1A: WEB-BASED QUESTIONNAIRE FOR NIDRR STAKEHOLDERS

Informed Consent Form

What the study is about: An expert committee of the National Research Council, of The National Academies, in Washington, DC is conducting an evaluation of some of the activities of the National Institute on Disability and Rehabilitation Research (NIDRR). The committee will be (1) reviewing NIDRR’s priority setting and peer review processes; and (2) reviewing the quality of grantee “outputs” for a sample of NIDRR grants. [“Peer review” refers to a process in which experts review grant applications and make recommendations about whether they should be funded. “Outputs” are publications, measures, intervention protocols, devices, and information resources that are produced as part of a grant.]

What we will ask you to do: We are inviting you to take part in the first part of the evaluation— specifically, the review of NIDRR’s priority setting processes. We will ask you a set of questions to help us understand these processes and how they may affect NIDRR’s work. The questionnaire will take about 15 to 20 minutes to complete. Your participation is completely voluntary. You can choose not to answer some of the questions or to stop at any point, and there will be no consequences.

Benefits and risks:

Benefits: By taking part in the evaluation you will provide information that may help NIDRR improve its research portfolio for the benefit of persons with disabilities.

Risks and protections: You might be concerned that the information you share will not be kept private. However, we want to assure you that all of your comments will be kept confidential. Study results will be presented only in combined form, with no individual person or organization being identified. Your name will not be attached to your answers. A research identification number will be used instead. The Study Director will keep a list linking your name with your number. This list, along with the data collected, will be stored securely at the National Research Council. Only the study personnel will have access to the master list, and only for research purposes.

Compensation: There is no compensation for taking part in the evaluation.

If you have any questions: Please contact the Senior Program Officer, Dr. Jeanne Rivard, if you have any questions about this consent form or the study. She can be contacted by phone at: 202-334-2967, or by email at: jrivard@nas.edu.

If you have any questions, comments, or concerns about taking part in this study, first contact Dr. Rivard. If for any reason you do not want to contact her, or you still have concerns after doing so, you may contact the Institutional Review Board (IRB) of the National Academy of Sciences (NAS), which reviewed and approved the study plans and this consent form. You can reach the chair of the IRB, Ronald D. Taylor, Human Protections Administrator, by telephone at 202-334-1659 or you may write to him at the National Academy of Sciences; Room 1026; 500 Fifth Street, NW; Washington, DC 20001.

Statement of Consent:

image   I have read the above information, understand it, and agree to take part in the study.

image   I do not agree to take part in the study.



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