School Principal Consent Information:
Participation in 5 Radical Minutes Program Evaluation

Purpose and Benefits

Your school is implementing 5 Radical Minutes, a program designed for students in K-12 schools to build deeper connections with one another.  The developers of 5 Radical Minutes are hoping to better understand how the program is working for your school and are partnering with Dr. Susan Ruby in Eastern Washington University’s Psychology Department to analyze existing data and to survey teachers who currently use the program.  Dr. Ruby will provide a report to the developers of 5 Radical Minutes that summarizes the data, and the program developers will use the information to implement improvements in the program.


We are asking your consent to:

  • release existing data that 5 Radical Minutes has collected from your teachers, students, and schools. Surveys from students were anonymous.  Surveys of teachers were confidential.  These data will remain confidential; all identifying information will be changed to protect teacher and school confidentiality.
  • allow 5 Radical Minutes to disseminate a confidential survey to your teachers for them to share information regarding their perceptions and use of the program in their classrooms. The survey includes 15 items and should take approximately 5-10 minutes to complete. Teachers will receive consent information in the survey that explains they do not have to answer any questions they do not feel comfortable answering.

If at any time and for any reason your school would prefer to not participate in this study, you can withdraw from the study without being penalized in any way.  Your participation status in the study will not impact your participation in 5 Radical Minutes.

Risk, Stress, Discomfort and Potential Benefits

There are minimal risks associated with participating in the program evaluation of 5 Radical Minutes. Your school will benefit from participating in this research study, as 5 Radical Minutes plans to improve the program based on information provided by multiple schools.  Analysis of existing data will help you better understand whether the program is effective for your school and for other participating schools.

Other Information

Please know that all existing data and survey data will remain confidential and will be maintained in a secure digital server.  Names of schools and teachers will be changed to ID numbers when data are analyzed. If you have any questions about the study, please contact Susan Ruby Ph.D., Director, School Psychology Program by phone at (509) 359 6050 or by email at  If you have questions or concerns about your rights as a participating school in this study or any complaints you wish to make, please contact Ruth Galm, Human Protections Administrator, 509-359-7971 or

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