Hello, I am Professor Terry Chi and working with me are Miss Amber Amundson and Miss Sherry Nelson. We are part of the Psychology Department at Northwestern College (NWC) and we would like to invite you to participate in our research study today on the factors that may influence college women’s emotional health while they are in college.
In order to take part in this study you must be at least 18 years old. This study has been reviewed and approved by the Institutional Review Board of Northwestern College. This document will outline the basic components of the study you are being invited to take part in and inform you of your rights as a research participant.
The purpose of this research is to investigate if personality, emotional wellbeing, feelings about one’s body, feelings about one’s life circumstances, and eating behaviors are interrelated over time. We are asking you to participate in this study because we believe that the information gathered from you today will help illuminate the nature of the connections among these variables, and may help college administrators better understand how to serve their students. Determining and clarifying the way in which these variables interact concurrently and over time could help psychologists form a better model for how eating behaviors may be influenced by personality, mood and self-perception.
The nature of your involvement in this study is to simply provide information. You will be asked to complete several questionnaires. The questionnaires will ask you for information about your own personality patterns, your emotional wellbeing, your perceptions of your body and your life, and eating habits. It should take you 60 minutes to answer all the questions. At all times you have the option to not participate. Even if you agree to participate now, you can stop at any time. There will be no negative consequences for you, academic or otherwise if you decide to stop participating in this study.
There is a minimal potential risk involved in participation in this study. You will be asked personal questions that could elicit negative emotions. You can decide to not answer any questions you prefer not to answer. However, receiving honest answers is essential to the validity of this study and its conclusions. Nonetheless, it is still possible that these questions may bring up feelings / moods that may need to be discussed more with a professional counselor. If that happens to you, let us know and we will refer you to the Wellness Center staff on NWC campus.
This study has not been designed to directly benefit the participants. However, your participation has the potential to help researchers and clinicians in their quest to understand the nature of human mind and the maintenance of individual mental health. Your participation today could have an impact on the greater body of scientific knowledge. This is not a treatment study; you will not receive direct treatment as a part of this research. However, as a token of our appreciation, we will forward a $10 Wal-Mart gift card through campus mail upon completion of the online and in-person sessions of this study. Since we are interested in how these processes evolve over time, if you agree to return in a few months to answer some similar questions, your time will be compensated similarly with a $10 Wal-Mart gift card.
All of the personal information collected from you today will be kept confidential. The forms you complete will be identified with unique research numbers that will in no way specifically identify you. The data you provide will be summarized without any personal information attached to them. Your name will not appear on any documents (except for this informed consent which will be separated from the other forms today). All of the questionnaires will be stored in locked cabinets in Professor Terry Chi’s office on NWC campus. Only the research staff will have access to the information and they have all gone through a standardized online research ethics training course offered by the National Institutes of Health. Individuals will not be identified in publication or reports and only group level summary statistics will be shown.
Any questions or concerns you have about this study can be directed to Professor Chi on campus:
Dr. Terry Chi
Department of Psychology
101 – 7th Street SW
Orange City IA 51041
Office VPH 305C
While we do not anticipate any undue emotional distress as a direct result of this study. If you do feel emotional distress after your participation, we encourage you to contact the professional staff at the NWC Wellness Center. The Wellness Center is located in the Rowenhorst Student Center (RSC) and its contact information is listed below:
I have read the above information and I voluntarily agree to participate in the current study. I know that I can stop my participation at any time, even after I have agreed to participate in the current study. However, I also understand that the gift card will only be forwarded to me after I have completed both the online and the in-person sessions of this study. By typing my name in the space provided, I certify my comprehension of the terms of this research study and my voluntary participation in the study.