Informed Consent

You are invited to participate in a survey to gather feedback from Native Americans who hold a college degree or are pursuing a degree.  Additionally, this survey aims to identify the barriers Native Americans face when pursuing a degree in higher education. The information obtained from this survey will be utilized to identify the needs of Native Americans in education and be used as a tool for those individuals who are involved in all educational settings.

Your participation in this survey is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. Your survey responses will be strictly anonymous and data from this research will be reported with no identifying information.  Once you complete the survey and submit it, anonymous data will be forwarded to the evaluators.

This survey should take approximately 20-30 minutes to complete. Please complete each question to the best of your ability. If you have any questions or require assistance to complete this survey please feel free to contact Leona Tsinajinnie at (208) 792-2792 or email any questions to lmtsinajinnie@lcwarriormail.com or Stephanie Bodden at slbodden@lcwarriormail.com.  By taking the time to complete and submit the survey, you are acknowledging acceptance of the informed consent provided. 

If you have any questions regarding this study feel free to contact Dr. Brian L. Christenson at (208) 792-2476; blchristenson@lcsc.edu, or the Institutional Review Board of Lewis-Clark State College at (208) 792-2461.  Thank you very much for your time and support. If you acknowledge this informed consent and decide to participate, you may start below by checking the appropriate box.

Please do not type your name or any other identifying details on this survey. Begin the survey by checking below.

1.  Please indicate your gender:

Female

Male

 

2. Please check your age:

18-24         

25-29

30-35

36-40

41-45

46 +

 

3. Please indicate your relationship status:

Married        

Single       

Long-term relationship/attached 

Divorced

Widowed

Living together

Other (please explain)

 

4.  What is your income level?

Below $15,000

$15,000-$34,999    

$35,000-$44,999

$45,000-$54,999

$55,000-$64,999

$65,000-$74,999

$75,000 +

 

Education

5. Please indicate if you completed high school

No

        If no, did you obtain a GED?

      No

      Yes

Yes

    If yes, was the school on a reservation?

      No

      Yes (please specify which reservation):

 

6. Please indicate your enrollment status in college:

Full-time

Part-time     

Graduate/alumni

 

7. How were you able to finance your college education? (check all that apply)

Scholarship

Tribal Scholarship

Student Loans

Pell Grant

Parental Assistance

Vocational Rehabilitation

Other: (please specify) ­

 

8. What is your highest level of college education?

2-year/Associates degree

Bachelors

Masters

Doctoral

No degree yet (in progress)

 

9. Did your parent(s) graduate from college?

No     

Yes

 10. Who/what are your main systems of support?

Friends      

Parents     

Siblings     

Counselor      

Teacher/Professor (former or current)

Advisor

Church

Club

Other (please specify):

 

11. Did you have a significant role model when growing up?

No

Yes

If yes, who was it? (please type in)­

 

12. Please rank the following according to its value in your life. Use a 1-5 scale with 1 being the most important and 5 being the least important (please type in).

Work/finances

Family/Relationships

Education

Religion

Social/cultural events

 

Heritage

 13. What tribe are you affiliated with? (please type in)

 

14. Are you enrolled?

No

Yes

 

15. How well do you know your tribal language?

Fluently     

Enough to get by      

A few words here and there     

I don’t know it

 

16. Have you ever heard your language spoken before?

Yes   

A few times     

Once     

Never

 

17. Do(es) your parent(s)/guardian(s) speak your tribal language?

No    

Yes

    If yes, what language? (please type in)

 

18. Do(es) your grandparent(s) speak your tribal language?

No

Yes

    If yes, what language? (please type in)

 

19. Do you know about the “Boarding School Era”?

No    

Yes

 

20. Does the “Boarding school Era” affect you in any way?

No     

Yes

    If yes, how did/does the “boarding school era” affect you? (please explain) 


 

21. Which of the following do you think are barriers for Native Americans when pursuing a degree in higher education?  Please check all that apply.

No support systems      

Alcoholism      

Drug use   

Abuse     

Neglect      

Gangs

Teen pregnancy     

Bad experiences in school system     

Laziness     

Parents are not involved      

Being a minority      

Illness/Disease

Other (please explain)                               

 

22. Did you personally overcome any obstacles to be where you are in your education?

No

Yes (please explain)

 

23. In thinking about your primary and secondary educational experience (K-12), what stands out to you? Who was in this memory and what made it special?  (please explain)

 

24. Was achieving a college degree a priority for you?

No

Yes (please explain)