VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY
Informed Consent for Participants in
Research Projects Involving Human Subjects
Title of Project: Interpersonal Mindfulness in the
Couple Relationship: A Measure Validation Study
Investigators: Fred Piercy; Laura Gambrel; Larissa Duncan
I. Purpose of
this Research
The
purpose of this research project is to evaluate
a new self-report questionnaire that measures interpersonal mindfulness in the
couple relationship, which has been developed by the researchers. The measures included in this research
project will help to determine the convergent and divergent validity and
reliability of this measure. If the
results of this study are positive, the measure will be made available to other
researchers who are studying couple relationships or programs designed to help
couples with their relationships. The
results of this study may be shared with the scientific and mind-body
communities through presentations and publications, however no information will
be used that could identify you.
II. Procedures
Undergraduate students
enrolled in human development classes in spring 2011 and summer 2011 and
graduate students will be asked to participate in this on-line survey. The survey
will take approximately 30 minutes to complete.
III. Risks
The risks of participating in
this study are minimal. All of your answers are confidential. Your name will
not be associated with your answers. Answering
some items might remind you of negative events or lead you to feel uncomfortable. You may choose not to answer any questions
that make you feel uncomfortable and you may choose to leave the study at any
time without repercussion.
IV. Benefits
While there is no guarantee that you will benefit from
being in this research project, you might experience some personal benefits. For
instance, you may feel a sense of personal satisfaction knowing that you have contributed
to a better understanding of interpersonal mindfulness that can benefit the
larger scientific community.
Comparing the risks of being in this study to the
benefits of being in this study suggests that the benefits are greater than the
risks. You may contact the researcher to get a summary of the research results
once the study has been completed.
V. Extent of Anonymity and Confidentiality
Your participation in this research
study is confidential. Any directly
identifying information will be removed from the survey, so that you will not
be identified as your survey is being processed. All information collected during this research
study will be stored in secure locations. Only members of the research team
will have access to this data. A database containing your answers with no directly
identifying information will be kept for future use, but only the research team
will have access to this data. If you are not interested in
receiving extra credit nor entering in a drawing for a gift card for your participation, you do not need to provide any
identifying information – and in this case your answers will be anonymous and
untraceable to you individually.
VI. Compensation
Participants who wish to
provide their e-mail address will have the opportunity to win a $100 gift card
to Amazon.com. Your approximate odds of winning are 1:350. Some undergraduate
students in human development classes may also be able to receive extra credit
for participation in this survey. Please check with your professors to clarify
if this is possible.
VII.
Withdrawal Procedures
You do not have to be a part
of this research study. If you agree to participate, you can stop at any time. You
may choose to withdraw without negative consequences; that is, no bad things
will happen if you choose to stop.
VIII. IRB Contact Information
If you have any questions
about this research project, please contact:
Laura Gambrel: lauraeg@vt.edu
If you have questions about
the treatment of you or other people in this study, you can contact
David Moore, IRB (540) 231-4991 moored@vt.edu