BronxWorks Consent Statement PRE SURVEY

Thank you for your willingness to participate in this survey. If you are an adult (at least 18 years of age) and are currently participating in the BronxWorks Nutrition Incentive Program (BNIP), you are eligible for this survey. This study is part of a research project being conducted by Fordham University on behalf of BronxWorks. The purpose of this consent form is to give you information on this research project. This information will help you decide whether or not you want to join the study.

What is this study?

You are being asked to join a research project being conducted between the Fordham Graduate School of Social Service and BronxWorks. The study is being administered by a team of professors at Fordham University: Drs. Sameena Azhar, Greg Acevedo and Abigail Ross.

There are no identifying links between the potential participant’s name, address or other personally identifiable information on the survey website. We will track the number of enrolled participants and change in produce consumption habits. BronxWorks staff will not be providing additional data about the participants for analysis.

What will you do if you participate in this study? 

If you agree to participate, you will complete a web survey, using the online survey platform Qualtrics.

 

Participation is voluntary. You do not have to participate in the study. All your answers are important. No opinion is right or wrong. We hope you will feel comfortable to answer the questions frankly and openly.

 

What are the possible risks of joining this study? The main risk of study participation is loss of confidentiality. Surveys will be labeled, using a unique ID number that has been deidentified. Each participant will be assigned a unique identifier. When the survey data is uploaded onto a spreadsheet, only this identifier will be used to identify the participant.

 

You might feel embarrassed by some of the questions on the survey. You can take a break or stop the survey at any time by simply asking the interviewer for a break or closing the web page. None of your responses will be recorded until your interviewer clicks the “submit” button. The questionnaire will remind you if you’ve missed a question. For some questions, we give you an option to not answer if the question makes you uncomfortable.

 

What are the possible benefits for me or others? 

We hope the results from our research will help us better understand how to improve service delivery for people who receive food pantry services at BronxWorks.

 

Compensation

Depending on recruitment site location, research participants will be placed either in the intervention arm or the comparison arm. Those in the intervention arm must spend a minimum of $1 EBT/SNAP to receive a $10 Bronx Bucks Incentive Coupon. Intervention arm participants will receive a $10 Bronx Bucks Incentive Coupon, using their EBT/SNAP, to purchase items at the farm staff and at the fresh food box. A comparison group of food pantry recipients, who also receive SNAP benefits, will be provided a $10 gift card to a local grocery store and do not need to purchase fresh produce. The comparison group will not receive BronxBucks coupons. The comparison arm participants will receive a $10 gift card to a local grocery store. We plan to conduct groups to complete a post-intervention survey.

 

This is to thank you for your time and your contribution to this study. Participants in focus groups and in-depth interviews who work for BronxWorks will not receive a financial incentive.

 

How will you protect the information you collect about me, and how will that information be shared? 

 

All of the information you provide us is confidential. You are not asked to share your name, position or any other personally identifiable information in the interview. The survey will not be connected to your name, address or BronxWorks affiliation.

 

For your own protection, we will complete the survey in a private location at BronxWorks. We plan to share the results of the study at conferences and in journal articles. Any results that we publish will not reveal any information that could be used to identify you. The results of the completed research will also be made available to you at your request. 

 

Data from the surveys will be saved onto a shared Dropbox folder, to which only research team members will have access. We plan to share the results of the study at conferences and in journal articles. Any results that we publish will not reveal any information that could be used to identify you. The results of the completed research will also be made available to you at your request.

To ensure the protection of confidentiality, each participant will be assigned a unique identifier. The unique identifier will be the participant’s birth year + zip code + + 2 digit ID. For example, if the participant is named John Doe and his birth year is 1965, lives in zip code 10456 and is the first person with this birth year and zip code, these will be differentiated by a two-digit ID at the end of the number. For example, the pre- and post-intervention survey would be labeled as: 196510456-01.

What are my rights as a research participant? Participation in this study is voluntary. You have the right to not answer a particular question; review any materials; request that we erase any of your responses; or make inquiries. You also have the right to address complaints to Fordham University. You can withdraw from the study at any time, for any reason, with no explanation, without any penalty. If you decide to withdraw from this study, the researchers will ask you if the information already collected from you can be used. If you have any questions about the project, please feel free to contact Dr. Sameena Azhar at (212) 636-6639 or email her at sazhar@fordham.edu.

You may also contact our program manager, Rachel Gill, at rgill@bronxworks.org if you have any questions about this research or your involvement in this study.

 

If you have questions about your rights as a participant, you may contact Michele Kuchera at Fordham’s Office of Research at (718) 817-0876 or email her at irb@fordham.edu.

 

If you complete this survey, it will be entered into a research study evaluating the program. Participation in this study is voluntary and confidential. Your name and contact information will not be linked with your responses. You can choose to not answer any questions you do not want to answer and/or you can stop at any time. We will protect the information that you provide by not attaching your name to your responses and safely storing this information. The information provided will be combined with responses from other individuals. By participating in this survey, I agree to my survey responses being part of a research study.

Informed Consent I have been read this form and the research study has been explained to me. I have been given the opportunity to ask questions and my questions have been answered. If I have additional questions, I have been told whom to contact. I agree to participate in the research study described above. I will also be offered a copy of this consent form after I provide my consent. The research project and the procedures associated with it have been explained to me. My participation is voluntary and I agree to participate in this study.