Consent Form 

You are invited to take part in a research study about The Psychological and Physical Impact of the Opioid Crisis on Families. This form is part of a process called “informed consent” to allow you to understand this study before deciding whether to take part.

This study seeks 102 volunteers who are:
A family member who has ongoing interaction with an individual struggling with opioid addiction.
18 – 100 years old
Has a family member that is an active part at the recovery center
The survey will be available only in the English; therefore, a criterion is the participants must be proficient in English.

This study is being conducted by a researcher named Adrienne Hunter-Green, who is a doctoral student at Walden University.

Study Purpose:
The purpose of this study is to gain understanding of a family members experiences who has ongoing interaction with an individual struggling with opioid or another addiction.

Procedures:
The survey will take approximately 35 minutes.

Here are some sample questions:
Friends/relations have helped to cheer me up.
I have friends/relations whom I trust.

Voluntary Nature of the Study:
Research should only be done with those who freely volunteer. So, everyone involved will respect your decision to join or not. If you decide to join the study now, you can still change your mind later. You may stop at any time.

Risks and Benefits of Being in the Study:
Being in this study could involve some risk of the minor discomforts that can be encountered in daily life such as sharing sensitive information. With the protections in place, this study would pose minimal risk to your wellbeing. The free national three-digit 988 national hotline phone number is for all experiencing a crisis, such as mental health, suicide, alcohol or a substance use crisis. By calling or texting 988 you can be connected to Crisis Specialist 24/7.

This study offers no direct benefits to individual volunteers. The aim of this study is to benefit society by studying the data to gain an understanding of a family members experiences who has ongoing interaction with an individual struggling with opioid or another addiction.

Payment:
There is no payment for completing the study.

Privacy:
The researcher is required to protect your privacy. Your identity will be kept anonymous, within the limits of the law. The researcher will not ask for your name at any time or link your responses to your contact information. The researcher will not use your personal information for any purposes outside of this research project. Also, the researcher will not include your name or anything else that could identify you in the study reports. If the researcher were to share this dataset with another researcher in the future, the dataset would contain no identifiers so this would not involve another round of obtaining informed consent. Data will be kept secure by storing it on a flash drive in a locked box. Data will be kept for a period of at least 5 years, as required by the university.

Contacts and Questions:
You can ask questions of the researcher by emailing them to adriennehunter@waldenu.edu. If you want to talk privately about your rights as a participant or any negative parts of the study, you can call Walden University’s Research Participant Advocate at 612-312-1210. Walden University’s approval number for this study is # 10-24-23-0614739. It expires on October 23, 2024.

You might wish to retain this consent form for your records. You may ask the researcher or Walden University for a copy at any time using the contact info above.

Obtaining Your Consent
If you feel you understand the study and wish to volunteer, please indicate your consent by clicking the OK button below: