Informed Consent
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You are invited to participate in a research study about lung cancer screening in African-American Female smokers. This form is part of the “informed consent” process to allow you to understand this study before deciding whether to take part.

This study seeks 77 African-American female volunteers who are:
  • Between the ages of 50 and 80 years old 
  • Current and former smokers average 20 packs a year
  • Quit within 15 years 

This study is being conducted by a researcher named Sonia Salmon-Gayle, who is a doctoral student at Walden University.
 
Study Purpose:
The purpose of this study is to investigate t whether the following factors: perceived cancer-related stigma, attitudes toward screening, and cultural beliefs influence African American Female smokers’ intention to receive lung cancer screening.
 
Procedures:
This study will involve you completing the following steps:
  • Basic demographics such as age, smoking status, and marital status. 
  • Four Surveys: Cancer Stigma Scale, Lung Cancer Screening Health Belief Scales, Cultural Belief Scales, and Intention to Screen Visual Analog Scale
Here are some sample questions
1. It is likely that I will get lung cancer sometime in my lifetime.
        o    Strongly Disagree
        o    Disagree
        o    Agree
        o    Strongly Agree
2.   It is likely that I will get lung cancer in the next ten years.
        o    Strongly Disagree
        o    Disagree
        o    Agree
        o    Strongly Agree
3.   It is likely that I will get lung cancer in the next five years.
        o   Strongly Disagree
        o    Disagree
        o    Agree
        o    Strongly Agree
 
Voluntary Nature of the Study:
Research should only be done with those who freely volunteer. So everyone involved will respect your decision to join or not.
If you decide to join the study now, you can still change your mind later. You may stop at any time. 
 
Risks and Benefits of Being in the Study:
Being in this study could involve some risk of minor discomforts that can be encountered in daily life, such as sharing sensitive information. With the protections in place, this study would pose minimal risk to your well-being.
 
This study offers no direct benefits to individual volunteers. The aim of this study is to benefit society by adding new knowledge to existing research on screening behavior. The survey results may change how healthcare organizations approach screening and access to detecting the disease in its earliest stage. Once the analysis is complete, the researcher will share the overall results on scholarly websites, professional journals, and spoken in public forums, as well as cited in future research.
 
Payment:  Your participation is voluntary. There is no financial compensation for completing the surveys.
 

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