FOR YOUR INFORMATION

INFORMED CONSENT:  READ & GO TO SHORT SURVEY

You are invited to take part in a research study of victims of intimate partner violence. The researcher is inviting men and women, age18 years and older, who lives in the United States and have been involved in an intimate relationship that was violent. Participant must be out of the abusive relationship for six months or more. This form is part of a process called “informed consent” to allow you to understand this study before deciding whether to take part.

If you begin to feel overwhelmed or emotionally distressed and feel you need someone to talk to or other intervention at any time during the completion of this form or participation in the study, please use the National Domestic Violence Hotline: 1-800-799-7233.

The research will be conducted by, Terri Ratliff, a doctoral student at Walden University. You may already know the researcher as a fellow student, former co-worker, or professional associate, but this study is separate from that role.

Background of Study: The purpose of this study is to examine the behaviors associated with intimate partner violence (IPV), focusing on the Emotional Intelligence levels of IPV victims.

Confidentiality: All information will be kept completely confidential. This means as a participant of this study, your name will not appear anywhere. Articles written about this study will only present data and not reveal any personal details, such as name, email address, and so forth.

Procedures:  If you agree to be in this study, the steps are as follows:
1) Following the Informed Consent, you will find the Survey, which will take approximately 15 minutes to complete.
2) Once completed, there will be a link to select, which will take you to another website.
3) Once at this site you can begin the questionnaire. There is no right or wrong answer. Answer is based on how you feel at the time. This may take from 30-45 minutes.

Sample questions for the questionnaire include multiple choice:
Are you male or female? (Example from survey)
Are you currently in an abusive relationship?  (Example from survey)
What mood (s) might be helpful to feel when meeting in-laws for the very first time?  (Example on questionnaire)
 
Voluntary Nature of the Study: This study is voluntary. Everyone will respect your decision of whether or not you choose to be in the study.  

Risks and Benefits of Being in the Study:  The benefit of this research is that you will be helping us to understand IPV victim’s emotional status. This information should help us to provide interventions and training based on the specific emotional needs of IPV victims. The risks to you for participating in this study could include eyestrain from computer use and can be minimized by resting your eyes, as needed. If you do not wish to continue, you have the right to withdraw from the study, without penalty, at any time.

Payment: There will be no cash or gifts provided to participants involved in this study. Privacy: Any information you provide will be kept confidential. The researcher will not use your personal information for any purposes outside of this project. The researcher will not include your name or anything else that could identify you in the study reports. Research material will be saved on a password-protected flash drive and locked file for 5 (five) years, at which time the researcher and administrator will shred and destroy documents/fla
Page1 / 4
 
25% of survey complete.

T