This free survey is powered by
Create a Survey
Surveys
2015
March
M
Mitigating Tornadoes
Mitigating Tornadoes
Do we prepare and respond to tornadoes
0%
Exit Survey
Informed Consent Form
Arkansas Tech University
Title of Project: Mitigating Tornadoes
Principal Investigators: Jennifer Stone
I invite you to take part in a research study the problems with mitigating tornadoes at Arkansas Tech University, which seeks to identify the problems there might be with mitigating tornadoes and warning systems and times. Taking part in this study is entirely voluntary. We urge you to discuss any questions about this study with me. Talk to your family and friends about it and take your time to make your decision. If you decide to participate you must sign this form to show that you want to take part.
Section 1. Purpose of the Research
You are being offered the oppertunity to take part in this research study because of your location. Your location which allows you the possibility to have tornadic weather. The purpose of this research study is to identify reactions to tornado warnings, identify if people are involved in self preparedness by retrofitting their homes, and if there is an understanding of the importance of building code enforcement.
Section 2. Procedures
Should you decide to take part in this study you will be asked to fill out a questionnaire. This is 8 question long multiple choice questionnaire with one short answer question. You are asked to answer these truthfully and to the best of your ability.
Section 3. Time Duration of the Procedures and Study
If you agree to take part in this study, your involvement will last approximately 7 minutes.
Section 4. Discomforts and Risks
There are no known risks associated with this research.
Section 5. Potential Benefits
Possible benefits to the participant:
You may benefit from this research if it impacts the way people prepare for tornadoes and warning systems and times are improved.
Possible benefits to others:
The results of this research may impact the way warning systems warn for tornadoes. It may also impact the amount of time people have to seek shelter by increasing it. This research can also show how people respond to preparedness in the form of retrofitting and building codes.
Section 6. Statement of Confidentiality
We will keep your participation in this research study confidential to the extent permitted by law. However, it is possible that other people may become aware of your participation in this study. For example, the following people/groups may inspect and copy records pertaining to this research.
-Arkansas Tech University Institutional Review Board
-The Arkansas Tech University IRB Office
Section 7. Compensation for Participation
You will not receive any compensation for being in this research study.
Section 8. Research Funding
There is currently no funding for this research.
Section 9. Voluntary Participation Section:
Taking part in this research study is voluntary. You do not have to participate in this research. If you choose to take part, you have the right to stop at any time. If you decide not to participate or if you decide to stop taking part in the research at a later date, there will be no penalty or loss of benefits to which you are otherwise entitled.
Section 10. Contact Information for Questions or Concerns
You have the right to ask any questions you may have about this research. If you have questions, complaints or concerns, contact Jennifer Stone at (662)404-0264. If you have questions regarding your rights as a research participant or you have concerns or general questions about the research, contact the research participants protection advocate in the Arkansas Tech University IRB Office at (479) 968-0319. You may also call this number if you cannot reach the research team or wish to talk to someone else.
For more information about participation in a research study and about the Institutional Review Board (IRB), a group of people who review the research to protect your rights, please visit Arkansas Tech University's IRB web site at
http://www.atu.edu/research/contact.php.
Included on this web site, under the heading "Participant Info", you can access federal regulations and information about the protection of human research participants. If you do not have access to the internet, copies of these federal regulations are available by calling the Arkansas Tech University at (479) 968-0319.
Before making the decision regarding enrollment in this research you should have:
-Discussed this study with an investigator
-Reviewed the information in this form, and
-Had the opportunity to ask any questions you may have.
Your signature below means that you have received this information, have asked the questions you currently have about the research and those questions have been answered. You will receive a copy of the signed and dated form to keep for future reference.
Participant: By signing this consent form, you indicate that you are voluntarily choosing to take part in this research.
Signature of Participant Date Time Printed Name
Participant’s Legally Authorized Representative: By signing below, you indicate that you give permission for the participant to take part in this research.
Signature of Participant’s Legally Date Time Printed Name Authorized Representative
(Signature of Participant’s Legally Authorized Representative is required for people unable to give consent for themselves.)
Description of the Legally Authorized Representative’s Authority to Act for Participant
Person Explaining the Research: Your signature below means that you have explained the research to the participant/participant representative and have answered any questions he/she has about the research.
Signature of person who explained this research Date Time Printed Name
Only approved investigators for this research may explain the research and obtain informed consent. A witness or witness/translator is required when the participant cannot read the consent document, and it was read or translated.
What is your age?
18-25
26-33
34-41
42-49
50- and over
How many people in your household?
1
2
3
4
5 or more
What is the highest level of education you have completed?
some high school
high school graduate
trade/technical/vocational training
some college
college graduate
How often do you hear tornado sirens?
never
sometimes
often
very often
not sure/ not applicable
How often do you seek immediate shelter right after hearing a tornado siren?
never
sometimes
every time
not sure/ not applicable
Most people do not make improvements in their homes to safeguard against tornadoes.
strongly agree
agree
neutral
disagree
strongly disagree
not sure/ not applicable
How important is building code enforcement?
not important at all
somewhat important
important
very important
not sure
Tornado sirens allow enough time to seek safe shelter.
strongly disagree
disagree
agree
strongly agree
not sure/ not applicable
What do you do when you hear a tornado siren?
Loading...
close
Loading...
Close
qprun1.questionpro.net