University of British Columbia - Avian Influenza/ Bird Flu Consent Form

[Snowy Owl]

University of British Columbia
Avian Influenza/ Bird Flu Consent Form
<TABLE cellSpacing=0 cellPadding=0><TBODY><TR><TD style="BACKGROUND: white 0% 50%; VERTICAL-ALIGN: top; -moz-background-clip: -moz-initial; -moz-background-origin: -moz-initial; -moz-background-inline-policy: -moz-initial" vAlign=top align=left width=155 bgColor=white height=92>Department of Psychology
2136 West Mall
Vancouver , B.C. Canada
V6T 1Z4
Tel: (604) 822-2755
Fax: (604) 822-6923
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Informed Consent

Principal Investigator: Dr. Anita DeLongis, Tel.#: (604) 822-4729 adlab@psych.ubc.ca

The purpose of this study is to gather information that will help us better understand how individuals are understanding, reacting and coping with Bird Flu. Understanding the psychological factors and responses to the threat of Bird Flu infection may help to identify more effective intervention strategies to help people cope with the Bird Flu threat. Potential risks include answering questions on a potentially upsetting topic (Bird Flu infection), however you may benefit from this study by gaining insight into how you are dealing with this threat.

If you choose to participate in this study, you will be asked to participate in an on-line questionnaire on the Bird Flu Virus. Completion of the questionnaire is entirely voluntary and has no effect on your medical care. You have the right to refuse to participate or withdraw from participation without penalty of any kind and the right to terminate your participation at any time.

All information is confidential and will be used for research purposes only. Anonymity is assured, as your name will not appear on the questionnaire. This consent form is not attached to your questionnaire. The data will be securely stored by the principal investigator. The questionnaire consists of 5 parts and takes approximately 15-20 minutes to complete. The survey works optimally on Internet Explorer.

Clicking on the link below ("I consent to participate") 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 waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to not answer specific items or questions in interviews or on questionnaires. You are free to withdraw from the study at any time without penalty. 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. If you have further questions concerning matters related to this research, please contact:

Dr. Anita DeLongis
Stress and Coping Lab
604-822-4729

If you are concerned about your rights or treatment as a research subject you may contact the Director of UBC Office of Research Services and Administration at 604-822-8598.

Please print this page to keep for your records and reference

I consent to participate

[LMonty]

Re: University of British Columbia - Avian Influenza/ Bird Flu Consent Form

very interesting study.

However, I found myself unclear- to me, the questions often didnt discriminate between a padnemic , infections in humans, current bird flu being in birds only, etc. I think that colored my answers. I found myself jumping between them. I think that lack of clarity may adversely affect the survey results, by introducing bias.

[hawkeye]

Re: University of British Columbia - Avian Influenza/ Bird Flu Consent Form

The title caught my attention...in particular "Consent Form."

I wonder if companies will start asking employees to sign a "Consent Form" or waiver in order to avoid being sued because employees caught BF from...ventilation, water, inproper cleaning of work surfaces..etc?

[Laidback Al]

Re: University of British Columbia - Avian Influenza/ Bird Flu Consent Form

I have to agree with LMonty. The factual questions didn't seem to be posed properly. Maybe FluTracker members are a little too sophisticated. I understand that this is a "psychological study", but when I got to the question below, I decided it wasn't for me. I am terribly worried about a "bird flu" pandemic, but I can truthfully say I have never checked myself for bird flu! At least, not yet!


<TABLE style="BORDER-COLLAPSE: collapse" borderColor=#111111 cellSpacing=0 cellPadding=0 width=655><TBODY><TR><TD vAlign=top width=130 height=22>Which of the following have you done to determine if you might have the Bird Flu virus? (Please tick as many as are applicable)

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<INPUT id=q110 type=checkbox value=1 name=q108> Paid close attention to coughing
<INPUT id=q111 type=checkbox value=1 name=q109> Paid close attention to sneezing
<INPUT id=q112 type=checkbox value=1 name=q110> Paid close attention to feelings of fatigue
<INPUT id=q113 type=checkbox value=1 name=q111> Paid close attention to headaches
<INPUT id=q114 type=checkbox value=1 name=q112> Gone to a doctor
<INPUT id=q109 type=checkbox value=1 name=q113> Paid close attention to muscle stiffness
<INPUT id=q110 type=checkbox value=1 name=q114> Paid close attention to muscle weakness
<INPUT id=q111 type=checkbox value=1 name=q115> Paid close attention to neck stiffness
<INPUT id=q115 type=checkbox value=1 name=q115c> Taken my temperature
<INPUT id=q115d type=checkbox value=1 name=q115d> Have not done any of the above

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[Niko]

Re: University of British Columbia - Avian Influenza/ Bird Flu Consent Form

I took the survey, but didn't realize how long it would be! I thought many of the questions were poorly worded preventing accurate responses. As someone who plans to SIP and hoping that I have sufficient warning to lock up before exposed, the questions about being concerned that I would get the flu were difficult to answer. While I am very concerned about it reaching my area, I'm not particularly concerned for my personal health. The questions did not allow me to properly qualify these differences.

[JJackson]

Re: University of British Columbia - Avian Influenza/ Bird Flu Consent Form

Like the rest of you I found many of the questions were unclear and more aimed at finding out if I was neurotic than if I was basing my concerns on a sound understanding of the dangers.

e.g. I said I was concerned after reading MSM reports but not after reading BF blogs. The answer is truthful but my concern is due to how poorly informed/prepared people who only read MSM are going to be not because the reports were scary.