"Human Subjects Protocol" Cover Page

Title of Projec

Health issues faced by older Sikh immigrants in Bakersfield

Responsible Investigator(Faculty Research Mentor if Student Research)Name: Dr. Chandrasekhar Commuri E-Mail: ccommuri@csub.edu

Department or

Program:

MSA-HCM

Department Chair or ProgramName:D

r.R. Steven Daniels E-Mail: rdaniels@csub.edu

StudentName: Rajwant Kaur E-mail: Nitu_tung@yahoo.com

Requested Level of Expedited

Describe how human subjects will be involved in the proposed research:The goal of this project is to learn about the health issues faced by older Sikh immigrants in Bakersfield. This is important for older Sikh immigrants to have better understanding of how culture values and beliefs shape their behaviors on health issues. This study focuses on the question: What are the health issues faced by older Sikh immigrants in Bakersfield? Semi-structured interviews lasting about 30-45 minutes will be conducted in Punjabi at four different Sikh Community churches in the Bakersfield or at locations of the participants' choice. Participation is voluntary and can be terminated by subjects without risk or penalty. Informed consent will be signed and practiced by participants. Interviews will not be tape recorded or videotaped but notes will be taken. Notes will be identified by a numbering system and destroyed when the project is completed.

This Section for GRaSP Office Use

Responsible investigator has affirmed accuracy and truth[check] Date Department Chair has

acknowledged submission[check] Date Assigned Level of Review: Standard

Expedited

Exemption from Full Review

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Rajwant Kaur, February 2014- Research Protocol

1. Title: What are the health issues faced by older Sikh immigrants in Bakersfield?

2. Professional Qualifications:

I received a Bachelor’s Degree in Business of Administration from CSUB in 2012. In the MSA-

HCM Program, I have completed PPA 505 Managed Health Care; PPA 611 Public Finance &

Budgeting and PPA 685 Strategic Management all of which had a qualitative research

component and I am currently taking PPA 691.

3. Sponsors:

N/A

4. Purpose:

The goal of this research is to learn about the health issues faced by older Sikh immigrants in

Bakersfield. This is because Asian immigrants are the fastest-growing ethnicity. Sixty percent of

growth in the US came from international immigration. According to U.S. Census Bureau,

Asians rose by 530,000, or 2.9 percent in 2012. According to the 2000 U.S. Census, there are

over 1.5 million Asian Indians residing in the United States, representing the third largest Asian

and Pacific Islander American group after Chinese and Filipino. Furthermore, this population

had the highest compound growth rate of all Asian subgroups at 7.49% per year from 1990 to

2000. Also it has been argued that Asian Indians are one of the fastest growing elderly groups in

the United States (Doorenbos, 2003).This study may help health care providers and managers to

understand how Sikh immigrants cultural values , beliefs, and adapting a new environment

provides barriers to treat health issues. In addition, lack of knowledge, lack of education, and

language might be the barriers for older Sikh immigrants to seek healthcare in the United States.

For example, even though the national language is Hindi, only about 40% of Asian Indians are

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fluent and use this language on a daily basis (Shapiro, 2001). In order to achieve this purpose;

my research will focus on questions like:

(1) How do older Sikh immigrants learn about health-related issues?

(2) How do culture and heritage affect older Sikh Indian immigrants’ health behaviors in the

United States? And,

(3) How do older Sikh immigrants mediate between Western and Indian healthcare approaches?

This study is important because very little research has been done on the older population of

Asian Indian immigrants. For this reason, my study will focus on older Sikh immigrants to have

better understanding of how culture values and beliefs shape their behaviors on health issues. I

am focusing on older Sikh immigrants because most of the older generation are foreign born and

share strong culture values, beliefs and traditional health practices which provides barriers to

seek healthcare in the United States.

1. Research question: What are the health issues faced by older Sikh immigrants in

Bakersfield?

5. Methods:

I will collect data through in-depth interviews with older Sikh immigrants in Bakersfield. I will

develop an interview guide which will have built-in prompts that remind me, as the researcher, to

do a time-check periodically to make sure that the interview is progressing appropriately. Data

will be analyzed based on answers and opinions provided by the interviewees. Participants will

be recruited through the snowball method.

6. Procedures:

After attaining the signature of participants on the consent (Attachment 3) I will conduct

interviews with 15-20 participants which will last between 30-45 minutes per participant. I will

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not audio-record but I will take notes. After finishing interviews I will prepare typed transcripts

which will be kept confidential and in a password computer and any printed copies will be kept

in a locked file cabinet. In very rare case, I will contact the participants for second follow up

which may be declined by the participants. The interview will only include older Sikh

participants from age 65 and above. A participant may withdraw from an interview at any time

and can request to see the notes that I will be taking for the groups. All interviews will be based

on the interview guide; however, I will ask follow up questions based on their original question.

7. Subjects:

1. Selection criteria: I have a list of participants that I have known in my community to

participate in my research. Participants would have to be born and raised in India currently living

in the United States. During the interview, the participants will be asked to recommend other

participants that would like to participate in my research. Participants must be able to speak

Punjabi.

2. Exclusion criteria: Sikh Asians who were born and grew up in the United States would be

excluded from the study for reasons explained in section 4. The participants that speak another

language besides Punjabi will also be excluded from the research. The reason is because older

Sikh immigrants who are born and raised in India are more likely to speak Punjabi.

3. Vulnerable populations: My participants are considered as a vulnerable population because of

their limited English comprehension, cultural isolation, and medical dependence on family

members.

4. Risk to participants: I expect that risks to participants will be minimal. This might include

painful feelings when providing information about a family member’s death due healthcare

issue. There should be few expected physical, emotional, economic, or political risks to

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participants since I do not intend to ask questions that are likely to involve these risks. For

example, this may happen as participants talk more about their family member of being sick due

to health issues in the United States. It is important to note that I will not ask any diseases that

participants may be experiencing.

5. Managing adverse reactions : All efforts will made to ensure that the discussion has a

minimum of risk, discomfort or stress while participating in this study. However some questions

may be personal and thought-provoking or emotional in nature. If there are any remaining issues,

the participants will encourage contacting the people listed on the consent form.

8. Informed Consent:

1. Circumstances surrounding the process:

1. Recruitment of subjects: The participants will be recruited based on my familiarity with

my community and the participants who are associated with Sikh community churches in

Bakersfield. Further participants will be recruited through recommendation by participants,

family, or friends.

2. Environment or setting: Interviews may be conducted at any of the four different Sikh

community churches in the Bakersfield or at locations of participants’ choice.

3. Time frame: Interviews will last between 30-45 minutes for each interviewer. In rare cases,

follow-up interviews will be conducted with the participants' consent. Such interviews are

likely to last about 20 minutes.

4. Condition of prospective subjects: I will not ask participants about their specific health

problems.

5. Primary language of prospective subjects: All interviews will be conducted in Punjabi.

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6. Autonomy of prospective subjects: All individual participants in this study are free to

participate, or to leave or terminate any time without any risk or penalty. Participants are not

obligated to consent to participate in the second interview.

2. Elements of informed consent:

All interviewees will be explained and informed about the purposes of the research while they

are being picked or recruited. The consent form and interview questions will be conducted in

Punjabi language. Before an interview, each participant will be provided with a copy of

interview question and the consent form (Attachment 2 and 3) for the details of their right which

will be translated in Punjabi document. The consent form will be signed by each participant

before interview. The signed consent form by each participant will be on file with for future

records and study. All participants will also receive a copy with contact information of the IRB

Human Subjects Research coordinator at CSUB for further details and question. Signed consent

forms will be given to Dr. Commuri and will be kept confidential.

3. Informed consent documented:

Signed consent form will be on file for future records that will be destroyed after the research

study will be accepted by University. The interview notes will be destroyed after the typed

transcription. The typed transcripts will be stored on a password protected computer and locked

file cabinet. The participants will keep a copy of the consent from. Signed consent forms will be

destroyed after graduation.

9. Attachments:

1. Select bibliography

2. Interview questions

3. Consent form

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1. Select Bibliography

Bogdan, R.C., &Biklen, S.K. (2003).Qualitative research for education: An introduction to

theory and methods (4th ed.).Boston, Allyn& Bacon.

Chopra, D. (1995). Creating health: How to wake up the body’s intelligence. Boston:

Houghton Mifflin.

Doorenbos, A.Z. (2003). Hospice access for Asian Indian immigrants. Journal of

Hospice & Palliative Nursing, 5(1), 27-33.

Shapiro, Michael C (2001). Hindi. Facts about the world's languages: An encyclopedia

of the world's major languages, past and present. Chester, Ct: New England

Publishing Associates.

U.S. Bureau of the Census. (2000). 2000 Census of Population and Housing. U.S.

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Bureau of the Census.

World Health Organization (WHO). (2002). Active ageing: A policy framework.

Retrieved May 6, 2006 from http://www.who.int/hpr/ageing/ActiveAgeing

PolicyFrame.pdf

2. Interview Questions

Title: Health issues faced by Sikh immigrants in Bakersfield

Have you discussed health issues with your family?

How do you take care of yourself or family member with healthcare issues in the United

States?

Have you tried anything else besides Western medicine to treat your diseases?

What are some of the barriers you face to treating your health issues in America?

How do older Sikh immigrants learn about health issues?

How do Sikh beliefs and values affect older immigrants’ health behaviors?

What are the health issues you face in the United States compared to India?

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3. Consent Form

CONSENT TO PARTICIPATE IN A RESEARCH STUDY

Project Title: Health issues faced by older Sikh immigrants in Bakersfield

Purpose: I understand that the purpose of this study is to explore and understand the health issues faced by older Sikh immigrants in Bakersfield. Participation: I understand that I will be interviewed individual by the researcher at convenient time and location. The initial interview will require about 30 to 45 minutes. I also understand that I may be contacted for a second interview. The second interview will require about 30 minutes and would occur within three to four weeks of the first interview. Participation in the first interview does not oblige me to participate in the second one.

Confidentiality: I understand that all identifying information which might link me to my interview data will be kept confidential. Only an identification number or false name will appear on printed materials. The interviews will not be tape-recorded but the researcher will take notes during the session. The interview notes and the transcripts will be destroyed after the completion of the study. My name will not be used in written reports or presentations of the study’s findings.

Voluntary Participation: I understand that I am free to choose not to participate in this study. In addition, if I do choose to participate I am free to withdraw at any time, even in the middle of an interview, without penalty.

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Benefits: I understand that this study may or may not be of direct benefit to me. It has not been designed to provide direct health-related benefits to participants. Rather, it is hoped that the knowledge gained from this study will help Older Sikh immigrants to have better understanding of how culture values and beliefs shape their behaviors on health issues.

Risks: I expect that I will experience a minimum of risk, discomfort or stress while participating in this study. However some questions may be personal and thought-provoking or emotional in nature. If I do feel some uncomfortable during the interview, the interview will stop and additional time will be available to talk about these thoughts.

If I experience any distress due to this project, I can call the Kern County Mental Health department’s hotline at 1-800-991-5272.

If I have further questions about the research itself, or I wish to obtain a summary of the results of the research, I may contact:

Rajwant Kaur Student of Master of HealthCare Administrator California State University, Bakersfield 661-303-0693; nitu_tung@yahoo.com

Dr. Chandrasekhar Commuri, Associate Professor Department of Public Policy & Administration California State University, Bakersfield 661-654-6140; ccommuri@csub.edu

For questions regarding my rights as a research subject, I may contact:

Dr. Steve SuterUniversity Research Ethics Review Coordinator Institutional Review Board/Human Subjects Research Department of Psychology California State University, Bakersfield Bakersfield, CA 93311-1099 (661) 654-2373

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Authorization: I have read this form completely and all of my questions about the study have been answered. I understand that the interviews will be recorded. I have decided that I will participate in the study described. The general purpose, the requirements of participation and possible hazards and inconveniences of participating have been explained to my satisfaction. I will be given a copy of this consent form. My signature indicates my consent to participate.

Signatures: Participant:________________________________________ Date:______________ Researcher:________________________________________ Date:______________

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