Study Title: El Trabajo no te Debe Dañar: Reduction of Hazardous Exposures in Small Businesses through a Community Health Worker Intervention

Principal Investigator: Paloma Beamer, PhD

Sponsor: National Institutes of Health

Summary of the research

This is a consent form for participation in a research project. Your participation in this research
study is voluntary. It contains important information about this study and what to expect if you
decide to participate. Please consider the information carefully. Feel free to ask questions
before making your decision whether or not to participate.

Why is this study being done?
Before the COVID-19 pandemic, we had just started to help businesses like yours reduce the
amount of chemicals their workers come in contact with. We had to stop doing these visits
because of the pandemic. To find out how we can best start this work again, we want to ask
you some short questions about how the pandemic has affected your business.

What will happen if I take part in this study?
We will ask you some short questions about your business. You do not have to answer all the
questions.

How long will I be in the study?
You will be in the study no more than the time it takes to complete the survey, about 5
minutes.

How many people will take part in this study?
We expect to enroll up to 1,520 people in this study, including those who participate in other
parts of the study.

Can I stop being in the study?
Your participation is voluntary and you can refuse participation. If you decide to participate you
may stop at any time. Whatever decision you make will have no effect on your position at your
business.

What risks or benefits can I expect from being in the study?
We do not see any risks by answering questions about your shop or your workplace.

We will not record any personal or confidential information, including your business name, and
we will never disclose any information which we think might cause embarrassment or harm.
You or your community may benefit by helping us work more effectively with businesses to
support them with educational resources during periods of COVID-19.

Will I be paid for participating in the study or experience any costs?
You will not be paid for participating. There is no cost for participating in the study, other than
your time.

Will my study-related information be kept confidential?
The information that you give in the study will be anonymous. Your name and the name of
your business will not be collected or linked to your answers.

At the end of your participation in the study, you will be asked if you would like your email
address or phone number added to our database of businesses interested in learning more
about the study or receiving information from our team, but that will not be linked to your
participation in this survey in any way.

Will my study-related information be used for future research?
Information collected about you will not be used or shared for future research studies.

Who can answer my questions about the study?
For questions, concerns, or complaints about the study you may contact Dr. Paloma Beamer at
520-626-0006.

For questions about your rights as a participant in this study or to discuss other study-related
concerns or complaints with someone who is not part of the research team, you may contact
the Human Subjects Protection Program Director at 520-626-8630 or online at
http://rgw.arizona.edu/compliance/human-subjects-protection-program.