Non-Trainee Informed Consent

0701-TPHB_Non-Trainee_Informed Consent.docx

Qualitative Study of Factors that Influence Healthcare Seeking in Pilots

Non-Trainee Informed Consent

OMB: 0701-0172

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Informed Consent

You are being asked to participate in a research study.

Key study information you should know:

One purpose of the study is to understand factors that influence pilot (civilian airline and active duty military) healthcare seeking behavior with hopes of better enabling the aeromedical system to serve pilots and stakeholders. 

Participation includes a one-time interview that will take approximately 30-60 minutes.

We will NOT ask about your personal health status or reasons for seeking care. This study is only aiming to collect your perceptions and opinions. If you begin to share personal health information, the researcher will kindly ask you to stop sharing. You will be reminded of this policy, which is in place to protect you. If information about serious medical concerns is shared, it may result in a report/referral to local medical clinic for an evaluation.

There are no foreseeable physical risks and very minimal privacy/confidentiality risks or discomforts from this study. 

The results from this study will be used to inform civilian and military aerospace leaders on factors that influence pilot healthcare behavior. The results will also be used to inform future research. 

Taking part in this study is voluntary. You can skip any question and discontinue participation at any time without penalty or loss.

The research team will take the following precautions to maintain the confidentiality of your data: We will not collect any direct identifiers, and the likelihood of re-identifying you based on the information you provide is minimal. Data will be presented and published in aggregate form. Electronic data will be password-protected.

The data may be accessed by the Department of Defense for auditing purposes. There will be no identifying information associated with your responses.

If you have further questions regarding the study, contact the Principal Investigator: Rachael N. Martinez, PhD, at Rachael.martinez.1@us.af.mil or Capt William R. Hoffman, MD USAF MC at william.r.hoffman43.mil@mail.mil. If you have questions regarding your rights as a research subject, contact the AFRL IRB: 937-904-8100 or afrl.ir.protocolmanagement@us.af.mil.

AF Portal list of Approved Surveys:  https://www.my.af.mil/gcss-af/USAF/content/valid 

By answering yes, you are stating that you have read this consent form and agree to participate in this study.

Do you agree to participate in this study?

Yes / No



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
Authorwilliam hoffman
File Modified0000-00-00
File Created2023-11-17

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