Appendix H - Data Linkage Forms

APPENDIX H: Data Linkage Forms

Caregiver and Child Data Linkage H-1

Legal Guardian Permission for Child Data Linkage H-3

Youth Age 13-17 Data Linkage H-5

Caregiver of Emancipated Youth Data Linkage H-7

Emancipated Youth Data Linkage H-9

Young Adult Data Linkage H-11

Caregiver and Child Data Linkage

Caregiver Consent and Permission Form for Combining NSCAW Data with Other Research Data

Why should I grant permission to combine my NSCAW interview data with other data?

The NSCAW interviews with you and your child can be more valuable to researchers when your answers are combined with other data. This includes information that exists now as well as future information. This form asks your approval to add other sources of information about you and your child to your interview data.

What kinds of other data would you gather?

We would add three types of information to you and your child’s interview data.

• We would add records collected from child welfare services agencies taking part in the study. Adding this information will help us learn about foster care, adoption, or other services you and your child receive.

• We would add data about your household’s income, such as wages and disability benefits from the Social Security Administration and from data available to the Administration for Children and Families—the agency funding the study.

• Researchers interested in NSCAW data may wish to add other types of information in the future. For example, in the past, data on county or state child welfare policies have been added to NSCAW interviews.

Your permission allows us to add these other types of information to you and your child’s interview data. We will add this information to you and your child’s interview data until your child becomes an adult (turns 18 years old). We can add some of the information about you and your child now. Some of the information we will add in the future.

Your permission to add other information will stop when your child turns 18 years old. When your child turns 18 years old, we will ask your child’s permission to add new information. Your child’s permission will allow us to add information about your child’s adult life.

How will you combine the data and who will have access?

We will allow some researchers to do studies that combine your NSCAW interview with the information we collect from other sources. We created a well-defined plan to protect the data shared with other researchers. The study must first be approved by persons responsible for protecting the rights of those who take in part in research studies. The researchers will use the data to write reports. None of these reports will include your name or your child’s name.

What are the risks and benefits with granting permission for this request?

We have significant protections in place to collect and store your information securely. However, there is a small risk that if someone does not follow the rules we set someone outside the study team might see your information. We minimize this risk by transferring and storing your information and interview data using a study ID and not your name.

Combining you and your child’s interview data with other information presents no direct benefit to you or your child. Your decision will not affect any services you or your child receive now or in the future.

What are my choices?

By answering “yes”, you give permission for us to link you and your child’s interview data with the sources described above. You have the right to say yes or no to this request. If in the future you decide you no longer want you or your child’s interview data combined with other records, you can opt out of this request and stop further collection from outside sources. Please contact Jennifer Keeney at RTI International (toll-free at 800-334-8571 extension 23525) or RTI's Office of Human Research Protections at 1-866-214-2043 (a toll-free number) to record this request.

Check one box.

	Yes, I agree to link and share my NSCAW information to other sources like those listed above. Your approval takes effect when RTI releases information from this round to researchers.
	No, I do not want to add the other types of information described above to my first NSCAW. interview.
Printed Name of Child			Printed Name of Current Caregiver		Fill in CCG Respondent 8-digit ID #
Fill in Child Respondent 8-digit ID			Signature of Current Caregiver		Date

Legal Guardian Permission for Child Data Linkage

Legal Guardian Permission Form for Combining Child’s NSCAW Data with Other Research Data

Why should I grant permission to combine the child’s NSCAW interview data with other data?

The NSCAW interview data we collect from the child can be even more valuable to researchers when combined with other data. This includes information that exists now as well as future information. We also ask the child’s current caregiver to offer permission to combine interview data with other information about them. This form requests your approval to add other sources to the child’s interview data.

What kinds of information would you gather?

We would add three types of information to the child’s interview data.

• We would add records collected from child welfare services agencies taking part in the study. Adding this information will help us to learn about foster care, adoption, or other services the child receives.

• We would add information about the child’s household, such as wages and other benefits from the Social Security Administration and from data available to the Administration for Children and Families—the agency funding the study.

• Researchers interested in NSCAW data may wish to add other types of information in the future. For example, in the past, data on county or state child welfare policies have been added to NSCAW interviews.

Your permission allows us to add these other types of information to the child’s interview data. We will add this information to the child’s interview data until the child becomes an adult (turns 18 years old). We can add some information about the child now. Some of the information we will add in the future.

Your permission to add other information will stop when the child turns 18 years old. When the child turns 18 years old, we will ask the child’s permission to add new information. The child’s permission will allow us to add information about the child’s adult life.

How will you combine the data and who will have access?

We will allow some researchers to do studies using data that combines the information we gather from other sources and the child and their caregiver’s interview data. We created a well-defined plan to protect the data shared with other researchers. The study must first be approved by persons responsible for protecting the rights of those of who take part in research studies. Researchers will use the data to write reports. None of these reports will include the child’s name.

What are the risks and benefits with granting permission for this request?

We have significant protections in place to collect and store the child’s information securely. However, there is a small risk that if someone does not follow the rules we set, someone outside the study team might see the child’s information. We minimize this risk by transferring and storing the child’s information and interview data using a study ID and not the child’s name.

Combining the child’s interview data with information presents no direct benefits to the child. Your decision will not affect any services the child or the caregiver may be receiving now or in the future.

What are my choices?

By answering “yes”, you give permission for us to link the child’s interview data with the sources described above. You have the right to say yes or no this request. If in the future should you decide you no longer want the child’s interview data combined with other records, you can opt out of this request and stop further collection from outside sources. Please contact Jennifer Keeney at RTI International (toll-free at 800-334-8571 extension 23525) or RTI's Office of Human Research Protections at 1-866-214-2043 (a toll-free number) to record your request.

Check one box.

	Yes, I agree to link and share all of the child’s NSCAW information ever provided to other sources like those listed above. Your permission takes effect when RTI releases information from this round to researchers.
	No, I do not want to add other types of information described above to the child’s first NSCAW interview.

Printed Name of Child		Printed Name of Legal Guardian		Date
Fill in Child Respondent 8-digit ID		Signature of Legal Guardian

Youth Age 13-17 Data Linkage

Adolescent (Aged 13 to 17) Assent Request for Combining NSCAW Information
with Other Research Information

What does “combining information” mean?

The NSCAW interview with you can be even more useful when we combine your answers with other data. This includes information available now as well as future information. We want to ask for your okay to add other types of information to your survey answers.

What kinds of information would you collect?

We would add three types of information to your interview data.

• We would add records collected from child welfare services agencies taking part in the study. Adding this information will help us learn about foster care, adoption, or other services you receive.

• We would add information about your household’s income, such as wages and disability benefits from the Social Security Administration and from data available to the Administration for Children and Families—the agency funding the study.

• Researchers interested in NSCAW data may wish to add other information in the future. This could include data on county or state child welfare policies.

If you give your okay now, we will collect these other kinds of information to combine with your interview data. Your okay to link your interview data to other information will last until you turn 18 years old unless you change your mind before then. Your okay means we can start adding information about you now or in the future. When you turn 18 years old, we will ask if it is okay to collect information about you as an adult. If you say no then, we will stop adding information about you as an adult and only keep and share the information collected before you turned 18 years old.

How will you add the information and who will use it?

We will allow some researchers to do studies using data that combine your survey answers to other sources. We created a clear plan to protect the data shared with other researchers. The study must first be approved by persons in charge of protecting the rights of those who take part in research studies. Researchers will use the data to write reports. None of these reports will include your name.

What are the risks and benefits for saying OK to this?

We have protections in place to collect and store your information securely. However, there is a small risk that if someone does not follow the rules we set, someone outside the study team might see your information. We reduce this risk by using a study ID and your name when moving and storing your interview data.

Combining your interview data with other information presents no direct benefit to you. Your decision will not affect any services you receive now or in the future.

What are my choices?

By answering “yes”, you give your “okay” for us to link your interview with the sources described above. You have the right to say yes or no to this request. If you change your mind, please call Jennifer Keeney at RTI International (RTI) (toll-free at 800-334-8571, extension 23525) or RTI's Office of Human Research Protections at 1-866-214-2043 (a toll-free number) to record this request.

Check one box.

	Yes, it’s OK to link and share my NSCAW information with other sources like those listed above. My okay takes effect when RTI releases information from this round to researchers.
	No, I do not want add the other types of information described above to my first NSCAW interview.

Printed Name of Youth		Fill in Youth Respondent 8-digit ID #
Signature of Youth				Date

Caregiver of Emancipated Youth Data Linkage

Caregiver of Emancipated Youth Permission Form for
Combining NSCAW Data with Other Research Data

Why should I grant permission to combine my NSCAW interview with other data?

The NSCAW interview data we collect from you can be more valuable to researchers when your answers are combined with other data. This includes information that exists now as well as future information. This form requests your approval to add other sources of information about you to your interview data.

What kinds of information would you gather?

We could link three types of data to your interview data.

• We would add records collected from child welfare services agencies taking part in the study. Adding this information will help us to learn about foster care, adoption, or other services you or your child receive.

• We would add information to your household’s income, such as wages and other benefits from the Social Security Administration and from data available to the Administration for Children and Families—the agency funding the study.

• Researchers interested in NSCAW data may wish to add other types of information in the future. For example, in the past, data on county or state child welfare policies have been added to NSCAW interviews.

Your permission allows us to add these other types of information to your interview data. We can add some of the information about you now. Some of the information we will add in the future.

How will you combine the data and who will have access?

We will allow some researchers to do studies using data that combines the information from other sources and your interview data. We created a well-defined plan to protect the data shared with other researchers. The study must first be approved by persons responsible for protecting the rights of those who take in part in research studies. Researchers will use the data to write reports. None of these reports will include your name.

What are the risks and benefits with granting permission for this request?

We have significant protections in place to collect and store your information securely. However, there is a small risk that if someone does not follow the rules we set, someone outside the study team might see your information. We minimize this risk by transferring and storing your information and interview data using a study ID and not your name.

Combining your interview data with other information presents no direct benefit to you or your child. Your decision will not affect any services you receive now or in the future.

What are my choices?

By answering “yes”, you give permission for us to link your interview data with the sources described above. You have the right to say yes or no to this request. If in the future you decide you no longer want your interview data combined with other records, you can opt out of this request and stop further collection from outside sources. Please contact Jennifer Keeney at RTI International (RTI) (toll-free at 800-334-8571, extension 23525) or RTI's Office of Human Research Protections at 1-866-214-2043 (a toll-free number) to record this request.

Check one box.

	Yes, I agree to link and share my NSCAW information to other sources like those listed above. Your approval takes effect when RTI releases information from this round to researchers.
	No, I do not want to add other types of information described above to my first NSCAW interview.

Printed Name of Caregiver		Fill in CCG Respondent 8-digit ID
Signature of Caregiver		Date

Emancipated Youth Data Linkage

Emancipated Youth Consent Request for Combining
NSCAW Information with Other Research Information

Why should I grant permission to combine my NSCAW interview data with other data?

The NSCAW interview with you can be even more valuable to researchers when your answers are combined with other data. This includes information that exists now and other future information. We want to ask for your okay to add other types of information to your interview data.

What kinds of information would you gather?

We would add three types of information to your interview data. .

• We would add records collected from child welfare services agencies taking part in the study. Adding this information will help us to learn about foster care, adoption, or other services you receive.

• We would add information about your household’s income, such as wages and other benefits from the Social Security Administration and from data available to the Administration for Children and Families—the agency funding the study.

• Researchers interested in NSCAW data may wish to add other types of information in the future. For example, in the past, data on county and state welfare policies have been added to NSCAW interviews.

Your okay allows us to add these other types of information to your interview data. Your okay means we can start adding information about you now or in the future.

How will you combine the data and who will have access?

We will allow some researchers to do studies using data that combines the information we gather from other sources and your interview data. We created a well-defined plan to protect the data shared with other researchers. The study must first be approved by persons responsible for protecting the rights of those who take part in research studies. Researchers will use the data to write reports. None of these reports will include your name.

What are the risks and benefits for saying OK to this request?

We have significant protections in place to collect and store your information securely. However, there is a small risk that if someone does not follow the rules we set, someone outside the study team might see your information. We minimize this risk by transferring and storing your information and interview data using a study ID and not your name.

Combining your interview data with other information presents no direct benefits to you. Your decision will not affect any services you receive now or in the future.

What are my choices?

By answering “yes”, you give your “okay” for us to link your interview data with the sources described above. You have the right to say yes or no to this request. If you change your mind about this, please call Jennifer Keeney at RTI (toll-free at 800-334-8571 extension 23525) or the Coordinator of RTI’s Office of Human Research Protections (toll-free at 866-214-2043), to record this request.

Check one box.

	Yes, it’s OK to link and share my NSCAW information to other sources like those listed above. Your approval takes effect when RTI releases information from this round to researchers.
	No, I do not want add the other types of information described above to my first NSCAW interview.

Printed Name of Youth		Fill in Youth Respondent 8-digit ID #
Signature of Youth			Date

Young Adult Data Linkage

Young Adult Consent for Combining
NSCAW Information with Other Research Information

Why should I grant permission to combine my NSCAW interview data with other data?

Your NSCAW interview data can be even more useful to researchers when your answers are combined with other data. This includes information that exists now and other future information. We want to ask for your permission to add other types of information to your interview data.

What kinds of information would you gather?

We would add three types of information to your interview data.

• We would add records collected from child welfare services agencies taking part in the study. Adding this information will help us learn about foster care, adoption, or other services you receive.

• We would add information about your household’s income, such as wages and other benefits from Social Security Administration and from data available to the Administration for Children and Families—the agency funding the study.

• Researchers interested in NSCAW data may wish to add other information in the future. For example, in the past, data on county or state child welfare policies have been added to NSCAW interviews.

Your permission allows us to add these other types of information to your interview data. Your okay means we can start adding information about you now or in the future.

How will you combine the data and who will have access?

We will allow some researchers to do studies using data that combines the information we collect from other sources and your interview data. We created a well-defined plan to protect the data shared with other researchers. The study must first be approved by someone responsible for protecting the rights of those who take part in research studies. Researchers will use the data to write reports. None of these reports will include your name.

What are the risks and benefits for saying OK to this request?

We have significant protections in place to collect and store your information securely. However, there is a small risk that if someone does not follow the rules we set, someone outside the study team might see your information. We minimize this risk by transferring and storing your information and interview data using a study ID and not your name.

Combining your interview data with other information presents no direct benefits to you. Your decision will not affect any services you receive now or in the future.

What are my choices?

By answering “yes”, you give your “okay” for us to link your interview data with the sources described above. You have the right to say yes or no to this request. If you change your mind about this, please call Jennifer Keeney at RTI (toll-free at 800-334-8571 extension 23525) or the Coordinator of RTI’s Office of Human Research Protections (toll-free at 866-214-2043) to record your request.

Check one box.

	Yes, it’s OK to link and share my NSCAW information to other sources like those listed above. My approval takes effect when RTI releases information from this round to researchers.
	No, I do not want add the other types of information described above to my NSCAW information. My refusal applies only to information collected for this round.

Signature of Young Adult		Printed Name of Young Adult		Date