CONSENT TO TAKE PART IN A RESEARCH STUDY

Principal Investigator: Crystal M Grant, MPA student

This consent form is part of an informed consent process for a research study and it will provide information that will help you decide whether you want to take part in this study.  It is your choice to take part or not. After all of your questions have been answered and you wish to take part in the research study, you will be asked to participate in the research survey by accessing the following link: Community-Engagement Research Survey. You will not be given a copy of the form to keep. Your alternative to taking part in the research is not to take part in it.

Who is conducting this research study and what is it about?

You are being asked to take part in research being conducted by CrystalM Grant who is a Rutgers student in the School of Public Affairs and Administration. The purpose of this study is to complete her Master of Public Administration Capstone project.

What date does this need to be in by?

You are being asked to complete the survey by Friday, December 4, 2020.

What will I be asked to do if I take part?

The survey will take about 5 to 15 minutes complete. 300 subjects are anticipated to take part in the study. 

What are the risks and/or discomforts I might experience if I take part in the study?

Breach of confidentiality is a risk of harm, but a data security plan is in place to minimize such a risk. Also, some questions may make you feel uncomfortable. If that happens, you can skip those questions or withdraw from the study altogether. If you decide to quit at any time before you have finished the survey your answers will NOT be recorded.

Are there any benefits to me if I choose to take part in this study?

There are no direct benefits to you for taking part in this research. You will be contributing by sharing your professional and personal experiences with Express Newark.

Will I be paid to take part in this study?

You will not be paid to take part in this study.

How will information about me be kept private or confidential?

All efforts will be made to keep your responses confidential, but total confidentiality cannot be guaranteed.

• We will not collect any information that can identify you or other subjects. Completed forms will be stored in a locked cabinet controlled by the investigator. Responses may be converted to digital format and stored on a password protected computer. There is no plan to delete the responses. We plan to study the data for some time.
• We will ask you to provide your race, gender, and age when you complete the survey. This identifiable information will be stored with your responses. When data collection is complete, we will securely store the key code linking your responses to your identifiable information in a separate password-protected file which will be destroyed after data analysis is complete and study findings are professionally presented or published.

No information that can identify you will appear in any professional presentation or publication. 

What will happen to information I provide in the research after the study is over?

After information that could identify you has been removed, de-identified responses may be used by or distributed to investigators for other research without obtaining additional informed consent from you.

What will happen if I do not want to take part or decide later not to stay in the study?

Your participation is voluntary. If you choose to take part now, you may change your mind and withdraw later. In addition, you may skip questions that you are not comfortable answering. You may leave without turning in a completed form or by turning in a blank or incomplete form. However, once you turn in the form, you can no longer withdraw your responses as we will not know which ones yours are.

Who can I call if I have questions?

If you have questions about taking part in this study, you can contact the Principal Investigator: Crystal M Grant, cmgrant@rutgers.edu, 917-557-2082. You can also contact the faculty advisor: Dr. Lois Warner, lmrs@rutges.edu, 973-353-3678

If you have questions about your rights as a research subject, you can contact the IRB Director at: Newark HealthSci 973-372-3608 or the Rutgers Human Subjects Protection Program at (973) 972-1149 or email us at humansubjects@ored.rutgers.edu.

Please keep this consent form if you would like a copy of it for your files. Survey deadline of completion: Friday, December 4, 2020.

Subject’s written signature is NOT required:

By beginning this research, you acknowledge that you have read the information and agree to take part in the research, with the knowledge that you are free to withdraw your participation without penalty.