the study is more risk than benefit to you.
If you volunteer to take part in this study, you will be one of about forty people to do so. Identifiable information such as your name, medical record number or date of birth may be removed from the information collected in this study. After removal, the information may be used for future research or shared with other researchers without your additional informed consent.
You can change your mind and NOT let the researcher(s) collect or release your interview information (revoke the Authorization). If you revoke the authorization:
- You will send a written letter to Lauri Andress to inform Lauri Andress of your decision.
- Researchers may use and release your unidentified interview information already collected for his research study.
If you have questions about the study, please feel free to ask; my contact information is given below. If you have questions regarding your legal rights as a research subject, you may call the UNM Human Research Protections Office at (505) 272-1129.
Thank you in advance for your assistance with this important project.
Sincerely,
Lauri Andress, MPH, J.D., Ph.D. College of Population Health, University of New Mexico Health Sciences PHONE: 713-553-8192 E-MAIL: laandress@salud.unm.edu