Consent Form
UNIVERSITY OF CALIFORNIA, SANTA CRUZ
Name: Dr. Christy Byrd
Department of Psychology
Address: Psychology Faculty Services, 1156 High Street, Santa Cruz, CA 95064
Title of Research Project: Studying Microaggressions Through a Mobile App
CONSENT TO PARTICIPATE IN RESEARCH
Introductory section: You are invited to take part in a research study conducted by Christy Byrd and researchers from the Department of Psychology at the University of California, Santa Cruz. Before you decide whether or not to participate in the study, you should read this form and ask questions if there is anything that you do not understand.
Description of the project: The purpose of the study is to explore the microaggressions, which are brief and sometimes unintentional slights that denigrate members of minority groups. Examples are an Asian American being asked “where are you really from?” or a woman being told, “You’re smart for a girl.” We are interested in documenting people’s experiences with microaggressions and the psychological effects of those experiences.
What you will do in the study: If you decide to take part in this study, you will be given access to the app, which is called MicroReport. We will ask that you use the app to report whenever you experience a microaggression. You will also be invited to take surveys approximately once a month on your psychological well-being. The study will continue for the next five years, although you can stop participating at any time.
Time required: Using the app should take a few minutes each time, and each survey will take about half an hour.
Risks or discomfort: You may feel uncomfortable or upset answering some of the questions in the surveys, as they pertain to negative experiences. If you do not wish to answer a question in the surveys, you may skip it and go to the next question. You may also feel uncomfortable or upset when using the app to make reports. The app includes a list of resources that you can consult if you are feeling distressed. Remember that you may discontinue participation in the study at any time.
Benefits of this study: Although there may be no direct benefit to you for taking part in this study, the researchers will learn more about how and where microaggressions occur and how they affect psychological well-being.
Compensation: You will receive 1 point each day that you open the app, regardless of whether or not you submit a report. You will also receive 50 points for each survey that you complete. You can exchange points for Amazon.com gift cards. Every 50 points will earn you $2.50 in gift cards.
Confidentiality: The information you give in this study will be handled confidentially. Your reports and survey data will be stored in an electronic file and kept on a password-protected server that only the research team has access to. Your name will only be connected to your responses by a secret ID number that is stored separately from your responses. The data will be kept indefinitely for use in future research, but the file linking your name and ID number will be destroyed at the end of the study. We will attempt to protect your confidentiality to the degree permitted by the technology being used. We cannot guarantee that your data will not be intercepted by third parties and please note that data may exist on server logs or backups beyond the timeframe for this study.
Decision to quit at any time: The decision to take part in this study is completely voluntary. You do not have to participate. Even if you decide at first to take part, you are free to change your mind at any time and quit the study. Whatever you decide will in no way penalize you or result in loss of benefits or services to which you are otherwise entitled.
Other Requirements: You must be over the age of 18, live in the United States, and have an Android or iOS mobile device to participate in this study. Do not include identifying information (i.e., names) about yourself or others in your reports. You may not use the app to harass, threaten, or intimidate others. We may ask you to discontinue your participation if you do not follow these rules.
Rights and Complaints: If you have questions about this research, please contact Dr. Christy Byrd, Assistant Professor, Psychology Faculty Services, 1156 High Street, Santa Cruz, CA 95064, (831) 459-3970, cmbyrd@ucsc.edu. If you have any questions regarding your rights as a research participant, please contact the Office of Research Compliance Administration at the University of California at Santa Cruz at 831-459-1473 or orca@ucsc.edu.
Other Terms of Use
MicroReport uses the Google Analytics, Location, and Maps API. By using MicroReport, you agree to be bound by Google’s Terms of Service. The app does not track your location and only stores your location if you submit a report and select “Use current location.” For information on Google’s Privacy Policy, see http://google.com/privacy-policy.