INFORMED CONSENT FORM

INFORMED CONSENT FORM – ONLINE FORMAT

Gay Males, Religiosity, and Suicidal Ideation
Informed Consent Form - Online Format

THIS FORM SHOULD BE THE FIRST PAGE YOU SEE. AFTER YOU HAVE READ THIS FORM, AND SHOULD YOU DECIDE TO CONTINUE, YOU ARE ACKNOWLEDGING THAT YOU HAVE BEEN THOROUGHLY INFORMED ABOUT THE NATURE OF THIS STUDY. BY DECIDING TO CONTINUE OR BY CLICKING THE “NEXT” BUTTON, BELOW, YOU ARE GIVING INFORMED CONSENT.

You are invited to participate in a research study about how a gay male’s level of religiosity during childhood affects his potential for suicidal ideation. We ask that you read this Informed Consent Form before agreeing to participate in the study. This study is being conducted by Joseph Claybaugh, a doctoral candidate at Walden University.

Background Information: The purpose of this study is to gain an understanding of the influences religiosity has on the potential for suicidal ideation in gay males, and why the rates are significantly higher than for heterosexual males.

Procedures: If you agree to participate in this study, please continue to the next page of this survey, which indicates you understand its contents and the nature of the study. You will then be asked to complete a short demographics questionnaire and two short surveys. The demographics questionnaire asks you to confirm that you are a gay male, are at least 18 years of age, and that you understand English. If your answers to all three of these questions are yes, please continue with the rest of the demographics questionnaire, the suicidal ideation survey, and the religiosity survey. You should be able to complete all three of these items within 10 to 15 minutes.

Confidentiality/Privacy: This study is completely anonymous, and the records of this study will be kept private and confidential. In any report that might be published, no information will be included that will make it possible to identify you or any other participant. Research records will be kept in a locked file; and only the researcher will have access to the records.

Voluntary Nature of the Study: Your participation in the study is entirely voluntary, and you are free to withdraw at any time during the process of completing the surveys. If you decide to withdraw your participation, you may do so without any recourse whatsoever.

Risks and Benefits of being in the Study: There are no physical risks and no individual benefits to participating in this study. Emotional upset while completing the questionnaires might be a possibility. Participants are not obligated to complete any parts of the questionnaires with which they are not comfortable. There are, however, potentially significant benefits to the gay community and the mental health community by helping mental health professionals to understand why suicidal ideation amongst gay males is so high. And it could assist them in helping their gay male clients understand and cope with any suicidal thoughts they might be having.

CALL ONE OF THE FOLLOWING NATIONAL HELPLINES, IF YOU FEEL THE NEED TO SPEAK TO SOMEONE AT ANY TIME.

GLBT National Hotline 1-888-843-4564
The Trevor Project 1-866-488-7386
National Suicide Prevention Lifeline 1-800-273-8255
KHC Hope Line 1-800-442-4673
Conflicts of Interest: There are no potential conflicts of interest by agreeing to participate in this research.

Contacts and Questions: The researcher conducting this study is Joseph Claybaugh. He can be reached via email at joseph.claybaugh@waldenu.edu. The researcher’s advisor is Dr. Tracy Marsh, who can be reached via email at tracy.marsh@waldenu.edu. If you have questions or concerns about your rights as a participant in this research, you may contact Dr. Leilani Endicott, who can be reached via email at irb@waldenu.edu or via telephone at 612-312-1210. Walden University’s approval number for this study is 03-21-14-0112440 and it expires on March 20, 2015.

Statement of Consent: By clicking on the “next” button, below, you are acknowledging that you have read the above information, and that you have no questions at this time to ask of the researcher.

YOU SHOULD PRINT A COPY OF THIS INFORMED CONSENT FORM FOR YOUR RECORDS.

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