*

1 .

Oral Consent



Title: Exploring the Relationship Between Increased Mobile Phone Use and Attentional Capabilities



Investigators: Mark Shamoon



We are asking you to participate in a research study. Please take your time to read the information below and feel free to ask any questions before signing this document.



Purpose: The purpose of this study is to further investigate the relationship between mobile phone use, and focus and attention. As cell phone use is a relatively new phenomenon in our society, it will be important to understand how it may be impacting our functioning. Research could help provide insight into this, and potential suggestions for healthy ways to use this technology.



Procedures: Let me explain what you will be asked to do. You will complete a series 3 of questionnaires on the Survey Monkey website. The first will inquire about your demographic information. The next form will ask about how you use your mobile phone, including aspects such as how often you use your phone, and what types of tasks you use it for. Finally, the third form will ask about some of your experiences with focus and concentration. Participation in this study should take between 10-15 minutes to complete. There is no compensation for completing the survey, however a $50 gift card to Amazon.com will be given out to one randomly chosen participant who completes the questionnaire.



Risks to Participation: The only risk to participation involves the information that you are sharing being stolen. Survey Monkey goes to great lengths to secure their data, but there is the possibility that they could be “hacked” and the information you fill out could be obtained. This is unlikely, but possible. The researcher will also store the data. The researcher will secure this data with encrypted passwords, though “hacking” is possible.



Benefits to Participants: You will not directly benefit from this study. However, we hope the information learned from this study may benefit society in our understanding of developing healthy ways to use technology.



Alternatives to Participation: Participation in this study is voluntary. You may withdraw from study participation at anytime without any penalty.



Confidentiality: Your responses will be protected by Survey Monkey’s security systems. Once the researcher acquires the data from Survey Monkey, it will be stored on a single drive with password protection. The only information associated with your responses will be your age, gender and ethnicity. Survey Monkey will also have an email address associated with your responses so that you may be informed if you win a gift card. None of this information will be used in any way to identify you except for the purpose of sending you a gift card and for analyzing the data as a whole group. If you win, you will be emailed letting you know that you have won, and then the gift card will be sent to you. Per APA guidelines, this information will be kept for 5 years.



Questions/Concerns: If you have any questions now or at any point, please feel free to contact me:



Mark Shamoon

818-971-9042

mss0912@ego.thechicagoschool.edu



Additionally, you may contact my dissertation chair, Michelle A. Meyer at 213.615.7256 or mmeyer@thechicagoschool.edu.



If you have questions concerning your rights in this research study you may contact the Institutional Review Board (IRB), which is concerned with the protection of subjects in research project. You may reach the IRB office Monday-Friday by calling 312.467.2343 or writing:

Institutional Review Board

The Chicago School of Professional Psychology

325 N. Wells St.

Chicago, IL, 60654



Consent:



Subject



The research project and the procedures have been explained to me. I agree to participate in this study. My participation is voluntary and I do not have to sign this form if I do not want to be part of this research project.