{"id":128,"date":"2020-07-15T05:59:16","date_gmt":"2020-07-15T09:59:16","guid":{"rendered":"https:\/\/research.ohioguidestone.org\/study\/?page_id=128"},"modified":"2021-10-25T12:13:12","modified_gmt":"2021-10-25T16:13:12","slug":"joyful-together-consent-lorain-medina-summit-or-wayne-county","status":"publish","type":"page","link":"https:\/\/research.ohioguidestone.org\/study\/joyful-together-consent-lorain-medina-summit-or-wayne-county\/","title":{"rendered":"Joyful Together&reg; Consent Form &#8211; Lorain, Medina, Summit, or Wayne County"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-container-save-resume\" id=\"wpforms-763\"><form id=\"wpforms-form-763\" class=\"wpforms-validate wpforms-form\" data-formid=\"763\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/study\/wp-json\/wp\/v2\/pages\/128\" data-token=\"a8e55d3e13c39678b5709a95fc0dcbfc\" data-token-time=\"1776658301\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-763-field_16-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"16\"><div id=\"wpforms-763-field_16\"><style>\r\nh6 {font-size: 1.2em;}\r\ntable {border: 2px solid #000; border-collapse: collapse; }\r\nth, td {border: none; text-align: center;}\r\nth {margin: 0 auto; text-align: center; font-weight: bold; color: #000;}\r\ntr {color: #000;}\r\n<\/style>\r\n<h6>Introduction<\/h6>\r\n<p>You are being asked to participate in a research study at OhioGuidestone called \u201cJoyful Play\u201d. The word \u201cyou\u201d in this document refers to a parent\/guardian.<\/p>\r\n<p>You are being asked to participate in this study because you or your child is a resident (\u201clives in\u201d) Medina County, Summit County, Wayne County or Lorain County. Parents\/caregivers and their child are being asked to participate in this study if the child is between 12 weeks\/3 months and 10 years old.  Parent\/caregivers and their child will participate as a pair together. Siblings or household members of children who are also Medina County, Summit County County or Lorain County  residents are also welcome to participate in the study if they, too, are between 12 weeks\/3 months and 10 years old.<\/p>\r\n<p>Your participation in this study is voluntary and is not required to receive services from OhioGuidestone or Ohio Children's Trust Fund.  If you currently receive services from OhioGuidestone or Ohio Children's Trust Fund, your current services will not be affected if you do or do not choose to participate.  Please read the information below and ask questions to better understand this research study.<\/p>\r\n<h6>Purpose of the Study<\/h6>\r\n<p>OhioGuidestone wants to create and study a short evidence-based intervention that will help children and parent\/guardians to play more and feel joy together.  The intervention wants to help children experience joy at an early age in hopes of building strengths in children to help them face life\u2019s stressors.  Evidence-based interventions are a type of activity that uses research results to support and improve services.<\/p>\r\n<h6>Procedures<\/h6>\r\n<p>Research staff will tell you about the research study.  If you are interested in participating, staff will review this document to explain the research study and allow you to ask questions.  If you agree to participate in the study you will sign an informed consent form (this document) and complete study sessions.<\/p>\r\n<p>You will begin study sessions once you have signed up for the study.  There is a chance that you may be placed on a \u201cwaitlist.\u201d  If you are placed on a waitlist you will still participate in the study, but will do study sessions at a later date once the participant list becomes shorter.  Study staff will inform you when you have been moved off of the waitlist.<\/p>\r\n\r\n<p>Your participation in this research study will have two parts: Part 1 and Part 2.<\/p>\r\n<h6>What Study Paperwork will I do?<\/h6>\r\n<p>During both Part 1 and Part 2 you will fill out study paperwork\u2014study forms and questionnaires. These will take you about 15-30 minutes to complete. Study staff can help you fill out the forms, and some forms can be filled out on the internet or during videoconference study sessions. Some questionnaires may be completed more than one time at the beginning, middle, and end of the study.<\/p>\r\n\r\n<h6>Forms &amp; Questionnaires:<\/h6>\r\n<ul style=\"margin-left: 30px !important;\">\r\n<li>Child Survey - survey about your child's strengths and behavior<\/li>\r\n<li>Parent Stress Survey - questions about general life stress, and stress connected to being a parent<\/li>\r\n<li>Family Survey - questions about strengths, needs, and differences for your family<\/li>\r\n<li>Information Sheet - basic questions about you and your family<\/li>\r\n<li>Joyful Together\u00ae Feedback - questions about which Joyful Together\u00ae games your family uses<\/li>\r\n<li>Weekly Joy Calendar- counts activities tried each week; questions about your opinions of the activities<\/li>\r\n<li>Ohio Children\u2019s Trust Fund Surveys- questions about your family\u2019s needs and experiences<\/li>\r\n<\/ul>\r\n<h6>What will I do in Part 1 of the study?<\/h6>\r\n<p>Your participation in Part 1 will last for 6 weekly study sessions. Study sessions are called \u201cPlay Sessions\u201d. You will be sent a copy of Joyful Together games and activities to try with your child (or children if you have more than one child in the study), and a sticker chart called a \u201cJoy Calendar\u201d to show which games you played in between play sessions. Play sessions will last for 30-60 minutes, and will take place either through video conferencing or in-person in your home so that you do not have to travel to participate.<\/p>\r\n\r\n<p>(Video conferencing is a face-to-face meeting over the internet using a device that has both video (see) and audio (hear). We will use a safe, and secure video conferencing platform like Zoom, or Teams. To participate in video conferencing sessions you will need a device that has a camera, audio (speakers), and can connect to the internet. Research staff will help connecting to video conferencing platforms.)<\/p>\r\n\r\n<p>During play sessions research staff will help you pick Joyful Together games and activities, and ask you to play as many games and activities every day with your child in between play sessions. Research staff may ask you for permission to record the play session for research, quality, and training purposes. You do not have to consent to recording in order to participate in this study. You will be able to choose whether you do, or do not consent to recording during play sessions at the end of this consent form.<\/p>\r\n\r\n<p>In between \u201cPlay Sessions\u201d you will be asked to play as many games and activities every day with your child. You will be given a parent version of the Joyful Together activity book, and a sticker chart called a \u201cJoy Calendar\u201d to show which games you played in between play sessions. Research staff can help you fill out the calendar. You will be asked to complete questionnaires during some of your play sessions.<\/p>\r\n<div style=\"overflow-x: auto; margin: 20px 0 20px 0;\">\r\n<table style=\"border: 1px solid #000; border-collapse: collapse;\">\r\n<tbody>\r\n<tr>\r\n<th colspan=\"4\">Summary of Part 1 of Joyful Together\u00ae Study Procedures<\/th>\r\n<\/tr>\r\n<tr style=\"background-color: #b0ce9a;\">\r\n<td style=\"padding-left: 10px !important;\"><strong>Study Enrollment<\/strong><\/td>\r\n<td>Learn about \"Joyful Play\" research study.<\/td>\r\n<td>Read Consent form and ask questions. Schedule 1st \"Play Session\".<\/td>\r\n<td>Fill out Study Questionnaires.<\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #fcfad1;\">\r\n<td style=\"padding-left: 10px !important;\"><strong>\"Play Session\" #1<\/strong><\/td>\r\n<td>Receive Joyful Together\u00ae Booklet and your Joy Calendar.\r\nResearch staff helps you start Joyful Together\u00ae activities.<\/td>\r\n<td colspan=\"2\">After Play Session #1 you and your child will play games as much as possible every day from the Joyful Together\u00ae booklet. Fill out the Joy Calendar.<\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #e5e5e3;\">\r\n<td style=\"padding-left: 10px !important;\"><strong>\"Play Sessions\" #2-5<\/strong><\/td>\r\n<td>Talk about what activities and games you and your child did.\r\nHand in your Joy Calendar.\r\nDo more Joyful Together\u00ae activities with research staff.<\/td>\r\n<td>Schedule next \"Play Session\".<\/td>\r\n<td>Keep playing games every day &amp; filling out Joy Calendar between Play Sessions.<\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #c0d4e8;\">\r\n<td style=\"padding-left: 10px !important;\"><strong>\"Play Session\" #6<\/strong><\/td>\r\n<td>Talk about your favorite activities and games you and your child did.<\/td>\r\n<td>Fill out Study Questionnaires<\/td>\r\n<td>After Play Session #6 you will get your thank you gift in the mail.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<h6>What will I do in Part 2? PART 2 Information<\/h6>\r\n<p>Your participation in Part 2 will take place during a one-time 6-month follow-up after you finish Part 1 of the study.<\/p>\r\n\r\n<img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-137\" src=\"https:\/\/research.ohioguidestone.org\/study\/wp-content\/uploads\/2021\/10\/jt-octf_fy22_p1-p2.png\" alt=\"Joyful Together Study Timeline\" width=\"633\" height=\"147\" \/>\r\n\r\n<p>During Part 2 you will only do four (4) questionnaires. You may be done with your OhioGuidestone or Ohio Children\u2019s Trust Fund program by then; that is ok! Study staff will contact you to provide instructions on how you will do the Part 2 questionnaires. You will have 3 options to complete Part 2: online you will use a special number called an \u201cAccess Code\u201d to log into a special page on our website), by phone, by mail (we will give you a stamped envelope to send back to us), or in-person.<\/p>\r\n\r\n<p>We will email and call you to remind you about the one-time 6-month follow-up. 6 months from finishing this part of the study, we will reach out to you and send you a link (or mail you forms, or complete over the phone) to fill out 4 surveys (repeat 3 surveys from this part of the study, and a feedback survey asking if you still use Joyful Together\u00ae). We will email and call with reminders about four (4) times.<\/p>\r\n\r\n<h6>Potential Risks<\/h6>\r\n<p>Some survey questions might ask about your life experiences, and might make you feel uncomfortable or even emotional. Study staff are available to talk through any discomfort, feelings or thoughts during or after filling out your study questions. If needed, they will tell you about other services to get more help about what made you feel uncomfortable or emotional. There are no other known potential risks associated with participation.<\/p>\r\n\r\n<h6>Anticipated Benefits<\/h6>\r\n<p>You may or may not benefit from this study. Possible benefits may include:<\/p>\r\n<ul style=\"margin-left: 30px !important;\">\r\n \t<li>Better relationship between child and parent\/guardian<\/li>\r\n \t<li>Increased fun and play in you and\/or your child<\/li>\r\n \t<li>Increased positive emotions and feeling in you and\/or your child<\/li>\r\n<\/ul>\r\n<p>Information learned from this research study may also benefit future children and families.<\/p>\r\n\r\n<h6>Thank You Gift<\/h6>\r\n<p>You will receive a parent version of our Joyful Together book at the start of the study to do activities at home. You will get to keep this book.<\/p> \r\n\r\n<p>You will also receive a $10.00 gift card for you and your family as a as a thank you gift for participating in Part 1 after each play session. If you have more than one child who participated with you in the same study, you will complete separate paperwork and questionnaires for each child- and receive a gift card for each parent-child pair. You will also receive a $10.00 gift card to say thank you at the end of part 2.<\/p>\r\n\r\n<h6>Confidentiality<\/h6>\r\n<p>Your information will be kept confidential and only used for this research study. Only people working on this research study will have access to your study information. We will collect your demographic information, but a unique number instead of your name or other identifying information will be used on study documents. Your name or anything else that could identify you will not be included in reports, presentations or publications from this study. Your information will be kept in a locked file cabinet in a locked room, and computer files will only be opened on password protected computers. All documentation with identifying information will be destroyed once the study has ended.<\/p>\r\n<h6>Voluntary Participation and Withdrawal<\/h6>\r\n<p><span style=\"font-style: underline;\">Your participation in this study is completely voluntary (only if you want to).<\/span> If you choose not to participate, it will <span style=\"font-style: underline;\">not<\/span> affect your relationship with OhioGuidestone. You will still have the right to services that you are eligible for at OhioGuidestone. You will not be treated differently by OhioGuidestone or any programs related to Ohio Children\u2019s Trust Fund if you decide not to participate.<\/p>\r\n\r\n<p>If you decide to participate, you are free to withdraw your consent and stop at any time. You will not be treated any differently if you decide to withdraw from the study. If you withdraw from the study, you will still continue to receive mental health services at OhioGuidestone.<\/p>\r\n\r\n<p>If you do participate in this study, your access to current and future services and client rights will not be changed or different. There is no cost to participate in this research study.<\/p>\r\n<h6>Contacts and Questions<\/h6>\r\n<p>If you have any questions about this study, you can contact the study team at <a href=\"mailto:research@ohioguidestone.org\">research@ohioguidestone.org<\/a> or <a href=\"tel:4402608865\">440.260.8865<\/a>.<\/p>\r\n\r\n<p>If you have any questions about OhioGuidestone's services, including client rights, you can contact the agency's Client Advocate at <a href=\"tel:4402608308\">440.260.8308<\/a>.<\/p>\r\n\r\n<p>You may also ask research staff any questions that you may have now, or at any point during the research study.<\/p>\r\n<h6>Signature of Research Subject<\/h6>\r\n<p>Informed consent to participate in research is very important. By signing below you agree:<\/p>\r\n<ul style=\"margin-left: 30px !important;\">\r\n \t<li>That you have read the information about this research study;<\/li>\r\n \t<li>You have been given the chance to ask questions and they have been answered;<\/li>\r\n \t<li>You have the option to participate in the study and not agree to record play sessions;<\/li>\r\n \t<li>You volunteer to participate in the study and understand that you can withdraw from the study at any time.<\/li>\r\n<\/ul>\r\n<p>A copy of this consent form will be provided to you.<\/p><\/div><\/div><div id=\"wpforms-763-field_23-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"23\"><label class=\"wpforms-field-label\">Electronic Agreement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-763-field_23\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-763-field_23_1\" name=\"wpforms[fields][23][]\" value=\"By checking this box, I agree to use electronic records and electronic signatures.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-763-field_23_1\">By checking this box, I agree to use electronic records and electronic signatures.<\/label><\/li><\/ul><\/div><div id=\"wpforms-763-field_0-container\" class=\"wpforms-field wpforms-field-name wpforms-one-third wpforms-first\" data-field-id=\"0\"><label class=\"wpforms-field-label\">Name of Child Participant <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-763-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-763-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-763-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-763-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-763-field_13-container\" class=\"wpforms-field wpforms-field-name wpforms-one-third\" data-field-id=\"13\"><label class=\"wpforms-field-label\">Name of Parent\/Guardian <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-763-field_13\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][13][first]\" required><label for=\"wpforms-763-field_13\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-763-field_13-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][13][last]\" required><label for=\"wpforms-763-field_13-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-763-field_4-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-third\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-763-field_4\">Date <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-763-field_4\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][4][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-763-field_11-container\" class=\"wpforms-field wpforms-field-email wpforms-one-third wpforms-first\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-763-field_11\">Email Address<\/label><input type=\"email\" id=\"wpforms-763-field_11\" class=\"wpforms-field-large\" name=\"wpforms[fields][11]\" spellcheck=\"false\" ><div class=\"wpforms-field-description\">If entered, we will email a copy of this consent to the supplied email address<\/div><\/div><div id=\"wpforms-763-field_6-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-third\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-763-field_6\">Phone Number<\/label><input type=\"tel\" id=\"wpforms-763-field_6\" class=\"wpforms-field-large wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][6]\" aria-label=\"Phone Number\" ><\/div><div id=\"wpforms-763-field_20-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-third wpforms-list-inline\" data-field-id=\"20\"><label class=\"wpforms-field-label\">How was this form completed? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-763-field_20\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-763-field_20_1\" name=\"wpforms[fields][20]\" value=\"In-Person\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-763-field_20_1\">In-Person<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-763-field_20_2\" name=\"wpforms[fields][20]\" value=\"By Phone\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-763-field_20_2\">By Phone<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-763-field_20_3\" name=\"wpforms[fields][20]\" value=\"Online\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-763-field_20_3\">Online<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-763-field_20_4\" name=\"wpforms[fields][20]\" value=\"Mail-In\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-763-field_20_4\">Mail-In<\/label><\/li><\/ul><\/div><div id=\"wpforms-763-field_21-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-half wpforms-first wpforms-list-inline\" data-field-id=\"21\"><label class=\"wpforms-field-label\">Acknowledgement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-763-field_21\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-763-field_21_1\" name=\"wpforms[fields][21][]\" value=\"I have received education about this research study and reviewed this document with a member of the Research Team.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-763-field_21_1\">I have received education about this research study and reviewed this document with a member of the Research Team.<\/label><\/li><\/ul><\/div><div id=\"wpforms-763-field_22-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-half\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-763-field_22\">Date of Informed Consent Education Session <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-763-field_22\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][22][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-763-field_5-container\" class=\"wpforms-field wpforms-field-signature\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-763-field_5\">Signature of Participant or Parent\/Guardian <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-763-field_5\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][5]\" autocomplete=\"off\" inputmode=\"none\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-763-field_5-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Clear Signature\" tabindex=\"0\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"1em\" height=\"1em\" preserveAspectRatio=\"xMidYMid meet\" viewBox=\"0 0 1536 1536\">\n\t\t\t\t\t<path fill=\"var( --wpforms-field-text-color, rgba(0, 0, 0, 0.25) )\" d=\"M1149 994q0-26-19-45L949 768l181-181q19-19 19-45q0-27-19-46l-90-90q-19-19-46-19q-26 0-45 19L768 587L587 406q-19-19-45-19q-27 0-46 19l-90 90q-19 19-19 46q0 26 19 45l181 181l-181 181q-19 19-19 45q0 27 19 46l90 90q19 19 46 19q26 0 45-19l181-181l181 181q19 19 45 19q27 0 46-19l90-90q19-19 19-46zm387-226q0 209-103 385.5T1153.5 1433T768 1536t-385.5-103T103 1153.5T0 768t103-385.5T382.5 103T768 0t385.5 103T1433 382.5T1536 768z\"\/>\n\t\t\t\t<\/svg>\n\t\t\t\t<div class=\"wpforms-signature-clear-caption\">Clear Signature<\/div>\n\t\t\t<\/div><\/div><div class=\"wpforms-field-description\">This electronic signature holds the same force and effect as an in-person signature.<\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-763-field-hp\" class=\"wpforms-field-label\">Name<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-763-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"763\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/pages\/128\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-763\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n<div class=\"wpforms-container wpforms-container-full wpforms-container-save-resume\" id=\"wpforms-765\"><form id=\"wpforms-form-765\" class=\"wpforms-validate wpforms-form\" data-formid=\"765\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/study\/wp-json\/wp\/v2\/pages\/128\" data-token=\"049d9f83417bfba8c755819f759504a8\" data-token-time=\"1776658301\"><div class=\"wpforms-head-container\"><div class=\"wpforms-title\">Joyful Together\u00ae Audio\/Video Consent Form - Lorain, Medina, Summit, or Wayne County<\/div><\/div><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-765-field_11-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"11\"><div id=\"wpforms-765-field_11\"><h2 style=\"text-align: center; margin: 0 auto;\">This section is to give permission to allow us to record video and audio during sessions.<\/h2>\r\n<h6 style=\"margin-top: 7px;\">Consent to Audio\/Video Recording<\/h6>\r\n<p>You already have agreed to participate in the research study in the sections above. This section asks for your permission to record play sessions as a part of this research study. <span style=\"font-style: underline;\">You do not have to consent to recording in order to participate in the study<\/span>.<\/p>\r\n<p>And we will let you know when recording begins and ends. You can ask to stop recording during any play session if you want to.<\/p>\r\n<h6 style=\"margin-top: 7px;\">What will the recording be used for?<\/h6>\r\n<p>Any recording during the study sessions will be used for research and training purposes only. The reasons for recording study sessions are:<\/p>\r\n<ul style=\"width: 90% !important; margin: 0 auto !important;\">\r\n \t<li>To make sure study sessions are being done correctly and properly;<\/li>\r\n \t<li>To gain more information about how participants (you and\/or your child) respond to sessions, directions, and activities;<\/li>\r\n \t<li>To potentially use recording as a demonstration in agency sponsored trainings.<\/li>\r\n<\/ul>\r\n<p>Individuals who may view the recording will be limited to staff at OhioGuidestone, trainers and trainees who create and participate in Ohioguidestone trainings.<\/p>\r\n\r\n<p>Recordings will include participants (you and\/or your child) and research staff (the person who meets with you for study sessions). Your faces might be visible and your voices will be heard in the recording. Also, written descriptions or quotations from the recording (what you do or say) may be included, without names or other identifying information, in reports, presentations, or publications, just like answers given in questionnaires might be used but without any identifying information.<\/p>\r\n<h6 style=\"margin-top: 7px;\">Confidentiality<\/h6>\r\n<p>Your information and any recording will be kept confidential and only used for this research study. Only people working on this research study will have access to your study information and the video\/audio recording. We will collect your demographic information, but a unique number instead of your name or other identifying information will be used on study documents, including audio\/video files. Your name or anything else that could identify you will not be included in reports, presentations, or publications from this study. Your information will be kept in a locked file cabinet in a locked room, and computer files will only be opened on password protected computers. All recordings will be retained with identifying information.<\/p>\r\n<h6 style=\"margin-top: 7px;\">Voluntary Participation and Withdrawal<\/h6>\r\n<p>Your participation in this study is completely voluntary, including permission to record you and\/or your child. If you choose not to give permission for you and\/or your child to be recorded, it will not affect your eligibility for the study. It will not affect your relationship with OhioGuidestone. You will still have the right to services that you are eligible for at OhioGuidestone. You will not be treated differently if you decide not to consent to recording.<\/p>\r\n\r\n<p>If you decide to grant permission for audio\/video recording, you are free to withdraw your consent and stop at any time. You will not be treated any differently if you decide to withdraw from the study or withdraw your consent to recording. If you withdraw from the study or your consent to recording, you can reach out to OhioGuidestone if you are interested in receiving services, but your participation on this Joyful Together\u00ae project will end. If you do participate in this study and consent to recording, your access to current and future services and client rights will not be changed or different. There is no cost to participate in this research study.<\/p>\r\n<h6 style=\"margin-top: 7px;\">Contacts and Questions<\/h6>\r\n<p>If you have any questions about this study, you can contact the study team at: <a href=\"mailto:research@ohioguidestone.org\">research@ohioguidestone.org<\/a> or <a href=\"tel:4402608865\">440.260.8865<\/a>.<\/p>\r\n<h6 style=\"margin-top: 7px;\">Signature of Research Subject<\/h6>\r\nInformed consent to participate in research is very important. By signing below you agree:\r\n<ul style=\"width: 90% !important; margin: 0 auto !important;\">\r\n \t<li>That you have read the information about audio\/video recording permissions;<\/li>\r\n \t<li>You have been given the chance to ask questions and they have been answered;<\/li>\r\n \t<li>You volunteer to be recorded and understand that you can withdraw your consent at any time.<\/li>\r\n<\/ul>\r\n<p>A copy of this consent form will be provided to you.<\/p><\/div><\/div><div id=\"wpforms-765-field_17-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"17\"><label class=\"wpforms-field-label\">Electronic Agreement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-765-field_17\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-765-field_17_1\" name=\"wpforms[fields][17][]\" value=\"By checking this box, I agree to use electronic records and electronic signatures.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_17_1\">By checking this box, I agree to use electronic records and electronic signatures.<\/label><\/li><\/ul><\/div><div id=\"wpforms-765-field_0-container\" class=\"wpforms-field wpforms-field-name wpforms-one-third wpforms-first\" data-field-id=\"0\"><label class=\"wpforms-field-label\">Name of Child Participant <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-765-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-765-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-765-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-765-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-765-field_14-container\" class=\"wpforms-field wpforms-field-name wpforms-one-third\" data-field-id=\"14\"><label class=\"wpforms-field-label\">Name of Parent\/Guardian <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-765-field_14\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][14][first]\" required><label for=\"wpforms-765-field_14\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-765-field_14-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][14][last]\" required><label for=\"wpforms-765-field_14-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-765-field_4-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-third\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-765-field_4\">Date <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-765-field_4\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][4][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-765-field_12-container\" class=\"wpforms-field wpforms-field-email wpforms-one-third wpforms-first\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-765-field_12\">Email Address<\/label><input type=\"email\" id=\"wpforms-765-field_12\" class=\"wpforms-field-large\" name=\"wpforms[fields][12]\" spellcheck=\"false\" ><div class=\"wpforms-field-description\">If entered, we will email a copy of this consent to the supplied email address<\/div><\/div><div id=\"wpforms-765-field_6-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-third\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-765-field_6\">Phone Number<\/label><input type=\"tel\" id=\"wpforms-765-field_6\" class=\"wpforms-field-large wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][6]\" aria-label=\"Phone Number\" ><\/div><div id=\"wpforms-765-field_15-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-third wpforms-list-inline\" data-field-id=\"15\"><label class=\"wpforms-field-label\">How was this form completed? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-765-field_15\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-765-field_15_1\" name=\"wpforms[fields][15]\" value=\"In-Person\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_15_1\">In-Person<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-765-field_15_2\" name=\"wpforms[fields][15]\" value=\"By Phone\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_15_2\">By Phone<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-765-field_15_3\" name=\"wpforms[fields][15]\" value=\"Online\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_15_3\">Online<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-765-field_15_4\" name=\"wpforms[fields][15]\" value=\"Mail-In\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_15_4\">Mail-In<\/label><\/li><\/ul><\/div><div id=\"wpforms-765-field_16-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"16\"><label class=\"wpforms-field-label\">Do you give your permission to record play sessions as a part of this research study? You do not have to consent to recording in order to participate in the study. <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-765-field_16\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-765-field_16_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][16][]\" value=\"Yes\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_16_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-765-field_16_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][16][]\" value=\"No\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-765-field_16_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-765-field_5-container\" class=\"wpforms-field wpforms-field-signature\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-765-field_5\">Signature of Participant or Parent\/Guardian <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-765-field_5\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][5]\" autocomplete=\"off\" inputmode=\"none\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-765-field_5-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Clear Signature\" tabindex=\"0\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"1em\" height=\"1em\" preserveAspectRatio=\"xMidYMid meet\" viewBox=\"0 0 1536 1536\">\n\t\t\t\t\t<path fill=\"var( --wpforms-field-text-color, rgba(0, 0, 0, 0.25) )\" d=\"M1149 994q0-26-19-45L949 768l181-181q19-19 19-45q0-27-19-46l-90-90q-19-19-46-19q-26 0-45 19L768 587L587 406q-19-19-45-19q-27 0-46 19l-90 90q-19 19-19 46q0 26 19 45l181 181l-181 181q-19 19-19 45q0 27 19 46l90 90q19 19 46 19q26 0 45-19l181-181l181 181q19 19 45 19q27 0 46-19l90-90q19-19 19-46zm387-226q0 209-103 385.5T1153.5 1433T768 1536t-385.5-103T103 1153.5T0 768t103-385.5T382.5 103T768 0t385.5 103T1433 382.5T1536 768z\"\/>\n\t\t\t\t<\/svg>\n\t\t\t\t<div class=\"wpforms-signature-clear-caption\">Clear Signature<\/div>\n\t\t\t<\/div><\/div><div class=\"wpforms-field-description\">This electronic signature holds the same force and effect as an in-person signature.<\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-765-field-hp\" class=\"wpforms-field-label\">Phone<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-765-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"765\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/pages\/128\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-765\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"class_list":["post-128","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/pages\/128","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/comments?post=128"}],"version-history":[{"count":21,"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/pages\/128\/revisions"}],"predecessor-version":[{"id":766,"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/pages\/128\/revisions\/766"}],"wp:attachment":[{"href":"https:\/\/research.ohioguidestone.org\/study\/wp-json\/wp\/v2\/media?parent=128"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}