RESEARCH SUBJECT CONSENT FORM
Title: Relationships, Rigor, and Routines in Progressive Urban High Schools
Protocol No.: 25996
Investigator: Maia Cucchiara
Associate Professor of Urban Education
1301 C.B. Moore Avenue, Ritter Annex 255
Philadelphia, PA 19122
Daytime Phone Number: 215-204-8184
What should I know about this research?
- Someone will explain this research to you.
- Taking part in this research is voluntary. Whether you take part is up to you.
- If you don’t take part, it won’t be held against you.
- You can take part now and later drop out, and it won’t be held against you
- If you don’t understand, ask questions.
- Ask all the questions you want before you decide.
How long will I be in this research?
We expect that your taking part in this research will last for about one hour.
Why is this research being done?
The purpose of this research is to understand how progressive urban high schools promote relationships and academic rigor. The study is designed to examine school policies, practices, and procedures and how students, educators, parents, and others experience them.
This study is funded by the National Science Foundation (#2017107).
What happens to me if I agree to take part in this research?
If you decide to take part in this research study, the general procedures include an interview that will take about one hour. The interview will cover your experiences and perspectives about the school. The interview will be audio recorded. The audio recording will be professionally transcribed. If you agree, you may be contacted for a follow-up interview.
Could being in this research hurt me?
- The time it will take to speak with me.
- A risk of loss of confidentiality.
Will being in this research benefit me?
The benefit you will obtain from the research is knowing that you have contributed to the understanding of this topic.
What other choices do I have besides taking part in this research?
Instead of being in this research, you may choose not to participate.
What happens to the information collected for this research?
All data from this study will be kept on the investigator’s computer, which is password protected and/or in a locked drawer in the investigator’s office. Data will be backed up on OwlBox, Temple University’s cloud storage platform. OwlBox is also password protected, and only members of the research team will have access to the study folders. Any written work that results from this research will use pseudonyms to refer to participants and programs.
Raw data from this study will remain private and cannot be shared. Because audio-files represent a particular threat to participants’ confidentiality, they will be destroyed within five years of completion of the project. I will, however, make metadata from the study available, which would allow other researchers to replicate it. This will include: recruitment materials, interview guides, data collection plans, coding schemes, and other materials that would be helpful to future scholars and do not compromise the confidentiality of my respondents. These materials will be stored in the ICPSR repository within three years of the expiration of the National Science Foundation grant.
We may publish the results of this research. However, we will keep your name and other identifying information confidential.
We protect your information from disclosure to others to the extent required by law. We cannot promise complete secrecy.
Your private information will be shared with individuals and organizations (if applicable) that conduct or watch over this research, including:
- The Institutional Review Board (IRB) that reviewed this research
- Temple University
Who can answer my questions about this research?
If you have questions, concerns, or complaints, or think this research has hurt you or made you sick, talk to the research team at the phone number listed above on the first page.
This research is being overseen by an Institutional Review Board (“IRB”). An IRB is a group of people who perform independent review of research studies. You may talk to them at (215) 707-3390 or email@example.com if:
- You have questions, concerns, or complaints that are not being answered by the research team.
- You are not getting answers from the research team.
- You cannot reach the research team.
- You want to talk to someone else about the research.
- You have questions about your rights as a research subject.
What happens if I agree to be in this research, but I change my mind later?
You can choose to leave the research at any time with no consequences to you.
Will I be paid for taking part in this research?
For taking part in this research, you may be paid up to a total of one $25 gift card for each interview at the time of the interview.
Federal tax law requires to you to report this payment as income to the Internal Revenue Service if you are compensated more than $599.00 (in total) this year for participating in research. You may be asked to tell us your social security number or other identifying information (e.g., full name). If payments for this study are more than $599.00, we will report them to the Internal Revenue Service and send you a Form 1099-MISC.
The researcher may contact me about a follow-up interview.
|Signature of adult subject capable of consent||Date|
|Printed name of subject|
|Signature of person obtaining consent||Date|
|Printed name of person obtaining consent|