Consent Form

What is the purpose of this research?
We are asking you to participate in a research study because we are trying to learn more about the way community psychology centers operate in terms of structure, cooperation, satisfaction, values, cohesiveness, levels of access, and research involvement. People working in various positions at community research centers across the country will be included in this study. You are invited to participate in this study because you either work or volunteer in a community research center. This study is being conducted by Dr. Nicole Porter at DePaul University.

How much time will this take?
This study will take about 15 minutes of your time.

What will I be asked to do if I agree to participate in this study?
If you agree to be in this study, you will be asked to complete a survey to assess the structure, cooperation, satisfaction, values, cohesiveness, levels of access, and research involvement of your community research center.

What are the risks involved in participating in this study?
Being in this study does not involve risks other than what you would encounter in daily life. You may feel uncomfortable about answering certain questions. Your name will not be associated with the information you provide, but you will be asked to identify your specific role at your community center and to name your community center. We intend to protect the confidentiality of this information and do not intend to disclose this in our research results, but, there is a small risk that this information would be unintentionally disclosed and that you would face other consequences as a result.

What are the benefits of my participation in this study?
You will not personally benefit from being in this study. However, we hope that what we learn will help community psychology centers.

Can I decide not to participate? If so, are there other options?
Yes, you can choose not to participate. Even if your community center has agreed to be in the study, you may opt not to personally participate. Also, even if you agree to be in the study now, you can change your mind later and exit the study. There will be no negative consequences if you decide not to participate or change your mind later

How will my privacy by protected?
The records of this study will be kept private. In any report we might publish, we will not include any information that will identify you. We will take the following steps to ensure confidentiality: Your identity will be coded and all research records will be stored securely in locked files of Dr. Nicole Porter. Only researchers will have access to the records.

Whom can I contact for more information?
If you have questions about this study, please contact Dr. Nicole Porter at 773-325-7151. If you have questions about your rights as a research subject, you may contact Shay-Ann Heiser Singh, Coordinator of the DePaul University’s Institutional Review Board at 312-362-7593 or by email at sheiser@depaul.edu.
Do you consent to this statement and wish to continue?*
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