DFM Kerala 2021 Household consumption survey consent form
| Project title | Dried Fish Matters: Mapping the social economy of dried fish in South and Southeast Asia for enhanced wellbeing and nutrition |
|---|---|
| Component | Scoping Study: Ernakulam-Kochi, India |
| Principal Investigator | Dr. Derek S. Johnson, Department of Anthropology, 432 Fletcher Argue Bldg., The University of Manitoba, Winnipeg, MB R3T 2N2 Canada. Email: Derek.johnson@umanitoba.ca |
| Local Coordinators | Dr. Holly Hapke, Research Development Director. School of Social Sciences, University of California, Irvine, CA 92697-5100. Phone: 949 824 3183. E-mail: hhapke@uci.edu |
| Dr. Nikita Gopal, Principal Scientist, Indian Council of Agricultural Research - Central Institute of Fisheries Technology (ICAR-CIFT), CIFT Road Matsyapuri, Willingdon Island, Kochi, Kerala 682029, India. E-mail: Nikiajith@gmail.com | |
| Sponsor | Social Sciences and Humanities Research Council of Canada (SSHRC) |
| Researchers | Dr. Holly Hapke |
This consent form, a copy of which will be left with you for your records and reference, is only part of the process of informed consent.
It should give you the basic idea of what the research is about and what your participation will involve.
If you would like more detail about something mentioned here, or information not included here, you should feel free to ask.
Please take the time to read this carefully and to understand any accompanying information.
Purpose of the research
“Dried Fish Matters” is an international study, funded by Canada, that aims to create a better understanding of the social aspects of the Indian Ocean dried fish economy.
The project is expected to last seven years, beginning in 2018.
The current phase of our research will involve general interviews, site observations, and community workshops among fishers, dried fish producers, wholesalers, and retailers located in India, Sri Lanka, Thailand, Cambodia, Bangladesh, and Myanmar.
The information gathered from this research will help develop policies and interventions that address food security, nutrition, and livelihood needs across South and South-East Asia.
Information you provide may be used in any of the following:
- Academic conference presentations, articles, or book chapters
- Technical reports for researchers and policymakers
- Non-technical summaries for the general public
- Policy briefs, proposals for follow-up interventions or research initiatives
- Broadcast or text interviews
- Online databases and websites
- Workshops and community events (knowledge mobilization in your community)
Survey
If you agree to be interviewed for this research, we will ask you to tell us about who lives in your household, when and how often you consume different types of fish and other protein, how the role of fish in your diet has changed in the past ten years, and your food preferences.
This interview will take approximately one hour.
Benefits
This research is expected to support policy improvements aiming to address the needs of dried fish producers and consumers.
The findings from this initial research will directly shape the design of pilot interventions in areas such as food security, health, and sustainable livelihoods.
Although you may not benefit directly from these future policy proposals or interventions, any information you provide will contribute to better awareness of your needs and concerns among researchers and policymakers.
You will not be paid for participating in this study.
Risks
The expected risks of participating in this survey are minimal.
Anonymity and confidentiality
All information we collect through this survey will be anonymous.
Although we will record information about your household and its members, we will not write down your name or address on the survey form. No one outside our research team will have access to the original survey data.
If you agree to this survey, we will speak with you at your home.
You are always free to decline answering any of our questions, without giving a reason.
Withdrawing from the research
Participation in this research is entirely voluntary.
Should you agree to take part in this study, you are free to withdraw your participation at any time during or immediately following the survey interview.
If you choose to withdraw, the survey form for your household will immediately be destroyed.
Debriefing
At the end of the survey, you will be invited to provide feedback and ask questions about the research.
Dissemination of results
The initial findings from this study will be available in approximately 8 months.
You may obtain a written summary of the results from the local partner organization listed at the top of this form.
Additionally, you will be able to obtain the latest information on our research and comment on our findings through our mobile-accessible online platform at http://driedfishmatters.org.
By checking the boxes on this form, you indicate that you have understood to your satisfaction the information regarding participation in the research project and agree to participate as a subject.
In no way does this waive your legal rights nor release the researchers, sponsors, or involved institutions from their legal and professional responsibilities.
You are free to withdraw from the study at any time, and /or refrain from answering any questions you prefer to omit, without prejudice or consequence.
Your continued participation should be as informed as your initial consent, so you should feel free to ask for clarification or new information throughout your participation.
The University of Manitoba may look at your research records to see that the research is being done in a safe and proper way.
This research has been approved by the University of Manitoba Joint Faculty Ethics Review Board.
If you have any concerns or complaints about this project you may contact any of the above-named persons or the Human Ethics Coordinator at +1 204-474-7122 or humanethics@umanitoba.ca.
A copy of this consent form has been given to you to keep for your records and reference.
❏ I understand the purpose and nature of this study.
❏ I have been told about the expected risks and benefits of participating.
❏ I understand that participation in this research is voluntary, and that I may withdraw my consent to participate at any time without penalty.
❏ I agree to participate in the survey.
To complete at the end of the interview.
❏ I agree to be contacted for follow-up research. I can be located in the following way (provide your name and contact information):
❏ I wish to have a written summary of research results sent to me at the following address (email or post):
I prefer to receive communications in (select one or more):
❏ Malayalam
❏ English
❏ Another Language______________________ (Specify)
| Participant code / pseudonym | ________________________________ |
| Researcher and/or Delegate’s Signature | ________________________________ |
| Date | ________________________________ |
