Media and Perceptions of Others Research Study Consent Form
Researchers: Hilary Keil, graduate student, Department of Psychology (hilarykeil@gmail.com; 657-278-2602) and Aaron T. Goetz, Department of Psychology Faculty (agoetz@fullerton.edu; 657-278-2602)
Dear Prospective Participant,
You are being asked to take part in a research study carried out by Hilary Keil under the guidance of Dr. Aaron T. Goetz in the department of Psychology. This consent form explains the research study and your part in it if you decide to join the study. Please read the form carefully, taking as much time as you need. You can decide not to join the study. If you join the study, you can change your mind later or quit at any time. There will be no penalty or loss of services or benefits if you decide to not take part in the study or quit later.
Purpose: The purpose of this study is to explore media viewing habits and how people perceive others.
Procedures: If you choose to participate, you will be presented with a brief questionnaire that will request information about your media viewing, your personal behaviors and attitudes, and your perceptions of others. Completion of the entire study will take about 5 to 10 minutes.
Confidentiality: Your answers will be completely anonymous as no identifying information will be requested, nor will any such information be added later. Your participant responses will not be connected to your e-mail address or other personally identifiable information. That is, no one will be aware of how you responded. Furthermore, your participation is strictly voluntary and you are free to withdraw from participation at any time without suffering any penalty.
Risks: Participation in this study involves minimal risk. You are free to skip any question at your discretion.
Benefits: You will be contributing to a new body of literature and experiencing the research process first-hand. Your participation is an opportunity to contribute to a new understanding in this area of research as well as to promote the growth of scientific knowledge.
Data Collection & Storage: Data will be kept in a password-protected computer accessible only to the Principal Investigator, and Dr. Aaron Goetz and authorized university personnel who maintain the Sona Systems database.
Right to Refuse: You are free to answer only the questions you are comfortable with. Furthermore, your participation is strictly voluntary and you are also free to withdraw from participation at any time without any penalty.
Compensation: All participants are allowed to enter themselves into an opportunity drawing for a $20.00 Target gift card if they chose to. Additionally, participation includes the possibility of earning partial credit towards Psychology 101 (when applicable), or possibly earning partial credit towards another class. Participants will be given the opportunity to provide their e-mail address at the end of the study to indicate their choice of extra credit or the Target gift card. Finally, those that choose not to participate in this study are given an equal opportunity to earn extra credit.
Conflict of Interest: I do not have any financial (or otherwise) conflict of interest relating to subsequent results of this study.
Who can I talk to if I have questions? If you have questions about this study or the information in this form, please contact the researcher, Hilary Keil (hilarykeil@gmail.com) and/or Dr. Aaron T. Goetz (agoetz@fullerton.edu; 657-278-2602). If you have questions about your rights as a research participant, or would like to report a concern or complaint about this study, please contact the Institutional Review Board at (657) 278-7640, or e-mail irb@fullerton.edu.
Consent Statement: By answering ‘yes’ below, you certify that you are at least 18 years of age, have carefully read this consent form, and agree to participate in this study. You understand that you are free to withdraw from this study at any time.
Sincerely,
Hilary Keil
Do you agree to participate in this survey?