Informed Consent Form for Online Survey
 
Informed Consent Form for Online Survey
INFORMED CONSENT FORM - ONLINE SURVEY- Page 1 of 2

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INFORMED CONSENT FORM - ONLINE SURVEY- Page 1 of 2

Research Project Title:
Variables Related to Citizen Engagement in Mediated Democratic Systems

Ethics Application Number: 2014s0383         

Principal investigator:
Amir H. Ghaseminejad,
Ph.D. Candidate,

School of Communication
Simon Fraser University
Faculty supervisor:
Dr. Richard Smith,
Professor,

School of Communication
Simon Fraser University
This study has been cleared by the Research Ethics Board of Simon Fraser University in accordance with the Tri-Council's guidelines. This consent form gives you the basic idea of what this research is about and what your participation will involve. Thank you for your time and effort participating in our study.

Participant Recruitment and Selection:
Some participants are purposefully invited, some are randomly selected, and some join the study through referral.
SFU students participating in this study must be at least 18 years old. All other participants must be at least 19 years of age. If you are not qualified, please do not proceed. Stop, and close the browser.

Purpose of Study:

The purpose of this study is to identify whether there are correlations among people’s democratic engagement in technologically mediated democratic systems, and their demographic attributes, life experiences and conditions, income, class identification, and quality of life; personal needs and desires; personality and interests; ideology, beliefs, and values; attention, concern, and deliberation about social/cultural, economic, and political issues;  habits of using media technologies and media outlets for reception of news and analysis, habits of using media technologies and media outlets as public sphere, and patterns of online and offline social networking; exposure to critical agendas and different forms of framing; perception and relative importance of possibilities, actual conditions, and trends; perception of risks and fears; hopes or despairs; perception of public opinion; trust or distrust in power elite, media, democratic institutions or political system; cognitive positions about social/cultural, economic, and political condition.


Your participation is voluntary
Participation in this study is voluntary. You have the right to refuse to participate in this study. 

Withdrawal
If you decide to participate, you may still choose to withdraw from the study at any time without any negative consequences to the education, employment, or other services that you are currently receiving or to which you are entitled. 
However, since the data collected is anonymous, data collected up to that withdrawal point will be retained and used by the researchers. This is because the identification and removal of your answers will not be feasible.

Study Details
This survey includes multiple choice and few very short answer questions. The questions pertain to topics including:

Your demographic attributes, life experiences and conditions, income, class identification and quality of life; your personal needs and desires; personality, interests; ideology, beliefs, and values; your attention, concern, and deliberation about social/cultural, economic, and political issues;  pattern and frequency of using media technologies and media outlets for data and information acquisition, and your personal and social networking; your habits of using media technologies and media outlets for reception of news and analysis, your habits of using media technologies and media outlets as public sphere, and your patterns of online and offline social networking; exposure to critical agendas and different forms of framing;  your perception about and relative importance of possibilities,  actual conditions,  and trends; perception of risks and fears; hopes or despairs; perception of public opinion; trust, or distrust in power elite, media, democratic institutions, or political system; cognitive positions about social/cultural, economic, and political condition; and the level and form of your engagement  in the technologically mediated democratic systems.

Confidentiality and Anonymity

Your anonymity will be maintained. The parts of survey are linked to each other by a random code number that you choose. The survey does not have any identifying question, the information you provide will be stored anonymously.  The survey will be administered using a survey server at SFU. This anonymous data is stored on a highly restricted, password protected survey server at SFU for no more than 11 months. It is then downloaded and stored on a password protected computer for data analysis. After analysis is complete, the raw data will be transferred to an external hard drive and stored in a locked cabinet at SFU for two years, at which time it will be permanently erased. The principal investigator will be the only one who will have access to the data on the hard drive. As with any data that is transmitted via the internet, we cannot completely assure confidentiality during transmission from your computer to our server at SFU.

Benefits and Risks for Participants
We do not think there is anything in this study that could harm you or be bad for you. Please let the principle investigator know if you have any concerns. Some questions in the study may benefit you by provoking deep thinking and reflection in areas of your interest. This survey can also be a useful means of exploring your own attitudes, beliefs, perceptions, and actions. Moreover, your participation may help researchers better understand the parameters in social systems which are related to informed citizen engagement in democratic discourse. Additionally, many other people may benefit from the findings of this study. However, each part of the survey may take between 30 to 80 minutes of your time; this may be inconvenient or uncomfortable for some participants. Some participants may have strong opinions or feel emotional about some of the questions. You do not have to complete all parts of the survey in one sitting. You can complete one part of the survey, and then complete other parts at other times or after taking some rest.

Remuneration  
-We will NOT pay you for the time you spend to participate in this study.
-If you are a student at SFU, your professor, instructor, or teaching assistant MAY decide to give you bonus marks by contacting the principle investigator.
-Participants in confidential survey, or the confidential interview, may obtain a certificate for volunteer participation with no link to the data collected about them; and those who help the snowball recruitment may receive a letter of recommendation, or a certificate for helping the study, by contacting the principle investigator.


Study Results
This study will be used by the principle investigator in his PhD thesis; moreover, the outcomes may be published in conference proceedings, journal articles, papers, reports, and presentations describing this research. Public presentations of the results will be in aggregate form with no reference to individuals. You can ask a copy of published results from the principle investigator.

Future Use of Data
Anonymous data collected by this survey may be used in future research studies. These future studies may be evaluative studies of this exploratory research, or may be attempts to make new inferences from data.

Contacts for Getting more Information and Concerns
If you want to get more information or if you have any concerns about the study, you may first contact:

 Amir H. Ghaseminejad
 Ph.D. Candidate,
 School of Communication, Simon Fraser University,
 ahghasem@sfu.ca
 604-618-9620,

or you may alternatively contact:

Dr. Richard Smith,

Professor,

School of Communication,

Simon Fraser University,

smith@sfu.ca

778-370-1012.

 

If you would like to speak to an office of the University not involved in the study, you may contact the Director of the Office of Research Ethics:

Dr. Jeff Toward
Director, Office of Research Ethics, Simon Fraser University
8888 University Drive
Multi-Tenant Facility
Burnaby, B.C. V5A 1S6
jtoward@sfu.ca
(778) 782-6593  

Q1 .     INFORMED CONSENT FORM ---- ONLINE SURVEY ---- Page 2 of 2 -- I understand that if I choose NO, this survey will be terminated. By choosing YES, I consent to participate in this study voluntarily. I certify that I have read and understood page 1 of the "Informed Consent Form" and have received sufficient information describing the procedures.
Yes  
No  


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