Minimal Risk UIndy Study # 01530
Study Version: 1
Study Version Date: 11/19/2021
Informed Consent Form (ICF) Version: 1
ICF Version Date: 11/19/2021

Krannert School of Physical Therapy

CONSENT TO PARTICIPATE IN RESEARCH STUDY

This survey aims to study the inter-relationship between the sleep pattern (including sleep thermal stress), psychological factors, quality of life, and level of and physical activity in students.

Why is this study being done?
You are then kindly invited to answer the following online survey (on your computer or your mobile phone) assessing your chronotype (your type of chronobiological pattern, being more morning or evening type), your sleep quality, eventual insomnias, daytime sleepiness, your quality of life, some selected psychological status questions, and your level of physical activity.

Are there any potential risks or discomforts that I can expect from this study?
You may experience some unlikely discomfort in answering some of the questions. In such case, you can skip the concerned question. However, we would like to kindly ask you to do your best to answer all questions, if possible, because this will allow us to anonymously process and analyze the data, and thus, improve the knowledge in the field.

Your participation in the study will not in any way interfere with the student-instructor relationship or affect students’ course grades assessment. Similarly, your unwillingness to participate in the study and/or withdrawal from the study will not in any way interfere with the student-instructor relationship or affect student’s course grades assessment.

How long will I be in the research study?
The estimated time to complete the survey is of about 20 minutes and we would preferably wish you to take the survey in one shot, even though if you are discontinued for any reason, it will be possible to resume it later. There will be no costs or remuneration for this task.

Will information about me and my participation be kept confidential?
All collected data and measurements are anonymous, confidential and will not be disclosed to anyone. No one will be able to identify you. Your data will be coded and put into an electronic database in a password protected institutional computer, and only the principal investigator of this study will have access to it. After the study, the data will be deleted according to the regulations and will not be used again.

Who can I contact if I have questions about this study?
For questions about this study you may contact the Study PI for the USA, Dr. Paul Salamh at salamhp@uindy.edu or via telephone at 317-788-3379. The UIndy Human Research Protections Program (HRPP) has reviewed and approved this study. The UIndy HRPP has the responsibility of protecting the rights and welfare of research participants. For questions regarding your rights and welfare as a participant in this study, you may contact the UIndy HRPP Team at hrpp@uindy.edu or 317-781-5774 or 800-232-8634 x5774.

How do I indicate my informed consent to participate in this study?

By ticking (checking) the box below, you acknowledge the following:

• I am aged at least 18 years;
• I am a student;
• I have read the content of this document including the purpose of the survey/questionnaire;
• I am not taking medication for chronic illness;
• I agree to answer, as accurately as possible, the questions of the Survey/ Questionnaire;
• I freely consent to participate to this study.