Informed Consent - Pilot Survey
What is the purpose of the pilot survey?
John Snow, Inc. (JSI), an independent public health firm, has been contracted by HRSA (Health Resources and Services Administration) to develop an employee well-being, burnout, and job satisfaction survey for use in HRSA-funded Health Centers called the HRSA Health Center Workforce Survey. The administration of the survey is part of a broad Workforce Well-being Initiative within the Bureau of Primary Health Care (BPCH) aimed at promoting workforce well-being and satisfaction, quality of care, and workforce recruitment and retention.
The purpose of this pilot survey is to test the draft HRSA Health Center Workforce Survey on a sample of health center staff to determine survey response rates; whether the software is easy to use and without any technical glitches; and if any further edits need to be made to the survey questions. The information that we gather in this pilot survey will help us create a more valid survey and will address any technology and data collection issues that may be problematic and will need to be addressed prior to administering the survey nationally to all health center FTE. Future national survey administration will provide data for targeted technical assistance at health centers in order to enhance workforce well-being and satisfaction as well as to promote patient quality of care.
How do I participate?
In addition to testing the survey instrument, JSI is testing different approaches to participant recruitment. You will be asked to participate in either Group A or Group B. Participants information and responses are kept confidential for both Group A and Group B.
Approach A: JSI is asking you to complete this pilot HRSA Health Center Workforce Survey on an online platform called Qualtrics. Your participation is anonymous since JSI does not know the identity of anyone invited by your health center to participate. The online program is set to not record or retain your email address, name, or IP address. No answers to this pilot survey will be given back to any health center; only JSI will have access to the answers. HRSA will only be given summary findings, not individual answers.
Participation in the pilot survey is voluntary and should take approximately 30 minutes of your time. Your participation will be kept anonymous.
Approach B: JSI is asking you to complete this pilot HRSA Health Center Workforce Survey on an online platform called Qualtrics. Your participation will be held in strictest confidence since JSI will be the only one to know which invitees responded and JSI will not provide that information to anyone. The online program is uses participant emails to know which invitee has responded or not so that we can send out a reminder after approximately 10 days and again at 20 days to those who have not yet completed the survey. After data collection is done your email address will be dropped from the data file. No answers to this pilot survey will be given back to any health center; only JSI will have access to the answers. HRSA will only be given summary findings, not individual answers.
Participation in the pilot survey is voluntary and should take approximately 30 minutes of your time. Your participation will be kept confidential.
We thank you for your participation in the Workforce Well-being Initiative and for supporting HRSA as we continue to refine the survey instrument and test any survey administration technology challenges prior to launching the survey nationally.
How will my responses be used?
Your responses during the pilot survey will help JSI and HRSA refine the HRSA Health Center Workforce Survey to ensure that the questions elicit responses that capture a variety of opinions and are understood by those answering them. We also want to gauge how many people participate in the pilot survey and gather your thoughts about its length and usefulness through responses to a few questions at the end of the survey. This information will help prepare the final survey for dissemination nationally across approximately 1,400 HRSA funded health centers for the purpose of assessing the causes, effects, and extent of employee burnout, well-being, and job satisfaction. Data from the final HRSA Health Center Workforce Survey will provide individual health centers and HRSA with valuable information on health center workforce well-being related to these factors so that targeted efforts to improve identified areas of need can be provided.
All pilot survey data will be kept anonymous though questions about your job title and demographic information will be asked. JSI will protect your privacy by not reporting results back to HRSA in ways that could directly identify participants and will not report any answers back to each participating health center for this pilot study.
What is the risk of taking part in the pilot survey?
The risks are minimal as individual answers will not be shared with HRSA nor your health center. If any of the questions make you feel uncomfortable, you can choose not to answer.
What are the benefits of taking part in the pilot survey?
The answers you provide during the pilot survey will help ensure that the survey program works well and help identify any final necessary refinements to the survey questions. This will help produce a well-crafted national survey that provide HRSA and your health center information to better understand the causes, impact and extent of burnout, well-being, and job satisfaction for health center employees. The national survey information will be used for quality improvement purposes and targeted technical assistance to improve employee working conditions.
Who should I call if I have questions?
This project is directed by Thomas Mangione, PhD at JSI. You may email him at tmangione@jsi.com if you have questions about this activity. If you have questions about your rights as a participant or if you feel you have been harmed, call Laurie Kunches, PhD, Chair of the JSI Institutional Review Board at (617) 385-3735.
Can I refuse to be part of the pilot survey?
Participation in the pilot survey is voluntary. Your decision to participate or not has no effect on your employment. However, by participating you will help us to build a more valid survey and will help us test the technology and data collection platform that will be used for data analysis and to provide targeted technical assistance that will benefit health center employees in the future.
Do I need to sign the Consent Form?
There is no need to sign and return this document. Your participation in the pilot survey will serve as documentation of your review and understanding of the information provided in this informed consent document.
Pilot Survey Informed Consent
HRSA Health Center Workforce Survey
OMB Control No. 0915-0379
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Ann Keehn |
| File Modified | 0000-00-00 |
| File Created | 2023-12-20 |