TITLE OF STUDY
The Freud Posse;
Anna Freud Research Project
PRINCIPAL INVESTIGATOR
Dr. Jerome A. Lewis
Bellevue University
Bellevue Nebraska
402-557-7519
jerlewis@bellevue.edu
PURPOSE OF STUDY
You are being asked to take part in a research study. Before you decide to
participate in this study, it is important that you understand why the research
is being done and what it will involve. Please read the following information
carefully. Please ask the researcher if there is anything that is not clear or
if you need more information.
The purpose of this study is to explore if or how depression dis-proportionally affects women. The study hopes to gain knowledge that will
equip individuals (medical professionals, including supervisors, or families) with
intervening tools.
Your participation in this survey is voluntary. You may refuse to take part in
the research or exit the survey at any time without penalty. Please answer all
questions.
STUDY PROCEDURES
Your survey answers will be sent to a link at Qualtrics.com where
data will be stored in a password protected electronic format. Qualtrics
does not collect identifying information such as your name, email address, or
IP address. Therefore, your responses will remain anonymous. No one will be
able to identify you or your answers, and no one will know whether or not you
participated in the study.
RISKS
The possible risks or discomforts of the study are minimal.
You may feel a little uncomfortable answering personal survey questions.
You may decline to answer any or all questions and you may terminate your
involvement at any time if you choose.
BENEFITS
You will receive no direct benefits from participating in
this research study aside from receiving extra credit in your class. However, your responses may help us learn more about depression/anxiety issues.
CONFIDENTIALITY
Your responses to this [survey] will be anonymous. Please do not write any
identifying information on your [survey]. Every effort will be made
by the researcher to preserve your confidentiality including the following:
Measures taken to ensure confidentiality listed below:
·
Assigning code names/numbers for participants
that will be used on all research notes and documents
·
Keeping notes, interview transcriptions, and any
other identifying participant information in a locked file cabinet in the
personal possession of the researcher.
Participant data will be kept confidential except in cases where the
researcher is legally obligated to report specific incidents. These incidents
include, but may not be limited to, incidents of abuse and suicide risk.
CONTACT INFORMATION
If you have questions at any time about this study, or you experience adverse
effects as the result of participating in this study, you may contact the researcher
whose contact information is provided on the first page. If you have questions
regarding your rights as a research participant, or if problems arise which you
do not feel you can discuss with the Primary Investigator, please contact the
Institutional Review Board at (865) 354-3000, ext. 4822.
VOLUNTARY PARTICIPATION
Your participation in this study is voluntary. It is up to you to decide
whether or not to take part in this study. If you decide to take part in this
study, you will be asked to sign a consent form. After you sign the consent
form, you are still free to withdraw at any time and without giving a reason. Withdrawing
from this study will not affect the relationship you have, if any, with the
researcher. If you withdraw from the study before data collection is completed,
your data will be returned to you or destroyed.
CONSENT
I have read and I understand the provided information and have had the
opportunity to ask questions. I understand that my participation is voluntary
and that I am free to withdraw at any time, without giving a reason and without
cost. I understand that I will be given a copy of this consent form. I voluntarily
agree to take part in this study.