Survey Instructions

1. Participants must be 18 years of age or older. If you are under 18 years of age and have been the victim of sexual abuse, please speak with a trusted pastor or teacher or counselor.

2. Participants must acknowledge having read the Consent Form and agree to provide information to be used for the stated purposes.

3. Participants must have (current or past) affiliation with the Conservative Holiness Movement (CHM) or having been victimized by someone with CHM affiliation.

4. If a participant has had more than one abuser, the survey can be taken multiple times.

Consent Form to Participate in Sexual Abuse in the CHM Study

Project Title: Sexual Abuse in the CHM

Principal Investigators: Regi Baker (victim's advocate); Andrew Graham (licensed counselor); Jon Hopkins (pastor)

Description and Purpose of the Research: The purpose of this study is to examine the prevalence of sexual abuse within the Conservative Holiness Movement (CHM). This study will contribute to the growing body of knowledge of sexual abuse in faith communities and will ultimately be used to inform denominational leaders, college administrators, individuals and families as to the need for identification and intervention as it relates to sexual abuse.

What you will be asked to do: The survey will take approximately 10-15 minutes to complete (longer for those who wish to complete further optional information). You will be asked about yourself, your abuser, your risks, and your affiliation within the CHM. Participation is anonymous but participants will be given an option to provide their email address in order to seek follow-up.

Risks and Discomforts: We anticipate that your participation in this study presents minimal risk or discomfort. If you experience discomfort during the survey, researchers suggest for you take a break, skip any questions, and/or stop participation in the study. If at any time, you experience distress during the survey process, and think that you would benefit from support please call one of these toll-free numbers: Rape Abuse and Incest National Network (RAINN)- 800-656-HOPE or National Domestic Violence Child Abuse and Sexual Assault Hotline: 800-799-7233.

Benefits: You may benefit from the awareness that you have contributed to the knowledge regarding the impact of sexual abuse within the CHM. This information may assist in improving prevention of sexual abuse and the provision of services for survivors of sexual abuse.

Privacy/Confidentiality/Data Security: Participation in this study is anonymous. Providing your name or any identifying information is optional. Data will be kept safely in password-protected files. Only the researchers will have access to the raw data.

Voluntary Participation: Participation is voluntary and you have the right to withdraw your consent or discontinue participation at any time without penalty.

Contact Information: For questions about this study, please contact: Regi Baker, Andrew Graham, or Jon Hopkins.

Toll-free Crisis Hotlines:

  • Rape Abuse and Incest National Network (RAINN)- 800-656-HOPE

  • National Domestic Violence Child Abuse and Sexual Assault Hotline: 800-799-7233