Online Survey Software | Qualtrics Survey Solutions

University of Oregon Department of Psychology
Informed Consent for Participation as a Subject in:
COVID-19 Study Survey 2
Consent Form

Important Information for you to consider (see more details below):

Why are we doing this? The University of Oregon is investigating how the novel coronavirus COVID-19 has been impacting community mental health. You are invited to participate for this study if you are over 18 years of age.
Do I have to participate? No! You are being asked to volunteer for a research study. It is up to you whether you choose to participate or not, and you may drop out at any time. There will be no penalty or loss of benefits if you choose not to participate or decide to stop participating after you have started.
Time Involvement? Your participation will take approximately 5 minutes to complete and is completely voluntary. If you provide your email address, then we can contact you in the future for more brief surveys to better understand your response to COVID-19.
What is involved? You will be asked to fill in a questionnaire about who you are (e.g., age, gender) and your feelings as they relate to COVID-19.
What are the risks? We have taken a lot of measures to make sure your data is as private as possible. Like all research studies, there is a small possibility that someone else might access your data, but this is very unlikely as your data is encrypted (i.e., stored in a form that is unreadable by anyone who does not have the “keys”).
What are the benefits? Reflecting on mood when completing the questionnaires might give benefits by helping participants to understand their moods and feeling better. In a broader sense, by becoming involved in this project, they also will be contributing to the advancement of scientific research to help understand and prevent mental health problems due to global pandemics.
What are my choices? Participation is totally voluntary so the only alternative is to not participate.

Description:
The purpose of this study is to evaluate mental health and stress in response to the novel COVID-19. You will have the option to provide your email address if you would be willing to complete future surveys to better understand how mental health and stress change over time in response to the COVID-19.

Description of the Study Procedures:
If you agree to be in this study, we would ask you to fill out a brief questionnaire. The research team will collect and use the following types of Study Data for this research.

Email Address
Gender
Race/Ethnicity
Income
Health Information

Alternatives:
Since this study is not designed to treat people for anything, the only alternative to participating in the study is not to participate.

Risks/Discomforts of Being in the Study:
Participants will face no more than minimal risk, meaning that they will experience no more psychological discomfort greater than what they might experience in everyday life. However, some participants may find some questions to be boring, difficult, or uncomfortable. Participation is voluntary, that no question is required, and that they can stop the study at any time without penalty.

Benefits of Being in the Study:
Reflecting on mood when completing the questionnaires might provide benefits by helping participants to understand their moods and feeling better. In a broader sense, by becoming involved in this project, they also will be contributing to the advancement of scientific research to help understand and prevent mental health problems due to global pandemics.

Compensation:
There is no payment for participation in this study.

Costs:
There is no cost to you to participate in this research study.

Confidentiality:
All data will be encrypted and stored on highly secure servers. Data collected from you during this study may eventually be shared with other researchers for scientific purposes only; however, these data will not contain any identifying information that would allow others to link the data to you. When the results of this research are published or discussed at conferences, absolutely no information will be included that would reveal your identity. Access to the records will be limited to the researchers; however, please note that regulatory agencies, the Institutional Review Board and internal University of Oregon auditors may review the research records. Data will be stored indefinitely and may be used in conjunction with future data collected through this study.

Voluntary Participation/Withdrawal:
Your participation is voluntary. If you choose not to participate, it will not affect your current or future relations with the University of Oregon.If you decide to participate, you are free to withdraw your consent and discontinue participating at any time without penalty. There is no penalty or loss of benefits for not taking part or for stopping your participation.

General Data Protection Regulation (GDPR):
The GDPR gives you rights relating to your Study Data, including the right to:

Access, correct or withdraw your Study Data; however, the research team may need to keep Study Data as long as it is necessary to achieve the purpose of this research.
Restrict the types of activities the research team can do with your Study Data.
Object to using your Study Data for specific types of activities.
Withdraw your concent to use your Study data for the purposes outlined in the consent form and in this document (Please understand that you may withdraw your consent to use new Study Data, but Study Data already collected will continue to be used as outlined in the consent document and in this Notice).

Contacts and Questions:
The Principal Investigator conducting this study can be contacted at uocovidstudy@gmail.com. For questions or more information concerning this research, or if you believe you may have suffered a research related injury, questions about GDPR data use, complaints about the use of your Study Data, or if you want to make a request relating to the rights listed above, you may contact him. If you have any questions about your rights as a research subject, you may contact: Research Compliance Services, University of Oregon at (541) 346-2510 or ResearchCompliance@uoregon.edu.

Statement of Consent:
By signing my name below, I affirm that I have read (or have had read to me) the contents of this consent form. I am aware that I can use the contact information provided if I have any questions. I give my consent to participate in this study.

Signature (Required)

Sign Here

clear

Email Address (enter if you would like to be contacted for possible follow-up surveys and enter even if you have submitted your email address in the prior survey)

Reenter your email