Department of Psychology

8001 Natural Bridge Road
St. Louis, Missouri 63121-4499
Telephone: 314-516-5824
Fax: 314-516-5347
E-mail: rhibberd@umsl.edu

Informed Consent for Participation in Research Activities
Investigation of Meaning and Life Significance In Bereaved Adults

HSC Approval Number _257550-1__________________

Principal Investigator _Rachel Hibberd, M.A.____________
PI’s Phone Number __314-516-5824_______
PI’s Email Address __rhibberd@umsl.edu___

Why am I being asked to participate?

You are invited to participate in a research study about life meaning and bereavement, conducted by Rachel Hibberd, M.A., a graduate student, and Brian Vandenberg, Ph.D., a faculty member in the Department of Psychology at the University of Missouri-St. Louis. You have been asked to participate in the research because you have experienced the loss of a loved one. We ask that you read this form and ask any questions you may have before agreeing to be in the research. Your participation in this research is voluntary. Your decision whether to participate will not affect your current or future relations with the University. If you decide to participate, you are free to withdraw at any time without affecting that relationship.

What is the purpose of this research?

The purpose of this study is to investigate the different ways that people experiences their lives as meaningful following the loss of a loved one.

What procedures are involved?

If you agree to participate in this research, you can expect:
To complete a series of short questionnaires asking about your demographic information, various aspects of meaning, positive and negative emotions, and your grief experiences. You are free to not answer any question which makes you uncomfortable.

Approximately 500 participants may be involved in this research at the University of Missouri-St. Louis.

What are the potential risks and discomforts?

There is a possibility you might be troubled or experience some mild emotional distress as a result of answering these questions, particularly those that deal with stressful events you’ve experienced. If at any time you wish to discontinue your participation, you are free to do so. If you have any questions that arise about your responses to the questionnaires, you are welcome to contact the principal investigator to discuss them in confidence.

Are there benefits to taking part in the research?

There are no direct benefits to you for participating. However, other bereaved individuals may benefit as a result of this research. As noted below, you will be eligible to enter a raffle for two $50 gift certificates to Amazon.com.

What about privacy and confidentiality?

Your responses to these questionnaires will remain anonymous. We will not have any way to connect your responses to your name or email address. In order to be entered into the raffle (see below), you will need to provide your email at the end of this questionnaire. That information will NOT be connected in any way to your questionnaire answers. You are also under no obligation to provide your e-mail address, though if you do not do so you will not be entered in the raffle. We will not share your email address with anyone.

If you would like to contact us, for example, with questions about the study or concerns about your participation, we wish to remind you that e-mail is not a confidential mode of communication. In the Contact Section, you can find both e-mail address and phone number of the investigator.

Any information that is obtained in connection with this study, and that can be identified with you, will remain confidential and will be disclosed only with your permission or as required by law.

Do you already have contact restrictions in place with UMSL? [ ] Yes [ ] No
(Example: no calls at home, no messages left for you, etc.)

Please specify any contact restrictions you want to request for this study only.

What are the costs for participating in this research?

There will be no cost to you for your participation.

Will I be compensated for my participation in this research?

You will not be directly compensated for your participation. You will have the option to enter into a raffle for two $50 gift certificates to Amazon.com. Your odds of winning are approximately one in 200.

Can I withdraw or be removed from the study?

You can choose whether to be in this study. If you volunteer to be in this study, you may withdraw at any time without consequences of any kind. You also may refuse to answer any questions you do not want to answer and still remain in the study. The investigator may withdraw you from this research if circumstances arise which warrant doing so. If you decide to end your participation in the study, please complete the withdrawal letter found at http://www.umsl.edu/services/ora/assets/WithdrawalLetter.doc, or you may request that the Investigator send you a copy of the letter. As noted above, if the researcher believes you are likely to be harmed by your participation, she may discontinue your participation. There will be no consequences to you for withdrawal from the study.

Who should I contact if I have questions?

The researcher(s) conducting this study are Rachel Hibberd, M.A., and Brian Vandenberg, Ph.D. You may contact them ask any questions you have now or later by calling 314-516-5824.

What are my rights as a research subject?

If you have any questions about your rights as a research subject, you may call the Chairperson of the Institutional Review Board at (314) 516-5897.

What if I am a UMSL student?

You may choose not to participate, or to stop your participation in this research, at any time. This decision will not affect your class standing or grades at UMSL. The investigator also may end your participation in the research. If this happens, your class standing will not be affected. You will not be offered or receive any special consideration if you participate in this research. At the end of the survey, you will be offered the option of entering your name, email address, and course information to receive credit for your participation within the SONA system. If you withdraw from the study, you may still receive SONA credit by contacting the principal investigator.

What if I am a UMSL employee?

Your participation in this research is, in no way, part of your university duties, and your refusal to participate will not in any way affect your employment with the university or the benefits, privileges, or opportunities associated with your employment at UMSL. You will not be offered or receive any special consideration if you participate in this research.

Remember: Your participation in this research is voluntary. Your decision whether to participate will not affect your current or future relations with the University. If you decide to participate, you are free to withdraw at any time without affecting that relationship.

Please print a copy of this form for your information and to keep for your records.