Informed Consent for Participation in a Research Study
Study Title: BlaqOut Young Black Men Who Have Sex with Men 2020 Vision Survey
Jannette Berkley-Patton, PhD, Principal Investigator
School of Medicine Biomedical and Health Informatics Department
University of Missouri Kansas City, Kansas City, MO
Request to Participate
You are being asked to take part in a research study that looks at factors related to health outcomes for Black men who have sex with men (e.g. gay, bisexual, etc.). This study is taking place at this and other places throughout the Kansas City area.
You do NOT have to participate. If you do not want to participate, you can still receive services at this organization. Research studies only include people who choose to participate.
The research team in charge of running the study are Jeanette Berkley-Patton, PhD, Natasha Aduloju-Ajijola, PhD, and D. Rashaan Gilmore. While they may run the study, other trained persons who work with them may act for them. This study is funded by the Health Care Foundation of Kansas City and Truman Medical Center and conducted in partnership with Calvary Community Outreach Network and BlaqOut.
To take part in this study, you must:
1) Identify as Black or African American
2) Be at least 18 years old
3) Be willing to share your personal experiences, physical health, sexual practices, and other behaviors; and,
4) Be able to read/complete the survey by yourself with little assistance (the survey is in English).
5) Be a man who has sex with men
6) Engaged in sexual activity in the previous 12 months
This document is a consent form. Please read this consent form carefully and take your time making the choice to participate. The study staff will go over this consent form with you. Ask him/her/them to explain anything that you do not understand. This consent form explains what to expect the risks and benefits of the study.
Background
This study focuses on young Black men who have sex with men (YBMSM) - a population experiencing many health disparities, such as higher rates of HIV/AIDS and other STDs; violence; mental health disorders; layered stigmas (e.g., HIV, homophobia, low-income); and discrimination. This community-based research study will assess the overall health and wellness needs along with needs specific to HIV of YBMSM; aged 18 to 35) in the Greater Kansas City (KC) Metropolitan Area. This community needs assessment survey seeks to: a) identify important health conditions and issues that disproportionately impact YBMSM; b) examine social determinants that may contribute to the identified priority health conditions/issues; and c) develop feasible/important multilevel intervention strategies that can address the identified health conditions/issues.
Purpose
The information from the study will be used to develop programs that aim to improve the quality of life for Black men who have sex with men, influence public policy and implement tools to increase engagement in their health care in Kansas City.
Procedures
If you decide to participate in the study, you will first screened to ensure that you meet the study criteria to participate. If you meet the inclusion criteria, then you will complete a brief survey that asks questions about your beliefs about HIV and sexual health, substance use, mental health, violence and criminality, healthcare access, overall physical health, and social concerns like housing, employment and racial and other discrimination. In addition to answering survey questions, you will be asked to review a number of strategies proposed by community members much like yourself, which would address these concerns. These strategies are rated according to their importance and feasibility (the practical likelihood of happening).
The survey will take approximately 30 minutes to complete. Your survey responses will be kept completely confidential. The survey does not ask for you any personal information. Participation in the study is voluntary at all times. You may choose to not participate or to withdraw your participation at any time. Deciding not to participate or choosing to leave the study will not result in a penalty, loss of benefits, or other privileges at this, or any other, organization to which you are entitled.
Risks of Participation
There are minimal risks for participating in this research study, which consists of completing one survey. The survey form will ask personal health questions and beliefs; you may feel a bit uneasy about answering some of these questions about your feelings and experiences related to HIV, drug use, and sexual practices. If you wish to have help to deal with these issues, referrals will be made for you to see a behavioral health practitioner. In addition, because this survey is specifically looking at men who have sex with men, there is a risk that by consenting to participate others may find out that you are a man who has sex with men.
Benefits
Participation in this research study does not guarantee any benefits to you. However, possible benefits include the fact that you may learn something about how research studies are conducted and you may learn something about this area of research (i.e., factors that are related to health outcomes for Black men who have sex with men). Benefits to the Kansas City area include effective programs, activities, and eventually policies that directly affect the YBMSM population in Kansas City.
Fees and Expenses
There are no fees/expenses cost to you for participating in this study.
Compensation
As a participant in this study, you will receive $30 for completing the survey.
Alternatives to Study Participation
You can choose to not take part in this research study, you will not be penalized for not participating.
Confidentiality
NO PERSONALLY IDENTIFYING INFORMATION IS COLLECTED ON THE SURVEYS AND YOUR RESPONSES WILL BE TOTALLY ANONYMOUS AND CONFIDENTIAL. THE SURVEY WILL NOT ASK YOU TO WRITE DOWN ANY PERSONALLY IDENTIFIABLE INFORMATION.
All data from this study will be kept from inappropriate disclosure and will be accessible only to the researchers. Data collected online will be stored on a password-protected website and de-identified for analyses. Data collected in person will be kept in a locked file cabinet, separate from consent forms, and all materials will be destroyed by or after 7 years. The researchers are not interested in anyone's individual responses, only the average responses of everyone in the study.
The results of this research may be published or presented to others. You will not be named in any reports of the results. Your name will not be collected at any time during the survey. There will be no personal identifiers on the surveys, and you will not be asked to use your, or anyone else's, personally identifiable information.
Results of the Study
You may obtain information about the outcome of the study at its conclusion, which we estimate will occur in the spring of 2018. To request a copy of the study report, contact the Project Director, D. Rashaan Gilmore at (816) 866-0355 or heyrashaan@blaqout.org.
Contacts for Questions about the Study
The University of Missouri-Kansas City appreciates the participation of people who help it carry out its function of developing knowledge through research. You should contact the Office of UMKC's Institutional Review Board at 816-235-5927 if you have any questions, concerns or complaints about your rights as a research subject. You may call the researcher, Dr. Jannette Berkley-Patton, at 235-6362 if you have any questions about this study. You may also call her if any problems come up. Dr. Berkley-Patton is located in the School of Medicine Biomedical and Health Informatics Department at the University of Missouri-Kansas City, Holmes Street, Suite M5-107, Kansas City, Missouri 64108.
Photo and Video Release
If you are participating in the research as part of a BlaqOut event photographs or videotapes may be taken that could identify you. You are hereby granting consent and authorization to use your image and likeness for future marketing and reporting purposes (for example, presentations, publications, grant reports, etc.) by the study research team and BlaqOut.
NONE OF YOUR SURVEY ANSWERS WILL BE SEEN OR SHOWN AND YOUR NAME WILL NOT BE USED OR DISPLAYED. YOU MAY CHOOSE NOT TO BE INCLUDED IN ANY IMAGES BY NOTIFYING THE SURVEY ADMINISTRATOR AT THIS TIME. YOU MAY, AT ANY TIME, WITHDRAW PERMISSION FOR PHOTOS OR VIDEOS INCLUDING YOU TO BE USED IN THIS RESEARCH PROJECT.
The study research team and Blaqout will select photos for use in conference presentations and in reports to funding agencies. You will not be compensated for the use of your likeness unless agreed upon as part of the larger research project.
Researcher Contact Information
Lead researcher, Dr. Natasha Aduloju-Ajijola, and Project Director, D. Rashaan Gilmore are administering this research study. The UMKC faculty supervisor is Dr. Jannette Berkley-Patton, Associate Professor, Director, Community Health Research Group - Biomedical and Health Informatics, School of Medicine. If you have any questions or concerns about your participation in this study, you may contact the researchers through D. Rashaan Gilmore at (816) 866-0355 or heyrashaan@blaqout.org.
Voluntary Participation
Taking part in this research study is voluntary. If you choose to be in study, you are free to stop participating at any time and for any reason. If you choose not to be in the study or decide to stop participating, your decision will not affect any care or benefits you are entitled to receive. The researchers are sponsors may stop the study or take you out of the study at any time if they decide that it is in your best interest to do so. They may do this for medical or administrative reasons or if you no longer meet the study criteria. You will be told of any important findings developed during the course of this research.
You have read this consent form or it has been read to you. You have been told why this research is being done and what will happen if you take part in the study, including risks and benefits. You have a chance to ask questions, and may ask questions at any time in the future by contacting the Project Director, D. Rashaan Gilmore at (816) 866-0355 or heyrashaan@blaqout.org. By participating in the study, you volunteer and consent to take part in this research study. Study staff will provide you a copy of this consent form
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