North Carolina Agricultural and Technical State University
Informed Consent to Participate in a Focus Group Research Study
Remember: Replace or remove all RED TYPE before distributing the letter.
Study Title:
Principal Investigator:
Faculty Advisor: [Delete if not applicable]
Purpose of the Study
You are being asked to take part in a research study about ______. The purpose of this research is to ______. You have been asked because you [insert participation criteria, such as age, program of study, student at A&T, etc.]Your participation is voluntary.
Procedures
We would like you to take part in a discussion on ______. We will talk about _____. The focus group is expected to last about _____.
Voluntary Participation
Your participation in this research study is voluntary, and you may end your participation at any time. You may choose not to answer any questions, refuse to complete any portions of the research you do not wish to, or leave the group at any time for any reason. Refusing to participate or leaving the study will not result in any penalty or loss of benefits to which you are entitled. If participants are students: Your grade, record, academic standing, or relationship with the University will not be affected if you choose not to participate or withdraw.
Risks
We do not anticipate any risks from your participation in this research. [If the questions may be sensitive or are very personal, state this and briefly describe the nature of the questions.]
Benefits
There are no direct benefits to participants in this research. We hope to learn more about [describe any benefits to society or to scientific knowledge].
Confidentiality
All information collected in this study will be kept strictly confidential to the extent permitted by law. We will ask everyone in the group to keep what we talk about confidential, but this cannot be assured.
Audio Recording
We will be using an audio recorder in order to accurately capture what is said. The recordings will be transcribed, but your name will not be included in the transcriptions. The recordings and transcriptions will be kept on a password-protected computer. [Include a statement about when the recordings will be transcribed and the audio recordings destroyed. Best practice is to transcribe the recordings as soon as possible and destroy the audio to minimize a breach of confidentiality since voices are potentially identifiable to anyone who hears the recording. Transcriptions must be kept at least three years after the close of the study.]Reports of study findings will not include any identifying information.
Compensation [Delete if not applicable]
You will receive xxxx as a token of appreciation for taking part in the focus group.
Questions About the Study
Please ask any questions you have. If you have questions or concerns about this research later, please contact [PI name, phone number, and/or email address]. You may also contact the faculty member supervising this work: [advisor’s name, title, phone number, and email address].
If you have any study-related concerns or any questions about your rights as a research subject, you may call the Office of Research Compliance and Ethics at North Carolina A&T State University at (336) 285-3183 or email .
You will be given a copy of this form to keep for your records.
Statement of Consent
I have read the above information and have received answers to all my questions. I am at least 18 years old and voluntarily consent to take part in this research study and to have this focus group conversation audio recorded.
Participant’s Name (Printed):
Participant’s Signature: Date:
Researcher’s Signature: Date:
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