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Name of Researcher, Faculty, Department, Telephone & Email: Dr. Emma A. Climie, Werklund School of Education, (403) 220-7770, eaclimie@ucalgary.ca

Co-investigators: Dr. Stacey Espinet (CADDRA - Canadian ADHD Resource Alliance), Dr. Joan Flood (Possibilities Clinic), Dr. Anton Miller (BC Children’s Hospital Research Institute)

Title of Project: Practices, Training, and Attitudes towards ADHD: A Survey of Canadian Medical and Nurse Practitioners

This consent form, which you are encouraged to print for your records, is only part of the process of informed consent. If you want more details about something mentioned here, or information not included here, you should feel free to ask. Please take the time to read this carefully and to understand any accompanying information.

The University of Calgary Conjoint Faculties Research Ethics Board has approved this research study. Participation is completely voluntary, and confidential.

Purpose of the Study

The purpose of this study is to explore the attitudes, training, and current practices of Canadian medical practitioners in relation to ADHD. To this end, we would like to obtain your input as a medical or nurse practitioner on what your own experiences and perspectives are regarding ADHD.

What Will I Be Asked to Do?

If you decide to participate in this research, you will be asked to complete a brief survey (up to 15 minutes) about your own professional experiences with ADHD. The content of the survey will consist of questions regarding your ADHD-related training, beliefs regarding ADHD, approach to and comfort working with ADHD cases in your practice, and practice needs you may have.

Participation is completely voluntary. You may refuse to participate altogether, may decline to answer any and all questions, and may withdraw from the study at any time without penalty or adverse consequence.

What Type of Personal Information Will Be Collected?

Should you agree to participate, you will be asked to provide some information about your professional background (e.g., your discipline and qualifications) and general demographic location (e.g., province or country of residence) so that we can get a general sense of the make-up of the participant sample providing feedback. This is important because some experiences and perspectives may be more common among family physicians than psychiatrists, for example, and having this background information on participants will allow us to contextualize our findings. Should you wish to participate in a draw (as described below), you will be required to provide an email address to be contacted with.
Are there Risks or Benefits if I Participate?

There are no risks to you in participating. Those who choose to participate will be entered in a draw to win one of their choice of either a one-year CADDRA membership or $250 to be donated to a charity of their choosing.

What Happens to the Information I Provide?

Your data will be stored in an encrypted, password-protected file on a secure server at the University of Calgary. Only members of the research team (Drs. Climie and Espinet) will have access to the results you provide. Prior to data being shared with other co-investigators or collaborators, all identifying information will be removed.

You will be free to withdraw your responses from the survey until 1 month after the survey closes. (If you wish to withdraw, please contact Dr. Climie or Dr. Espinet). After this time, withdrawal will no longer be possible, because your de-identified responses will be synthesized with those of other participants and written for publication.

Only group information will be summarized for any presentation or publication of results. It is possible that the de-identified anonymized datafile will be uploaded to an online data repository. Data repositories can be used to share de-identified and non-confidential data only. Contributors are required to remove, replace, or redact such information from datasets prior to upload.

The researchers acknowledge that the host of the online survey (Survey Monkey) may automatically collect participant data without their knowledge (i.e., IP addresses). Although this information may be provided or made accessible to the researchers, it will not be used or saved without participant’s consent on the researchers’ system. Further, because this project employs e-based collection techniques, data may be subject to access by third parties as a result of various security legislation now in place in many countries and thus the confidentiality and privacy of data cannot be guaranteed during web-based transmission.
Questions/Concerns

If you have any further questions or want clarification regarding this research and/or your participation, please contact:

Dr. Emma A. Climie
Werklund School of Education,
(403) 220-7770, eaclimie@ucalgary.ca

Dr. Stacey Espinet
CADDRA - Canadian ADHD Resource Alliance
stacey.espinet@caddra.ca

If you have any concerns about the way you’ve been treated as a participant, please contact the Research Ethics Analyst, Research Services Office, University of Calgary at 403.220.6289 or 403.220.8640; email cfreb@ucalgary.ca. A copy of this consent form has been given to you to keep for your records and reference. The investigator has kept a copy of the consent form.

Question Title

* 1. Signatures

By clicking “I consent to participate in this research study” below, you are indicating that 1) you understand to your satisfaction the information provided to you about your participation in this research project, and 2) you agree to participate in the research project.

In no way does this waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from this research project at any time. You should feel free to ask for clarification or new information throughout your participation.

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