TIMU Parental Consent & IRB

UNIVERSITY OF NORTH FLORIDA

Human Research Consent Form

Title: Exploration of the Timucuan Preserve and the Kingsley Plantation

Investigators: John A. Eisler, Ph.D.

Affiliations: University of North Florida, Department of Psychology

Contact Information: 904-620-1633

Approved By Institutional Review Board:      

This is an important form. Please read carefully. It tells you what you need to know about this research study. If you agree to take part in this study, you need to sign this form. Your signature means that you have been told about the study and what the risks are. Your signature on this form also means that you want to take part in this study.

Your participation in this research is entirely voluntary. Refusal to participate in this research will involve no penalty or loss of benefits to which you otherwise are entitled.

You may discontinue participation in this research study at any time without penalty or loss of benefits you are otherwise entitled to.

What is the purpose of this study?

We would like to thank you for you and your child's participation in this project. This study involves research on the experiences of children during kayaking in the Timucuan Preserve and historical exploration of the Kingsley Plantantion. We are developing a program to bring children out to the National Park for healthy recreation who otherwise might not have the opportunity to engage in such activities. The data collected in this study will help us: (1) determine if children enjoy and benefit from the program; (2) improve upon the design of the program using the children's input; and (3) to secure future funding to bring more children out to the park on a regular basis. 

How many participants will take part in this study?

There will be a total of 70 middle school-aged children participating in the study. Ten children will be involved in a given day. At least five experienced adults will be supervising the children at all times.

What will happen in this study?

On Day 1, students will be transported to Hugenot State Park for an in-water kayaking demonstration/ water safety course in the morning. A pre-test survey will be given to the children upon arrival at the park. It will take about 5 minutes to complete. One week later, the children will be transported to the Alimicani Boat Ramp where they will depart in kayaks that they will paddle 1.5 miles to the Kingsley Plantation. At the Plantation, they will participate in an interpretive program with park rangers about slave history and culture lasting about 45 minutes. The children then paddle back to boat ramp and are served lunch. At this time, we will ask the children to complete a post-test survey. The children will then be transported back to Hollybrook Homes, their pick-up point in Jacksonville, by mid-afternoon. All ground transportation will be provided by Hollybrook Homes. The kayaking instruction will be provided and the paddling will be supervised by Ray and Jody Hetchka, owners of Kayaking Amelia and certified paddling instructors. 

How long will I be in the study?

Two days total, one week apart. Each day includes four to five hours of involvement.

Are there reasons I might leave the study early?

Taking part in this study is your decision. You may decide to stop at any time. You should tell the director of the study that you wish to stop. In addition, the director of this study may stop you from taking part if it is in your best interest.

What are the risks of the study?

Filling out the opinion surveys poses minimal risk, if any at all. The questions are not psychological in nature, but simply address the children's views about the experience. Issues of safety on the water and in the park are handled by the National Park Service.

What happens if I am injured because I took part in this study?

The National Park Service is responsible for the physical safety of the children.

(If more than minimal risk, will I be compensated if injured? Will medical treatment be provided? If so, what will it consist of? Where can I get further information on this matter?)

     

Are there benefits to taking part in this study?

Children will have the opportunity to experience nature up close, to learn about slave history and culture, and to learn about healthy exercise and nutrition as part of an initiative by the National Park Service (NPS) to promote healthy recreation in parks.This is a "pilot" project funded by the NPS to determine if programs like this have positive impact on children. The responses from the children will help us fine-tune the program to make it more enjoyable and more meaningful for future participants. 

What other choices do I have if I do not take part in this study?

Any appropriate alternative procedure or courses of treatment, if any, that might be advantageous to the subject.

Are there any monetary or other compensation or inducements for my taking part in this subject?

No

Are there any financial costs to me to take part in this study?

No

What are my rights if I take part in this study?

You do not have to take part in this study; but if you do, you may stop at any time. You will be told of important new findings or any changes in the study or procedures that may affect you.

You do not give up any of your rights by taking part in this study. 

What about confidentiality?

Information from this study may be published or used in publications. However, your child's name and other identifying information will not be sent outside of UNF without written permission unless the law allows it.

Explain your method further

Since we are collecting pre- and post-test surveys, we must be able to account for individual scores. The surveys will be numbered and matched to names via a coded list. Only Dr. Eisler, the principal investigator of the study, will have access to the number code matching names and numbers.

Will there be audiotaping or videotaping? If so, will I get to view them before they are used? Who will review tapes besides the researchers? Who will have access to the tapes? When will they be destroyed?

(Note – If tapes are to be used outside of the research project, a separate release form should be obtained.)

No videotaping or photographing of children will take place in this study.

Who can answer my questions?

You may talk to Principal Investigator, Dr. John A. Eisler, at any time about questions and concerns you may have about this study. You may contact Dr. Eisler at the University of North Florida [904-620-1633. Department of Psychology, UNF, 1 UNF Drive, Jacksonville, FL 32224].



You may get further information about UNF policies, the conduct of this study, the rights of research subjects or if you suffer injury related to your participation in this research project from the Chair of the Institutional Review Board, Dr. Kathaleen Bloom, at (904) 620-2684.

I have had an opportunity to have my questions answered. I have been given a copy of this form. I agree to take part in this study. I am over 18 years of age.

I am at least 18 years old. (initials)

I have had the study that I am agreeing to participate in explained to me to my satisfaction.

(initials)

I have had the opportunity to ask any questions that I may have had regarding this study.

(initials)

I agree to participate in (study name) Exploration of the Timucuan Preserve and the Kingsley Plantation being conducted by

(PI) John A. Eisler, Ph.D and the University of North Florida.

__________ _______________________________________

Date Printed Name of Participant

________________________________________

Signed Name of Participant

_________ _______________________________________

Date Printed Name of Individual Obtaining Consent

________ ______________________________________

Date Signed Name of Individual Obtaining Consent

IRB #

Status

Approval Date