INDIANA UNIVERSITY STUDY INFORMATION SHEET FOR





Body Image and Sexual Satisfaction







You are invited to participate in a research study on body image and sexual satisfaction . You were selected as a possible subject because you are between the ages of 18 and 28 and are either in a current sexual relationship or have been in a sexual relationship. We ask that you read this form and ask any questions you may have before agreeing to be in the study.







The study is being conducted by Shannon Henderson, a psychology undergraduate student at Indiana University Purdue University Columbus, and is supervised by Dr. Kimdy Le, Associate Professor of Psychology at Indiana University- Purdue University Columbus.







STUDY PURPOSE



The purpose of this study is to determine how a person’s perceived body image affects their attitudes towards relationships and people.







PROCEDURES FOR THE STUDY:





If you agree to be in the study, you will do the following things:



Each participant will be asked to consent to the form that will appear on their computer screen before they will be able to begin the online web-based survey via surveymonkey. Each participant will answer a series of questions that I have combined from previous surveys that measure body image shape satisfaction, body image self-consciousness, sexual satisfaction, and relationship satisfaction. The survey will consist of 85 questions and should take 20-35 minutes to complete. Evidence of completion will be given if needed.











CONFIDENTIALITY





Efforts will be made to keep your personal information confidential. We cannot guarantee absolute confidentiality. Your personal information may be disclosed if required by law. Your identity will be held in confidence in reports in which the study may be published





Organizations that may inspect and/or copy your research records for quality assurance and data analysis include groups such as the study investigator and his/her research associates, the Indiana University Institutional Review Board or its designees, the study sponsor, Dr. Kimdy Le, and (as allowed by law) state or federal agencies, specifically the Office for Human Research Protections (OHRP), the National Cancer Institute (NCI) [for research funded or supported by NCI], the National Institutes of Health (NIH) [for research funded or supported by NIH], etc., who may need to access your medical and/or research records.







PAYMENT



You will not receive payment for taking part in this study. There will be no payment received for completing this study; however, if you are a student at IUPUC your instructor may give you some extra credit for participation if they choose to do so.











CONTACTS FOR QUESTIONS OR PROBLEMS





For questions about the study, contact the researcher Shannon Henderson at (317)-412-5343





For questions about your rights as a research participant or to discuss problems, complaints or concerns about a research study, or to obtain information, or offer input, contact the IU Human Subjects Office at (317) 278-3458 or [for Indianapolis] or (812) 856-4242 [for Bloomington] or (800) 696-2949.







VOLUNTARY NATURE OF STUDY





Taking part in this study is voluntary. You may choose not to take part or may leave the study at any time. Leaving the study will not result in any penalty or loss of benefits to which you are entitled. Your decision whether or not to participate in this study will not affect your current or future relations with Indiana University Purdue University- Columbus











