Notice of Action
University of Wisconsin–Madison
Institutional Review Board (IRB)
Principal Investigator: Bruce E Wampold
Department: Counseling Psychology
Co-Investigator: Stephen L Gresham
Point of Contact: Stephen L Gresham
Protocol Title: Minority Status Based Victimization: Examining the Role of Social Self-
Efficacy and Social Support as Partial Mediators of the Relationship
between Bias Based Victimization and Black Gay Male Psychological
Protocol Number: SE-2009-0706
IRB: Social & Behavioral Sciences IRB (Contact: Lill Larson, 265-4312)
Committee Action: Approved on: December 08, 2009 Expires: November 19, 2010
We have received the information you sent regarding the above named protocol. This information
complies with the modifications required by the Institutional Review Board, and your protocol is
now approved. You may begin collecting data at any time.
Thank you for your cooperation.
Special Notes or Instructions: The modifications requested have been submitted and this
protocol is now approved. The IRB has waived the requirement for documentation of written
consent per 45 CFR, 46.117 (c)(2). An alternative consent process will be employed. The
research is minimal risk and involves no procedures for which written consent is required outside
of the research context.
Unless this protocol is exempt, or the IRB specifically waived the use of written consent, an
approved consent form that is stamped with approval and expiration dates can be found on IRB
WebKit. To find the stamped consent form, go to IRB WebKit at
https://rcr.gradsch.wisc.edu/irbwebkit/Login.asp. Login and open this protocol number. The
link to the consent form can be found on the left side of the page. All copies of the form must be
made from this original. Any changes to the consent form must be approved in advance by the
Any changes to the protocol must be approved by the IRB before they are implemented.
Any new information that would affect potential risks to subjects, any problems or adverse
reactions must be reported immediately to the IRB contact listed above.
If the research will continue beyond the expiration date indicated above, a request for
renewal/continuing review must be submitted to the IRB. You must obtain approval before the
current expiration date. If you do not obtain approval by the expiration date noted above, you are
not authorized to collect any data until the IRB re-approves your protocol.
Bruce E Wampold
Signed consent forms must be retained on campus for seven years following the end of the
If you are continuing to analyze data, even though you are no longer collecting data, you should
keep this protocol active.