Adults With Type 2 Diabetes Survey

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INFORMED CONSENT TO PARTICIPATE IN RESEARCH
Information to Consider Before Taking Part in this Research Study
IRB Study # Pro00014521
Researchers at the University of South Florida (USF) study many topics. To do this, we need the help of people who agree to take part in a research study. This form tells you about this online research study.

The person who is in charge of this research study is Ashley Wingert. This person is called the Principal Investigator. The research will be conducted by the University of South Florida and will be completed online.

PURPOSE OF THE STUDY
The purpose of this study is to
Find out about your experiences living with diabetes. You are being asked because are a younger adult with type 2 diabetes.

STUDY PROCEDURES
You will be asked to answer some questions about living with type 2 diabetes. The online survey will take approximately 20 minutes to complete.

VOLUNTARY PARTICIPATION/WITHDRAWAL
You should only take part in this study if you want to volunteer. You should not feel that there is any pressure to take part in the study. You are free to participate in this research or withdraw at any time. There will be no penalty or loss of benefits you are entitled to receive if you stop taking part in this study.

BENEFITS
We are unsure if you will receive any benefits by taking part in this research study.

RISKS OR DISCOMFORT
This research is considered to be minimal risk. That means that the risks associated with this study are the same as what you face every day. There are no known additional risks to those who take part in this study.

COMPENSATION
We will provide $50 gift cards to the winners of those who choose to participate in the gift card drawing.

PRIVACY & CONFIDENTIALITY
We must keep your study records as confidential as possible. It is possible, although unlikely, that unauthorized individuals could gain access to your responses because you are responding online. Your results will be kept confidential. Your name will not be saved with your survey responses nor will your computer’s IP address be saved. If you choose to provide contact information for gift card distribution, your information will not be linked to survey responses or saved. Once the gift cards have been distributed your contact information will be destroyed. Your results will be password protected and may be stored for up to 5 years after the Final Report is filed with the IRB.
However, certain people may need to see your study records. By law, anyone who looks at your records must keep them completely confidential. The only people who will be allowed to see these records are:
• The research team, including the Principal Investigator, the Advising Professor, and all other research staff
• Certain government and university people who need to know more about the study. For example, individuals who provide oversight on this study may need to look at your records. This is done to make sure that we are doing the study in the right way. They also need to make sure that we are protecting your rights and your safety.) These include:
•The University of South Florida Institutional Review Board (IRB) and the staff that work for the IRB. Other individuals who work for USF that provide other kinds of oversight may also need to look at your records.
•The Department of Health and Human Services (DHHS).

CONTACT INFORMATION
If you have any questions please contact the USF IRB at 974-5638 or the Principal Investigator at 813-396-2677

We may publish what we learn from this study. If we do, we will not let anyone know your name. We will not publish anything else that would let people know who you are. You can print a copy of this consent form for your records. If you agree please proceed with the survey.

Thank you!
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