Appendix A – Informed Consent
ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
DOCUMENTATION OF INFORMED CONSENT AND HIPAA AUTHORIZATION
IRB Number: 2016-7382
You are being asked to participate in a research study called When She Makes More: Female Breadwinners and Marital Satisfaction.
The study is being conducted by Lina Perl, M.A., of Yeshiva University under the guidance of Shelly Goldklank, Ph.D., and it has been approved by the Institutional Review Board (IRB) of the Albert Einstein College of Medicine and Montefiore Medical Center. Your participation is voluntary and your decision will not affect your rights or benefits. It is fine to say “no” now or at any time after you have started the study.
Why is this study being done?
|The researcher in charge of this project is called the “Principal Investigator.” Her name is Shelly Goldklank, Ph.D. You can reach Dr. Goldklank at:
Ferkauf Graduate School of Psychology
1165 Morris Park Ave
Bronx, NY 10461
212 666 7004
For questions about the research study, contact the Principal Investigator or the IRB.
|The Institutional Review Board (IRB) of the Albert Einstein College of Medicine and Montefiore Medical Center has approved this research study. The IRB # is in the stamp in the upper right hand corner. If you have questions regarding your rights as a research subject you may contact the IRB office at 718-430-2253 or by mail:
Albert Einstein College of Medicine
1300 Morris Park Ave., Belfer Bldg #1002
Bronx, New York 10461
The goal of this study is to examine how relative earnings affect marital happiness and stability. I am particularly interested in what happens when women in heterosexual marriages begin to earn proportionally more than their husbands.
Why am I being asked to participate?
You are being asked to participate in this study because you are an English-speaking married adult, aged 25 to 75, in a heterosexual relationship. To participate, you may be in a heterosexual relationship in which your partner makes more, you make more or you make the same amount. It's possible that one partner makes all or none of the family income.
What will happen if I participate in the study?
You will be asked to complete a series of online questionnaires. The questionnaires will take roughly 20 minutes to complete. Questionnaires will ask about various demographic information, as well as information about your income, your relationship satisfaction, and your feelings about your career and role as a parent. (If you are not a parent, these questions can be left blank). If you need to interrupt your completion of the questionnaires, your information will be saved and you can return to complete it at a later time.
Information Banking (Future Use and Storage)
We do not plan to share the information from this study with other researchers.
Will I be paid for being in this research study?
You will not receive any payment for taking part in this study. However, participants who complete the online questionnaire will be entered into a raffle to win a $100.00 gift card. The gift card winner will be announced upon the completion of data collection. In order to be eligible, participants must complete the questionnaire fully and consent to provide an email address. The winner will be contacted by the researchers, via email.
Will it cost me anything to participate in this study?
There will be no cost to you to participate in the study.
Are there any risks to me?
Risks of the study are minimal. It is possible that the questionnaires may evoke distressing feelings or the memory of negative experiences or old conflicts. In the event that answering personal questions in the course of the study does cause distress, you can be provided referrals for local assistance by contacting the Parnes Clinic at 718-430-3852.
Your research records will be kept confidential, and your name will not be used in any written or verbal reports. Your information will be given a code number and separated from your name or any other information that could identify you. In no case will responses from individual participants be identified. Rather, all data will be pooled and published in aggregate form only. All information will be kept in a secure manner and computer records will be password protected. Your study information will be kept as long as they are useful for this research.
The only people who can see your research records are:
the research team and staff who work with them
groups that review research (the Einstein IRB, and the Office for Human Research Protections)
Are there possible benefits to me?
There will be no direct benefits, but you will add clinical understanding of better ways to treat couples.
What choices do I have other than participating in this study?
You can refuse to participate in the study.
Are there any consequences to me if I decide to stop participating in this study?
No. If you decide to take part, you are free to stop participating at any time without giving a reason. However, some of the information may have already been entered into the study and that will not be removed.
CONSENT TO PARTICIPATE
I have read the consent form and I understand that it is up to me whether or not I participate. I know enough about the purpose, methods, risks and benefits of the research study to decide that I want to take part in it. I understand that I am not waiving any of my legal rights by signing this informed consent document. I can save a copy of this page for my records.
If you are 18 years of age or older, understand the statements above, and freely consent to participate in the study, click on the "I Agree" button to begin.