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Survey and Informed Consent To Insert Into E-Mail Body
Survey and Informed Consent To Insert Into E-Mail Body
Please copy and paste the Informed Consent Form and Survey below into an e-mail and forward to me. Please type your name and date on the Informed Consent Form and answer the questions on the Survey. My e-mail address is: ruthie.trent2011@hotmail.com Again, thank you very much. I appreciate your participation in my study. Sincerely, Ruthie Trent
Notice: This study has been approved by the RWU Human Subjects Review Board INFORMED CONSENT FORM Project Title: Principle Investigator: Protecting the Elderly Against Abuse in the State of RI Ruthie A. Trent, Graduate Student Roger Williams University Providence, RI 02903 Purpose of Study The purpose of this study is to increase public awareness about elder abuse and to provide information about community resources. It is also the purpose of this study to call every citizen to take action to prevent elder abuse. Explanation of Research Procedure Graduate student, Ruthie A. Trent, will present the research study via e-mail. The presentation will consist of an on-line video of approximately 10 minutes by Ruthie A. Trent. The video will provide basic information about elder abuse. Participants will be informed about the need to lobby Congress for funding to support the Elder Justice Act which was recently passed on March 23, 2010. Documentation will be attached to the e-mail which provides resource information, state elder abuse hotline numbers, and lobbying information. Knowledge gained will be evaluated subsequent to the presentation by the administration of a short survey which will be e-mailed back to the student. Confidentiality The identity of the Participants will be protected at all times. The information obtained from the survey is strictly confidential and for research purposes only. Only the investigator and his/her assistants will have access to their identity and to information that can be associated with them. In the event of publication, pseudonyms will be used. Any information received during this study will be used anonymously in the study results. Voluntary Participation Participation in this research study is voluntary and a participant can withdraw at any time. Agreement to Participate (Please read the following statement and type your name as your signature in the space above the line below. Also, type in the date you sign the consent form.) I have been fully informed about the proposed research project and I agree to participate freely of my own will. I understand that my identity and the information I provide are confidential, will be protected, and will be used only for the purposes of a research study regarding elder abuse.
Participant
Date
1. In my opinion, the planned objectives of the program were met. 2. The issues were dealt with in as much dept as the length of the course allowed. 3. The length of the course was adequate for the objectives and content. 4. The training received is useful for the community. 5. The training received is useful for my personal development. 6. The training received merits a good overall rating.
Measure Y 1Strongly Disagree 2Disagree 3-Neither Agree nor Disagree 4Agree 5Strongly Agree
7. I have sufficient knowledge about elder abuse. 8. I can use recognition of elderly abuse way of thinking. 9. I have learned various ways and strategies of understanding elder abuse and resources available to provide assistance to the elderly.