What is the purpose of this research?

• We are asking you to be in a Focus Group because we are trying to learn more about student participation in the program. Youare invited to participate because you can help us provide better programs for teens. This study is being conducted by A Positive Approach to Teen Health and ITMESA which evaluates the program.

How much time will this take?

• This study will take about 60 minutes of your time.

What will I be asked to do if I choose to participate in this study?

• If you choose to participate, you will be asked to be in group discussions about instruction in the program and teen issues.

What are the risks involved in participating in this study?

• Being in this study does not involve any risks other than what you would encounter in daily life. For example, you may feel uncomfortable or embarrassed about answering certain questions. You will be encouraged not to discuss anything you feel uncomfortable about. You can choose not to discuss any question. We take all possible precautions not to allow students to become uncomfortable during the focus group.

What are the benefits of my participation in this study?

• You will not personally benefit from being in this study. However, we hope that what we learn will help us better understand teens. We also hope that what we learn will be used to develop better programs to help teens live a healthy lifestyle.

Will I receive any kind of payment for being in this study?

• You will receive a $30.00 cash stipend (or gift card) for being in the Focus Group.

Can I decide not to participate? If so, are there other options?

• Yes, you can choose not to participate. Even if you participate, you can change your mind later, and you can leave during the Focus Group. There will be no negative consequences if you decide not to participate or change your mind later. Also, even if you give your permission, you may decide that you do not want to be in this study, and that is ok with us.

How will privacy be protected?

• The taping of the Focus Group will be kept private. In any report we might publish, we will not include any information that will identify you. Only the ITMESA evaluation team will review the taped record.

Whom can I contact for more information?

• If you have questions about this study, please contact Donna Golob, Project Director at 219-254-2678 or 219-629-5316 or by email at Donna@PositiveTeenHealth.org.

By checking the circle on the registration form you are telling us you read this form and you volunteer to participate.