Your participation in this pre-screening survey is voluntary. You are also free to withdraw from this survey at any time.
The following survey questions pertain to your voluntary interest in participating in a research study investigating the mechanisms of integrative mind and body interventions (i.e., MBCT or MBSR) that you are participating in. Some of the questions involve your medical and psychological history and may be of sensitive nature ( e.g., about experience of anxiety, depression, pain, and/or stress). Some of the questions may make you uncomfortable; you do not have to answer any question that you would not like to answer, but without answers to these questions, you will not be eligible to participate in the study.
By clicking YES on this form, you are consenting only to the completion of this pre-screening survey so our research team may determine whether you qualify.
It should take about ~10 minutes to complete.
If you should have any questions, please feel free to contact the study coordinator, Emily Mohr, at
email:
cnimlab@vumc.org
or the Principal Investigator, David Vago at
email:
david.vago@vanderbilt.edu
For additional information about giving consent or your rights as a participant in this study, to discuss problems, concerns, and questions, or to offer input, please feel free to contact the Institutional Review Board Office at (615) 322-2918 or toll free at (866) 224-8273.
All efforts, within reason, will be made to keep your personal information confidential but total confidentiality cannot be guaranteed. To protect confidentiality, all data collected will be stored on REDCap. REDCap is a secure web application for managing online surveys housed at Vanderbilt. All data will be de-identified and coded with numbers, so your personal information is not linked with the data. Three years following the completion of the study, all personal identifiers will be removed and a de-identified database will be maintained indefinitely. Only the principal investigator and study staff will have access to the data.
Vanderbilt may share your information, without identifiers, to others or use it for other research projects not listed in this form. Vanderbilt, David Vago, and his research staff will comply with any and all laws regarding the privacy of such information. Your information may be shared with Vanderbilt or the government, such as the Vanderbilt University Institutional Review Board, Federal Government Office for Human Research Protections. Vanderbilt may give or sell your data without identifiers for other research projects not listed here. There are no plans to pay you for the use or transfer of this de-identified information.
If it is determined that you do not qualify for any of our research studies, your information will be kept in for possible participation in other future research studies.