Interview/Focus Group Interest Form

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Our team at the University of Minnesota Prevention Research Center has recently received funding to support a community-partnered project focused on COVID-19 vaccination. The goal of this project is to understand barriers to COVID-19 vaccination and inform intervention strategies to increase COVID-19 vaccine confidence and uptake among people who are incarcerated and corrections staff in Minnesota’s jails and prisons. You can read more about the project here: https://sites.google.com/umn.edu/rebeccashlafer/research/covid-19-vaccine-confidence-in-minnesota-prisons-and-jails?authuser=0

If you would like to participate in a compensated interview or focus group to help us better understand barriers to COVID-19 vaccination and inform intervention strategies to increase COVID-19 vaccine confidence and uptake among people who are incarcerated in Minnesota’s jails and prisons, we would love to hear from you. Please fill out the form below if you are interested in participating in any of these ways and we will be in touch. If you have any questions, please contact the Project Director, Ingie Osman, via email: osman175@umn.edu.

Thank you so much for your time and interest.

Name (First, Last) *

Email Address *

Phone Number *

What is the best way to reach you? *

Phone

Other:

Do you live in Minnesota? *

Yes

Have you been impacted by the criminal legal system? This includes, but is not limited to, those who have been formerly incarcerated or those who have family members that are currently incarcerated. *

Yes

Other:

Which of the following are you interested in participating in? (Select all that apply) *

Interview

Focus group

Required

For those who are interested in participating in a focus group, please indicate your vaccination status below. This information will be used to form focus groups based on vaccination status.

I am partially or fully vaccinated against COVID-19.

I am not vaccinated against COVID-19.

Clear selection

Do you have any questions for us?

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of University of Minnesota Twin Cities. Report Abuse

Forms