2.

Texas Christian University
Fort Worth, Texas

CONSENT TO PARTICIPATE IN RESEARCH
Title of Research: Determining Level of Adherence to the Mediterranean Diet by Individuals Living in the United States

Funding Agency/Sponsor: None

Study Investigators:
Anne VanBeber – Professor and Chair, Department of Nutritional Sciences
Stephanie Cowart, Junior – Coordinated Program in Dietetics
Rachel Seguin, Junior – Coordinated Program in Dietetics

What is the purpose of the research?
To determine how closely components of the Mediterranean Diet are followed by individuals living in the United States.

How many people will participate in this study?
Approximately 200-300

What is my involvement for participating in this study?
Participants will complete an online anonymous questionnaire on Survey Monkey®. Gathered data will be analyzed to compare the participants’ diets to the Mediterranean diet and lifestyle.

How long am I expected to be in this study for and how much of my time is required?
Participants will voluntarily complete a questionnaire on Survey Monkey® which takes approximately 10 minutes.

What are the risks of participating in this study and how will they be minimized?
Potential risks include participants feeling uneasy about their privacy and whether their privacy is being protected by researchers. To diminish this risk, we will ensure that the participants’ responses are completely anonymous.

What are the benefits for participating in this study?
Participants may gain awareness of how their eating patterns affect their individual risks for developing chronic diseases. In addition, participants may have the opportunity to change their diet and lifestyle to improve overall health. Potential benefits to society include possible improvement of the health of the entire society, which could decrease the mortality caused by chronic illnesses.

Will I be compensated for participating in this study?
No, the participants will not be compensated.

What is an alternate procedure(s) that I can choose instead of participating in this study?
There is no alternate procedure.

How will my confidentiality be protected?
Data will be collected anonymously through a questionnaire on Survey Monkey®. Participants will remain anonymous and each questionnaire submitted will be organized according to a given number. Collected data will be utilized by researchers to determine adherence to the Mediterranean Diet and how it influences the risk for chronic diseases.

Is my participation voluntary?
Participation is completely voluntary, and consent may be withdrawn at any time during the study.

Can I stop taking part in this research?
Participants have the right to withdraw from this study at any time.

What are the procedures for withdrawal?
Depending on time of withdrawal, participants will either choose to not take the survey or leave the questionnaire by exiting out of the Survey Monkey® website.

Will I be given a copy of the consent document to keep?
If a participant would like a copy of the consent form, please email Dr. Anne VanBeber at a.vanbeber@tcu.edu.

Who should I contact if I have questions regarding the study?
Anne VanBeber, Professor and Chair, Department of Nutritional Sciences, 817.257.7518
Stephanie Cowart, Junior, Coordinated Program in Dietetics, 956.605.4167
Rachel Seguin Junior, Coordinated Program in Dietetics, 915.920.6006

Who should I contact if I have concerns regarding my rights as a study participant?
Michael Faggella-Luby, Chair; m.faggella-Luby@tcu.edu; 817-257-4355
Dru Riddle, Chair-elect; d.riddle@tcu.edu; 817-257-6
1.By answering "AGREE" below you indicate that you have read or been read the information provided above, you have received answers to all of your questions and have been told who to call if you have any more questions, you have freely decided to participate in this research, and you understand that you are not giving up any of your legal rights.(Required.)
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