CONSENT TO PARTICIPATE IN RESEARCH Principal Investigator: Lo, Yi-An, M.A.
Dissertation Advisor: Jeffrey Daniels, Ph.D. Co-Investigator(s): Not applicable.
Department: Counseling, Rehabilitation Counseling, and Counseling Psychology Tracking Number: H-23806
Study Title: (Dissertation research) Determination of the differential effect of secure attachment styles on the quality of romantic relationships and levels of depressive moods between
international students from Taiwan or China and American students. Contact Persons
In the event you experience any discomfort or have any concerns related to this research, you should contact the primary investigator, Yi-An Lo, M.A. at [email protected], or call (240) 421-4791; or the research advisor, Dr. Jeffrey Daniels at [email protected], or call at (304) 293-2235. If you have urgent needs associated with this research, please contact the counseling center at your university or local mental health providers after normal business hours.
The West Virginia University Institutional Review Board (IRB) has approved this study. For information regarding your rights as a research subject, to discuss problems, concerns, or to obtain information or provide suggestions related to the research, contact the Office of Research Compliance at (304) 293-7073.
Introduction of this Study
You have been asked to participate in this research study. The participation criteria, procedures for participation, and incentives will be explained in the following section. This research is being conducted to fulfill the requirements for a doctoral dissertation in counseling psychology in the Department of Counseling, Rehabilitation Counseling, and Counseling Psychology at West Virginia University, under the supervision of Dr. Jeffrey Daniels. Purposes of the Study
The purpose of this study is to learn more about effect of secure attachment styles on the quality of romantic relationships and levels of depressive moods between international students from Taiwan or China and American students. A total of approximately 120 participants at 30 randomly selected universities in the U.S. are expected to participate in this study.
Description of Procedures
This study involves completion of a demographic questionnaire, six open-ended
questions, and three measures of quality of romantic relationships, attachment styles, and moods, and will take approximately 20 to 25 minutes for you to complete the questionnaires. You do not have to answer all the questions and you can withdraw from participating at any time during the process of filling out questionnaires. We would like to invite you to participate in this study and to also forward the "invitation to participate" to other students who may also be interested in this study.
The criteria for the American student group are 1) students currently enrolled in a
university or college for undergraduate or graduate level studies in the United States; 2) currently involved in a dating relationship, cohabitation, or marriage; 3) identifying as American (born and raised in the United States, second generation or beyond), and 4) ranging in age from 18 to 40.
The criteria for the Taiwanese or Chinese international student group are: 1) international students from Taiwan or China (self-identifying as Taiwanese or Chinese, born, and raised in Taiwan or China) currently enrolled in a university or college for undergraduate or graduate level studies in the United States; 2) currently involved in a dating relationship, cohabitation, or
marriage; and 3) ranging in age from 18 to 40.
If you meet the criteria for either group, please choose this link:
https://docs.google.com/spreadsheet/viewform?formkey=dDdkcGtDTGh2MnRMdklpc2psR0Vf c3c6MQ#gid=0
You can either click the link or copy and paste it into your Internet browser. It should take approximately 20 to 25 minutes to complete the study. After completing the four
questionnaires online, you will be asked to provide a valid email address to enter a drawing for one of two $30 Amazon gift cards. After the data collection is completed, a drawing will be conducted based on the email contact you provide. If you have any questions you may contact the primary investigator, Yi-An Lo, at [email protected] or call (240) 421-479, or the
research advisor Dr. Jeffrey Daniels at [email protected] or call at (304) 293-2235. Risks and Discomforts
There are no known or expected risks from participation in this study, except for mild frustration that may be associated with answering the questions.
Alternatives
You do not have to participate in this study. Benefits
After completing the four questionnaires online, you will be asked to provide a valid email address to enter a drawing for one of two $30 Amazon gift cards. After the data collection
is completed, a drawing will be conducted based on the email contact you provided. The knowledge gained from this study may eventually benefit others.
Financial Considerations
There are no fees for participating in this study. Confidentiality
Any information about you that is obtained as a result of your participation in this
research will be kept as confidential as legally possible. Your responses will not be connected to your personal account(s) on electronic social networks, such as Facebook, MSN, or Yahoo Groups. In any publications that result from this research, neither your name nor any information from which you might be identified will be published without your consent. You can decide to sign or not to sign this authorization section. However, if you choose not to sign this authorization, you will not be able to take part in the research study. Whatever choice you make about this research study will not have an effect on your access to education, health care, or mental health services.
Persons/Organizations receiving the information: The members and staff of any Institutional Review Board (IRB) that oversees this research study.
West Virginia University Office of Research Compliance and Office of Sponsored Programs.
The following information will be used: Information from your responses to the
demographic questionnaire, six open-ended questions, and three measures of quality of romantic relationships, attachment styles, and moods will be used.
The information is being disclosed for the following reasons:
Publication of study results (without identifying you)
Other research purposes such as developing a better understanding of attachment styles and cultural differences and its impact on moods or quality of romantic relationships for of future culturally competence counseling for Chinese or Taiwanese international or American college students.
You may cancel this authorization at any time by writing to the Principal Investigator: Yi-An Lo at [email protected] or 1099 Valley View Avenue, Lot#4, Morgantown WV 26505. If you cancel this authorization, any information that was collected already for this study cannot be withdrawn. Once information is disclosed, according to this authorization, the
recipient may retrieve it and then the information may no longer be protected by federal regulations. This authorization will not expire unless you cancel it.
Voluntary Participation
Participation in this study is voluntary. You are free to withdraw your consent to participate in this study at any time. Refusal to participate or withdrawal will not affect your class standing or grades, or access to mental health care and will involve no penalty to you.
In the event new information becomes available that may affect your willingness to participate in this study, this information will be given to you so that you can make an informed decision about whether or not to continue your participation.
Upon signing this form, you can print a copy by clicking file and choose print on the Internet browser.
I willingly consent to participate in this research.
___________________________ ____________________ ________ __________
Signature of Subject or Printed Name Date Time
The participant has had the opportunity to have questions addressed. The participant willingly agrees to be in the study.
___________________________ ____________________ ________ __________
Signature of Investigator or Printed Name Date Time
APPENDIX D: DEMOGRAPHIC QUESTIONNAIRE