EVALUATION PROCEDURES GUIDE - Evaluation of the San José BEST Program Cycle 30 (PY 2020-2021) September 10, 2020 - Social Policy Research Associates
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Evaluation of the San José BEST Program
Cycle 30 (PY 2020-2021)
EVALUATION PROCEDURES GUIDE
September 10, 2020
Contents
OVERVIEW ...................................................................................................... 1
Study Team Liaison Assignments 2
I. Survey Procedures ........................................................................................ 3
STEP 1: DISTRIBUTE THE BEST PARENT SURVEY INFORMATION FORM 4
STEP 2: IDENTIFY SURVEY PARTICIPANTS AND SURVEY TIMING 4
STEP 3: ADMINISTER THE SURVEY 6
STEP 4: TRANSMIT PAPER SURVEYS (In-Person Paper Forms Only) 7
II. Consent Form Procedures ............................................................................ 9
STEP 1: IDENTIFY TO WHOM AND WHEN YOU INTRODUCE THE CONSENT 9
STEP 2: INTRODUCE THE CONSENT FORM 11
STEP 3: ANSWER QUESTIONS 15
STEP 4: HELP INDIVIDUALS COMPLETE CONSENT FORMS 17
STEP 5: TRANSMIT CONSENT FORMS (In-Person Paper Forms Only) 18
San José BEST Evaluation Procedures Guide (2020-2021) iOVERVIEW
The evaluation of the Bringing Everyone’s Strengths Together (BEST) program for program year
PY 2020-2021, is being run by Social Policy Research Associates, Inc. (SPR) under contract to the
City of San José Parks, Recreation, and Neighborhood Services (PRNS) department. The
evaluation includes two separate studies: 1) an implementation study and 2) an outcomes
study. The implementation study will draw upon data in the grantee workbooks and interviews
with grantee staff to examine how grantees put program services into place, spend funds, and
serve participants during PY 2020-2021. The outcomes study will examine changes in
participant outcomes over time, including changes in psychosocial measures gathered through
a participant survey and changes in education and criminal justice system measures as reflected
in administrative data gathered from public agencies.
This evaluation procedures guide focuses on two activities related to the outcomes study; it
does not concern the implementation study. The first activity is the administration of the
participant survey. The second activity is the collection of the evaluation consent form, which
authorizes SPR (and PRNS) to gather administrative data on program participants. The guide
includes two main sections that address these two main outcomes study data collection
activities as well as instructions and scripts to assist you in conveying important information to
program participants about why they are providing this information and their rights and
responsibilities around doing so.
The consent forms and surveys have been reviewed and approved by Solutions IRB, which is an
Institutional Review Board (IRB). The IRB has reviewed SPR’s study procedures to ensure they
meet international standards for the protection of individuals involved in research projects.
Please only use the latest versions of the survey and consent forms contained on the website,
https://www.spra.com/sjbest2021_evalforms/, and always confirm that the guide and forms
you are using are the most recent ones for the current BEST program year (PY 2020-2021).
We understand that COVID-19 and Shelter-in-Place orders have greatly impacted program
delivery in the second half of PY 2019-2020 and will continue to do so in PY 2020-2021. In order
to allow you to collect surveys and consent forms remotely during this time, we have added a
virtual option to both the survey and the consent form as well as a verbal option to the consent
form. While it is uncertain when the Shelter-in-Place orders will be lifted and when you will
return to normal operations, these additional options should allow you to continue to collect
these forms during this time.
San José Evaluation Procedures Guide (2020-2021) 1Study Forms
Please find each of the virtual and paper survey and consent forms as well as the webinar
training recording at the following link:
https://www.spra.com/sjbest2021_evalforms/
Study Team Liaison Assignments
Study Team Liaison Assignments
Caitlin Grey Mahika Rangnekar Lea Folsom
caitlin_grey@spra.com mahika_rangnekar@spra.com lea_folsom@spra.com
510-788-2465 510-788-2487 510-788-2462
• Bay Area Tutoring Association • Alum Rock Counseling Center • Bill Wilson Center
• Catholic Charities of Santa • Caminar (FCS) • Girl Scouts of Santa Clara
Clara County • Conxión (CTC) County
• Fresh Lifelines for Youth (FLY) • Ujima Adult and Family Services, • Lighthouse of Hope
• New Hope for Youth Inc. • San Jose Jazz
• The Firehouse Community • Uplift Family Services • Teen Success, Inc.
Development Corporation • The Art of Yoga
• The Tenacious Group
San José Evaluation Procedures Guide (2020-2021) 2I. Survey Procedures
Participant Surveys are important for helping the study track the various psychosocial changes
that happen to youth as a part of being in the program as well as help to capture their
satisfaction with services. PRNS would like to have as many participants as possible complete
the survey. To help with this, the surveys are anonymous, optional, and not linkable to other
participant data. As explained below, there are three different surveys, based upon a
participant’s age or service strategy. Depending on the ways in which you serve participants,
you will administer the surveys at different times throughout the program year; you will work
with your liaison to determine the right schedule for your program. By comparing responses
from survey participants who were in the program for longer with responses from participants
who have been in the program for only a shorter time, we will be able to investigate the effects
of BEST programs at an individual level.
Overall, there are five steps to administering the participant survey. These are outlined below
and summarized in the following graphic.
1: BEST Parent Survey Information Form
2: Identify Survey Approach
Distribute form to
parents/guardians Which of the 3 3: Administer Survey
of minors surveys 4: (paper only) Send
to SPR
Read the script to
Who is excluded
particpants
When to administer In December and
Answer their May
How (individually or questions/
group)
reassure them Send with
provided
Survey is optional packaging
San José Evaluation Procedures Guide (2020-2021) 3STEP 1: DISTRIBUTE THE BEST PARENT SURVEY INFORMATION FORM
While all participants can choose to take the survey or not, parents or guardians of participants,
ages 7 to 17, need to be informed about the survey (any 6-year old participants will not take
the survey) and those who are 18 or older do not need to have parents or guardians informed.
As stated in this form, parents or guardians may choose to omit their child from the survey.
We have prepared the “BEST Parent Survey Information Form” to convey information about the
survey to parents/guardians of minor participants and to provide them with the option to omit
their child from the survey. The following are the instructions regarding this form.
• Identify all program participants, ages 7 to 17. These are the participants who should
receive (or whose parents or guardians should receive) this form. You do not need to
provide it to participants who are any other age.
• Fill out the “Agency Name” and “Date” field at the top of the form for the date you
pass out the form. This is important to help parents know when they need to respond
by if they chose to respond.
• Give parents of participants, ages 7-17, the “BEST Parent Survey Information
Form.”Please do this as soon as possible after the study training, and at intake for any
new participants thereafter. This can be emailed, mailed, or given in person.
• This is an ‘opt-out’ form. Parents or guardians do not need to return this form. They
only need to return this form if they do not want their child to complete the survey.
• Participants, ages 7 to 17, need at least ten (10) days to return this form before the
survey is administered. As noted, please pass this form out to participants as soon as
you start to work with them. Please be sure that you have passed out forms at least 10
days prior to administering the survey.
• If you receive any forms from parents, please keep them on file. You will need to note
which participants to omit from the survey. SPR does not need these forms sent back.
STEP 2: IDENTIFY SURVEY PARTICIPANTS AND SURVEY TIMING
As part of the evaluation, your BEST program will need to administer the participant survey.
Before you do, there are four things you need to consider: 1) who gets which survey (there are
three); 2) who is excluded from the survey; 3) when you should administer the survey, 4) how
you should administer the survey.
San José Evaluation Procedures Guide (2020-2021) 4A. Who gets which survey?
You will administer one of three surveys to each BEST participant, depending upon the
participant’s age or service strategy. Before distributing survey forms, assess your participants
and decide which survey(s) make sense for your BEST participants. The three surveys are the:
• Kids Survey: This survey is for participants ages 7-13.
• Youth Survey: This survey is for participants ages 14-24.
• Parent Participant Survey: This survey is for participants in the parenting strategy, who
may be any age.
Importantly, your BEST program may use one or more surveys and participants may take one or
more of the three surveys, depending on the age of your participants and what strategies your
participants engage in. For example, an afterschool program at a middle school may only use
the kids survey while a program for older high school students or young adults may use only the
youth survey. However, a drop-in program for teens and transition age youth may use both the
kids and youth survey. Similarly, you may run a program that offers both young adult services
but also engages in a parenting strategy that involves some of these same youth (in addition to
other individuals), so you could have a youth participant engaging in both services, in which
case they would complete both the youth and parent participant survey.
B. Who is excluded from the survey?
As explained in Step 3, the survey is optional for all participants. However, some participants
should be excluded from the survey outright. These include four groups:
• Minor participants whose parents or guardians have returned the parent survey
information form and opted their child out of the survey.
• Participants who are six (6). Six-year-olds cannot participate in any evaluation activities.
• Participants only receiving street outreach services. The survey should only be
administered to street outreach participants if they have moved into other BEST
strategies such as case management services.
• Participants who are incarcerated or in juvenile detention facilities.
C. When do you administer the survey?
All grantees should administer the survey at the beginning and the end of your program cycle
based on the evaluation plan you develop with your liaison During your program cycle, please
survey all BEST program participants except those listed above in section B.
San José Evaluation Procedures Guide (2020-2021) 5D. How do you administer the survey?
Depending upon your mode of service delivery for your BEST program, you can introduce the
survey in one of two ways.
• Individually. You may work with participants one-on-one. If so, you may administer the
survey on an individual basis such as during a case management session.
• In a group. You may work with participants in a group setting. In this case, it may be
more efficient to administer the survey to a group of participants.
STEP 3: ADMINISTER THE SURVEY
Once you have identified the survey participants and survey timing (Step 2), you will administer
the survey.
You may administer the survey either:
• In-person (the link to the paper forms can be found on page 2) or
• Virtually (links below)
Kids’ Survey Youth Survey Parents’ Survey
participants ages 7-13 participants ages 14-24 participants in the parenting
strategy of any age
English-Kids English-Youth English-Parents
Spanish-Kids Spanish-Youth Spanish-Parents
Vietnamese-Kids Vietnamese-Youth Vietnamese- Parents
A. Introduce the Survey
The cover sheet of the survey includes the following important points that you should tell
participants either in-person or virtually.
• The survey is anonymous. Participants should not include their name on the survey. It is
important to clarify to them that there is no way for anyone to know who filled out the
survey and that we hope this makes it easier for them to be honest in their answers.
• This survey is optional. They do not have to fill out this survey or any questions if they
do not want to. If they choose not to, it does not affect their participation in the
program. That said, we hope they will participate as it will help the program improve.
San José Evaluation Procedures Guide (2020-2021) 6• They will not be paid for completing this survey.
• There are no wrong answers. The survey asks about what participants think and feel. It
is not a test.
Please note as well that there are two fields at the top of the paper survey and at the beginning
of the online version of the survey for Agency and date. The agency is your organization. The
date is the date the individual takes the survey. Please ask participants to fill out this
information.
B. What if a participant decides not to take the survey?
Some participants may choose not to participate in the survey or may not want to answer
particular questions. This is OK as is outlined in the cover sheet/script. However, we would
encourage you to answer participant questions and reassure them that the survey is
anonymous. Also, you might remind them why we are asking them to complete the survey – to
find out about how the program helps participants in order to improve program services.
C. What to do during the survey?
Simply distributing the survey and asking participants to respond may suffice. However, you
may need to provide additional support. You may want to read survey questions and make sure
participants understand what is being asked of them. You can also define difficult words or
concepts. However, please refrain from offering responses for the participant. The survey is
aiming to gauge participants’ own self-assessment. There are no right or wrong answers – the
survey is meant for participants to express their opinion – and they should fill it out based on
their own views. If you discover that certain items are not understandable to participants,
please notify your study team liaison.
STEP 4: TRANSMIT PAPER SURVEYS (In-Person Paper Forms Only)
If you are using paper surveys that you have administered and collected in-person, you will
need to send these to SPR. Please do so at three points in time: December 4, 2020, May 7,
2021, and August 31, 2021. To transmit paper surveys to SPR, please do the following:
• Locate the FedEx paks with FedEx “express saver” shipping labels provided to you by
SPR. If you are unable to locate these supplies, please contact your study team liaison.
• Only include surveys in this package. Do not send consent forms in these packages.
These packages are not designed to include the sensitive information collected in
consent forms.
• Send the package. You may call FedEx for a pickup, drop off the package at a FedEx
location, or drop off the package at a FedEx box.
San José Evaluation Procedures Guide (2020-2021) 7• Whenever you send in surveys, please email your study team liaison with the number of
surveys sent, the date the package was sent, and the tracking number of the package.
• To confirm, the shipping label should show the following:
Christian Geckeler
FedEx Office Print & Ship Center
3167 College Ave
Berkeley, CA 94705
San José Evaluation Procedures Guide (2020-2021) 8II. Consent Form Procedures
By signing the consent form, your program participants are providing their consent for SPR and
PRNS to gather individual-level administrative data on participants from public agencies,
including the California Department of Education, local school districts, the San José Police
Department, the Santa Clara County Probation Department, and the California Department of
Justice. These data are important for helping PNRS understand the ways and extent to which
BEST improves participants’ educational and justice system outcomes. This outcomes analysis is
critical for supporting ongoing funding. We recognize that collecting consent for administrative
data is not easy and it is something that many participants will not want to provide. However,
please be sure to ask as many participants as possible so that we can provide policymakers with
the most information possible about the program’s effectiveness.
Overall, there are six steps to administering the participant consent form. These are outlined
below and summarized in the following graphic.
1: Identify To Whom And When You Introduce The Consent
2: Introduce the Consent Form
Who is
excluded 3: Answer Questions
Which consent
When to form 4: (paper only) Collect Forms
administer Read the script
What approach to particpants 5: (paper only)
How Ensure Send Forms
(Paper, virtual,
(individually or or verbal) Answer their necessary
group) questions/ fields are • In
December,
reassure them complete May, and Dece
Consent form mber
August send
is optional with and
provided May
packaging
• Send
with
provid
STEP 1: IDENTIFY TO WHOM AND WHEN YOU INTRODUCE THE CONSENT ed
packa
There are three questions to consider in this pre-planning stage of the process: 1) to whom do
ging
you introduce the form, 2) when do you introduce the form, and 3) how do you introduce the
form.
Please remember that nothing about the evaluation changes the eligibility requirements that
you already use for your BEST program. You will continue to serve all the youth you have been
according to the terms of the program. Also, a participant does not need to sign the consent
San José Evaluation Procedures Guide (2020-2021) 9form to begin or to continue to receive program services. In other words, while we encourage
everyone to consent, consent is not a requirement for services.
A. To Whom Do You Introduce the Consent Form?
In general, you should introduce the consent form to as many BEST program participants as you
can. In other words, if you include them in BEST data collection activities, they are to be asked
about consenting, with the following four exceptions:
1. Only introduce the consent form to BEST participants that are age seven (7) to twenty-
four (24). Six is considered too young by many to offer assent or consent and so these
individuals should not be included in your consent procedures. Also, even if your
participants may be in parent and family services, if they are 24 or younger, please ask
them for consent.
2. You should not introduce the form to individuals who are currently housed in juvenile
justice facilities. You may introduce the form to participants who have previously been
held at facilities but not currently incarcerated participants.
3. You should not introduce the consent form to Street Outreach participants unless they
also engage in other eligible service area services (e.g., case management).
B. When Do You Introduce the Consent Form?
You should introduce the consent form at a point at which you have determined that an
individual is eligible and will begin receiving BEST-funded services (with the exceptions noted
immediately above).
How Do You Introduce the Consent Form?
Depending upon how you deliver services, you can introduce the form in one of two ways.
• Individually. You may work with participants one-on-one. If so, you may choose to
introduce the form on an individual basis. For example, you could introduce it into your
intake process when a participant completes other paperwork.
• In a group. You may work with participants in a group setting. In this case, it may be
more efficient to introduce the form in a group setting. Just be sure you are able to
answer individual participant questions. This group setting may also be ideal for all
grantees in seeking consent from participants that are already enrolled in your services.
Once you have decided which way you plan to introduce the consent form, please do so as
soon as you can. In the future, you should include the consent form as part of your regular
intake procedures for new participants.
San José Evaluation Procedures Guide (2020-2021) 10STEP 2: INTRODUCE THE CONSENT FORM
To allow the study to collect administrative data, program participants need to sign the
evaluation’s consent form. If they are 18 or older they can sign the form themselves. If they are
under 18, they will sign the second part of the form called an assent form and then they need a
parent or guardian to sign the first part of the consent form. The goal of this step is to introduce
the form to participants and walk them through the key points.
You may introduce the consent form in one of three ways. Please note that both the paper and
virtual consent approaches are preferred to the verbal approach due to various data partners’
ability to accept verbal consent forms. The options are:
• Paper form (the link to the paper forms can be found on page 2). The first approach is
to use a paper consent form, administered in-person. This is the approach used in prior
program years and involves a obtaining a physically signed copy of a paper form from
the participant.
• Virtual (links below). This approach involves using DocuSign to have participants walk
through the consent form online. DocuSign is an online platform for digitally signing
documents with e-verification and security. You can send the virtual consent form links
on DocuSign via email. DocuSign is compatible on desktop computers, laptops, tablets,
and smartphones. Once the link is opened, the participant can fill out the various fields
in the form. A confirmation is emailed to the signers and the information is submitted
directly to SPR.
Minor Assent Form and Parental Consent Form Adult Consent Form
for participants ages 7 to 17 for participants ages 18 and over
English English
Spanish Spanish
Vietnamese Vietnamese
San José Evaluation Procedures Guide (2020-2021) 11Consent Form DocuSign Screenshots
• Verbal. A third option is to call participants, and/or their families (over the phone or on
video) and walk through the consent form with them. You will first need to get them the
form via mail or email. You might choose this approach should DocuSign prove too
technologically challenging. In this approach you will introduce the consent form as you
do with the other two approaches (explained immediately below) and then ask for their
consent. If they consent, you will fill in the box on the last page (see Step 4) either on
the paper form or virtually through DocuSign, whichever is preferred.
San José Evaluation Procedures Guide (2020-2021) 12Virtual and Verbal Consent on DocuSign
You can use DocuSign to send participants the forms to sign themselves or to sign your own
name in attestation of a participant and/or their parent/guardian’s verbal consent. Once the
links are opened, you will enter the signer name(s) and email address(es). The signer(s) will vary
based on the type of form you are sending.
o 18+ Consent Form
▪ Virtual Signing—you will enter the participant name and email address.
▪ Verbal Consent—you will need to sign for the participant so you will enter
only your own name and email address.
o Age 7 to 17 Assent and Parent/Guardian Consent form
▪ Virtual Signing—you will enter your own name and email address as well
as the participant and parent/guardian’s names and email addresses. You
will the fill out your portions of the form first, the participant will fill out
their portions next and then the parent/guardian will fill out theirs last.
▪ Verbal Consent—you will need to sign for the participant and the
parent/guardian so you will enter only your own name and email address.
No matter the approach you will need to introduce the consent form to the individual, either in
person, over the phone or over video. You should go over the form differently, depending upon
the participant’s age and the introduction style.
• For participants who are 18 or older or when speaking to parents or guardians, please
use the script (next page) to help summarize key elements of the form.
• For participants who are 7 to 17, please direct them to the Assent form (page 1), which
is what they will need to sign, and which also summarizes the consent form. You can
simply read these youth the text of the assent form.
Please note that the Minor Assent and Parent Consent Form requires signatures from the
participant themselves, a Grantee staff person, and a Parent or Guardian.
San José Evaluation Procedures Guide (2020-2021) 13Script for Introducing the Informed Consent Document
This form is called an Informed Consent form. As the form explains, this program gets money
from and is part of something called the Bringing Everyone’s Strengths Together program,
which is run by the City of San José. This program, known as BEST, also pays for other programs
and services in the city. The City, along with its contracted provider, Social Policy Research
Associates (known as SPR) is conducting a research study of all the programs that receive BEST
grants to learn how our services help people and how to make the program better. By signing
this form, you would agree to several things.
[Grantee staff: please customize the script depending on whether you are reading this to
participants or parents/guardians]
• By signing this form, you agree to allow the study to use certain information about
[you/your child]. This means that you agree to have the City and their evaluator, SPR,
collect information about [you/your child] for up to three years, including information
about your participation in this program, your education records, and any involvement
you might have with the police, courts or probation.
• All information will be kept private and confidential. The City and SPR follow strict
rules to ensure that your information will be kept safe, private, and confidential. Your
information will never be shared with anyone outside of the City and SPR unless
required by law. And your name will never be used in a public report or document. No
one will sell or give away your information.
• You won’t have to do anything to make any of this happen. You may be asked in the
future to complete a survey, but you only need to do so if you want to. By signing this
form, you give the City and SPR the right to collect data on your behalf. You won’t have
to do anything to make that happen. They will do all the work.
• Participating in our program does not require being in the study. If you [your child]
choose not to participate in the study, it will not affect the services you [your child]
receive in the program.
• Being in the study may help to improve the program. By learning about how the
program helps young people, the city hopes to offer services that may help young
people even more than they do now.
• You [or your child] can change your mind later. Even if you [or your child] sign the form
now and agree to participate in the study, you [or your child] can decide to withdraw
from it in the future. The way to do that is provided to you on the consent form. If you
[or your child] withdraw from the study, it won’t affect the services you [or your child]
receive from the program.
San José Evaluation Procedures Guide (2020-2021) 14Please take a few minutes to read the form. Let me know if you have any questions. If you do
agree, please fill out the form.
STEP 3: ANSWER QUESTIONS
After summarizing the key features of the consent form and providing participants with a
chance to read it over, offer them a chance to ask questions about the form, using the “San
José BEST Study Questions and Answers Guide” (below) to help answer any questions.
San José BEST Evaluation Questions and Answers
Use this document to answer any questions potential participants have about the study.
Why is this study being conducted?
The study is being conducted by the City of San José Parks, Recreation and Neighborhood
Services (PRNS) Department, which is the agency that provides money to run the San José BEST
program. The evaluation will help people in city government learn how programs like BEST help
youth and young adults do better in school, make better choices, and stay out of or reduce
their involvement with gangs and crime. The goal is to make these services better.
Who is running the study?
The study is being run by the City of San José with a research organization in Oakland,
California, called Social Policy Research Associates, or SPR. SPR is a private organization that has
been around for nearly 30 years doing studies of programs like this one both in California and
around the country.
Do I have to sign this form?
No. The decision to sign the form is up to you and you can choose to do it or not. If you decide
not to sign the form, it will not affect the services you receive. However, signing the form may
lead to better services in the future. If you don’t sign the form, you may still be asked to do
other things related to the study like participate in a survey, which you can similarly chose to do
or not do when it is introduced to you.
What if I change my mind?
If you change your mind and do not want to share your information with the study, you should
contact the people listed on your consent form and they can help make this change. However,
it’s important to remember that once you sign the form, you won’t need to do anything related
to the consent form. In other words, you don’t have to do anything other than sign this form.
What is the purpose of the consent form?
The consent form is your way of telling the researchers that you understand what it means to
share your information for the study. It gives the City of San José and SPR permission to collect
San José Evaluation Procedures Guide (2020-2021) 15and use information from public agencies for up to three (3) years before and after you enroll
to see how you are doing in your life by looking at education and criminal justice system
records. The form also provides PRNS and SPR with the information they need to collect this
information without you having to do anything further. Importantly, signing the form also
guarantees that information collected for the study will be kept private and confidential. They
won’t use your name in any reports and will protect your information.
What happens if I don’t sign the consent form?
Your personal information will not be used in the study and the study team will not collect the
types of information about you described in the form. Importantly, you can still participate in
the program and receive services. Not signing will not affect the services you can receive.
Can I sign up later if I want to?
Yes. If you don’t want to sign up for the study now, you can sign the consent form later. We do
encourage you to sign up now if you are interested since your participation may help the
program. The more people we get to sign up the better the evaluation will be.
How do I know that my information will be safe?
SPR follows strict rules to ensure that your information will be kept safe, private, and
confidential. The standards for protecting your information are very high and involve electronic
and physical protections for this information. The information gathered through this evaluation
will not be shared with anyone outside of PRNS/the City of San José and SPR unless required by
law. And your name will never be used in a public report or document.
What is the different between the consent form and the assent form? Why are the different
lines on the different pages of the form?
If you are 18 or older, you can consent on your own. To do so, you should fill out page 2. Please
leave the information on page 3 blank.
If you are 7 to 17, you can agree to be in the study but will also need permission from a parent
or guardian. You should read and fill out the “assent form”. You will then need to have your
parent or guardian fill out parent consent form.
San José Evaluation Procedures Guide (2020-2021) 16STEP 4: HELP INDIVIDUALS COMPLETE CONSENT FORMS
For individuals who complete a consent or assent form, please do the following.
• For participants 18 or older (as of the day of completing the form):
o Have them fill out the following fields:
▪ Initial the Education and/or Criminal Justice boxes
▪ print their name
▪ list their date of birth (MM/DD/YYYY)
▪ sign their name
▪ fill out the current date
• For participants 7 to 17 (as of the day of completing the form) they should use the
“Consent Form for Parents/Guardians and Assent form for Participants, 7 to 17”
o Have them fill out the information the “Assent Form.” They should:
▪ Initial the Education and/or Criminal Justice boxes
▪ print their name
▪ sign their name
▪ fill out the current date
o Have them obtain parent/guardian consent. The parent/guardian should
complete the following information:
▪ Parent/guardian prints their own name
▪ Parent/guardian fills out the youth’s date of birth (MM/DD/YYYY)
▪ Parent/guardian signs their own name
▪ Parent/guardian fills out the current date
• You, as the grantee program staff member, should:
o Print, sign, and date the “assent” form when you are conveying information to a
participant that is age 7 to 17.
o Complete the “for grantee staff use only” box in the upper right-hand corner of
whatever pages are filled out for participants of any age.
▪ Fill in the name of your organization.
San José Evaluation Procedures Guide (2020-2021) 17▪ Complete the ID number for the participant you will use to complete
PRNS data collection.
• For verbal consent, you as the grantee program staff member, should:
o Print, sign, and date the verbal consent box at the end of the Consent Form, the
Assent Form, and/or the Parental Consent Form
o Initial the Education and/or Criminal Justice boxes
• When using paper forms, provide the participant with blank copy of the form they
complete and let them know that you can provide them with a completed copy upon
request. Be sure to provide the participant with a copy and keep the original form on
file. For minors, you may wish to provide them with a blank copy of the form and mail
the signed copy home. DocuSign emails all signers copies after signing virtually.
Protecting Participant Information
Once you collect any paper forms, please store them securely. Please adhere to the following rules
designed to protect participant information.
• Do not email study participant information to SPR. If you need to communicate with SPR
about participants, please email or call your SPR study team liaison and let them know that
you need to communicate about a participant and convey the information over the phone.
• Keep consent forms in a locked drawer/cabinet or locked room, until you are ready to ship
them to SPR.
• Only share consent forms with PRNS or SPR. No one else should have access to these forms
except you, the participant, SPR and PRNS.
• Only transmit the consent forms as instructed in Step 6. Do not email the forms or send
them in any other way.
STEP 5: TRANSMIT CONSENT FORMS (In-Person Paper Forms Only)
Prior to transmitting the forms, please make a copy of all consent forms and keep a copy on file,
in a locked drawer or cabinet as described in Step 5.
Please send collected forms to SPR by December 4, 2020 , May 7, 2021, and August 31, 2021.
To transmit the forms to SPR, please do the following:
• Locate the shipping supplies provided to you by SPR (including a FedEx pack with a “2-
day” shipping label and a white, Tyvek envelop). If you are unable to locate these
supplies, please contact your study team liaison.
San José Evaluation Procedures Guide (2020-2021) 18• Insert consent forms into the white Tyvek envelope. Be sure to count the number of
forms. Seal the envelope when complete.
• Insert the white Tyvek envelope into the pre-paid, plastic FedEx pack and seal the
mailer. The label indicating “2-day delivery” should be visible.
• Drop off the FedEx Mailer at a FedEx dropoff or box location or contact FedEx for
pickup. Do not leave the package unattended while waiting for pickup.
• Whenever you send in study forms, please email your study team liaison with the
number of forms sent, the date the FedEx package was sent, and the FedEx tracking
number of the package.
• Send forms to the following address (already provided on the FedEx mailers):
Christian Geckeler
FedEx Office Print & Ship Center
3167 College Ave
Berkeley, CA 94705
San José Evaluation Procedures Guide (2020-2021) 19You can also read
