Attach5D Consent Form

Attach5D Consent Form.docx

A Generic Submission for Theory Development and Validation (NCI)

Attach5D Consent Form

OMB: 0925-0645

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Consent Form


Thank you for continuing to be part of the KnowledgePanel®. This survey contains questions for a research study.


Purpose:

These surveys are being conducted by researchers at The National Institutes of Health.

We are interested in people’s psychological experiences and in how these relate to the responses people have when they encounter different types of communication stimuli. We are testing multiple research questions in the course of this research. We will describe these questions to you once you complete your participation in the study. The information gained from this study will help us design future research studies and tools and approaches for communicating about health topics.


What is Involved in the Study:

Task 1: You will write about a specific topic for five minutes.

We will also ask you to answer a couple of questions about what you write.


Task 2: You will watch a computerized, virtual reality doctor and answer his questions. You will then answer more questions about yourself, your experiences, and your thoughts about your weight.


Risks:

It is possible that some people may feel uncomfortable with some of the information provided in the studies or answering some of the questions asked during the study.


Benefits:

There are no direct medical benefits to you for doing these studies.


Alternatives:

You do not have to take part in these studies if you do not want to.


Security:

As with all Knowledge Networks surveys, your response to this survey, or any individual question on the survey, is completely voluntary. You will not be individually identified and your responses will be used for statistical purposes only. The information you provide will be kept secure, to the fullest extent provided by law.


Questions and Contact:

If you have questions about your rights as a participant in this survey, or are dissatisfied at any time with any aspect of the survey, you may contact Knowledge Networks at 800-782-6899.






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