Funding: Canadian Institution of Health Research (CIHR)

Invitation to Participate: I am invited to participate in the CAPP 2.0 research study conducted by Dr. Josephine Etowa and the research team mentioned below.

The main objective of this project is to accelerate the use of high quality and real-time evidence collected on the contextual vulnerability and challenges experienced by ACB communities to develop, implement and evaluate community-driven solutions to structural inequalities including systemic racism that continue to hamper the response and recovery from COVID-19.

I am aware that I can participate in the asynchronous learning (learners will participate at their own time) series of 5 modules if I am 18 years of age or older; can communicate in English or French.

I am aware that the 5 modules will use audio and/or video communications for interactive activities including virtual simulation games, polls, and quizzes. I am also aware that comprehensive evaluations will occur throughout the series including pre/post surveys and website analytics. Upon completion of the 5 learning modules, I may partake in a follow-up interview if I choose (this will require me signing a separate consent form for the focus group discussion (FDG)). Participation will also consist of completing a demographic survey that will take approximately 10 minutes to complete, prior to commencing the modules. Each training module will last for approximately an hour or less.

Module topics include:

1. Social Determinants of Health and health inequities
2. COVID-19 & HIV and its Impact on Health (Syndemic)
3. Critical Racial Literacy
4. Critical Health Literacy
5. Cultural Competence and safety-Organizational and individual levels

There is a risk of emotional stress. I am aware that there is free psychological counseling, which is available in Ontario at ConnexOntario. Toll-free by phone: 1-866-531-2600,

Online web chat: https://1576prairiefyre.cloudcollaboration.ca/ccmwa/chat/a91000d1-9584-466b-bb4f-6b039b802173?client=99_238_242_204.

This study will give me the opportunity to share my experiences regarding the modules to provide professional education and training. My contribution may provide insight about the implementation and impact of online strategies to build capacity of professionals, to capacity-building needs, to reduce the impact of COVID-19 on ACB communities.

I am aware that the research team will be the only people with access to the personal information I provide. This information will be kept in a secure location and will not be disclosed to anyone, nor will my name or any personal identifiers be used on study materials. Once I agree to participate in this study, researchers will protect my anonymity by using a code name in all written information.

I am aware that everyone who has access to the raw data will be asked to sign a confidentiality agreement. In any reports coming from this research all information that could be used to identify me, will be substituted with fictional or generic names. The results of this study may be described in oral and written presentations and may be published in professional journals. However, at all times the results will be presented in a combined group format only and no personal identifiers will be used.

While the researchers will respect the confidentiality of all participant’s information, they cannot promise or ensure that other participants will do the same. They will, however, ask all participants in the study to respect the confidentiality and anonymity of all participants. They ask all participants not to share or disclose anything mentioned here with others.

I am aware that both hard copy and electronic data collected, including website analytics, pre/post survey datasets, demographic survey datasets, researchers’ notes, and consent forms, will be kept in a secure manner. The researchers directly involved in this study will be the only people with access to the personal information I provide. This information will be kept in a secure location and will not be disclosed to anyone outside of the research team. The study data will be securely stored in accordance with the policy of the University of Ottawa REB and other Ethics committees. All notes on asynchronous activities will be kept in a locked filing cabinet in Professor Etowa’s secured office at the University of Ottawa. This consent form and my contact information will be stored in a separate folder from research data. The recorded data from activities will be downloaded onto a password-protected computer and be transcribed into written texts as a password-protected document. Once the transcription is completed, my data files will be stored on password-protected computers. All recordings, transcripts, and notes will be destroyed five years after study completion.

I am under no obligation to participate and if I choose to participate, I can withdraw from the study at any time and/or refuse to answer any questions, without suffering any negative consequences. I am aware that due to the collective nature of the data being collected, some of the data provided may still be used even if I withdraw. If I have any questions about the study, I may contact the researchers. If I have any questions regarding the ethical conduct of this study, I may contact the Office of Research Ethics and Integrity via email (ethics@uottawa.ca) or telephone (613-562-5387). It is recommended that I (keep/print/save) a copy of this consent form for my records.

By selecting the consent statement and signing below, I acknowledge that I have read the consent form information above, and I am satisfied with the answers to all my questions about this study. I agree to take part in this study. I have been given a copy of this consent form, and I fully understand my rights as a person taking part in this study.

I confirm that I have reviewed this consent form with the participant named above and I have answered all questions.