INFORMED CONSENT FORM
NORTHEASTERN ILLINOIS UNIVERSITY
DEPARTMENT OF SOCIAL WORK

PRINCIPAL INVESTIGATOR: Troy Harden
FACULTY SPONSOR: N/A
TITLE OF STUDY: Community-based Crime Reduction Englewood-TIME 21:36

ABOUT THE STUDY: This is research study aimed to collect data on safety, including policing, crime, community engagement, and community building for the purpose of reducing crime and increase public safety within the Englewood community in Chicago. It is a collaborative effort between Northeastern Illinois University Department of Social Work and Inner City Studies, Teamwork Englewood, R.A.G.E., The Englewood Public Safety Task Committee, and the Chicago Police Department 7th District. Dr. Troy Harden, faculty within the Department of Social Work serves as the Principal Investigator, and Dr. Lance Williams from the Department of Inner City Studies serves as a Co-Investigator. This study is made possible through funding from the Department of Justice Bureau of Justice Assistance Community based Crime Reduction grant.

PROCEDURES INVOLVED IN THIS STUDY: During this study you will be asked to fill out a questionnaire and possibly be part of a focus group interview to determine your perceptions of crime, safety, community well-being, and community engagement. We are seeking 200 residents of Englewood to complete the questionnaire. The questionnaire will take approximately 20 minutes to complete. There will be questions related to perceptions of safety, including policing, crime, community engagement and community building.

POSSIBLE BENEFITS: Participating in the study is not expected to be of direct benefit to you, but the information you provide will help the researchers understand the overall quality of life in the community and determine community and officer input for methods of improvement.

POSSIBLE RISKS: Some of the questions concerning police and community relations may cause some discomfort. You are free to skip any questions that you do not want to answer. Experienced researchers train all persons facilitating the questionnaires and interviews with backgrounds in clinical mental and public health. If you experience some discomfort, you can inform the researcher and you request to speak with a listing of qualified mental health professionals in your area will be provided to you.

YOUR PARTICIPATION AS A RESEARCH SUBJECT: Your participation in this study is voluntary, and you may withdraw at any time. Refusal to participate or a decision to discontinue participation will not result in any penalty or loss of benefits to which you are entitled. Your participation can also be terminated by the investigator if so deemed appropriate.

CONFIDENTIALITY: The surveys will be anonymous and will only list the Beat number of the community that the participant is from. No information will connect the consent forms to the survey completed. All surveys will be kept in a locked file cabinet in the lead researchers locked office. If you are completing this survey electronically, your survey answers will be sent to a link at SurveyMonkey.com where data will be stored in a password protected electronic format. SurveyMonkey does not collect identifying information such as your name, email address, or IP address. Therefore, your responses wi

PARTICIPANT’S CONSENT: If you would like to participate, please select "agree" below to confirm the following:
I have read the above information about the study and have been able to express questions and concerns, which have been satisfactorily responded to by the research investigator. I believe I understand the study.

ELECTRONIC CONSENT: Please select your choice below. You may print a copy of this consent form for your records. Clicking on the “Agree” button indicates that:
  • You have read the above information
  • You voluntarily agree to participate
  • You are 18 years of age or older
THIS RESEARCH PROJECT/STUDY HAS BEEN REVIEWED BY NEIU’S REVIEW BOARD FOR THE PROTECTION OF HUMAN PARTICIPANTS.

Question Title

I agree

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