generic visual consent template
TRANSCRIPT
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Welcome
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the icon should relate as
directly as possible to the core
concept of the study. in the
example, we have included a
sleeping person – appropriate
for a sleep tracking study.
This is a research
study exploring
[explain concept].
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Activities
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To better understand
[study concept], you will
be asked to perform
[study actions]
List the most common and
important activities in plain
language. Match with
relevant icons – the
connection of “on task”
images with text is shown to
increase attention and slow
down the on-screen reading!
In this example, icons
indicating self-tracking of
weight and surveys are
included.
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gn/T/noun_dna_77921.pngYou’ll create an account at
[study website], and enroll
in the study
Activities
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gn/T/noun_dna_77921.pngThe study will also gather
sensor data from your phone
and [wearables if using] - with
your permission.
Sensor Data
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gn/T/noun_dna_77921.pngYour study data will be
combined with similar data
from other participants.
Data Processing
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We will replace your name
with a random code. The
coded data will be encrypted
and stored on a secure cloud
server under the control of
[study investigator] to prevent
improper access.
Protecting Your Data
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gn/T/noun_dna_77921.pngYour coded data will be
used for research and may
be shared with other
researchers worldwide.
Data Use
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In Sage apps, this is
a setting the
participant makes. If
youdon’t enable this
setting, the
sentence ends after
“research” on line 2.
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gn/T/noun_dna_77921.pngThis study will take about
20 minutes per week.
Issues to Consider
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True? More? Less?
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gn/T/noun_dna_77921.pngUsing [survey mechanism],
we will ask you to tell us
about your [diet, daily
activity, medications, etc]
Study Survey
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gn/T/noun_dna_77921.pngYour participation is
voluntary. You may
withdraw your consent and
discontinue participation at
any time.
Withdrawing
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gn/T/noun_dna_77921.pngYou will be able to visualize
your data and potentially
learn more about trends in
your health.
Potential Benefits
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gn/T/noun_dna_77921.pngThis research is not a
treatment study. Some
questions may make you
feel uncomfortable. Simply
do not respond.
Issues to Consider
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gn/T/noun_dna_77921.pngParticipating in this study
could generate a wide
range of emotions.
Issues to Consider
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gn/T/noun_dna_77921.pngYou may learn things that
make you want to
spend more time
with your doctor.
Issues to Consider
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gn/T/noun_dna_77921.pngWe will make every effort to
protect your information,
but total anonymity cannot
be guaranteed.
Risk to Privacy
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