Statement of Informed Consent
A. PURPOSE AND BACKGROUND
You have been asked to give permission for you and/or your child to participate in a research study to learn about the quality of life and behavioral and psychosocial changes of siblings of children with Diabetes. Wendy Packman, PhD, JD and Heather Preston, B.A. from Palo Alto University’s Pacific Graduate School of Psychology are conducting this study.
You are being asked to participate in this study because you have a child with Type I Diabetes between the ages of 5 and 17 years.
B. PROCEDURES
If you agree to be in this study, the following will happen:
1. You will be asked to agree to the conditions of this study by clicking "Agree" at the end of this survey.
2. You and/or your child will be asked to complete self-report questionnaires about your child's behavior and quality of life. These tasks will take approximately 60 minutes for the child and 30 minutes for the parent. Each participant will complete each questionnaire only one time.
3. All study procedures will be done online.
4. You will be asked to submit this form online prior to completing the questionnaires.
C. RISKS/DISCOMFORTS
1. Confidentiality: Participation in research may involve a loss of privacy, but information about you will be handled as confidentially as possible. Your child’s results will also be handled as confidentially as possible, within the law. Special precautions will be taken to protect the identities of participants in the study and the confidentiality of all information provided. All records will be coded and kept in locked files so the study investigators have access to them. No individual identities will be used in any reports or publications resulting from the study.
2. If instances when abuse or soon-to-occur physical injury to self or another person are discussed, they will need to be reported, as required by law.
3. Completion of the questionnaires or discussion of experiences may result in psychological distress and/or bring up painful memories for you or your child. If this occurs, you are free to abandon completion of the questionnaires at any time. If you are completing the study by mail, you may use the information sheet included in the packet to gain psychological services. If you are completing the survey online, when you discontinue the survey (whether you complete it or not) you should be redirected to information on how to gain psychological services in your area.