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Consent for Participation 

LONG ISLAND UNIVERSITY
INSTITUTIONAL REVIEW BOARD (IRB)
RESEARCH PARTICIPANT INFORMED CONSENT FORM


Study Title: Does Emotional Invalidation Moderate the Relation Between Occupational Stress and Mental Health Outcomes in Law Enforcement?

Faculty Investigator: Camilo Ortiz, Ph.D.
Long Island University Post- Clinical Psychology Doctoral Program (Psy.D.)
Drcamilo.ortiz@gmail.com
Office: 516-299-3211

Student Investigator: Sahar Jaafar, M.S.; M.A.
Long Island University Post- Clinical Psychology Doctoral Program (Psy.D.)
Sahar.jaafar@my.liu.edu
Office: 718-223-4737

• Your identity will remain confidential, as your name and badge number will not be requested or noted at any point during the questionnaire/survey.

Raffle Volunteers: Please email sahar.jaafar@my.liu.edu if you would like to enter the raffle to win one of four $25 Visa gift cards. Your contact information will remain confidential if you volunteer to sign up for the raffle.
You are being asked to join a research study. Participation in this study is voluntary. Even if you decide to join now, you can change your mind later. This study is being conducted by Sahar Jaafar, M.S.; M.A., a doctoral candidate in the Clinical Psychology Doctoral Program at LIU-Post. Ms. Jaafar is under the supervision of Camilo Ortiz, Ph.D., Professor of Psychology in the Clinical Psychology Doctoral Program. This study is being conducted to fulfill one of Ms. Jaafar’s requirements toward the degree of Doctor of Psychology.
1. Why is this research being done?
This research is being done to understand the experiences of police officers in the United States. Police officers are exposed to numerous occupational stressors daily, which may impact their personal and work lives. This study attempts to explore the extent to which officers feel supported by others and the impact support may have on officer well-being.

Prior to the survey, you will be asked to complete a demographic questionnaire to determine your eligibility to participate in the study. This questionnaire is expected to take 2-3 minutes to complete. Eligible subjects will be sworn police officers recruited from police departments across the United States. To qualify, participants had to be involved in one or more of the following activities: gathering evidence, investigating or prosecuting perpetrators, responding to emergency calls, assisting crime victims, testifying in court, conducting outreach to the public, and/or witnessing or being involved in a police shooting.  You are not eligible to participate in this study if you fail to meet the above criteria or if you report that you are actively suicidal. We anticipate that about 48 people will take part in this study.
2. What will happen if you join this study?
If you agree to be in this study, we will ask you to do the following things:
• As a participant, you will be asked to take part in a one-time confidential online survey regarding your experiences as a police officer.
• The survey will consist of 20 items, and you will be provided with the option of completing the online survey on your own in a confidential space or by means of a structured interview with the student investigator.
• If you decide to complete the online survey using a structured interview, the student investigator will ask you the same questions provided in the online survey and will note your responses on Survey Monkey.
• Your identity will remain confidential, as your name and badge number will not be requested or noted at any point during the questionnaire/survey.
3. How long will you be in the study?
Participation in the study will take approximately 10-15 minutes.
4. What are the risks or discomforts of the study?
The risks associated with participation in this study are no greater than those encountered in daily life or during the performance of routine physical or psychological examinations or tests. As with any activity, participation in this study may come with some risks. As a participant, you will be asked about your personal and occupational experiences as a police officer being exposed to stressors. You will also be asked about the extent to which you feel supported by others due to these experiences. You may experience a range of reactions to these questions, including experiencing negative feelings such as sadness, anger, grief, or anxiety. Should you feel distressed because of the questions posed by the investigator, you may request a support/resource referral. Referrals will be provided to the Psychological Services Center (PSC), a clinic with sliding scale services. Furthermore, referrals may also be provided to the mental health resources hotline/chats exclusive to police officers, which offer peer-support services and assistance in locating local resources.
You may get tired or bored when we are asking you questions, or you are completing questionnaires. You do not have to answer any question you do not want to answer. Although your IP Address will not be stored in the survey results, there is always the possibility of tampering from an outside source when using the Internet for collecting information. While the confidentiality of your responses will be protected once the data is downloaded from the Internet, there is always the possibility of hacking or other security breaches that could threaten the confidentiality of your responses, however your responses can not be traced back to you since your identifying information will not be collected.
5. Are there benefits to being in the study?
You may or may not benefit from being in this study. This study may benefit society and the law enforcement community if the results lead to a better understanding of the experiences and occupational stressors encountered by police officers. Participants may also personally benefit from anonymously sharing their experiences using the survey as a confidential medium.
6. What are your options if you do not want to be in the study?
Your participation in this study is entirely voluntary. You choose whether to participate. If you decide not to participate, there are no penalties, and you will not lose any benefits to which you would otherwise be entitled.
7. Will it cost you anything to be in this study?
No
8. Will you be paid if you join this study?
In compensation for your time, you may volunteer to be eligible to receive one of four $25 Visa® gift cards upon completion. The participants who win an incentive will be provided the incentive after all data is collected from 48 participants. You understand that you may stop participation at any time. However, you also understand that you will only receive the research compensation if you complete the research protocol and your participation is deemed adequate. The location of the raffle drawing will be at LIU-Post under the supervision of the investigator's dissertation chair- Dr. Camilo Ortiz.
9. Can you leave the study early?
• You can agree to be in the study now and change your mind later, without any penalty or loss of benefits.
• If you wish to stop, please tell us right away.
• If you want to withdraw from the study, please notify the primary investigator and your survey and/or incomplete responses to the survey will be deleted.
10. Why might we take you out of the study early?
You may be taken out of the study if:
• Staying in the study would be harmful.
• You fail to follow instructions.
• The study is cancelled.
• There may be other reasons to take you out of the study that we do not know at this time.

If you are taken out of the study early, LIU may use or give out your information that it has already collected if the information is needed for this study or any follow-up activities.
11. How will the confidentiality of your data be protected?
Any study records that may identify you will be kept confidential to the extent possible by law. The records from your participation may be reviewed by people responsible for making sure that research is done properly, including members of the Long Island University Institutional Review Board and officials from government agencies such as the National Institutes of Health and the Office for Human Research Protections.
Study records, including the demographic questionnaire and survey will be data encrypted, password protected. Two volunteer coders from the Clinical Psychology Doctoral Program at LIU-Post will be used to analyze the data. The volunteer coders are required to keep any potentially identifying information in the surveys confidential. Participants’ names will not be requested for the purpose of this study and participants have the option to volunteer any identifying information for the purpose of the raffle. Participants’ identifying information and the survey responses will not be linked.

This consent form will be downloaded from Survey Monkey directly to the principal investigator’s password-protected computer and would only be available to the investigators. Study data will also be stored on the principal investigator’s password-protected computer and would only be available to the investigators.
12. What does a conflict of interest mean to you as a participant in this study?
In some situations, the results of this study may lead to a financial gain for the researcher and/or Long Island University. This financial interest has been reviewed in keeping with LIU’s policies. It has been approved with certain conditions, which are intended to guard against bias in how the study is conducted, how the results are analyzed, and how participants are protected.

If you have any questions about this financial interest, please talk to Paul Kwon, 516-299-3211. This person is a member of the study team, but does not have a financial interest related to the study. You may also call the Office of Sponsored Projects 718-488-1413 for more information. The Office of Sponsored Projects reviews financial interests of researchers and/or LIU.
13. What other things should you know about this research study?

What is the Institutional Review Board (IRB) and how does it protect you?
This study has been reviewed by an Institutional Review Board (IRB), a group of people that reviews human research studies. The IRB can help you if you have questions about your rights as a research participant or if you have other questions, concerns or complaints about this research study. You may contact the IRB at 516-299-3591 or lacey.sischo@liu.edu.

What should you do if you have questions about the study?
Contact the student investigator Sahar Jaafar at 718-223-4737, Sahar.jaafar@my.liu.edu or the faculty investigator Camilo Ortiz at 516-299-3211, drcamilo.ortiz@gmail.com. If you wish, you may contact the principal investigator by letter. The address is on page one of this consent form. You can also contact the department chair, Paul Kwon at 516-299-3211, paul.kwon@liu.edu. If you cannot reach the investigators or wish to talk to someone else, call the IRB office at 516-299-3591.

You can ask questions about this research study now or at any time during the study.
If you have questions about your rights as a research participant or feel that you have not been treated fairly, please call the Institutional Review Board at Long Island University at (516) 299-3591.
14. What does your signature on this consent form mean?
Your signature on this form means that: You understand the information given to you in this form, you accept the provisions in the form, and you agree to join the study. You will not give up any legal rights by signing this consent form.

Question Title

* 1. 1. Please check a box to indicate that you have read and AGREE or DISAGREE with the statements below:

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