TEXAS AM UNIVERSITY HUMAN SUBJECTS PROTECTION PROGRAM
PARENTAL PERMISSION AND CONSENT FORM
Project Title: EXPLORING THE USE OF THE ACT ENGAGE 6-9 TO ASSESS NON-COGNITIVE COLLEGE AND CAREER READINESS LEVELS AMONG
9TH GRADE TEXAS 4-H PARTICIPANTS
You and your 9th-grade child that is involved in the 4-H Youth Development Program have been invited to take part in a research study being conducted by a research team from Texas AM University. The information in this form is provided to help you and your child decide whether or not to take part. If you decide to participate and allow your child to take part in the study, you will be asked to sign this permission form. If you decide you or your child do not want to participate, there will be no penalty to you or your child, and you and your child will not lose any benefits they normally wouldhave.
Why Is This Study Being Done?
The purpose of this study is to help us understand the current non-cognitive college and career readiness levels of
9th grade; public schooled, Texas 4-H participants, with over two years of tenure in order to design interventions to assist you, your child, 4-H “life skills” programs and other youth serving extension activities. Specifically, your child will be taking the commonly known and widely used ACT ENGAGE 6-9 non-cognitive survey which asks questions related to students’ motivation, self-regulation, and social engagement. More information about the ACT ENGAGE 6-9 survey can be found here: http://www.act.org/content/act/en/products-and-services/act- engage/about-act-engage.html.
Why is My Child Being Asked to Be in This Study?
You and your child are being asked to be in this study because they fit the population being studied: 8th grade;
public schooled, Texas 4-H participants, with over two years of tenure.
How Many People Will Be Asked To Be In This Study?
2,600 participants will be invited to participate in this study.
What Are the Alternatives to being in this study?
The alternative to being in the study is not to participate.
What Will my Child and I Be Asked To Do In This Study?
You will be asked to assist your child to log onto an online survey that they will complete by themselves. The survey, which takes approximately 15-30 minutes, asks questions related to non-academic measures of motivation, self-regulation and social engagement that are shown in the literature to factor into student college and career readiness levels.
Are There Any Risks To Myself or My Child?
The things that you and your child will be doing present no more risks than you would come across in everyday life.
Will There Be Any Costs To My Child and Me?
Aside from their time, there are no costs for taking part in the study.
Will My Child or I Be Paid To Be In This Study?
While students will not be paid for their participation, those that are in the 200 that complete the survey will be put in a raffle for one of three (3) $50 American Express gift cards.
TEXAS AM UNIVERSITY HUMAN SUBJECTS PROTECTION PROGRAM
PARENTAL PERMISSION AND CONSENT FORM
Selection of the recipients will be chosen by a 4-H representative and distribution of gift cards will occur at the conclusion of the survey section of the study (approximately December 1, 2017). Only students that complete a valid/complete survey will be eligible.
Will Information From This Study Be Kept Private?
The records of this study will be kept private. No identifiers linking you or your child to this study will be included in any report that might be published. Research records will be stored securely, and only the Principal Investigator and other research study personnel will have access to the records. Information about you or your child will be stored in locked file cabinet and/or computer files protected with a password.
Who may I Contact for More Information?
You may contact the Principal Investigator, Edward Tarlton, to tell him about a concern or complaint about this research at 301.803.0100 or . For questions about your rights as a research participant; or if you have questions, complaints, or concerns about the research, you may call the Texas A&M University Human Subjects Protection Program office at (979) 458-4067 or .
What if I Change My Mind About Participating?
This research is voluntary, and you have the choice whether or not to participate yourself and/or allow your child to be in this research study. You and/or your child may decide not to begin or to stop participating at any time. If you or your child chooses not to be in this study or stop being in the study, there will be no effect on your relationship with Texas 4-H, Extension or Texas A&M University.
STATEMENT OF CONSENT
The procedures, risks, and benefits of this study have been told to me, and I agree to be and allow my child to be in this study. My questions have been answered. I may ask more questions whenever I want. I do not give up any of my or my child’s or my legal rights by signing this form. A copy of this consent form will be given to me.
TYPE NAME HERE
Child’s Name
TYPE NAME HERE TYPE DATE HERE
Parent/Legal Guardian Signature Date
(Typed name will serve in place of signature)
INVESTIGATOR'S AFFIDAVIT:
Either I have, or my agent has carefully explained to the parent the nature of the above project. I hereby certify that to the best of my knowledge the person who signed this consent form was informed of nature, demands, benefits, and risks involved in his/her participation.
October 30, 2017
Signature of Presenter Date
Edward L. Tarlton October 30, 2017
Printed Name Date