Consent Form

Study Name: Measuring psychosocial assets in adults.

Researchers: Dr. Joseph Baker and Ms. Shruti Patelia, School of Kinesiology and Health Science, 338 Bethune College, York University, 4700 Keele St. Toronto, ON M3J 1P3.

Purpose of the Research: This study seeks to measure psychosocial assets among young and older adults.
What You Will Be Asked to Do in the Research: In this study you will be requested to complete a questionnaire on Google Forms that may require 5-10 minutes to complete.

Risks and Discomforts: We do not foresee any risks or discomfort from participation in the research.

Benefits of the Research and Benefits to You: There are no explicit benefits through participation; however, adults in this study will be provided the opportunity to reflect on their personal development and active engagement. In addition, they will also get the opportunity to gain knowledge on how psychosocial assets can be measured.

Voluntary Participation: Your participation in the study is voluntary and you may choose to stop participating at any time. Your decision not to participate will not influence the nature of the relationship you may have with the researchers and study staff or the nature of your relationship with York University either now, or in the future.

Withdrawal from the Study: You can stop participating in the study at any time, for any reason, if you so decide. Your decision to stop participating, or to refuse to answer particular questions, will not affect your relationship with the researchers, York University, or any other group associated with this project. In the event you withdraw from the study, all associated data collected will be immediately destroyed.

Compensation: There will be no incentives provided to participate in this study.

Confidentiality: All information you supply during the research will be held in confidence and unless you specifically indicate your consent. Information regarding your personal identity (e.g., name, address) will not be collected for the study, instead participants will be assigned a computer-generated randomized number to further maintain anonymity. Hence, researchers in this study will not have any information pertaining to your identity. Responses will be collected through an online survey and will be safely stored indefinitely in a password-encrypted computer that only research staff will have access to for this study and for future research. At all times, confidentiality will be provided to the fullest extent possible by law. The researcher(s) acknowledge that the host of the online survey (e.g., Qualtrics, Survey Monkey, etc.) may automatically collect participant data without their knowledge (i.e., IP addresses). Although this information may be provided or made accessible to the researchers, it will not be used or saved without participant’s consent on the researchers’ system. Further, because this project employs e-based collection techniques, data may be subject to access by third parties as a result of various security legislation now in place in many countries and thus the confidentiality and privacy of data cannot be guaranteed during web-based transmission.

Questions About the Research?  If you have questions about the research or about your role in the study, please feel free to contact me (Shruti Patelia) at (spatelia@yorku.com), or my supervisor, Dr. Joseph Baker at (bakerj@yorku.ca). You may also contact the Graduate Program in Kinesiology and Health Science at kahs@yorku.ca and/or 416-736-5728.

This research has received ethics review and approval by the Human Participants Review Sub-Committee, York University’s Ethics Review Board and conforms to the standards of the Canadian Tri-Council Research Ethics guidelines. If you have any questions about this process, or your rights as a participant in the study, please contact the Sr. Manager & Policy Advisor for the Office of Research Ethics, 5th Floor, Kaneff Tower, York University (telephone 416-736-5914 or e-mail ore@yorku.ca). The graduate program of Kinesiology and Health Science can also be contacted by main (341 Bethune College, York University, 4700 Keele St. Toronto, ON M3J 1P3).

Legal Rights and Signatures: I consent to participate in the “Psychosocial assets scale” conducted by (Dr. Joseph Baker and Ms. Shruti Patelia).  I have understood the nature of this project and wish to participate.  I am not waiving any of my legal rights by signing this form.