Skip survey header

Does involvement in a Community Gardens Change How You Perceive Food

Informed Consent to Participate in Research

Information to Consider Before Taking Part in this Research Study

Pro # 00027091

Researchers at the University of South Florida (USF) study many topics. To do this, we need the help of people who agree to take part in a research study. This form tells you about this research study. We are asking you to take part in a research study that is called:  This study will analyze how involvement in a community garden affects how an individual views food and their health overall.]. The person who is in charge of this research study is Melissa Falzon. This person is called the Principal Investigator. 

Purpose of the Study
This study will analyze how involvement in a community garden affects how an individual views food and their health overall.
Why are you being asked to take part?
We are asking you to take part in this research study because you are an adult in the Tampa Bay region that has been/are involved in a community garden. 

 Study Procedures
If you take part in this study, you will be asked to complete an anonymous brief online survey that will be administered through your community gardens newsletter.

Alternatives / Voluntary Participation / Withdrawal
You have the alternative to choose not to participate in this research study.
You should only take part in this study if you want to volunteer; you are free to participate in this research or withdraw at any time.  There will be no penalty or loss of benefits you are entitled to receive if you stop taking part in this study.

Benefits and Risks
You will receive no benefit from this study
This research is considered to be minimal risk.

Compensation
We will not pay you for the time you volunteer while being in this study. 

Privacy and Confidentiality
We must keep your study records as confidential as possible. It is possible, although unlikely, that unauthorized individuals could gain access to your responses because you are responding online.

Certain people may need to see your study records. By law, anyone who looks at your records must keep them completely confidential. The only people who will be allowed to see these records are:  the Principal Investigator, the research advisor, DR. Jennifer Marshal, and The University of South Florida Institutional Review Board (IRB).
  • It is possible, although unlikely, that unauthorized individuals could gain access to your responses.  Confidentiality will be maintained to the degree permitted by the technology used.  No guarantees can be made regarding the interception of data sent via the Internet.  However, your participation in this online survey involves risks similar to a person’s everyday use of the Internet.  If you complete and submit an anonymous survey and later request your data be withdrawn, this may or may not be possible as the researcher may be unable to extract anonymous data from the database.
Contact Information
If you have any questions about your rights as a research participant, please contact the USF IRB at (813) 974-5638 or contact by email at RSCH-IRB@usf.edu. If you have questions regarding the research, please contact the Principal Investigator at mfalzon@mail.usf.edu.

We may publish what we learn from this study. If we do, we will not let anyone know your name. We will not publish anything else that would let people know who you are. You can print a copy of this consent form for your records.

I freely give my consent to take part in this study.  I understand that by proceeding with this survey that I am agreeing to take part in research and I am 18 years of age or older.


 
2. Please choose your gender
3. Please select your ethnicity
4. Please select your race (select all that apply)
5. What is the highest degree or level of school you have completed? If currently enrolled, the highest degree received
6. Marital Status
9. Are you currently
11. Yearly household income
Survey Software powered by SurveyGizmo
Survey Software