Parent Survey

Welcome!

 
RESEARCH SUBJECT INFORMATION AND LETTER OF AGREEMENT

PRINCIPAL INVESTIGATOR:
Sharon Hayes, PhD
Center for Obesity Research and Education (CORE)
Temple University

CO-INVESTIGATOR:
Melissa Napolitano, PhD
Center for Obesity Research and Education (CORE)
Temple University

SITE: Center for Obesity Research and Education (CORE) Temple University 3223 N. Broad St., Suite 175 Philadelphia, PA 19140

STUDY-RELATED PHONE NUMBER: (215) 707-8641 E-MAIL: smhayes@temple.edu

Dear Parent,

You are being asked to participate in a brief study that will use information that you will provide to adapt a weight management program for parents and children.

What Do I Have To Do?

Participation requires 10-15 minutes of your time. You will be asked to complete a brief survey designed to help us learn more about you and your thoughts about a new weight management program that is being developed for parents and children.

To participate:
• You should have a child 6-11 years old.
• You and your child should both drink at least 1 sugar-sweetened beverage per day.
• You and your child should both spend more than 2 hours per day online or on the computer (not for school/work purposes), watching TV, and/or playing video games.
You will not be asked to provide your name or any other potentially identifying information. Drs. Hayes and Napolitano, and study staff members are the only people that will have access to your study data. All of these data will be kept in a secure location on a password-protected computer at the Center for Obesity Research and Education.

What Are The Benefits To Taking Part In The Study?

There is no direct benefit to you from taking part in this research. However, the information you provide may help others in the future. Benefits from this research include the possibility that new and better ways to help parents and children adopt healthy behaviors and achieve healthy weight losses.

What Are The Risks From Taking Part In This Study?

There may be unforeseeable risks with different aspects of this study. For example, there is a slight chance for breach of confidentiality of some of the information (both survey answers and/or private information); however, we will take precautions to minimize this risk. While we do ask you several questions about your background, these surveys are anonymous. You will not be asked to provide your name or any other identifying information. Additionally, the survey is housed on a secure site that is encrypted. Paper copies will not include identifying information and will be entered into the secure online survey database by study staff.

Will I be compensated for taking part in the study?

Every 50th participant to complete this survey will receive a $10 Amazon.com gift card.

Will it cost me anything to participate in this study?

No, there is no cost to participate in this study.

Are there alternatives to taking part in this study?

You can choose not to participate in the study.

Do you have any questions?

If I have any questions about my rights as a research subject, I may contact the Institutional Review Board Coordinator at (215) 707-3390. The IRB Coordinator may also be reached by email: IRB@temple.edu or regular mail: Institutional Review Board Coordinator Temple University Research Administration Student Faculty Conference Center 3340 North Board Street – Suite 304 Philadelphia, PA 19140

If you have additional questions about the study, you can contact Sharon Hayes, PhD, at (215) 707-8641, or via e-mail at smhayes@temple.edu to provide answers to your questions.

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1. Statement of Agreement:
I have read this letter of agreement (or it has been read to me [if applicable]) and the study has been explained to me. All my questions about the study and my participation in it have been answered. I freely agree to participate in this research study. I understand that my participation in this study is entirely voluntary, and that refusal to participate will have no penalty or loss of benefits to me. By clicking the “I agree and would like to participate” link below, I have not waived any of the legal rights that I otherwise would have as a subject in a research study.