Solomon Publishing Group
Start
Finish
INFORMED CONSENT
TITLE OF STUDY: Negative Experience(s) Case Study Questionnaire.
INVESTIGATOR(S): Tressa Sanders
Contact for Tressa Sanders: tsanders@solomonpublishinggroup.com
Purpose of the Study
You are invited to participate in a research study. The purpose of this study is to collect and analyze the negative experiences of the following target groups: Black, Native American, Irish, Scottish, Person of Color, Female, LGBT, Mature/Elderly, and the Disabled. The results of this study will provide us with useful, accurate information about the types of negative experiences, the methods used to insult, hurt or demean members of the target groups and who is using them and the effects these negative experiences have on our target groups.
Participants
You are being asked to participate in the study because you are over the age of 18 and belong to one or more of the following target groups:
Black (African, African American, Black Brazilian, Aboriginal Australian, etc.)
Person of Color (Native American, Asian, Indian, Non-white Hispanic, etc.)
Irish
Scottish
Native American
Female
LGBT
Mature/Elderly
Disabled
Procedure
If you volunteer to participate in this study, you will be asked to complete simple questions about any negative experience(s) you have had as described below:
We are looking for detailed experiences where a person or group of people said or did something to or around you that made you feel bad or inferior because you are Black, Native American, A Person of Color, Irish, Scottish, Female, LGBT, Mature/Elderly, or Disabled.
We are looking for detailed experiences where social messages have made you feel bad or inferior because you are Black, a Person of Color, Irish, Scottish, Native American, Female, LGBT, Mature/Elderly, or Disabled.
We are also looking for how these events made you feel and if you changed anything about yourself or your behavior because of this experience(s).
We ask that you answer each question carefully and honestly
Who Should Complete this Questionnaire
The people we would like to answer this questionnaire should belong to one or more of the above target groups.
Who Should NOT Complete this Questionnaire
If you do not belong to at least one of our target groups or you negative experience(s) had no affect on you at all, please do not complete this questionnaire. Thank you.
Filling Out the Questionnaire
If you decide to fill out the questionnaire, you will be expected to answer all the questions and you must answer them fully and honestly. That is why this questionnaire is designed to be anonymous. Your honest responses will ensure that our research continues to be valid.
Benefits of Participation
There are no direct benefits to you as a participant in this study other than the knowledge that you are helping us learn more about abusive relationships and how you are or were affected by them.
Risks of Participation
There are risks involved in all research studies. The risks associated with participating in the project are minimal; you may experience some mild, and temporary discomfort as some of the questions in this survey are of a sensitive nature. You may choose to quit participating at any time by closing the browser window. You may also skip an item if you do not wish to answer it. In the event discomfort as a result of completing the questions is prolonged, you will be provided a referral list.
This is an anonymous survey (which means that we will not gather any information from your answers that could track your answers back to you), so we encourage you to be honest with your replies.
I completely understand the details of this questionnaire and fully agree with the terms outlined in this Informed Consent, and wish to complete the questionnaire. *
Yes
No
* Required Value
