Informed Consent to Participate in Research

The purpose of this research is to explore how mothers in New York are able to financially support themselves and their child/ren, especially with the added factor of a child born prematurely. This research will hopefully aid in providing more accessible resources for all mothers, especially low income mothers who need the benefactors to sustain themselves. Preterm birth is a condition that is yet to be found with an identifiable cure, so this study will help to push more information on the topic as well.

I will ask you to provide personal information such as your racial background, household income, and employment status, to name a few. The only thing being asked of you is to complete a google form provided by me. The questionnaire will only take about 20-25 minutes of your time to complete. If there are any follow up questions or requests you will be notified.

Taking part in this study is entirely voluntary. You may refuse to participate before the study begins, discontinue at any time, or skip any questions that may make you feel uncomfortable. There will be absolutely no penalty to you for any of these things occurring. However, if you decide to participate in this study, the only required aspect will be filling out a google form that will be shared out to you.

Participation in this research study can offer many benefits that can aid in many different aspects, especially after giving birth prematurely. You may have access to support resources; by participating in this study, you are offering a hand in the expansion of research and important information that can help other mothers/parents. We hope to learn more about how low income mothers and families can sustain themselves after pregnancy.

There will be no legal risks, physical risks, social or economic risks, or emotional risks while participating in this study.

All information and data that is received will be protected and will remain confidential. Any form or survey that needs to be completed for this study will remain anonymous. Certain people may need to see your study records. By law, anyone who looks at your records must keep them completely confidential.

You will receive no payment or other compensation for taking part in this study.

We will keep your study records private and confidential. Certain people may need to see your study records. By law, anyone who looks at your records must keep them completely confidential. ● Certain government and university people who need to know more about the study. For example, individuals who provide oversight on this study may need to look at your records.This is done to make sure that we are doing the study in the right way. They also need to makesure that we are protecting your rights and your safety.● Any agency of the federal, state, or local government that regulates this research. This includes the Department of Health and Human Services (DHHS) and the Office for Human Research Protection (OHRP).● The USF Institutional Review Board (IRB) and its related staff who have oversightresponsibilities for this study, staff in the USF Office of Research and Innovation, USFDivision of Research Integrity and Compliance, and other USF offices who oversee thisresearch.We may publish what we learn from this study. If we do, we will not include your name. We will not publish anything that would let people know who you are.

You should only take part in this study if you want to volunteer. You should not feel that there is any pressure to take part in the study. You are free to participate in this research or withdraw at any time. There will be no penalty or loss of benefits you are entitled to receive if you stop taking part in this study. Decision to participate or not to participate will not affect your job status.

During the course of this study, we may find more information that could be important to you. This includes information that, once learned, might cause you to change your mind about being in the study. We will notify you as soon as possible if such information becomes available.You can get the answers to your questions, concerns, or complaints. If you have any questions, concerns or complaints about this study, contact Abigail Akhere at 347-575-1277, abigailakhere@gmail.com, or (718) 474-6918If you have questions about your rights as a participant in this study, general questions, or havecomplaints, concerns or issues you want to discuss with someone outside the research, contactKimberly Newman, knewman9@schools.nyc.gov

It is up to you to decide whether you want to take part in this study. If you want to take part, please sign the form, if the following statements are true.I freely give my consent to take part in this study and authorize that my health information asagreed above, be collected/disclosed in this study. I understand that by signing this form I amagreeing to take part in research. I have received a copy of this form to take with me.

This is the actual form to complete if you have completed and provided consent above to participate in this research study. This research study should take 5-10 minutes. All of this information that is shared on this form will remain private and confidential. Thank you so much for participating in my research study. Your help is greatly appreciated.