AccessAbility on Campus Consent Form

1. Consent Form

 
Northwestern University
Master of Science in Education
CONSENT FORM

Project Title: AccessAbility on Campus: Disability Service Programs
Student Investigator: Andrea R. Abel
Faculty Advisor: Dr. Lois Trautvetter

Introduction/Purpose:
You are being asked to participate in a research study that is focused on disability services in Higher Education. You are being asked to participate because you have had contact with a disability service office in some capacity. The purpose of my study is to determine the effectiveness of disability service programs and whether or not their programs and services align with “best practices.” We will be surveying approximately 100 people for this study. I am completing for a graduate class at Northwestern University. My instructor is Dr. Lois Trautvetter, who may be contacted by phone at (847) 491-3901.

Procedures
As a participant in this study, you will be asked to come to complete an online survey regarding your interaction and experience with the Disability Service office on your campus. Some participants will answer questions about their experience with Disability Services as a student and others will answer questions from the perspective of faculty and staff members.

Your participation in this study will initially take approximately 15-20 minutes. After the survey, data will be analyzed to find similarities and differences. Some participants may be contacted for follow-up and/or additional questions regarding their experiences.

Participation in the initial survey indicates consent to be interview at a later date. You may request not to be contact in the future. This question is included in the survey and you have the option to request not to be considered for future interviews.

At any time in the study, you may decide to withdraw from the study. If you withdraw no more information will be collected from you. When you indicate you wish to withdraw the investigator will ask if the materials already collected in the study can be used.

Risks
Your participation in this study does not involve any physical risk or emotional risk to you. You may be uncomfortable with some of the questions and topics we will ask about. If you are uncomfortable, you may decide not to answer the questions. You may stay in the study even if you skip some of the questions. You may withdraw at any time.

Benefits:
There may be no direct benefit to you by your participation in this research study. The potential benefits to you from participation in this study may include gaining information about your own program or provide you insight into how improve your experience in the future. Your participation in this study may aid in our understanding of disability service programs and the different perspectives of individuals using and benefiting from these programs.

Alternatives:
You have the alternative to choose not to participate in this research study.

Confidentiality:
Participation in this research study may result in a loss of privacy, since persons other than the investigator(s) might view your study records. Unless required by law, only the study investigator, members of the investigator’s staff, the Northwestern University Institutional Review Board, and representatives from the Office for Human Research Protections (DHHS) will have authority to review your study records. They are required to maintain confidentiality regarding your identity.

Results of this study may be used for teaching, research, publications, or presentations at meetings and/or conferences. If your individual results are discussed, your identity will be protected by using a study code number rather than your name or other identifying information.
Centralized data collection or registries:
The results of your examinations will be collected in a centralized computer or data registry at Northwestern University, Evanston, IL and Survey Monkey, Portland OR. Results will be stored by coded identifier, not your name or other identifiable information.

Financial Information:
Your participation in this study will involve no cost to you. You will not be paid for your participation in this study.

Subjects’ Rights:
Your participation in this study is voluntary and you are free to withdraw at any time. You are free to choose not to answer particular questions if you do not want to.

Contact Persons:
If you have any questions about this study you may call Andrea Abel at telephone number (402) 770-9423 or Dr. Lois Trautvetter at (847) 467-1458. If you have any questions about your rights as a research subject you may call the Office for the Protection of Research Subjects of Northwestern University at telephone number (312) 503-9338. If problems arise evenings or weekends, you may call (773) 687-9033.


Consent:
I have read this form and the research study has been explained to me. I have been given the opportunity to ask questions and my questions have been answered. I agree to voluntarily participate in this survey. I understand that I may be asked to answer additional qualitative questions in follow up interviews by email or phone. If I choose to do so, I will submit my contact information. If I have additional questions, I have been told whom to contact. I agree to participate in the research study described above and, by accessing the survey at the provided URL, give my consent to participate.
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