Introduction

Karla Thornton, MD MPH from the Department of Internal Medicine, and Project ECHO staff and evaluators are conducting a study called, “Evaluation of International ECHO Programs.” The purpose is to understand how the ECHO model is used and its impacts.

You are being asked to complete a survey because you participated in an ECHO program.

What will happen if I decide to participate?

If you agree to participate, you will be asked to complete a brief electronic survey. The survey includes questions about what you liked and did not like about the ECHO program, and its impact on you.

What are the risks or side effects of participating in a survey?

There are minimal risks of discomfort when answering questions.

What are the benefits to participating in a survey?

By participating in this survey, you will provide key information for Project ECHO’sinternational programs. Results will be used to improve and expand the response of ECHO programs across the world.

How will my information be kept confidential?

You will complete the survey using a secure and private electronic survey tool. Only study team members will have access to your survey results. We will only report summary results; reports will not include any information that would let anyone know what your specific answers were.

Can I stop participating in the survey once I begin?

It is your choice to participate in this survey or not, and you can choose to stop at any time or skip questions you prefer not to answer. Declining to participate in this survey will not impactyour relationship with Project ECHO.

Whom can I call with questions or complaints about my survey?

If you have any questions about this research project, please call Dr. Thornton at (505) 272-2808.If you have questions regarding your legal rights as a research subject, you may call the UNM Human Research Protections Office at (505) 272-1129.

CONSENT

By answering the survey questions, you give your consent to participate in this study.

Thank you for your consideration,