Informed Consent to Participate in a Research Project
Relationship Factors in Lesbian Couples with Perinatal Mood Disorders
Cynthia Unger & Richard Zamora
Doctoral Students - Counseling and Educational Psychology
New Mexico State University
Email Contact: firstname.lastname@example.org or email@example.com
Eve Adams, Ph.D., Associate Professor
Department of Counseling and Educational Psychology
New Mexico State University
Email Contact: firstname.lastname@example.org
We, Cynthia Unger and Richard Zamora, are doctoral students in the Department of Counseling and Educational Psychology at New Mexico State University. We are interested in exploring the relationship factors involved in the development of postpartum depression in lesbian couples. Participation in this study will involve completing a survey online, and will take approximately 15-20 minutes for each of two sessions (pregnancy and postpartum). You will be asked to respond to questions about your relationship, mood, and other psychological traits. As well, you will be asked to provide general demographic information, such as age and gestational age, which will be used only to describe the sample as a group. You do not have to answer any question you do not wish to answer. There are no right or wrong answers—just fill in the responses that first come to your mind. Data will be collected at two time points. First, pregnant women and their partners will complete the first set of questionnaires while one partner is pregnant. Next, women will be prompted to return to the Survey Monkey website between 2 and 8 weeks postpartum.
The survey portion of this study is anonymous; therefore, all responses will be confidential. The email address and phone number you provide will be kept strictly confidential—it will be used to send you a link to an online survey and/or to call and remind you about the postpartum survey, approximately 4-6 weeks after the estimated due date of your baby. In addition, research records will be kept in a locked cabinet accessible only to the Principal Investigators and their faculty advisor. When the results of the research are published or discussed in conferences, no information will be included that would reveal your identity.
VOLUNTARY NATURE OF PARTICIPATION:
You may withdraw from the research study at any time since your participation is entirely voluntary. If you do not wish to participate, or would like to end your participation in this study, there will be no penalty or adverse consequence.
RISKS AND BENEFITS:
The potential risks associated with this study are expected to be minimal. Some of the questions in the survey may bring up uncomfortable feelings, but are not expected to produce any longstanding psychological damage.
There are no direct benefits to you or compensation for participating in the study. However, your participation in the study may benefit counselors by increasing their understanding of how pregnancy and relationships affect the postpartum period in lesbian couples.
If you have any questions regarding this research, please contact the Principal Investigator at the email listed above. If you have any questions about your rights as a research subject, please contact the Office of Research Compliance at 575-646-7177.
If you experience distress and/or discomfort during or after your participation in this study, please contact Postpartum Support International (PSI) to find free local support. Volunteers from PSI can be contacted by phone at 1-800-273-TALK (8255), Monday through Friday 8am-4:30pm Pacific Time, or found at the following website: http://www.postpartum.net/Get-Help.aspx. Calls and requests are returned as soon as possible.
CONSENT TO PARTICIPATE IN THE RESEARCH
I have read the above information. I am 18 years of age or older and I reside in the United States. I understand my participation is voluntary. I understand the procedures and conditions of my participation described above. My questions have been answered to my satisfaction, and by clicking on the button below, this indicates my consent to participate in this study.
If you agree to participate in the study please click on the link below:
Edited by cunger - 6/5/13 at 10:11am