You are an expert in research ethics and informed consent design. Score the informed consent form, script, or process I have attached or pasted using the rubric below. The document may be a standalone consent form, a verbal consent script, or a description of the consent process embedded in a protocol or inception report.
SCORING RUBRIC - Informed Consent Design
Score each dimension 1-5 using these criteria:
DIMENSION 1: Information Completeness
| 5 | All elements present. Purpose of the activity is stated in plain terms. Procedures the participant will go through are described (what will be asked, how long, where, by whom). Risks (including discomfort, time burden, social or psychological risk) are named. Benefits (to the participant, the community, the program) are described honestly, with no overpromising. Contact information for questions or concerns is provided (name, role, phone or email, and an independent oversight contact where applicable). |
|---|---|
| 4 | At least four of five elements present. Purpose, procedures, and risks clear; benefits or contacts partial. |
| 3 | Standard elements named but not specific to the activity. Some elements (often risks or independent contacts) missing. |
| 2 | Brief generic statement. Most elements absent or boilerplate. |
| 1 | No information about purpose, procedures, risks, benefits, or contacts. |
DIMENSION 2: Comprehension Aids
| 5 | Language is pitched at the appropriate reading level for the population (short sentences, plain words, no jargon, technical terms defined). Comprehension is verified through a teach-back step, a short comprehension check, or a structured pause for questions. Translation or interpretation is planned for non-dominant languages. The form or script is laid out for readability (headings, white space, no wall of legal text). Visual aids or examples are used where helpful (especially for low-literacy or technical concepts). |
|---|---|
| 4 | At least four of five elements present. Language and layout clear; verification or translation partial. |
| 3 | Language is mostly accessible but verification is not built in. Translation handled ad hoc. |
| 2 | Dense or technical language. No verification step. No translation plan. |
| 1 | Inaccessible language. No comprehension aids. |
DIMENSION 3: Voluntariness Signals
| 5 | The right to refuse is stated explicitly and early in the script. The right to withdraw at any time, including mid-interview, is named. The right to skip individual questions is named. The script includes language that neutralizes pressure (no consequences to services, employment, or program participation; the interviewer is not in a position of authority over the participant). The consent process is conducted in a setting that supports a real choice (private, unhurried, without supervisors or program staff present). |
|---|---|
| 4 | At least four of five elements present. Refusal and withdrawal explicit; setting or pressure-neutralizing language partial. |
| 3 | Refusal stated but withdrawal or skip rights unclear. Pressure not addressed. |
| 2 | Voluntariness mentioned in passing. Withdrawal and skip rights absent. |
| 1 | No voluntariness signals. |
DIMENSION 4: Confidentiality Specifics
| 5 | Where data is stored is described (device, server, location, encryption). Who has access is named (interviewer, analyst, supervisor, donor). Whether responses are anonymous, pseudonymized, or identifiable is stated plainly. How findings will be reported (aggregated, with or without quotes, with or without identifying details) is described. How long data is kept and what happens at the end is stated. |
|---|---|
| 4 | At least four of five elements present. Storage, access, and identification clear; reporting or retention partial. |
| 3 | Confidentiality promised but operational details thin. Storage or access mentioned without specifics. |
| 2 | Generic confidentiality statement. No data handling specifics. |
| 1 | No confidentiality detail. |
DIMENSION 5: Special Populations
| 5 | Accommodations for children include parental or guardian consent plus child assent in age-appropriate language. Accommodations for low-literacy respondents include verbal consent, witnessed if needed, with the form read aloud. Accommodations for persons with disabilities are named (sign language, accessible format, support person). Accommodations for displaced, marginalized, or other vulnerable groups are described (trusted interpreter, safe location, gender-matched interviewer where relevant). The script names which special populations apply to this activity and how each is handled. |
|---|---|
| 4 | At least four of five elements present. Children and low-literacy handled; disability or vulnerable-group accommodations partial. |
| 3 | One special population addressed; others mentioned without operational detail. |
| 2 | Special populations named as a concept. No accommodations built in. |
| 1 | No consideration of special populations. |
OUTPUT FORMAT:
Return your assessment as a table followed by a summary:
| Dimension | Score (1-5) | Evidence | Priority Revision |
|---|---|---|---|
| Information Completeness | |||
| Comprehension Aids | |||
| Voluntariness Signals | |||
| Confidentiality Specifics | |||
| Special Populations |
Total: X/25 Band: Strong (22-25) / Adequate (17-21) / Needs Revision (11-16) / Substantial Revision (5-10) Single Most Important Revision: [One specific sentence]
For any dimension scored 1 or 2, add a brief explanation and a concrete revision example.
CONSENT DOCUMENT TO SCORE:
(See the attached or pasted document.)
Document to review: Attached, or pasted below. Base everything above on it and do not invent details that are not in it.