CAPITULO III. Derechos y obligaciones
3.3 De los derechos sucesorales
I understand that whereas no assurance can be made concerning results that may be obtained (since results from investigational studies cannot be predicted), the researcher will take every precaution consistent with the best scientific practice. Participation in this project is completely voluntary, and subjects may withdraw from this study at any time without penalty, prejudice, or loss of benefits.
Questions concerning the research should be directed to either Melissa A. Bonnell, MS at [email protected] or Michael B. Madson, Ph.D., at (601) 266-4546 or [email protected].
This project and this consent form have been reviewed by the Institutional Review Board, which ensures that research projects involving human subjects follow federal regulations. Any questions or concerns about rights as a research subject should be directed to the Chair of the Institutional Review Board, The University of Southern Mississippi, 118 College Drive #5147, Hattiesburg, MS 39406-0001, (601) 266-6820. A copy of this form will be given to the participant.
8. Signatures:
In conformance with the federal guidelines, the signature of the subject must appear on all written consent documents. The University also requires that the date and the signature of the subject appear on the consent form. I understand that in providing my name and student ID, I am signing this consent form, and that by completing this survey, I am consenting to participate.
Student ID: ___________________________
Student Signature: ____________________________________ Date: ___________
Participant Debriefing Form
Thank you for participating in our survey. Please remember that all information will be kept confidential and any identifying information such as your ID will be separated from the aggregated data file.
If you are experiencing any discomfort after completing this survey you are encouraged to either:
1) Visit campus counseling services:
USM Student Counseling Services Kennard-Washington Hall, Room 200 601-266-4829
Community Counseling and Assessment Clinic Owings-McQuagge Hall
601-266-4601
2) Contact:
Melissa Bonnell, MS Principal Investigator
Dr. Michael Madson Co-principal Investigator [email protected] 601-266-4546
APPENDIX C
DEMOGRAPHICS QUESTIONNAIRE
APPENDIX D
PROTECTIVE BEHAVIORAL STRATEGIES SCALE (PBSS)
APPENDIX E
PBS—IS QUESTIONNAIRE
Introduction: Below are list of behaviors that can be used to protect yourself from harm while drinking alcohol. These behaviors are divided into four broad categories: Mixing Non-alcoholic with Alcoholic Drinks, Planned Limits on Drinking, Manner of Drinking and Serious Harm Reduction. Previous research has shown these behaviors to reduce the likelihood of experiencing negative consequences while drinking alcohol.
Mixing Non-alcoholic with Alcoholic Drinks behaviors may include:
Alternating alcoholic and nonalcoholic drinks
Drinking water while drinking alcohol
Putting extra ice in your drink
Planned Limits on Drinking behaviors such as:
Determining not to exceed a set number of drinks
Having a friend let you know when you have had enough to drink
Leaving the bar/party at a predetermined time
Stop drinking at a predetermined time
Manner of Drinking behaviors may include:
Avoiding drinking games
Avoid shots of liquor
Avoid mixing different types of alcohol
Drinking slowly, rather than gulping or chuging
Avoid trying to “keep up” or “out-drink” others
Serious Harm Reduction may include behaviors such as:
Using a designated driver
Making sure that you go home with a friend
Knowing where your drink has been at all times
Avoiding getting in a car with someone who has been drinking
Always know what you are drinking
Avoid mixing alcohol with prescription drugs (whether prescribed for you or not)
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