CONSENT FORM

Read below the information contained in the consent form each participant must agree to in order to complete the survey

Thank you for agreeing to participate in our survey. 


Before we start, we’d like for you to read the informed consent information below. Informed consent refers to the voluntary choice of an individual to participate in research based on an accurate and complete understanding of its purposes, procedures, risks, benefits, and alternatives.  This survey will be completely anonymous and voluntary.  We do not ask about or identify any individuals who plan to participate in this survey.   

Informed consent:
You must be 18 years of age or older to participate.


The purpose of this project is to understand perceptions about the COVID-19 pandemic among self-identified members of the Black community

 

As a participant in this survey, you will be asked to complete a brief questionnaire that asks about your general thoughts and feelings, and the impact of the COVID-19 pandemic on your life and the lives of your friends and family members. No personally identifying information about you will be recorded with your responses. Your involvement in this survey will begin when you agree to participate and will end when you submit your responses or stop answering questions. The survey may take about 10 minutes to complete.

 

Your participation is completely voluntary and you are free to withdraw or discontinue participation at any time. 


There are no known risks involved in completing the survey. Even though there are no tangible benefits for completing the survey, by participating, you may help researchers and community organizers better understand how to develop programs and services to meet the needs of the Black community during and after the COVID-19 pandemic.

 
All data obtained will be anonymous. There is no way for us to find out who you are, and your responses will not be shared with any other parties under any circumstance. 

 

Only the investigators and members of the research team will have access to the data. If information learned from this survey is published, you will not be identified by name. By participating, however, you allow the investigators to make your anonymous responses available to the University of Maryland, Baltimore County (UMBC) Institutional Review Board (IRB) and regulatory agencies as required to do so by law.


The principal investigators of this survey are Dr. Shawn M. Bediako (Professor of Psychology at UMBC) and Dr. Kameelah Mu’Min Rashad (Founder and President, Muslim Wellness Foundation). They are available to answer any and all questions you might have regarding your participation. If you have any further questions, you can contact Dr. Bediako at bediako@umbc.edu and Dr. Mu'Min Rashad at kameelah@muslimwellness.com.

 

This project has been reviewed and approved by the UMBC Institutional Review Board (IRB).  A representative of that Board, from the Office of Research Protections and Compliance, is available to discuss the review process or your rights as a survey participant. Contact information of the Office is (410) 455-2737 or compliance@umbc.edu.

After reading this, please choose one of the options below and click the button with the blue arrow on the bottom right portion of this page. If you'd like to leave the survey at any time, simply close your browser. 

Co-Principal Investigator

© 2020 - Muslim Wellness Foundation + University of Maryland, Baltimore County