An Analysis of Primary Care Providers’ Perceptions on the Clinical Utility of Genetic Counselors into Primary Care Practices

RESEARCH PARTICIPANT INFORMED CONSENT FORM

Thank you for participating in our survey. Your feedback is important.
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.

1. Why is this research being done?

This research is being done to assess primary care providers’ perceptions of the clinical utility of genetic counselors in primary care facilities. This study aims to determine whether primary care providers believe genetic counselors would be useful in their practice and identify the potential barriers to successfully incorporating genetic counselors into these settings. Primary care physicians, nurse practitioners, registered nurses, and physician assistants may join.

 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:

·Take an anonymous survey with 40 multiple-choice questions and three open-ended questions.

·The questions will assess your credentials, your location of practice, your allotment of time to various tasks in your specific role in primary care, genetic testing in your practice at this time, and your perceptions of genetic counselors and how they may impact your facility.

·This survey will be sent via email with a link to SurveyMonkey where the survey can be answered. This survey needs to be filled out once.
How long will you be in the study?
Participation in the study will take approximately 15-20 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. Although your IP Address will not be stored in the survey results, tampering from an outside source is always possible 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.

 5.Are there benefits to being in the study?

This study may benefit society if the results lead to a better understanding of the clinical utility of genetic counselors in primary care settings and how to best institute their incorporation in these settings.

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?
No.

 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.

 10. How will the confidentiality of your biospecimens and/or data be protected?
Any study records that 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. (All of these people are required to keep your identity confidential.) Otherwise, records that identify you will be available only to people working on the study, unless you give permission for other people to see the records.

 11. 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 th
Contact the student investigator Erica Hilsenrath at erica.hilsenrath@my.liu.edu or the faculty investigator Meghan McGath at meghanjmcgath@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, Karin Melkonian at karin.melkonian@liu.edu. If you cannot reach the investigators or wish to talk to someone else, contact the IRB office at OSP@liu.edu. 

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 contact the Institutional Review Board at Long Island University at OSP@liu.edu.

12. What does your agreement on this consent form mean?

By marking the “Agree to Participate” box below, you are indicating that you have fully read the above text and have had the opportunity to print the consent form (or ask for a printed copy) and ask questions about the purposes and procedures of this study. If you choose not to participate, please choose the “Decline to Participate” box below.
1.I have fully read the above text and(Required.)
2.What is today's date(Required.)