University of Hawai'i
Consent to Participate in a Research Project
Claire Townsend Ing, Principal Investigator
Project title: Native Hawaiian Health Survey Project
Aloha! We are part of the Native Hawaiian Health Survey Project, led by Kula no na Po'e Hawai'i (KULA), a Native Hawaiian beneficiary serving non-profit organization, the Department of Native Hawaiian Health of the John A. Burns School of Medicine, the University of Hawai'i Cancer Center, and Native Hawaiian & Indigenous Health, Office of Public Health Studies. You are being invited to take part in this research study.
What am I being asked to do?
If you participate in this project, you will be asked to fill out a survey.
Taking part in this study is your choice.
Your participation in this project is completely voluntary. You may stop participating at any time. If you stop being in the study, there will be no penalty or loss to you.
Why is this study being done?
The purpose of this study is to identify health behaviors, health status, and related factors in Native Hawaiians.
What will happen if I decide to take part in this study?
If you decide to take part in this project, you will be asked to fill out an online survey found at the link provided. The survey questions are mainly multiple choice. The survey includes, but isn't limited to, questions about your health status, health behaviors, perceptions of your community, social support. Completing the survey will take approximately 30 minutes to one hour. You may choose to take breaks during the survey rather than completing it in one sitting.
What are the risks and benefits of taking part in this study?
I believe there is little risk to you for participating in this project however, disclosing information relating to health may feel personal. Should you feel you need counseling, the social worker at Kula no na Po'e Hawai'i, Dr. Adrienne Dillard, Ph.D, MSW, LSW is available at 808-520-8997 and can help you to find the appropriate counseling. Additionally, I Ola Lāhui is able to help you access resources in your area. Please contact them at 808-525-6255.
There will be no direct benefit to you for taking part in this project. The findings from this project may help create a better understanding of the health behaviors of Native Hawaiians residing in Hawai'i and the Continental U.S.
Confidentiality and Privacy:
Your survey responses will not be linked to any personal information, such as your name or address during the survey. Your name and address are being collected so that we are able to mail your makana to you. We will keep all study data secure in a locked office on encrypted on a password protected computer. Only my University of Hawai'i advisor and I will have access to the information. We plan to talk about the results of this study at community and scientific meetings and print the results of this research study. The results will be printed as group data without identifying any of your individual information. Other agencies that have legal permission have the right to review research records. The University of Hawai'i Human Studies Program has the right to review research records for this study.
Compensation:
You will receive a small makana for your time and effort in participating in this research project.
Future Research Studies:
Even after removing identifiers, the data from this study will not be used or distributed for future research studies.
Questions: If you have any additional questions about this study or would like the overall findings of this study, please call or email Dr. Claire Townsend Ing at [808-692-1042 or clairemt@hawaii.edu]. You may also contact the UH Human Studies Program at 808-956-5007 or uhirb@hawaii.edu to discuss problems, concerns and questions, obtain information, or offer input with an informed individual who is unaffiliated with the specific research protocol. Please visit http://go.hawaii.edu/jRd for more information on your rights as a research participant.
To Access the Survey: Please find a link below to continue on to the survey. Going to the first page of the survey implies your consent to participate in this study.
Please download and save a copy of this page for your reference by clicking on the attachment link below.
Mahalo!