Informed and debriefing form ( violence and video games for 8th grade reading level )

Introduction

Title of study

Purpose of study

Key information

How do I know if I can be in this study( bullet eligibility criteria inclusion and exclusion

You can participate in this study if you ; inclusion

You cannot participate in this study if you:

Exclusion criteria

What am I being asked to do? List all research activities

What

When

Where

How

Who will have access to my information

Any possible rissues or discomfort?

Any direct benefits for me ?

Any paid compensation for my time?

How will my information and/or identify be protected?

Presentation of information collected

Additional costs for illness or injury?

Termination of participate

Describe circumstances or signs of distress that would lead researchers to stop participation

Describe procedures to be followed if the participate wants to leave

The study ( I will use or will not use )

Privacy and Data security

Will the researcher ever be able to link my datav/ responses back to me(state no or explain why ?)

Will my data include information that can identify me name address etc.

Will researchers assign my data / response a research ID c I de to use instead of my name, state no or explain

If yes will the researchers make a list of names with their research ID codes ? State n/a or explain

If yes how will researchers secure the link of names and research ID codes ? How long will the link be kept? who had access .approximate destroy date .(state n/ a or explain

How will my data be protected ( electronic or hardcopy .where and how long , who will have access? Approximate destroy date or de- identification date ? Answer each question

Where and how will the signed concent form be secured ? Explain how secured and if the signed consent forms are stored separately from the date.

Future research:

Please change the language in the sentences below to align with the study

Once identifiers ( name,address etc.) Are removed from these data ( identifiers private information or identifiable bio-specimens ,which ever is applicable) collected for this studyc( the de-identifer information or bio-specimem ,which ever Is applicable) could be used for future research studies without additional informed concentvm from you or your legally authorized representative.

Study contacts :

Any questions you have concerning the research study or your participation in the study before and after consent will be answered by ( name of individual Gu email and telephone number of PI the name

If you have any questionsxabout your rights as a subject/ participate in this research or if you feel you have placed at risk you can contact the chair of human subject institutional review board though college ID doctoral studies

Please include 5 in text citations and 5 references thank you