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Andrews University

Behavioral Science Department

Consent Form

Title: Health Habits: Implications of Sex, Age, Resilience, Religiosity, Stress, Self-Efficacy, and Perceived Seriousness of Health Habits

Researcher:

Christiana Atkins

atkinsc@andrews.edu

Research Supervisor:

Dr. Harvey Burnett

Behavioral Science Department

8488 E Campus Circle Dr.

Berrien Springs, MI 49104-0030

harveyb@andrews.edu

(269) 471-6881

Purpose:

The purpose of this study is to examine various aspects of health habits including diet, exercise, and sleep habits, substance abuse patterns, and use of preventative health options (like disease screening). Psychological factors will be measured as well, such as resilience, stress, self- efficacy, and perceived seriousness of health habits.

Inclusion Criteria:

I have been told that for me to participate in this study I need to be at least 18 years of age.

Procedure:

I have been informed of the following: I will be asked to fill out an online survey about various health habits. The researcher has explained these tasks to me. This survey should take between 25 and 30 minutes in it’s entirety.

Risks and Discomforts:

I have been told that there are no known risks or discomforts in participating in this study. I have been told that if I become uncomfortable, I can choose to leave any questions blank, or chose to no longer participate in the study without consequence. Participants from the Andrews University Behavioral Sciences Research Participation Pool will not receive class credit if they choose to not complete the study. I have been told that data recorded during this experiment will be assigned a random number that will never be associated with my name or other identifying information during analysis. I have been told that the data collected from this experiment will be analyzed as group, rather than individual data.

Benefits and Results:

I understand that I may not receive any direct benefits from participating in this study, aside from participants from the Andrews University Behavioral Sciences Research Participation Pool, who will receive class credit for participating. I understand that the results may help psychologists to better understand people’s health habits. I understand that the information collected during this study will be presented in a class setting, and may be presented or published in professional meetings or journals, or as part of undergraduate research forums on campus.

Voluntary Participations

I have been told that my participation in this study is voluntary. I have been told that I may discontinue my participation in this study at any time without any penalty or prejudice.

I have been told that I may contact the researcher, Christiana Atkins by email at atkinsc@andrews.edu or the research supervisor, Dr. Harvey Burnett, at (269)-471-6881 or harveyb@andrews.edu. I have been told that if I wish to contact an impartial third party about concerns with this study, I may contact the Chair of the Behavioral Sciences Department at harveyb@andrews.edu for information and assistance.

I have read the contents of this consent form. Any questions have been answered to my satisfaction. I hereby give voluntary consent to participate in this study. If I have additional questions or concerns, I may contact Christiana Atkins using the information above. If I wish to retain a copy of the consent form, I can print this form out. By clicking "next" I am acknowledging that I give my informed consent to participate in this study.