Local Environments and Alcohol Study (LEAS)
CONSENT FORM
Introduction and Purpose
We invite you to take part in a research project funded by the National Institutes of Health. This study is being conducted with young adults in California to better understand stigma experiences, alcohol use and beliefs, other substance use, and alcohol-related problems.
This study is a collaborative effort involving the Prevention Research Center at the Pacific Institute of Research and Evaluation, the California LGBTQ Health & Human Services Network, the Center for Critical Public Health, and the University of Pittsburgh’s Department of Behavioral and Community Health Sciences.
Procedures
This study involves two research activities. The table below shows these research activities, estimated time for completion, timeline, and compensation.
| Research Activity | Estimated Time | When | Compensation |
|---|---|---|---|
| Initial online survey about your background and personal life, stigma experiences, alcohol use and beliefs, other substance use, and alcohol-related problems | 25-30 minutes | Beginning of the study | $30 |
| Brief daily survey over 14 consecutive days about stigma experiences, alcohol use, and problems | ~5-minute brief survey each morning (between 8am to noon) | 14 consecutive days, starting the Friday after completing the initial online survey | $5 per daily survey + $25 weekly bonus for completing all 7 daily surveys each week = $120 for completing ALL 14 daily surveys |
$150 total for completing the initial survey + all 14 daily surveys
Links to online surveys and reminder messages will be sent by text to the phone number you provided during screening. By consenting to participate in the study you give us permission to text the phone number you provided. Message and data rates may apply.
We will never spam you, share your phone number, or contact you about anything other than this study. You can opt out of these text messages at any time by replying with the word “STOP.” Please note that opting out means that you will not receive, or be compensated for, any more surveys.
Compensation
In total, you can receive up to $150 in electronic gift cards for your participation in the study. Specifically, you will receive $30 for completing the initial survey. You will also receive $5 for each daily survey you complete, and a $25 bonus for completing all 7 surveys each week. Payments are contingent upon validation of your eligibility.
After completing each survey, you will receive a link to redeem your e-gift card. We will use Tango, which allows you to select your gift using a global catalog that includes digital Visa and Mastercard prepaid cards, popular e-gift cards (e.g., Target, Starbucks), non-profit donations, and bitcoin e-gift cards. You can select different e-gift cards or rewards each time you receive the link to redeem your compensation.
Benefits
Aside from the compensation, there is no direct benefit to you from taking part in this study. We hope that the research will provide key information to reduce local structural stigma and prevent harms associated with alcohol use among young people.
Risks/Discomforts
Taking part in this study might make you feel uncomfortable or stressed because of the nature of some of the questions (e.g., stigma experiences, alcohol use and associated problems). All the questions we ask are strictly confidential and voluntary. That means you can decide not to take part in this study, not to answer specific questions, or to end participation at any time. We will also provide you a resources list with contacts you may use if you feel disturbed by the study or want to ask for help regarding alcohol or other substance use, or related problems of your own, your friends or family members.
We care about your privacy, so the risks of accidentally sharing your information are minimal. We take several precautions to prevent the risk that information you share might accidentally be revealed to someone not working on the project, like family members, employers, or friends. Specifically, we will:
1) store all data and records in a secure online platform that only research team members can access;
2) separate your name and contact information from survey data; and
3) use a number instead of your real name on project records and data.
As a general rule, if someone asks our office about your participation in the study, we will not give them any information. The information in this project will be used for research purposes only. All records of names and contact information will be destroyed 5 years after the study ends. The information will be available only to the people who work on this project, and we will only share de-identified data.
Privacy
We will handle your data as privately as possible. If we publish or present the results of this study, we will never include your name or other details that would identify you to others. Also, any admission of current alcohol use, substance use, or unsafe behaviors will not be reported to authorities. This includes, but is not limited to: policing agencies, hospital systems, social services, etc.
If someone enters the space while you are completing any of the online surveys, you can close it and return to it later when you have privacy.
Taking part in the study is voluntary. You can choose not to take part, decide to skip any question, and can stop the study at any time. There is no penalty or punishment for any of these decisions.
Data Repository
A data repository holds research data – such as your answers to the survey questions, but NOT your name, email, or phone number – and makes that data available for future use by the broader research community. We are asked to share data from this study with a data repository run by the funder of this project (i.e., the National Institutes of Health) so that it is available to other researchers for future research. However, if you consent to share your research data, we will only share de-identified data with the data repository or other researchers. We will never share your name, IP address, or contact information.
De-identification is the process used to prevent someone’s personal identity from being revealed. This will be done by not including any of your personal identifying information (e.g., name, email, phone number) in any data we share with other researchers.
| I DO want you to share my de-identified data outside of this research project. |
| I DO NOT want you to share my de-identified data outside of this research project. |
If you want more details about the study, please call the Study Director, Dr. Sharon Lipperman-Kreda at 1-800-486-0727. For questions about your rights as a research participant, you may call Elizabeth Waiters at 866-PIRE-ORG (866-747-3674) ext. 1, or e-mail IRB@pire.org.
THE CONSENT FORM HAS BEEN GIVEN TO ME AND EXPLAINED TO MY SATISFACTION. I HAVE BEEN INFORMED OF MY RIGHTS AND PROTECTIONS. I AM 18 YEARS OF AGE OR OLDER. I UNDERSTAND THE RISKS AND BENEFITS INVOLVED AND I CONSENT TO PARTICIPATE.
| YES, I consent |
| NO, I do not consent |