aiatsis.gov.au · web viewyou have been invited to participate because

51 Lawson CrescentActon Peninsula, Acton ACT 2601

GPO Box 553, Canberra ACT 2601ABN 62 020 533 641

P | 02 6246 1111F | 02 6261 4286

www.aiatsis.gov.au

Office Use OnlyClearance No:

PARTICIPANT INFORMATION SHEET AND INFORMED CONSENT FORM

Project Title: <Insert Project Title>

Researcher(s): <Insert name(s) of researcher(s)>

Organisation(s): <E.g. The Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS)>

What is the project about?

The aim of this research project is to <describe in plain language what the research project is about>.

Who is involved in the project?

This research project is being conducted by <insert name(s) of researcher(s)> who work for <insert name of organisation(s)> for the period of <insert date(s)> to <insert date(s)>

The research is supported by <insert organisation(s)/community group(s) supporting research including details of who is funding the project>.

Why have I been invited to participate?

You have been invited to participate because <describe in plain language the reasons why the participant has been chosen to participate in the research project and include the value and benefits of the research to the participant(s)>.

You can pull out at any time and it won’t change your relationship with the researcher(s) or anyone else. If you do decide to pull out of the project, you will need to do this by <insert date>.

What will the researcher(s) do and when?

The researcher(s) will <describe in plain language the research methods and techniques, interview/focus groups/workshop process, use of digital recordings/photographs, etc.>.

The research will happen around the <insert date(s)> at <insert location(s)>.

It will require the following time commitments from you: <describe in plain language how much time the participant will need to take part in project and whether the participant will be paid or recompensed in some form>.

What will happen to my information?

Your information will be used to create <describe in plain language what the participant's information will be used to create, i.e. report, video, education program, etc.>.

Any information that is obtained in connection with this research project and that can be identified with you will remain confidential unless otherwise permitted by you, or as required by law. The procedures for ensuring the

Version 1.0 – Last updated 12 March 2015 –

confidentiality of your information during the collection phase and the later publication of results are <outline how the participant's confidentiality will be contained during these stages>.

You will retain any Intellectual Property from your own personal interview recordings.

Copyright will be <outline who owns copyright of the material being produced and whether it will be shared with the participant>.

The researcher(s) will provide you with a copy of the <describe research output(s)>.

What are the potential risks?

<Describe in plain language any potential risks to the participant and any other risks associated with the research>

< Outline the risk mitigation strategy>

Data storage and giving materials to AIATSIS

During the project, the data will be stored in <describe in plain language where the data will be stored, i.e. password protected computers/USBs/hard drives, locked filing cabinets, etc.>.

The information will be kept for <outline how long the data will be stored for>.

If you agree, the researcher(s) propose to give all notes/recordings to AIATSIS for safekeeping. At AIATSIS these materials can be preserved and made available in the future.

When donating materials to AIATSIS you can place conditions on who can access them, although it is advisable to consider if this is absolutely necessary now and in the future.

Culturally restricted information

<State whether any culturally restricted information will be collected or not, and if so, indicate that permissions will be sought from relevant community organisations, traditional owners, elders, etc.>

Inclusion and exclusion criteria

<If relevant, outline details for the exclusion criteria, i.e. people under the age of 16 won't take part in the interviews/focus groups/workshops>

Contact

I know that if I am worried about the research I can contact <insert name of researcher(s) and contact details>.

Complaints

I know that I can complain to:

<insert contact details of the researcher(s) supervisor/governing body>.

Dr Lisa Strelein, Director of Research, AIATSIS, 51 Lawson Crescent, Acton ACT 2601, (p) 02 6246 1155, (e) [email protected]

Ms Chrissy Grant, Chair of the AIATSIS Research Ethics Committee, by calling 02 6261 4251 or writing to the AIATSIS Research Ethics Committee, AIATSIS, 51 Lawson Crescent, Acton ACT 2601. This is an independent Committee whose members do not work for AIATSIS.

If I think there has been a breach of my privacy I can write to the Office of the Australian Information Commissioner, GPO Box 5218 Sydney NSW 2001 or call 1300 363 992.

Ethics Committee Clearance

The ethical aspects of this research project have been approved by the AIATSIS Research Ethics Committee.


mailto:[email protected]

PARTICIPANT INFORMATION SHEET AND INFORMED CONSENT FORM (CONTINUED)

Project Title: <Insert Project Title>

Researcher: <Insert name(s) of researcher(s)>

Organisation(s): <E.g. The Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS)>

DECLARATION BY PARTICIPANT

1 I understand what this project is about

I have read [or had read to me] the Participant Information Sheet, which explains what this research project is about, and I understand it.

I have had a chance to ask questions about the project, and I am comfortable with the answers that I have been given. I know that I can ask more questions whenever I like.

2 I voluntarily agree to my participation in this study

I agree to participate in the research. I know that I do not have to participate in it if I don’t want to. I made up my own mind to participate and nobody is making me do it.

I know that I don’t have to answer any questions I don’t like.

The researcher(s) will not write anything down unless I agree they can.

AND (if appropriate)

a. The researcher(s) will turn off the tape/stop filming if I ask them to.

3 I understand that I can withdraw from the project at any time

I know that I can pull out at any time and it won’t change my relationship with the researcher(s) or anyone else.

If I do decide to pull out of the project, I understand that I will need to do this by <insert date>.

AND (choose as appropriate)

a. If I pull out, none of the information I have given the researcher(s) can be used in the research.b. If I pull out, the researcher(s) will be allowed to use any information that I have given them before then, and

they will be able to write down that I have stopped participating. However, they won’t be able to make me keep participating if I don’t want to.

4 I understand what will happen to me during the research project as explained to me

Choose as appropriate

a. I agree that the researcher(s) can interview me for the research.b. I agree to talk about questions that the researcher(s) gives us in a group of people. This is called a ‘focus

group’. c. I agree to visit <insert location> with the researcher(s) to talk about <insert topic of enquiry>.

I understand the research will take place on <insert date(s)>, at <insert location(s)>, over <insert number of days/weeks/months>.


a. During that time the researcher(s) will interview me <how often> and each interview will last for about <insert number of minutes/hours>.


b. A focus group discussion will take about <insert number of minutes/hours>.

5 Having my picture taken or being filmed (including when performing)

I consent to this interview/focus group/workshop (delete as appropriate) being audio taped and/or filmed:

Yes ☐ No ☐I agree to photographs being taken of this interview/focus group/workshop (delete as appropriate):

Yes ☐ No ☐I agree to the recording of my interview and the transcript to be lodged with AIATSIS:

Yes ☐ No ☐

6 I understand that I will be paid/will not be paid for my participation as explained to me


a. I know that I won’t be paid for participating in the research project.b. I will be paid <insert amount> for participating in this research project. This is a payment for my time <insert

details for paid participant's use of time>. But just because I am paid does not mean that I have to give answers that I think the researcher(s) want(s) me to give.

7 I understand the potential risks and possible benefits of participating in this research as explained to me

I know that the risks of the research are <describe in plain language any potential risks to the participant and outline a risk mitigation strategy>.

I understand that in talking about my recollections it may make me feel sad or angry. I know that I can stop the interview at any time if I feel sad or angry and that I can talk to someone at <identify a specific counselling service or agency for the participant to access support>.

I understand that the research may have the following benefits <describe in plain language any potential benefits of the research to the participant>.

8 I understand that the results of this research may be published in a public or other forum


a. I understand that the researcher(s) want(s) to write about the research in a <describe the research outputs, i.e. report, video, education program, etc.>. They will be the sole author(s) of the research.

b. I understand that researcher(s) want(s) to create <describe research output(s)> with me and I agree to become an author/producer. My name will be mentioned on the <describe research output(s)> as an author/producer.

9 Will people find out personal things about me from the research?


a. I understand that my name will NOT be mentioned in any <describe research output(s)> that come out of this research, and that people won’t know who I am from <reading/watching/listening to> the <describe research output(s)>.

b. I agree that my name and other following personal information can be mentioned in any <describe research output(s)> that come out of this research. I don’t mind if people find out these things about me from the <describe research output(s)>. The researcher(s) will check with me before they publish the <describe research output(s)> that it only contains the accurate personal information.


If the researcher(s) keep(s) a record of what I said [or did] during the research with my name on it, or which could be used to identify me, they will keep it in <outline where the data will be stored, i.e. password protected computers/USBs/hard drives, locked filing cabinets, etc.>.

The information will be kept for <outline how long the data will be stored for>.


a. If the researcher(s) keep(s) a record of what I said [or did] with my name on it, or which could be used to identify me, I want them to give it to AIATSIS for safekeeping. Other people will not be allowed to access this information without permission.

b. If the researcher(s) keep(s) a record of what I said [or did] with my name on it, or which could be used to identify me, I want them to give it to AIATSIS for safekeeping. I don’t mind if AIATSIS lets other researchers/people read this record.

10 What about culturally restricted information or things?


a. I understand that no secret or sacred information will be collected by the researcher(s). b. I understand that, if researcher(s) find out secret or sacred information, or are given secret or sacred things,

they won’t tell or show them to the wrong people.c. I agree that, when the researcher(s) have collected all the information or things they need, they will talk to

me [and/or whoever else has the authority to discuss them] about what to do with any secret or sacred information or things.

d. I understand that, if the researcher(s) collect any secret or sacred information or things, they will put them into <safe keeping place; AIATSIS for safekeeping>. Other researchers/people will not be allowed to access this information or these things without permission.

11 Who will have access to the research results?


a. I understand that this research will produce a <describe research output(s)> report for <insert organisation, community, individual(s)>. Members of the organisation will be able to read it, and so will other Aboriginal and/or Torres Strait Islander people who participated in the research. The researcher(s) won’t give a copy of the report to anyone else without <insert organisation, community, individual(s)> permission.

b. I understand that anyone can read the <describe research output(s)> that comes out of this research, and that even people on the other side of the world might see it, maybe on the internet. That’s OK with me.

c. I understand that the information may also be used in future.

The researcher(s) will give me a copy of the <describe research output(s)> that is produced as a result of this research.

12 Intellectual property and copyright

I understand that I will retain any Intellectual Property from my personal interview recordings.


a. I understand that the researcher(s) will hold copyright in the <describe research output(s)> produced as a result of this research. This means that the researcher(s) will be able to reproduce the information that is in the <describe research output(s)> in other places or for other purposes without asking for anyone else’s permission. The researcher(s) will be able to let other people reproduce that information without asking for anyone else’s permission. The researcher will grant <insert organisation/individual/other> an irrevocable perpetual license to use this copyright material for any purpose whatsoever.

b. I understand that the researcher(s) will SHARE copyright in the <describe research output(s)> produced as a result of this research with <insert organisation, community, individual(s)>. This means that the researcher(s) cannot reproduce the information that is in the <describe research output(s)> in other places or for other purposes without first getting permission from <insert organisation, community, individual(s)>.


The researcher(s) will not be able to let other people reproduce that information without first getting permission from <insert organisation, community, individual(s)>.

c. I understand that where a patent application is going to be made from the research results, the researcher(s) will include the names of <insert organisation, community, individual(s)> on any patent application. <<Where a patent application is envisaged or likely to arise out of the research, indigenous participants must get independent legal advice about intellectual property issues>>

13 Complaints

I know that if I am worried about the research I can contact <insert name of researcher(s) and contact details>.

I know that I can complain to:

<insert contact details of the governing body from the researcher(s) Organisation(s)>.

Dr Lisa Strelein, Director of Research, AIATSIS, 51 Lawson Crescent, Acton ACT 2601, (p) 02 6246 1155, (e) [email protected]

Ms Chrissy Grant, Chair of the AIATSIS Research Ethics Committee, by calling 02 6261 4251 or writing to the AIATSIS Research Ethics Committee, AIATSIS, 51 Lawson Crescent, Acton ACT 2601. This is an independent Committee whose members do not work for AIATSIS.

If I think there has been a breach of my privacy I can write to the Office of the Australian Information Commissioner, GPO Box 5218 Sydney NSW 2001 or call 1300 363 992.

14 Signatures

Participant to complete:

I have read the Participant Information Sheet and Informed Consent Form [or someone has read it to me in language I understand] and I agree with it.

Name: __________________________________________

Signature: _______________________________________

Date: / /

Researcher to complete:

I have described the nature of the research to the Participant and I believe that he/she understood and agreed to it.

Name: __________________________________________

Signature: _______________________________________

Date: / /


mailto:[email protected]

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