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VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY

Consent for Participants

Virginia Gay Dads’ Health Insurance and Family Well-Being

Researcher: Emma Potter

Purpose of this Research: The purpose of this study is to investigate the ways in which gay fathers provide health insurance for their families.

Procedure: I am asking you to spend 15-20 minutes telling me about health insurance (who has it, what has the process of getting health insurance been like) for you and your family. Some questions will be multiple choice, other questions will be open-ended. There are no right or wrong answers, I am interested in your experience. This research project has been approved, as required, by the Institutional Review Board for Research Involving Human Subjects at Virginia Tech. My faculty sponsor is Katherine R. Allen.

Risks: You may become upset or uncomfortable while filling out information about your experiences providing health insurance. You do not have to answer any questions that make you feel uncomfortable. You can stop at any time.

Benefits: In return for your completion of the questions and interview, I will personally be donating $1 to the gay rights organization, Equality Virginia.

Extent of Anonymity and Confidentiality: Your participation in this study is confidential. This QuestionPro site is a secure network. This means that no one, except this researcher, will see or read your answers to the questions. All names will be changed and at no time will I release the results of the study to any other individuals working on the project.

If I think you are threat to yourself or someone else, I must tell the authorities. These are the only times when your confidentiality would not be protected.

Freedom to Withdrawal: You can withdraw from a study at any time without penalty.

If you have any questions about this research project, please feel free to contact:

Emma Potter
540-231-6817
[email protected]

Dr. Katherine Allen
540-231-6526
[email protected]

Dr. David Moore, IRB Chair
540-231-4991
[email protected]

By clicking "I AGREE" you are agreeing that you have read and understand
1) the study
2) your rights, and
3) agree to participate.
 
 
 
The next set of questions will determine if you are eligible to participate.





Yes No
* Are you between the ages of 18 and 65 years old?
* Do you identify as a gay male or are in a same-sex male relationship?
* Do you have any children under your care?
* Do you reside Virginia?
 
 
 
Let's get started. How did you find out about this study? (Please type answer below. Max 100 words)
   
 
 
 
Who are the people you need to insure? (Please type answer below. Max 100 words)
   
 
 
 
Have you been able to insure them all?
   
 
 
 
Can you tell me more about that? (Please type answer below. Max 500 words)
   
 
 
 
Where did you turn to for information and help to find out about your family’s insurance options? (i.e., what helped you figure out who can be on your policy, how to insure each member of your family) Please check all that apply.
 
My current partner
 
Other LGB friends with children
 
Health insurance agent
 
Lawyer/legal advice
 
Patient Navigator/Community Health Worker (promotores de salud)
 
Medical Professional
 
Online healthcare community groups (non-LGB)
 
Online LGB community groups/networks
 
Other family members (not partner)
 
Community (friends in churches, schools, workplace)
 
No one else
 
Other
 

 
 
 
In what ways have they been helpful to meeting your family’s insurance needs?
   
 
 
 
In what ways have they been unable to meet your needs or unhelpful?