Participant Informed Consent

Dear Parents and Students,

I am conducting a research study to better understand the scope and effects of bullying on children adopted into transracial families.  As a Social Work faculty member at Northeastern State University, I am interested in understanding this topic so that we can develop effective supports and interventions for children/adoptees who experience bullying based on racial or ethnic differences.  I am requesting your participation because it will help us to do this. 

Your participation is voluntary and your responses are anonymous.  Neither I nor anyone else will be able to identify from whom any completed questionnaire came.

It will take about 30-40 minutes to complete our survey.  You will make an important contribution to this project that may lead to creating effective help for trans-racial adoptees who are facing school bullying.  

The value of this study’s results will depend on how many participants choose to respond.

If you wish to discuss the information above or concern you may have with this project, please do not hesitate to contact me, Eun-Jun Bang, Ph.D., MSW, at (918) 449-6564.  For questions about your rights while participating in this study, you may contact the Institutional Review Board at Northeastern State University at (918) 456-5511 ext 2965.

Thank you so much for your attention and time.


Sincerely,


Eun-Jun Bang, PhD, MSW

Associate Professor of Social Work
Northeastern State University
3100 E. New Orleans Street  
Broken Arrow, OK 74014
Phone: 918-449-6564
Email: bang@nsuok.edu

cc.
Kendra Zollener, PhD. MSW
Kathlyn Shahan, PhD. MSW
PARENT CONSENT TO PARTICIPATE IN A RESEARCH STUDY

Purpose of the Study:  
The purpose of this study is to investigate prevalence rates, types and causes of school bullying and also explore risk and protective factors and their relationship to stress, social support, and resilience among minority adoptees in trans-racial families.  Also, this study aims to investigate the ways that protective factors and social support may act as moderating factors for school bullying related stress and how this support varies in effectiveness based on their resources.

Procedures to be Followed:
Upon agreement to participate in this study, your child will be asked to complete the Olweus Bullying Questionnaire, Perceived Stress Scale, Social Support Scale and Resilience Scale. The survey will ask your child questions about experiences with bullying in school and questions about their stress level.  There will also be question about your child’s level of social support and resilience. This should take approximately 30-40 minutes to complete.

Discomforts and Risks:
Although it is not anticipated, it is possible that your child may experience some emotional discomfort as a result of answering questions from the surveys.  It is not required that your child respond to each question on the questionnaire.  If your child experiences emotional discomfort, distressing memories, he/she has the right to terminate his/her participation any time.  There are no consequences for refusal to participate in or withdrawal from the study.

(If, as a result of completing these survey your child experiences emotional discomfort, distressing memories, or feel a need to talk to a mental health professional, you may contact Dr. Eun-Jun Bang, the Principal Investigator at (918) 407-4883 to receive a referral.) 

Benefits:
It is hoped that this study will be used to assist adoption agencies, educators, school administrators, and parents of adopted minority children to understand school bullying issues faced by minority adoptees in trans-racial families and provide effective intervention plans as well as effective ways to deal with minority adoptees’ stress.

Duration:
It will take approximately 30-40 minutes to complete the Olweus Bullying Questionnaire, Perceived Stress Scale, Social Support Scale, and Resilience Scale. 

Statement of Confidentiality:
Information collected in this study will be treated as strictly confidential.  Your (your child’s) name will not appear on any of the assessments or in any of the published materials.  All research data will be stored in a secure, locked filing cabinet.  The data will be kept for three years. If this research is published or presented, absolutely no information that would identify you will be used.

Right to Ask Questions:
If you have any questions while participating in this study, you may contact Dr. Eun-Jun Bang.  For questions about your rights while participating in this study, you may contact the Institutional Review Board at Northeastern State University at (918) 456-5511, ext 2965.

Voluntary Participation and Right to Withdraw:

Participation in this study is completely voluntary. You may withdraw your child at any time and your child may also decline to answer any questions that you do not want to answer.  There are no consequences for refusal to participate in or withdrawal from the study. You can end your participation at any time by telling the person in charge.


PARENT CONSENT TO PARTICIPATE IN A RESEARCH STUDY

Purpose of the Study:  
The purpose of this study is to investigate prevalence rates, types and causes of school bullying and also explore risk and protective factors and their relationship to stress, social support, and resilience among minority adoptees in trans-racial families.  Also, this study aims to investigate the ways that protective factors and social support may act as moderating factors for school bullying related stress and how this support varies in effectiveness based on their resources.

Procedures to be Followed:
Upon agreement to participate in this study, your child will be asked to complete the Olweus Bullying Questionnaire, Perceived Stress Scale, Social Support Scale and Resilience Scale. The survey will ask your child questions about experiences with bullying in school and questions about their stress level.  There will also be question about your child’s level of social support and resilience. This should take approximately 30-40 minutes to complete.

Discomforts and Risks:
Although it is not anticipated, it is possible that your child may experience some emotional discomfort as a result of answering questions from the surveys.  It is not required that your child respond to each question on the questionnaire.  If your child experiences emotional discomfort, distressing memories, he/she has the right to terminate his/her participation any time.  There are no consequences for refusal to participate in or withdrawal from the study.

(If, as a result of completing these survey your child experiences emotional discomfort, distressing memories, or feel a need to talk to a mental health professional, you may contact Dr. Eun-Jun Bang, the Principal Investigator at (918) 407-4883 to receive a referral.) 

Benefits:
It is hoped that this study will be used to assist adoption agencies, educators, school administrators, and parents of adopted minority children to understand school bullying issues faced by minority adoptees in trans-racial families and provide effective intervention plans as well as effective ways to deal with minority adoptees’ stress.

Duration:
It will take approximately 30-40 minutes to complete the Olweus Bullying Questionnaire, Perceived Stress Scale, Social Support Scale, and Resilience Scale. 

Statement of Confidentiality:
Information collected in this study will be treated as strictly confidential.  Your (your child’s) name will not appear on any of the assessments or in any of the published materials.  All research data will be stored in a secure, locked filing cabinet.  The data will be kept for three years. If this research is published or presented, absolutely no information that would identify you will be used.

Right to Ask Questions:
If you have any questions while participating in this study, you may contact Dr. Eun-Jun Bang.  For questions about your rights while participating in this study, you may contact the Institutional Review Board at Northeastern State University at (918) 456-5511, ext 2965.

Voluntary Participation and Right to Withdraw:

Participation in this study is completely voluntary. You may withdraw your child at any time and your child may also decline to answer any questions that you do not want to answer.  There are no consequences for refusal to participate in or withdrawal from the study. You can end your participation at any time by telling the person in charge.


PARENT CONSENT TO PARTICIPATE IN A RESEARCH STUDY

Purpose of the Study:  
The purpose of this study is to investigate prevalence rates, types and causes of school bullying and also explore risk and protective factors and their relationship to stress, social support, and resilience among minority adoptees in trans-racial families.  Also, this study aims to investigate the ways that protective factors and social support may act as moderating factors for school bullying related stress and how this support varies in effectiveness based on their resources.

Procedures to be Followed:
Upon agreement to participate in this study, your child will be asked to complete the Olweus Bullying Questionnaire, Perceived Stress Scale, Social Support Scale and Resilience Scale. The survey will ask your child questions about experiences with bullying in school and questions about their stress level.  There will also be question about your child’s level of social support and resilience. This should take approximately 30-40 minutes to complete.

Discomforts and Risks:
Although it is not anticipated, it is possible that your child may experience some emotional discomfort as a result of answering questions from the surveys.  It is not required that your child respond to each question on the questionnaire.  If your child experiences emotional discomfort, distressing memories, he/she has the right to terminate his/her participation any time.  There are no consequences for refusal to participate in or withdrawal from the study.

(If, as a result of completing these survey your child experiences emotional discomfort, distressing memories, or feel a need to talk to a mental health professional, you may contact Dr. Eun-Jun Bang, the Principal Investigator at (918) 407-4883 to receive a referral.) 

Benefits:
It is hoped that this study will be used to assist adoption agencies, educators, school administrators, and parents of adopted minority children to understand school bullying issues faced by minority adoptees in trans-racial families and provide effective intervention plans as well as effective ways to deal with minority adoptees’ stress.

Duration:
It will take approximately 30-40 minutes to complete the Olweus Bullying Questionnaire, Perceived Stress Scale, Social Support Scale, and Resilience Scale. 

Statement of Confidentiality:
Information collected in this study will be treated as strictly confidential.  Your (your child’s) name will not appear on any of the assessments or in any of the published materials.  All research data will be stored in a secure, locked filing cabinet.  The data will be kept for three years. If this research is published or presented, absolutely no information that would identify you will be used.

Right to Ask Questions:
If you have any questions while participating in this study, you may contact Dr. Eun-Jun Bang.  For questions about your rights while participating in this study, you may contact the Institutional Review Board at Northeastern State University at (918) 456-5511, ext 2965.

Voluntary Participation and Right to Withdraw:

Participation in this study is completely voluntary. You may withdraw your child at any time and your child may also decline to answer any questions that you do not want to answer.  There are no consequences for refusal to participate in or withdrawal from the study. You can end your participation at any time by telling the person in charge.


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1. If you agree to let your child to participate in this study after reviewing the above participant informed consent please click on the left button.

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2. If you agree to let your child to participate in this study after reviewing the above participant informed consent please click on the left button.

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3. Please validate your consent form by filling out the following information.

PARTICIPANT/CHILD ASSENT TO PARTICIPATE IN A RESEARCH STUDY

Purpose of the Study:

The purpose of this study is to find out how often and what kinds of bullying students may experience in school.  Another purpose is to find out why school bullying happens.  Also, the reasons why some students are bullied more than others and why some students who are bullied are able to manage the effects or stress of bullying better.  This study will also explore how some factors might protect the student from bullying.  These factors and social support may have an effect on how bad bullying makes you feel.

Procedures to be Followed:
If you say yes to be in this study, you will be answering questions about bullying, stress, social support and how you are best able to deal with bullying.  The questions will be in a survey.  The questions take about 30-40 minutes to answer. 

Discomforts and Risks:
It might be feel uncomfortable to remember what it was like to be bullied. If a question is too hard to answer, you can skip it.  If it is way too hard to answer the questions and you decide you don’t want to be in the study anymore, you can stop being in the study.  It is okay if you decide to stop the study.  Because the surveys will not have any names on them, the researchers will not be able to contact you if your answers show that you are sad or under stress.  If you want to speak with someone about your experiences, you will have to contact Dr. Eun Jun Bang.  If you feel badly, have bad memories, or feel like you need to talk to a mental health professional, you may contact Dr. Eun-Jun Bang, the Principal Investigator at 918-407-4883 to receive a referral.

Benefits:
It is hoped that what we learn from this study will help other children, adoption agencies, teachers and principals to better understand bullying.  Also the study will help find better ways to stop the bullying and how best to help a child who has been bullied.

Duration:
It will take about 30-40 minutes to answer all of the questions. You can take as long as you need to answer the questions.

Statement of Confidentiality:
The information you give us is not shared with anyone else.  No one will know that it is you answering all the questions.  We do not know who you are when you return your completed survey. Your name will not be on the survey.  We have no way of knowing who returns their completed survey and who does not.  The data collected from the questions will be stored in a locked filing cabinet.  It will be kept there for three years.  Your name will not be put on anything having to do with the information we collect in the survey even if the information is used in a publication or presented to other people interested in school bullying. 

Right to Ask Questions:
If you have any questions about the study, you may contact Dr. Eun-Jun Bang.  You may also ask questions about your rights while being in the study.  You may contact the Institutional Review Board at Northeastern State University at 918-456-5511, extension 2965.  You may want to tell your parents about your questions and they can contact Dr. Bang or the Institutional Review Board too.

Voluntary Participation and Right to Withdraw:
You do not have to be in this study if you don’t want to be.  You may quit being in the study at any time.  You may skip questions or not answer certain questions if you don’t want to.  It is okay if you decide to stop being in the study.

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4. If you want to be in the study, please click on the left button below.   If you click on the left button below, it means that you have read this and that you want to be in the study. If you don’t want to be in the study, don’t click on the left button below. Being in the study is up to you, and no one will be upset if you don’t want be in the study or if you change your mind later.

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5. Please validate your consent form by filling out the following information.

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