Consent Form

THE CITY UNIVERSITY OF NEW YORK

Sarah Zeller-Berkman, PhD

CUNY School of Professional Studies Youth Studies

ORAL HISTORY TESTIMONIAL INTERVIEW INFORMED CONSENT SCRIPT 

Title of Research Study: COVID-19 Needs Assessment of DYCD programs                                             

Principal Investigator: Sarah Zeller-Berkman, PhD

Who we are: On behalf of the CUNY School of Professional Studies and the Department of Youth and Community Development (DYCD), we invite you to participate in a “COVID-19 Needs Assessment” research interview process. We are an interdisciplinary and intergenerational research team of Youth Studies and Data Science professors and students. Our group is made up of individuals from 13 to 45 years old who are connected to youth programs and communities across the city and we seek to understand the impacts of COVID-19 on DYCD programs and the communities from which constituents come and where staff work.

You are being asked to participate in this research study because you are ages 13 or older and you identify as being a participant or provider in a DYCD funded program.  The purpose of this research study is to understand both the challenges facing the hardest hit communities during this global pandemic and the ways in which people are finding and providing support. We want to gather research on the needs of families and their communities during this time period in a manner that facilitates healing along the way and provides recommendations to the city.

If you agree to participate, we will ask you to participate in a one hour interview via Zoom. We will create a safe and welcoming space where you can share your perspective on your work and the challenges you are facing during this time. It will allow you to have their stories heard and understood by others who may be having a similar experience. We hope that participants will find comfort in having this space while also being connected to resources around them. Please indicate which of the following consent that you give to our research team:

  • No Restrictions to oral history testimonial interview:
    • Your testimonial will only be an audio recording and transcript that gets donated to publications and an archive website for public use and consumption.
  • No Name associated with oral history testimonial interview:
    • You wish to not use your name or place of work in the recording, transcript and in any publications. We can archive your audio and written testimony under a pseudonym (fake name) and without your place of work.
  • No Audio of oral history testimonial interview:
    • Do not archive the audio recording. We can use an anonymized (nameless) and placeless transcript.
  • No Archive of oral history testimonial interview:
    • Do not archive my testimony. We can use anonymous quotes in publications and reports without obvious identifying context.

Although minimal there is a risk involved in this study, it may be uncomfortable to bring up trauma associated with this time. As compensation for your time we are offering a $20 gift card of your choice. You can stop participation at ANY time and still get the gift card.  Although you may not receive any personal benefit beyond this gift card, you will be contributing to a body of knowledge about the challenges youth and communities face during this time.  We are working with many organizations around the city that want to use this research to inform their advocacy and support services.

While we will be recording our Zoom session to be able to do analysis later, we will not share any identifying information in anything that we publish.  All of our data will only be handled by our research team.  We take seriously the privacy of participants in this research study.

Your participation in this research is voluntary. If you have any questions, you can contact Sarah Zeller-Berkman at Sarah.Zeller-Berkman@cuny.edu or 646 522-2912. If you have any questions about your rights as a research participant or if you would like to talk to someone other than the researchers, you can contact CUNY Research Compliance Administrator at 646-664-8918 or HRPP@cuny.edu.