Study Title: Strengthening Cancer Center Capacity to Serve Sexual and Gender Minority Patients
Principal Investigator: Mandi Pratt-Chapman,
mandi@gwu.edu
Key Information
You are invited to participate in an educational research study that aims to improve patient-centered care in U.S. cancer centers for sexual and gender minority patients. This research involves completing a survey. Participation is voluntary. Contact
mandi@gwu.edu (the Principal Investigator) or
ohrirb@gwu.edu (GW's Office of Human Research) if you have questions about this study. You may wish to participate in this study to improve research to advance the health of sexual and gender minority patients. You may not wish to participate in this study if you feel uncomfortable being asked about sexual orientation or gender identity. Ask the research team questions during the consent process, and use the contact information on this form to ask questions later. If you would like to take this survey in another language, please contact
mandi@gwu.edu to arrange a time for interpretation services.
What is this study about?
The purpose of this study is to pilot a technical assistance (TA) program called TEAM SGM to increase the capacity of cancer centers to better serve sexual and gender minority (SGM) patients.
Why am I being asked to participate?
This survey we are asking you to complete will assess how patients experience the environment and interactions with cancer care providers. Specifically, we will ask about your experiences with LGBTQ-affirming care practices.
You do not need to identify as lesbian, gay, bisexual, transgender or queer to participate in the study. We are interested in what you observe in the clinic environment and what types of questions your providers ask you. We will survey patients before and after providers participating in TEAM SGM make changes at their institution. This will help us understand if changes were observed by patients like you.
What do I have to do to participate?
• Taking part in this study is completely voluntary.
• You will be asked to participate in a survey that will take approximately 5 minutes to complete.
• You will be asked to indicate consent by marking the box below.
Will this study benefit me?
• You will not benefit individually from this research.
Will I be paid to participate?
• You will not be paid to participate in this research.
How many people will participate?
• Approximately 360 people will complete the same survey.
What are the risks of participating in this study?
• Risks of research participation are hard to predict.
• You may feel uncomfortable answering certain questions.
• The biggest risk to you is the possibility that someone will connect your responses to you or know you are participating in the study. This is called loss of confidentiality.
What can I do to reduce my risks?
• You do not need to participate in the study. You may withdraw at any time.
What is the research team doing to reduce my risks?
• We will not use any individual identifying information when we report results.
• Only the study team will have access to data and files. All data and files will be password protected and stored on a secure server.
• To help us protect your privacy, we have obtained a Certificate of Confidentiality from the National Institutes of Health. The researchers can use this Certificate to legally refuse to disclose information that may identify you in any federal, state, or local civil, criminal, administrative, legislative, or other proceedings, for example, if there is a court subpoena. The researchers will use the Certificate to resist any demands for information that would identify you. The Certificate cannot be used to resist a demand for information from personnel of the United States Government that is used for auditing or evaluation of Federally funded projects or for information that must be disclosed in order to meet the requirements of the federal Food and Drug Administration (FDA). You should understand that a Certificate of Confidentiality does not prevent you or a member of your family from voluntarily releasing information about yourself or your involvement in this research. If an insurer, medical care provider, or other person obtains your written consent to receive research information, then the researchers will not use the Certificate to withhold that information. Data from this study will be retained on secure servers accessible only to the research team until all analyses are complete.
Do I have to answer every question?
• You do not have to answer any question that you do not want to answer.
Who will have access to the information I share?
• Aggregate data may be used in presentations and/or publications.
What if I change my mind and don't want to participate?
• You do not have to participate.
• Your clinical care will not be affected in any way by participating, refusing participation, or withdrawing from this study.
Who do I contact if I have questions?
This research is being overseen by an Institutional Review Board ("IRB"). You may talk to them at 202-994-2715 or via email at
ohrirb@gwu.edu if:
• You have questions, concerns, or complaints that are not being answered by the research team or if you wish to talk to someone independent of the research team.
• You have questions about your rights as a research subject.
• If you would like to take this survey in a language other than English, please contact
mandi@gwu.edu to arrange a time for phone-based interpretation services and assistance with survey completion.
You may wish to save this form, so you can look back at it in the future.
Please indicate you consent to complete the survey.