Approval No: HC16273
THE UNIVERSITY OF NEW SOUTH WALES
PARTICIPANT INFORMATION STATEMENT AND CONSENT FORM
Stakeholder Perceptions of Reporting Barriers and Problems in Service Provision for Victims of Youth-to-Parent Domestic Violence
The study is being carried out by the following researchers:Role / Name / Organisation
Chief Investigator / Dr Jane Bolitho / UNSW
Student Investigator/s / Rachael Stanic is conducting this study as the basis for the degree of Bachelor of Arts (Honours) at The University of New South Wales. This will take place under the supervision of Dr Jane Bolitho. / UNSW
You are invited to participate in a study of the challenges experienced by victims of youth-to-parent domestic violence.
Purpose of the study
I hope to learn about the factors thatmay keepsome victims of youth-to-parent domestic violence from reporting the violence, the challenges they face when they do report, and ways in which services can be improved to help these parents access support.
What I plan to do
I will be sending surveys in online and print form to staff from seven domestic violence and women’s health services in NSW. If you choose to complete the survey, you will also be given the option of participating in a semi-structured interview. I will also be doing secondary data analysis of crime statistics.
Why you have been selected to participate in the study
You have been selected as a possible participant in this study because you have worked for an organisation that provides support for victims of domestic violence.
What I am asking of you
If you decide to participate, you will be asked to complete an online or mail out questionnaire. You will then be given the option to participate in a semi-structured interview.
How will I ensure that I have accurately recorded what you say in the interviews?
With your permission, I would like to use an audio tape to record the interviews.
How long will the interview/questionnaire take?
The online questionnaire will take about 15-20 minutes to complete, while the semi-structuredinterview will take about 25-30 minutes to complete.
What sort of questions will I be asked?
You will be asked about the prevalence of youth-to-parent domestic violence as seen by your service, and the emotional and practical challenges faced by these clients in accessing reporting violence and accessing support. You will also be asked about how you think services can improve their support of parents being abused by their children.
What are the intended outcomes of this study?
This study is intended to improve knowledge around the challenges faced by victims of youth-to-parent violence in NSW and recommend how services can improve their support of these victims.However,I cannot and do not guarantee or promise that you will receive any benefits from this study.
What will happen to the information I provide for the study? Is it confidential?
Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permission, except as required by law. This research will form the basis of my Honours thesis undertaken for UNSW. In the thesis, information will be provided in such a way that you cannot be identified.
What if I have a problem?
Complaints may be directed to the Ethics Secretariat, The University of New South Wales, SYDNEY 2052 AUSTRALIA (phone 9385 4234, fax 9385 6648, email ). Any complaint you make will be investigated promptly and you will be informed of the outcome.
Will I be able to see the results of the study?
At the completion of the study, you will be able to request a summary of the findings by emailing me at
Can I decide not to participate?
Your decision whether or not to participate will not prejudice your future relations with the University of New South Wales. If you decide to participate, you are free to withdraw your consent and to discontinue their participation at any time without prejudice.
What if I have questions that are not answered here?
If you have any questions, please feel free to email Rachael Stanic at . If you have any additional questions my academic supervisor Dr Jane Bolitho (, 9385-2193) at the University of New South Wales will be happy to answer them.
Can I keep this form?
Youwill be given a copy of this form to keep.
THE UNIVERSITY OF NEW SOUTH WALES
PARTICIPANT INFORMATION STATEMENT AND CONSENT FORM (continued)
Stakeholder Perceptions of Reporting Barriers and Problems in Service Provision for Victims of Youth-to-Parent Domestic Violence
You are making a decision whether or not to participate. Ticking the following boxes, along with your signature, indicates that having read the information provided above, you have decided to participate:
I have decided to participate in the online questionnaire
I have decided to participate in the interview
…………………………………………………….…………………………………………………..
Signature of Research ParticipantSignature of Witness
…………………………………………………….…………………………………………………….
(Please PRINT name)(Please PRINT name)
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DateNature of Witness
At the completion of the study, you will be able to request a summary of the main findings by emailing . If you would like a hard copy summary of the study please tick this box:
Yes I would like to receive a hard copy of the research summary:
Please email this form to .
REVOCATION OF CONSENT
Stakeholder Perceptions of Reporting Barriers and Problems in Service Provision for Victims of Youth-to-Parent Domestic Violence
I hereby wish to WITHDRAW my consent to participate in the research proposal described above and understand that such withdrawal WILL NOT jeopardise any treatment or my relationship with The University of New South Wales.
I wish to withdraw my consent for the questionnaire
I wish to withdraw my consent for the interview
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Signature ParticipantDate
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(Please PRINT name)
The section for Revocation of Consent should be forwarded to:
Dr Jane Bolitho
Faculty of Arts and Social Sciences
University of New South Wales
NSW 2052
, 9385-2193
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