1. Consent

* 1. IRB No. 2430; Version 2, December 16th, 2009
Adult Online Consent Document
Approval Date: December 10, 2009
Approved Consent Version No.: 1
PI Name: Robert Blum
IRB No. 00002430
IRB No. 2430; Version 2, December 16th, 2009


Thanks for your interest in participating in our study. As we described in our letter,the Pacific Command in Hawaii, the University of Hawaii, and Johns Hopkins Bloomberg School of Public Health are collaborating on a research study to understand the perceptions and needs of military families stationed in Hawaii. Since there are nearly 25,000 military families based in Hawaii with approximately 8,000 arriving and departing annually, this information is of considerable importance, especially as it relates to the education and well-being of military children. To implement this study, we are going to be recruiting military parents and their children who are between 10-17 years old to participate in a web-based survey annually during the course of their stay in Hawaii.

Right now, we have drafted both the parent and child questionnaires, but we need them both to be tested for readability, clarity, and the length of time it will take a parent and child to complete the surveys For this pilot test, we are asking you and your child, between the ages of 10-17 years, to help us test the questionnaires. Results of the pilot test will be used to revise the parent and child surveys so that they can be finalized for the actual surveys among military parents and children.

What are the procedures?
To take part in the pilot test, you will be taken to the survey page immediately after you click on “I agree” at the end of this page. After you complete the survey, there will be five open-ended questions that will ask you specifically about the survey. The answers to these questions will help us to improve the survey for future use among military parents. The same procedures will be used for the child survey. The survey is expected to take approximately 20-30 minutes to complete online.

What are the risks?
There are some minor risks in this pilot test. Some of the questions may cause you to be to be uncomfortable, as they ask about a deployed parent and any possible problems your child may be having with school. You do not have to answer the questions if you do not feel like it.

What are the benefits?
There are no direct benefits to participating in the pilot test. The results of the pilot test will be used to improve the survey that will be used in the near future among a larger sample of military parents. That survey will allow the military and schools to better understand the needs and priorities of military families.

How will your information be protected?
No personal identifiers will be recorded or collected as part of the pilot test. Responses to the survey will also not be recorded and are only going to be used to refine the survey instrument. Following the pilot test, all of the data will be immediately destroyed.

Who do I call if I have questions or problems?
• Call the principal investigator, Dr. Robert Blum, at 410-955-3385 or email him at rblum@jhsph.edu if you have questions or complaints as a result of being in this
• Call or contact the Johns Hopkins Bloomberg School of Public Health IRB Office if you have questions about your rights as a study participant. Contact the IRB if you feel you have not been treated fairly or if you have other concerns. The IRB contact information is:
Address: Johns Hopkins Bloomberg School of Public Health
615 N. Wolfe Street, Suite E1100
Baltimore, MD 21205
Telephone: 410-955-3193
Toll Free: 1-888-262-3242
Fax: 410-502-0584
E-mail: irboffice@jhsph.edu

By clicking “I agree” on this form:
• You have been informed about this study’s purpose, procedures, possible benefits and risks.
• You have voluntarily agreed to be in this study.