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2016
June
K
Kent 17-01
Kent 17-01
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INFORMED CONSENT
Exercise Habits and Motivational Factors of University Students
You are invited to participate in a research study which will involve examining a further depth of the physical activity level and motivational/discouraging factors of university students.
My name is Clark Kent and I am a student at the University of the Pacific, Sport Sciences department. You were selected as a possible participant in this study because of you are 18 years old or older and a University of the Pacific student.
The purpose of this research is to get a closer look at how much physical activity university students are performing and the motivations or discouragements they are faced with on a daily basis. If you decide to participate, you will be asked to complete a short online survey. Your participation in this study will be approximatley five minutes.
There are some possible risks involved for participants.
The risks associated with taking the online survey are listed below.
1. Psychological
– You may have feelings of discouragement if they do not participate in physical activities regularly.
2. Sociological
– You may feel embarrassed to discuss their lack of exercise if applicable.
3. Loss of confidentiality
– There is always a minimal risk that the information could be breached but it is highly unlikely.
The safeguards for these risks, are as follows:
1.Psychological
– You will be able to stop taking the online survey at any time. Additionally, the surveys’ responses will not be directly associated with you.
2. Sociological
– All answers to the survey questions will be anonymous so you will feel a sense of security because you will not be identifiable.
3. Loss of confidentiality
- The data will come from the survey results which will be anonymous. All the data will be electronically converted into a password-protected computer database. Furthermore, the list of name with emails will be kept in a separate file on a password protected computer.
There are some benefits to this research, particularly that. you will benefit from being able to take time and reflect on the time that you do or do not spend on physical activities for your wellbeing. For those who do have a healthy balance of physical activity, they will feel more positive about continuing their physical activities. For participants who do not achieve their physical activity balance, will be able to reanalyze their situation and be able to see what they need to change in order to live a more active life.
If you have any questions about the research at any time, please call me at Clark Kent at 209-946-3903
,
or my faculty advisor Oliver Queen 209-946-3903. If you have any questions about your rights as a participant in a research project please call the Research & Graduate Studies Office, University of the Pacific (209) 946-7716. In the event of a research-related injury, please contact your regular medical provider and bill through your normal insurance carrier, then contact the Office of Research & Graduate Studies.
Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permission. Measures to insure your confidentiality are having your online survey responses remaining anonymous. Additionally, any data collected such as your name and email will be in a password protected computer. The data obtained will be maintained in a safe, locked location and will be destroyed after a period of three years after the study is completed.
Your participation is entirely voluntary and your decision whether or not to participate will involve no penalty or loss of benefits to which you are otherwise entitled. If you decide to participate, you are free to discontinue participation at any time with out penalty or loss of benefits to which you are otherwise entitled.
By completing and submitting this survey you indicate that you have read and understand the information provided above, that you willingly agree to participate, that you may withdraw your consent at any time and discontinue participation at any time without penalty or loss of benefits to which you are otherwise entitled, that you may print a copy of this form to keep for your records, and that you are not waiving any legal claims, rights or remedies.
*
What is your age?
18 to 24
25 to 30
35 to 44
45 or older
*
What is your gender?
Female
Male
Other
*
Is your school workload too heavy, too light, or about right?
Too heavy
Somewhat heavy
About right
Somewhat light
Very light
*
In a typical week, how many days do you exercise?
I don't regularly exercise
Once a week
2 to 4 days a week
5 to 7 days a week
*
What type of exercise do you most often do?
Lift weights
Walk
Run
Dance
I don't excerise
Other
*
How important is exercise to you?
Extremely important
Very important
Somewhat important
Not so important
Not at all important
*
How much exercise do you feel you achieve?
Too much
Slightly too much
About the right amount
Slightly too little
Much too little
No excercise at all
*
Please explain what motivates you to exercise.
*
Please explain what discourages you to exercise.
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