Parental Informed Consent for the Medford High School Similarity Study
October 3, 2014
Dear Parent/Guardian,
Dr. Perella, Headmaster at Medford High School, and researchers from the Harvard Graduate School of Education are conducting a study to learn more about how we might help MHS faculty and students improve the learning experience for both parties. We would like to invite your child to participate in this study. We developed this study to better understand counselors-students relationships and the factors that influence them. The results from this study will help Medford High School develop programs that address the academic and social needs of its diverse student body.
Participation is voluntary Your participation is voluntary. Students can decide whether they want to participate. There is no penalty for not participating. Even if they start the questionnaire, they can decide to not answer any question or quit in the middle. Refusal to participate or stopping your participation will involve no penalty or loss of benefits to which you or your child are otherwise entitled.
What is the purpose of this research? The purpose of this research is to better understand counselor-student relationships and the factors that influence them.
How long will my child take part in this research? Your childs participation will take approximately 40 minutes of total time spread out over a couple separate occasions. This study will continue through J une 2015.
What can I expect if my child takes part in this research? To avoid interrupting course instructional time, students will complete a questionnaire during an advisory period in October. The questionnaire will take about 25 minutes for most students to complete, and students will answer a series of get to know you questions, such as what they like to do in their free time, what traits they would use to describe themselves, etc. They then may be provided with feedback about their responses to the survey and they will be asked for some brief reactions to this feedback. They will also be asked to fill out an exit ticket after meeting with their counselors so that students can assess how helpful the counselors were and how useful the meeting was. Student records such as performance data, attendance data, counselor appointment data, and demographics will be shared with the research team to look at the factors that influence counselor-student relationships.
What are the risks and possible discomforts? The risks of participating in this study are minimal. There is a minimal risk to confidentiality, but the upmost precautions are being taken to ensure data security.
Are there any benefits from being in this research study? There are some benefits to participating in research like this. The data will be used to inform the field of educational and development research on ways to improve the academic and social outcomes of students
Version 2.0; September 29, 2014 Page2 from diverse backgrounds. If you wish, you can send an email message to Hunter Gehlbach at Hunter_Gehlbach@gse.harvard.edu and we will send you a copy of any articles based on the research. There is no compensation for participation.
How will my childs privacy be protected? What happens to the information you collect? The first get to know you questionnaire is not confidential the whole point of the survey is to help counselors and students get to know each other better. However, all following information your child gives us will be kept confidential. In other words, no administration, faculty, or other students will have access to these responses. Only the research team will be able to link students questionnaire responses to their school records. After the questionnaire is completed and the responses matched to your adolescents school records, a number will be assigned to his/her information and all names will be removed. No one at your childs school will be able to find out exactly what any individual student said. We will report back information to the Medford community only as averages and trends. The school will provide a copy of the records disclosed upon request.
Who can I talk to with questions, concerns or complaints about this research? The researcher for this study is Hunter Gehlbach who can be reached at hunter_gehlbach@harvard.edu; 13 Appian Way, Cambridge, MA 02476; 617-496-7318.
This research has been reviewed by the Committee on the Use of Human Subjects in Research at Harvard University. They can be reached at 617-496-2847, 1414 Massachusetts Avenue, Second Floor, Cambridge, MA 02138, or cuhs@fas.harvard.edu.
You do not have to do anything unless you do not want your child to participate. If you do not want youre your child to participate, please sign and return this form to the front desk by Friday, October 10 th or contact Hunter Gehlbach, principal investigator, at hunter_gehlbach@gse.harvard.edu. Research administrators will otherwise assume that parents consent to their child participating.
PLEASE RETURN only if you DO NOT want your child to participate
Students Name (please print) _________________________ Grade: __________________
I have read this letter about the Medford High School Similarity Study and do not want my child to take part in this project.
________________________________ _______________________________ Parents Name (please print) Parents Signature