INFORMED CONSENT
You are being asked to participate in the evaluation study of the Pathways to Success (PTS) program at California State University San Bernardino (CSUSB), Norco College (NC), and San Bernardino Valley College (SBVC). The project's Principal Investigator is Dr. Brian Heisterkamp from CSUSB; the evaluation is being conducted by Dr. Rebecca Eddy, Courtney Koletar, and Sasha Zuker from Cobblestone Applied Research & Evaluation, Inc. (Cobblestone). This study has been approved by the Institutional Review Board at California State University, San Bernardino.
PURPOSE: The evaluation study in which you are being asked to participate is designed to investigate, document, and assess the PTS program. The goal of the study is to provide insight into program implementation, operations, and outcomes.
DESCRIPTION: As a participant in the evaluation, you will be invited to complete an online survey to provide feedback on the event you attended today. The data collected from this survey will be analyzed and reported by researchers from Cobblestone. In addition, demographic information (e.g., sex, ethnicity) will be requested from CSUSB’s institutional research office.
PARTICIPATION: Participation in this evaluation study involves completing a survey at the end of the event you attended. Your participation in this survey is completely voluntary. You can decide not to answer all or parts of the survey associated with this study, even if you have signed this letter of consent. Your decision whether or not to participate will in no way affect your current or future relationship with Cobblestone or the faculty, students, or staff at CSUSB, NC, or SBVC.
CONFIDENTIALITY: Your individual privacy will be maintained in all publications or presentations resulting from this evaluation. Specifically, your information will be grouped with all other participants and reported as a whole. Identifying information will be removed from any quotes you provide. Information obtained in connection with this evaluation that could potentially identify you will only be shared with your permission or as required by law. All information you provide will remain confidential and will be kept in a password-protected database accessible only to Cobblestone employees.
DURATION: It is expected that completing the survey will take between 5-10 minutes.
RISKS: There could be some questions that you are uncomfortable answering or to which you would simply prefer not to respond. Your participation in this evaluation is strictly voluntary, and you will be under no obligation to answer any questions that you do not wish to answer. You may choose not to answer any specific questions you do not want to answer and still remain in the evaluation.
BENEFITS: Evaluation activities allow you to give feedback on your experiences in the PTS program and this may lead to improvements in program services. In addition, you may benefit from a self-examination of your experience at today’s event. Results of the evaluation will be used for program improvement, which will benefit future students and faculty members served by the program. The evaluation may provide information that can be used to gain a broader understanding of how to best support Arts and Humanities students at CSUSB, NC, and SBVC.
COMPENSATION: You will not receive any compensation for your participation in this evaluation.
CONTACT: If you have any questions or concerns about the evaluation, please contact Dr. Rebecca Eddy at rebecca.eddy@cobblestoneeval.com or (800) 971-3891 or the Principal Investigator, Dr. Brian Heisterkamp at bheister@csusb.edu or (909) 537-7665. A copy of the consent form will be given to you at your request.
RESULTS: Upon the completion of the evaluation study, a summary of the results can be obtained through Cobblestone at 2120 Foothill Blvd #202, La Verne, CA or by contacting Rebecca.Eddy@cobblestoneeval.com.