Survey Consent Form

Purpose of Research. We are conducting an ethnographic study of multicultural awareness as it is represented in Western New York higher education. This project utilizes aspects of the Grounded Theory approach, first introduced by Drs. Barney Glaser and Anselm Strauss (1967), in conjunction with the quantitative principles of the Multivariant Approach. We hope that the combination of both theoretical approaches will allow us to use historical research, survey and census data, as well as participant profile tabulations to observe multicultural occurrences in regional institutions. Participants will submit surveys to communicate with external and internal audiences the role of multicultural awareness in Western New York institutions of higher education. 

Defining Multicultural Awareness:

"Multicultural Awareness involves a greater understanding, sensitivity, and appreciation of the history, values, experiences, and lifestyles of groups that include, but, are not limited to: race, ethnicity, gender, sexual orientation, religious affiliation, socio-economic status, and mental or physical abilities." - University Counseling Center-Notre Dame University (2017). Multicultural Awareness. Retrieved from http://ucc.nd.edu/self-help/multicultural-awareness/

Why is this survey important in 2017/2018?

Being multiculturally aware can provide you with the 21st century skills to engage diverse populations with sensitivity as well as develop competencies in “[h]ealing, harmony, and unity between groups … become more aware about, and become better educated about one another."   - University Counseling Center-Notre Dame University (2017). Multicultural Awareness. Retrieved from http://ucc.nd.edu/self-help/multicultural-awareness/

Procedure and Duration. This study will include a short survey and participant profile form about your experiences with multicultural awareness.

Voluntary Nature. Participation is voluntary and responses will be kept confidential. You have the option to not respond to any survey questions that you choose. Participation or nonparticipation will not impact your relationship with your current institutions of higher education. Though the PI’s are affiliated with said institution, only those students who consent will have their experiences included in the analysis. Status of Consent will not impact your status at your institution in any way. You are free to withdraw your participation at any time without penalty.

Confidentiality. During this survey, you will not be asked for your name. Your survey responses will not impact your grades at your institution of higher education in any way.

The results from the study could be presented in educational settings and at professional conferences, and the results might be published for a professional journal. No identifying information will be presented in any capacity to protect your anonymity.

Risks and Benefits. Whenever one works with the internet there is always a risk of compromising privacy, confidentiality, and/or anonymity. We have taken precautions to insure this does not happen, but if you participate in the online survey and submit answers, you should close your browser.

The results of the study will be used for improving various learning experiences, like forums, training, or courses at your institution.

Contact Information. If you have any questions concerning your rights as a subject, contact Brian Goodale, Compliance Officer, Empire State College, One Union Avenue, Saratoga Springs, NY 12866-4391; 518 587-2100 ext.2580. For the Principal Investigator Rhianna Rogers, PhD and Co- PI Dominique Murawski, MA you can contact 716 686-7842

Implied Consent. By pressing OK, you are acknowledging that you have signed the "Survey Consent Form" for the Buffalo Project 2.0 survey. Thank you for your participation.

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* 1. What is your gender?

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* 2. What is your age?

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* 3. How long have you lived in Western New York (years)?

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* 4. Which of the following best fits your financial status:

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* 5. Do you consider yourself spiritual?

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* 6. How do you classify your race? (Check all that may apply or fill in the space below)

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* 7. How are you enrolled in your college (mark all that apply):

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* 8. I believe that my current institution is a multiculturally aware.

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* 9. I believe that multicultural awareness enriches my education in the college learning environment.

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* 10. I believe that my own cultural identity is equally as important as other students’ cultural identities.

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* 11. I make an effort to understand various cultures including their differences and similarities.

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* 12. I believe that a cultural diversity course should be required at institutions of Higher Learning.

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* 13. I am unsure how to approach others about their cultural backgrounds.

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* 14. I believe it is important to reflect on my own cultural bias when communicating with people from diverse cultures.

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* 15. I believe that cultural barriers (race/ethnicity, socio-economic, language, religion, gender/sexual orientation, technology) inhibit academic success.

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* 16. I believe that developing cultural awareness is valuable for the job market.

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* 17. I consider myself multiculturally aware.

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* 18. Do you believe that your institution should encourage or develop multicultural activities? Yes or No? If Yes, have you attended any events on campus? If No, why not?

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* 19. Do you think your institution provides an atmosphere that is supportive of difficult dialogues about current cultural national and local events? Does the institution effectively create safe spaces between people who think, feel, and believe differently than each other? Why or why not?

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* 20. What aspects of culture (e.g., race/ethnicity, socio-economic, language, religion, gender/sexual orientation, mental/physical, or others) do you believe should be included in a college setting?

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* 21. What do you feel are your biggest obstacle(s) in your pursuit of higher education? Please explain.

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