Consent to Take Part in a Research Study

Information for Participation in a Research Study

Principal Investigator: Dr. Julia C. Basso

IRB# and Title of Study: IRB-24-835; DJing and Hip Hop Music Production as a Clinical Intervention for ADHD

WHAT SHOULD I KNOW? You are invited to participate in a research study. Below is important information about the study and how to contact us if you have any questions.The goal of this study is to explore the effects of DJing and Hip Hop music production on individuals with Attention-Deficit/Hyperactivity Disorder (ADHD). If you agree to take part in this study, you will first complete a screener questionnaire to determine your eligibility for participation in the full study. This process should take approximately 5-10 minutes. If you are eligible to participate, you will be contacted by the research team with additional details about the study. If you are not eligible, you will not be invited to participate, and no further steps will be taken.

STUDY OVERVIEW:If you are selected for participation, the study will last for 4 weeks, with two 2-hour sessions per week. You will be randomly assigned to one of two intervention groups: 1) DJing and Hip Hop Music Production Intervention; 2) Movie Watching Intervention. During the study, you will engage in tasks such as answering questions, playing computer games, and having your brain and body activity recorded. These activities will be conducted during both pre-and post-intervention testing. 

COMPENSATION: You will be compensated up to $100 for completing the study. If you complete the study, you will be entered in a drawing to receive a pair of AlphaTheta headphones (33.3% chance).

ELIGIBILITY CRITERIA: To participate in this study, you must meet the following requirements: 1) Age: 18-26 years old; 2) Diagnosis: Self-reported diagnosis of ADHD (to be verified during screening).

If you are eligible, the study team will reach out to you with further instructions about scheduling and the next steps.

RISKS AND CONFIDENTIALITY: The risks associated with this screener are minimal. Some of the questions may address sensitive topics, such as mental health or behavior. Specifically, there may be questions related to ADHD symptoms or behaviors that might feel uncomfortable. If any responses indicate potential concerns such as suicidal ideations, the Principal Investigator (PI)will follow up with you directly, and you will be provided with access to local and national mental health resources. Answering questions in this way will not disqualify you from participating in the study.Your responses will be kept confidential to the best of our ability. However, we cannot guarantee100% confidentiality. All data collected from this screener will be stored securely, and any identifying information will be removed or coded before analysis. Data will be stored on a password-protected computer and retained for a period of 3 years, after which it will be destroyed.

YOUR PARTICIPATION: Your participation in this study is voluntary. You may choose not to participate or withdraw from the study at any time without any negative consequences. You also have the option to skip any questions that make you feel uncomfortable and still remain in the study.The research team may withdraw you from participation if any circumstances arise that warrant doing so.

WHO CAN I TALK TO? If you have any questions or concerns about this research, please contact the lab at embodiedbrainlab@gmail.com. If you have questions regarding your rights as a participant in a research study, please contact theVirginia Tech HRPP Office at 540-231-3732 or irb@vt.edu.

Please print or save a copy of this consent form for your records.

Participant Acknowledgement and Consent
By signing below, I acknowledge that I have read and understood the information provided in this consent form. I understand the purpose of this study, the procedures involved, and the potential risks. I am voluntarily agreeing to participate in the eligibility screener for the study titled DJing and Hip Hop Music Production as a Clinical Intervention for ADHD. I understand that my participation is voluntary, and I may withdraw at any time without any negative consequences.

By clicking "I Agree" below, you are consenting to complete the eligibility screener for the study titled DJing and Hip Hop Music Production as a Clinical Intervention for ADHD. Your completion of this screener signifies that you have read and understood the information provided, and that you voluntarily consent to participate in this study. Do you consent to participate in the DJing and Hip Hop Music Production as a Clinical Intervention for ADHD study screener? If you would like to participate in this screener survey, click yes to begin or no to exit.  

*
Required
Name (first and last) *
Email address *
Phone number *
How old are you? *
Are you currently pregnant? *
Do you have a formal diagnosis of any presentation of Attention Deficit/Hyperactivity Disorder (hyperactive/impulsive, inattentive, combined)? *
Do you have any of the following conditions outside of Attention Deficit/Hyperactivity Disorder? Check all that apply. *
Required
Please list any current medical diagnoses, including physical and mental (e.g., hypertension; hypothyroid; diabetes; depression; anxiety). *
Please list any medications you are currently taking. *
Would you be available on the following days/times during the fall semester? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report