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INFORMED CONSENT

DESCRIPTION: You are invited to participate in a research study on the preparedness of workers in human service agencies who service the growing refugee population in Buffalo. The questions that will be asked pertain to training that workers may or may not have had. This survey is not intended to pass a judgment on the agency, but to simply develop a basis of how prepared the workers of agencies such as Baker Victory Services are in providing the best service possible to this growing population.

TIME INVOLVEMENT: Your participation will take approximately 5 to 10 minutes

RISKS AND BENEFITS: There are no foreseeable risks associated with this study. The benefits which may reasonably be expected to result from this study are an increased awareness of the growing population of refugees within the communities and an enhanced understanding in meeting the needs of this population. We cannot and do not guarantee or promise that you will receive any benefits from this study. Your decision whether or not to participate in this study will NOT affect your employment

SUBJECT'S RIGHTS: If you have read this form and have decided to participate in this project, please understand your participation is voluntary and you have the right to withdraw your consent or discontinue participation at any time without penalty or loss of benefits to which you are otherwise entitled. The alternative is not to participate. You have the right to refuse to answer particular questions. Your individual privacy will be maintained in all published and written data resulting from the study.

CONTACT INFORMATION: Questions: If you have any questions, concerns or complaints about this research, its procedures, risks and/ or benefits. If you are not satisfied with how this study is being conducted, or if you have any concerns, complaints, or general questions about the survey or your rights as a participant, please contact the any of one of the group members by the emails listed below

Rebecah Dingle: [email protected]

Brandy Loveland: [email protected]

Bakht Arif: [email protected]

With your permission, the data from this study will be used for future analysis of the cultural competence of workers in human service agencies in the Buffalo region.

By clicking continue, you agree to participate in this survey.
 
 
 
This questionnaire is designed to assess cultural competence training needs of mental health and human service professionals. The self-­assessment process is used to develop agency specific training interventions, which address cross­-cultural weaknesses and build upon cross-­cultural strengths of the staff generally and organization specifically. Cultural competence is a developmental process; therefore the goal is to promote positive movement along the cultural competence continuum. Thus, the assessment should be viewed as an indication of areas in which the agency and staff can, over time, enhance attitudes, practices, policies, and structures concerning service delivery to culturally diverse populations. Your responses are strictly confidential and will solely be used to identify areas in which planned growth and greater awareness can occur.

Instructions: Please mark the response that most accurately reflects your perceptions. If you have trouble understanding a question, answer to the best of your ability. Feel free to expand your responses or note concerns on the backs of the pages. Inapplicable questions will be statistically eliminated from the analysis. Please keep in mind that there is no way to perform poorly.

KNOWLEDGE OF COMMUNITIES
 
 
1. How well are you able to describe the communities of refugees in your service area?
NOT AT ALL BARELY FAIRLY WELL VERY WELL
 
 
 
 
2. Please list the Refugee group(s) who reside in your service area:
   
 
 
3. How well are you able to describe the strengths of the groups of refugees in your service area?
NOT AT ALL BARELY FAIRLY WELL VERY WELL
 
 
 
1. 4. To what extent do you know the following demographics within communities of refugees in your service area? (Circle the number of your response for each area.)
NOT AT ALL BARELY FAIRLY WELL VERY WELL
Social Service Agencies
Formal Leaders
Community Leaders
Business People
Advocates
Clergy, Spirituals, or Religious Leaders
 
 
5. To what extent do you know the following state of the refugee population in your service area? (Circle the number to your response for each area.)
NOT AT ALL BARELY FAIRLY WELL VERY WELL
Unemployment Rates
Geographic Locations
Income Differentials
Educational Attainment
Birth/Death Rates
Crime Rates
 
 
6. Do you know the prevailing beliefs, customs, norms and values of the refugee population in
your service area?
NOT AT ALL BARELY FAIRLY WELL VERY WELL
 
 
 
7. Do you know the social service needs within the refugee population that go unaddressed by the formal social service system?
NOT AT ALL BARELY FAIRLY WELL VERY WELL
 
 
 
8. Do you know of any conflicts between or within groups of refugees in your service area?
NOT AT ALL BARELY FAIRLY WELL VERY WELL
 
 
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