Physical Activity Attribution Survey

Dear Potential Participant,
My name is Justin Haegele, and I work at Old Dominion University. Thank you for your interest in
participating in this study. Below, please find essential information regarding your participation in this
research. If you agree with this information, and to participate in this study, please click the “continue”
link at the bottom of the screen. This will take you to the first page of the online survey. If interested,
those completing the survey can enter their email address on the last page to enter a drawing to win one
of three gift cards (grand prize: $50.00; second and third prize: $20.00 gift cards). Thank you.

Purpose: The purpose of this study is to examine self-efficacy and motivation of adults with visual
impairments toward participating in physical activity.

Confidentiality: All information obtained about participants in this study will be strictly confidential
unless disclosure is required by law. The results of the study may be used in reports, presentations, and
publications, but the research will not identify individuals who acted as participations in the study.

Anonymity of Participants: The anonymity of the participants will be protected in several ways. First, the
survey will not ask for any identifiable information of the participants (e.g., name, social security
number). Second, the survey instrument will not record IP addresses of the participants who successfully
complete the survey using the electronic version. Lastly, after data is collected, it will be aggregated and
all participant information will be deleted/ destroyed.

Data Management: Data from the online survey will be directly entered into an excel file on the
researchers' Survey Gizmo account. No one outside of the research team will have the credentials to
enter this account to view or download the data. After data collection is completed, the researchers will
download the excel file from the Survey Gizmo account and delete the online version of the data. This
excel file will be saved to the lead researcher's laptop, and backed-up on his external hard drive. Data
will be permanently deleted five years after the conclusion of this project.