My name is Jacqueline Chinappi and I am a doctoral student with Capella University. I am contacting you in regards to recruitment of members from your online forums to be participants in the dissertation study. INFORMED CONSENT FORM Study Title: Body image perception examined: A comparison of ballet dancers with chronic skin disorders and ballet dancers without chronic skin disorders. Researcher: Jacqueline Chinappi Email Address and Telephone Number: jcataldo@capellauniversity.edu Research Supervisor: Brianna Eiter. Ph.D. Email Address: Brianna.Eiter@Capella.edu You are invited to be part of a research study. The researcher is a doctoral candidate at Capella University in the School of Social and Behavioral Sciences. The information in this form is provided to help you decide if you would like to participate in the study. The form describes what you will do during the study and the risks and benefits of the study. If you have any questions or do not understand something in this form, please ask the researcher. I ask that you do not participate in the study until the researcher has answered your questions and you have all of the information necessary to decide to take part in this study. WHAT IS THIS STUDY ABOUT? The purpose of the study is to understand the relationship between chronic skin disorder and body image dissatisfaction, particularly with ballet dancer population. In addition, stress, social support, and self-esteem will be evaluated in dancers who do and do not have chronic skin disorders as well as non-dancers who do and do not have chronic skin disorders. HOW MANY PEOPLE WILL BE IN THIS STUDY? About 111 participants will take part in this study. WHY AM I BEING ASKED TO BE IN THE STUDY? You are invited to be in the study because you fall into one of the four groups: Inclusion criteria for eligibility: Group 1: • Over 18 years of age • Ballet dancer for at least 5 years • Currently diagnosed with chronic skin disorder Group 2: • Over 18 years of age • Ballet dancer for at least 5 years • Not currently diagnosed with chronic skin disorder Group 3: • Over 18 years of age • Non-dancer • Currently diagnosed with chronic skin disorder Group 4: • Over 18 years of age • Non-dancer • Not currently diagnosed with chronic skin disorder If you are a person that fits within any of the above categories then you are eligible to participate in the study. All participants must be over the age of 18.If you do not meet the description above, you are not able to be in the study. WHO IS PAYING FOR THIS STUDY? The researcher is a doctoral candidate at Capella University, but is not receiving funds to conduct this study. The researcher will not be paid for conducting the study. WILL IT COST ANYTHING TO BE IN THIS STUDY? There is no cost to participate in the study. HOW LONG WILL I BE IN THE STUDY? If you decide to be in this study, your participation will last about 1 hour. WHAT WILL HAPPEN DURING THIS STUDY? You will sign an informed consent form detailing the study. After completing the consent form you will be redirected to an online survey to: • Provide personal information about yourself such as age, gender, amount of years diagnosed with chronic skin condition, amount of years dancing. • Complete surveys about body image, stress, social support, and self-esteem. WILL BEING IN THIS STUDY HELP ME? Being in this study will not help you. Information from this study might help researchers help others in the future. ARE THERE RISKS TO ME IF I AM IN THIS STUDY? No study is completely risk-free. However, we don’t anticipate that you will be harmed or distressed during this study. You may stop being in the study at any time if you become uncomfortable. You should be aware, however, that there is a small possibility that responses could be viewed by unauthorized parties (e.g. computer hackers because your responses are being entered and stored on a web server) WILL I GET PAID? You will not receive anything for being in the study. DO I HAVE TO BE IN THIS STUDY? Your participation in this study is voluntary. You can decide not to be in the study and you can change your mind about being in the study at any time. There will be no penalty to you. If you want to stop being in the study, tell the researcher. WHO WILL USE AND SHARE INFORMATION ABOUT MY BEING IN THIS STUDY? Any information you provide in this study that could identify you such as your name, age, or other personal information will be kept confidential. No names will be used within the study nor will any names need to be provided in the surveys. All answers within the survey will be completely anonymous. In any written reports or publications, no one will be able to identify you. The researcher will keep the information you provide in a password protected computer in the researchers personal office and only the researcher, researcher’s supervisor, and dissertation committee will have access to the study data. Additionally, Capella University’s IRB, the Research Compliance Committee (RCC), or its designees may review your research records. Even if you leave the study early, the researcher may still be able to use your data. For example, if a survey is submitted with some questions left blank the researcher can still use the data that has been submitted. Limits of Privacy (Confidentiality) Generally speaking, the researcher can assure you that she/he will keep everything you tell him/her or do for the study private. Yet there are times where the researcher cannot keep things private (confidential). The researcher cannot keep things private (confidential) when: • The researcher finds out that a child or vulnerable adult has been abused • The researcher finds out that that a person plans to hurt him or herself, such as commit suicide, • The researcher finds out that a person plans to hurt someone else, There are laws that require many professionals to take action if they think a person might harm themselves or another, or if a child or adult is being abused. In addition, there are guidelines that researchers must follow to make sure all people are treated with respect and kept safe. In most states, there is a government agency that must be told if someone is being abused or plans to hurt themselves or another person. Please ask any questions you may have about this issue before agreeing to be in the study. It is important that you do not feel betrayed if it turns out that the researcher cannot keep some things private. WHO CAN I TALK TO ABOUT THIS STUDY? You can ask questions about the study at any time. You can call the researcher at any time if you have any concerns or complaints. You should call the researcher at the phone number listed on page 1 of this form if you have questions about the study procedures. Capella University’s Institutional Review Board (IRB) has been established to protect the rights and welfare of human research participants. Please contact us at 1-888-227-3552, extension 6313, for any of the following reasons: • You have questions about your rights as a research participant. • You wish to discuss problems or concerns. • You have suggestions to improve the participant experience. • You do not feel comfortable talking with the researcher. You may contact the IRB without giving us your name. We may need to reveal information you provide in order to follow up if you report a problem or concern. DO YOU WANT TO BE IN THIS STUDY? By clicking the link below you agree to the following statement: I have read this form, and I have been able to ask questions about this study. I voluntarily agree to be in this study. I agree to allow the use and sharing of my study-related records as described above. I have not given up any of my legal rights as a research participant. I will print a copy of this consent information for my records. CLICK link below to CONTINUE TO THE SURVEY if you agree to participate. https://www.surveymonkey.com/s/Balletdancersandchronicskindisorderdissertation
