KT Methods Cluster-Consensus Methods Phase 2B: Project 4 Interior Health
Consent for Delphi Survey
Principal Investigator: Dr. Nelly Oelke
University of British Columbia Okanagan (UBCO), Nursing
Knowledge User: Brent Hobbs
Regional Director Patient Transportation Services, Interior Health
Research Coordinator: Ashmita Rai
This survey is a part of the “KT Methods Cluster-Consensus Methods” project which is being led by Dr. Nelly Oelke and is funded by BC Support Unit. By completing this survey, you will assist us in understanding transportation needs of individuals living in rural communities within the Interior Health region. Results will provide information to Interior Health on how to deliver services that best meet the needs of rural communities.
You can take part in the survey if you are 19 years and over and are a rural community member, provider, decision maker or policymaker from the Interior Health region. You must be fluent in English; that is, you must be able to understand and communicate in English and understand this consent form
This survey has four parts: Part 1 involves rating the appropriateness and importance of the indicators using the Likert Scale in the survey. We would ask you to rate the weight of relevance and importance of each indicator within the group for each specific integration principle identifying which one is most important (with #5) and so on. Additional sample components may be added in the blank spaces for consideration. Any indicators that you add should be included in your priorities. You will be asked about your demographic information i.e. if you are a patient partner, community member, administrative staff, provider, policymaker, or decision maker; your age, sex, and rural community you identify with.
After the completion of Part 1, you will be redirected to Part 2 of the survey where you will be asked if you would like to enter the draw for prize. If yes, you will have to answer a skill-testing question. You will then be redirected to Part 3 of the survey where you will be asked if you would like to receive a summary of the evaluation report from the Delphi Survey. After that you will be redirected to the final part of the survey (Part 4) where you will be asked if you would like to participate in the following deliberative dialogue session.
You can skip any of the questions in the survey and participate in different parts of the survey (e.g., you may wish to skip part 2 and still be able to part 3 or part 4 and so on). This survey should take approximately 20-30 minutes to complete. Please note that the information collected from part 1, 2, 3, and 4 will be separate from each other, i.e. if you would like to sign up to enter the draw, receive the summary of the results or participate in the following deliberative dialogue session your contact information will not be connected to your data in the survey.
There are no known risks associated with this study beyond those you may experience in your day-to-day life, although some of the questions may be sensitive to some. We recognize though, that this research is taking place during a time of COVID-19, and all those engaged in health services may be facing additional stressors or challenges. You do not have to answer any questions if you do not wish to do so. We have four $50 gift certificates/cash prize for the participants. The winners will be drawn randomly. You will have to complete the survey for your chance of winning one.
All responses to the survey will be kept confidential and collected online. All data will be stored in a password protected folder separate from other files on the UBC Okanagan’s (UBCO) secure network. Only those directly involved in the study will have access to any of the research files. Once the study is complete, all files will be stored at UBCO. All research files will be stored securely in a UBCO designated research area for 5 years after the results of the study have been published. After this time, files will be deleted. Please note that the survey reports will not include your name or any information that could potentially identify you.
If you have any questions or concerns about the study, please contact research coordinator Ashmita Rai at 250-807-9948 or by email at email@example.com or principal investigator Nelly Oelke at 250-807-9880 or by email firstname.lastname@example.org
If you have any concerns about this study, you may contact the Research Participant Complaint Line in the UBC Office of Research Ethics toll-free at 1-877-822-8598 or the UBC Okanagan Research Services Office at 250-807-8832. It is also possible to contact them by email (RSIL@ors.ubc.ca). Please reference the study number (H18-03416) when contacting the Complaint Line so the staff can better assist you.
Note: Taking part in the survey is entirely your choice. You have the right to refuse to take part in the study or stop taking part at any time. If you decide to withdraw from the study, it will not result in the loss of any of your benefits or rights as a patient or caregiver. There is no way to connect your survey data to you, so once you have submitted the survey, it cannot be withdrawn.
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