Consent Form

Vancouver Island University Research Involving Human Subjects

Work-Related Injury/Illness and Workers' Compensation Experiences in British Columbia

Brayden Boyd
Principal Investigator
Department of Psychology
Vancouver Island University
BraydenBoyd@stumail.viu.ca

Melanie O’Neill, Ph.D.
Supervisor
Department of Psychology
Vancouver Island University
Melanie.ONeill@viu.ca
Our research aims to gain insight into the experiences that injured workers have with their workers’ compensation claims in British Columbia. Eligible participants are those over 18 years of age that filed a workers’ compensation claim in British Columbia anytime since January 2018. It is the hope of the research team that this study will contribute to understanding the impact that the workers’ compensation process has on injured workers.

Research participants are asked to volunteer approximately 30 minutes of their time to complete an online survey related to their occupational injury and their experience with the workers’ compensation process. The survey will consist of a demographic questionnaire and a variety of validated measures to assess psychological health. Due to the nature of these measures, participants may feel uncomfortable or distressed by the subject matter. Please note that the psychological measures used in the study will not be used as diagnostic instruments by the research team.

There is no direct benefit to taking part in this study. Participants have the right to decline to answer any question they do not wish to answer, and they may withdraw from participation at any time by navigating to the consent form using the “previous” button located at the bottom of the survey.

This study is designed to protect participants’ anonymity. No personally identifiable information will be collected at any point. Please do not include your name or contextual information that might directly or indirectly identify you. Participants are under no obligation to share information that they do not feel comfortable disclosing and may withdraw consent, alter answers, and skip questions at anytime prior to submitting the survey. However, due to the anonymous nature of the data collection, withdrawing will not be possible after the survey is submitted.

Responses to this survey will be stored on SurveyMonkey’s database. SurveyMonkey’s servers are located in the United States and are therefore subject to the U.S. Patriot Act (https://www.congress.gov/bill/107th-congress/house-bill/3162). For more information regarding SurveyMonkey’s policies on privacy and security, follow the links provided:
https://www.surveymonkey.com/mp/legal/security/ 
https://www.surveymonkey.com/mp/legal/privacy-policy/
All records will be kept strictly confidential. All data collected will be stored electronically on a secured drive at Vancouver Island University. Only the principal investigator and the research supervisors will have access. Consent forms and data collected will be kept on this secured drive until December 2029, at which point all unaggregated data will be destroyed. This specific research project is estimated to be completed by April 2023, but aggregated data may be kept for future research purposes.

The results of this research will be written in a final report, presented at academic conferences, and submitted for publication in an academic journal. The products of this research will include only aggregate data, rather than individual information.

The risk to participants is low however, the research team has included a list of resources on the last page of this document that is both general and injured-worker-specific for participants to access should they feel the need to seek support after taking part in the survey. If a question in the survey causes too much discomfort or distress, participants are welcome to refrain from responding to it, and either continue with the survey or withdraw participation.

If you have concerns about the ethical conduct of this study, please contact the Vancouver Island University Research Ethics Board at reb@viu.ca or (250) 740-6631. If you wish to have a copy of this form for your records, please feel free to screenshot or print this page.

If you have any questions or concerns about the research at any time during your participation, please do not hesitate to contact the principal investigator or the research supervisor. Please see the resources below.
Support Resources:

Canadian Mental Health Association:
https://cmha.ca/find-help/if-you-are-in-crisis/

Canada Suicide Prevention Hotline:
1-833-456-4566 (24/7)
1-866-277-3553 in Quebec (24/7)
Text 45645 (4 p.m. to Midnight ET). Text messaging rates apply.

CMHA Bounceback:
Nation-Wide, Free Mental Health Coaching
https://bounceback.cmha.ca/
1-855-873-0013

CMHA Local Search Option:
https://cmha.ca/find-help/find-cmha-in-your-area/

Canadian Injured Workers Association:
https://www.ciwa.ca/groups/

Injured Workers Support Links:
https://www.injuredworkersonline.org/
https://injuredworkersonline.org/resources/links/

Dr. Melanie O'Neill
Registered Psychologist
Phone: (250) 753-3245, Local 2241
Email: Melanie.ONeill@viu.ca

Question Title

* 1. I have read the above form, understand the information read, and understand that I can ask questions or withdraw at any time. I consent to participate in this research study.

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