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National Cervical Cancer Coalition


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PostPosted: Mon Apr 09, 2012 4:44 pm 
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Joined: Wed Oct 04, 2006 4:08 pm
Posts: 2122
Location: North Carolina
http://www.surveymonkey.com/s/CervicalCancerSurvey

Principal Investigator (PI): Barbara G. Hollie, Nursing Doctoral Student, aj8362@wayne.edu
College of Nursing, Wayne State University; Dr. Benkert, (Dissertation Chairperson)

Purpose: Welcome. This page explains the purpose of the study and the informed consent process that is required to participate in the study. You are being asked to be in a research study about the effect of cervical cancer treatment on the sexual health of women because you have been treated in the US for cervical cancer; it was your first diagnosis of cervical cancer, you have had no additional cancer occurrences and are at least 18 years old. The study will evaluate the cancer treatment you received, certain characteristics about you, how you have coped and how you feel as a sexual person.

Study Procedures: You will be asked to complete a questionnaire that may take 15 to 30 minutes to complete. The questionnaire is anonymous and there is no way for the researcher to find out which responses belong to which participants. Responses will be presented in aggregate formats only.

Benefits: As a participant in this research study, there will be no direct benefit for you; however, information from this study may benefit other women now or in the future, and the PI is providing compensation (see below).

Risk and Study Cost: If you experience any distress when answering any questions please feel free to stop completing the questionnaire. If you become highly distressed you should contact your physician or you may call Barbara Hollie (Researcher) at (313) 690–4408. Participation in this study will be at no cost to you except 15-30 minutes of your time.

Compensation: The names of the first 100 participants, who complete the questionnaire and wish to participate, will be entered into a raffle from which one name will be drawn to receive one 32” LED flat screen television at the end of the study. If you wish to participate in the drawing you must forward your name and address to the PI, Barbara Hollie at aj8362@wayne.edu after completion of the questionnaire. One name will be drawn at the end of the study from the pool of the first 100 participants. Contact information will not be linked to questionnaire responses and will be discarded after the drawing.

Confidentiality: All information collected about you during the completion of the questionnaire will be kept without any identifiers. If participant contact information is sent for inclusion in the raffle, it will be held in a secure password protected file. Only the PI will have access to the file and the information will be deleted following the drawing.

Voluntary Participation/Withdrawal: Taking part in this study is voluntary. You have the right to choose not to take part in this study or to only answer questions that you want to answer or to withdraw from participating at any time. Your decisions will not change any present or future relationship with Wayne State University or its affiliates, the National Cervical Cancer Coalition or the Michigan Cancer Consortium.

Questions: If you have any questions about this study now or in the future, you may contact Barbara G. Hollie, the Principle Researcher, at the following phone number 313-690-4408. If you have questions or concerns about your rights as a research participant, the Chair of the Institutional Review Board can be contacted at (313) 577-1628. If you are unable to contact the research staff, or if you want to talk to someone other than the research staff, you may also call (313) 577-1628 to ask questions or voice concerns or complaints.

Consent to Participate in a Research Study: By reading this information sheet and proceeding to the survey questionnaire you are agreeing to participate in this study.

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