Evaluation of Anxiety Information and Materials

Information and Consent Form

Student Researcher

Matthew Bernstein, M.A.
Department of Psychology, University of Manitoba
Email: umbernsm@myumanitoba.ca

Research Supervisor

John Walker, Ph.D.
Department of Clinical Health Psychology, University of Manitoba
Telephone: (204) 237-2055
Email: john.walker@umanitoba.ca

Purpose of the Study

The purpose of this study is to gather opinions and preferences concerning treatment information for problems with anxiety. Results of this study will enhance our understanding of what information people have received in the past and what they want to know about anxiety treatment. This study is part of Matthew Bernstein’s Ph.D. dissertation research.

Study Procedures

As a participant in this study you will complete a questionnaire that will take about 20 minutes to complete. You may complete the questionnaire in the location of your choice preferably before your first appointment with your mental healthcare provider (psychologist or psychiatrist). Questions covered in the questionnaire include: questions about anxiety information preferences and opinions, background information (such as age, gender, education, marital status, and race/ethnicity); and history of treatment for problems with anxiety.

Potential Costs and Benefits of the Research

It will take you about 20 minutes to complete the questionnaire. Benefits of this study include enhancing our understanding of peoples’ preferences for information about treatment for anxiety.

Potential Risks of the Research

There are no known risks associated with this study. However, reviewing information about treatments may cause discomfort for some people. A list of resources for help with problems with emotional distress will be provided.

Participant Compensation

If you choose to participate in this study, you will be emailed or mailed a $10 gift card to Amazon.ca or Tim Horton’s. These will only be provided to participants living in Canada.

Voluntary Participation

Participation in this research is voluntary and your decision to participate or not participate will not influence your treatment at the clinic you are attending. You may withdraw at any time with no penalty. If you decide to withdraw from participation in this research, the information in your survey will be destroyed.

Confidentiality

This survey will not ask participants to provide their name, or any other identifying information while they are doing the primary survey. Information gathered in this primary survey will be published in scientific journals or presented at conferences but the names and/or identifying information of participants will not be used or revealed. Email and/or home addresses will be asked for in order for participants to receive their gift cards or if they wish to receive a summary of survey findings. This personal information will not be associated with their response and will be a second survey at the end of the primary survey. The file with identifying information will be stored on a computer connected to a secure server in the St. Boniface Hospital McEwen building. The names and addresses will be stored for 12 months and then it will be destroyed. The University of Manitoba and St. Boniface Hospital may look at your research records to see that the research is being done in a safe and proper way. Medical records that contain your identity will be treated as confidential in accordance with the Personal Health Information Act of Manitoba.

By clicking “I agree” below on this page, this indicates that you have understood to your satisfaction the information regarding participation in the research project and agree to participate. In no way does this wave your legal rights nor release the researchers, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from the study at any time, and/or refrain from answering any questions you prefer to omit, withdraw without prejudice or consequence. Your continued participation should be as informed as your initial consent, so you should feel free to ask for clarification or new information throughout your participation. The U of M and St. Boniface Hospital may look at your research records to see that the research is being done in a safe and proper way. This study has been approved by the Psychology/Sociology Research Ethics Board.

Questions or Concerns

If you have any questions about this study, please do not hesitate to contact Mr. Matthew Bernstein at umbernsm@myumanitoba.ca, or his research supervisor, Dr. John Walker at (204) 237-2055 or john.walker@umanitoba.ca.

For questions about your rights as a research participant, you may contact the University of Manitoba Human Ethics Office at (204) 474-7122 or by email at humanethics@umanitoba.ca.

Statement of Consent

Completing the survey will indicate that you have given your consent to participate. When you click to leave the survey, the window closes and it goes back to the web browser. If you would like to print this page for your records, please CLICK HERE