Consent to Participate in a Research Study

Encuesta Buenos Vecinos: Building Capacity to Promote Washtenaw County Latino/a Health

We are conducting this project to understand health issues in Latino/as who live in Washtenaw County. The results will be used in efforts to improve health and health related conditions. All adult (at least 18) Latino/a residents of Washtenaw County can participate. You will be asked questions about your health, health related behaviors, your experiences, your neighborhood, and children in your household. Your participation is voluntary; you may stop at any time. All information will be stored in a locked office at the University of Michigan. You will directly benefit from being in this study because you will be paid $30. You may also benefit from the study through resulting improvements in community conditions. We have taken steps to minimize the risks of this study; some of the questions may make you uncomfortable. You may choose not to answer any question. The study is funded by Michigan Department of Community Health (MDCH), Michigan Institute for Clinical and Health Research (MICHR), U.S. Housing and Urban Development (HUD), and Washtenaw County Public Health (WCPH).

• We will not record your name
• No one else will know what answers you give
• All information we share will combine your answers with those of others
• The survey will take about 35 minutes to complete
• You will receive a $30 gift certificate for completing the survey