*Informed Consent

Investigator(s): Brandon Do

Study Title: Parental Factors that Moderate Child Media Use During Childhood: A Quantitative Cross-Sectional View

I’m a student at the Chicago School. This study is being conducted as part of my dissertation requirement for the Clinical PsyD Program.

I am asking you to participate in a research study examining the ways that parenting influences how a child uses digital media. You will be asked to provide information to the screening questions to see if you qualify to participate in the survey. If you meet the inclusion criteria, you will be asked to provide background information and complete a survey.

This survey will take approximately 15 minutes. This survey includes questions that may be regarded as sensitive in participating in the study may trigger some emotional distress and loss of confidentiality.

Although you may not directly benefit from participating in the study, it will help contribute to the field of psychology and expand the understanding of child media use. You will be asked to report your own screen time, attitudes towards media, and other aspects of your child’s routines. The ways in which these factors affect child media use will be analyzed together, contributing to a more comprehensive understanding of child media use and its correlates.

Please take your time to read the entire document and feel free to ask any questions before agreeing to participate.

If you have questions concerning your rights in this research study you may contact the Institutional Review Board (IRB), Which is concerned with the protection of subjects in research projects. You may reach the IRB Office Monday-Friday by calling 312.467.2335 or writing: Institutional Review Board, The Chicago School, 325 N. Wells, Chicago, Illinois, 60654.

Consent to Participate in Research

Please take your time to read the entire document before agreeing to participate.

Participant:

Clicking the checkbox below indicates that I have read the description of the study and I agree to participate in the study.

Participants may download a copy of the consent form for their records.

Alternatives to Participation: Participation in the study is voluntary. You may withdraw from study participation at any time without any penalty.

Confidentiality: The indirectly identified information about you will be collected for the purpose of the study. This includes demographic information and your consent to participate. All information will be confidential, as no identifying information will be collected within the survey data via a HIPAA-compliant survey platform. All response data will be downloaded from SurveyMonkey and stored in a password protected file on a password protected computer. Research materials will be kept for a minimum of five years after publication per American Psychological Association (APA) policy.

It is possible that your data may be used for future research or distributed to another researcher without your consent. However common information that could identify you will be removed.

Your research records may be reviewed by federal agencies whose responsibility is to protect human subjects participating in research, including the Office of Human Research Protections (OHRP) And by representatives from the Chicago School Institutional Review Board, a committee that oversees research.

Questions/Concerns: If you have questions related to the procedures described in this document, please contact the principal investigator, Brandon Do, at bdo@ego.thechicagoschool.edu and/or the dissertation chair, Dr. Natasha Wheeler, at nwheeler@thechicagoschool.edu.(Required.)

I have read the above information and have received satisfactory answers to my questions. I understand the research project, and the procedures involved have been explained to me. I agree to participate in the study. My participation is voluntary and I do not have to agree to participate if I do not want to be a part of this research project.

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