Thank you for your interest in this research. Please read the following document carefully.

Acknowledgment of Informed Consent – This is a research project where participation is completely voluntary.

Section I: Identification of Project and Responsible Investigator:

By filling out these questionnaires, data will be gathered to help me better understand the parent child relationship within the context of the Jewish Community. Further, I will be able to use parenting style influence as factor for a possible determinant for which may or may not lead to higher percentages of excess alcohol use within the United States Jewish Community.

Section II: Participant Rights and Information:

1. Purpose of the Project:
The purpose of this research is to gain insight into the effects of different parenting styles of Jewish young adult alcohol consumption.

Procedure:
This study focuses on Jewish college and university students in the United States aged between 19-27 years. Participants will be asked to answer a number of survey questions on line to the best of their ability. Participation in this research will require approximately 10-15 minutes. Here are 3 samples of a few of the questions that you will be asked to complete:

  • As I was growing up my mother did not allow me to question any decision she had made.
  • As I was growing up, my mother seldom gave me expectations and guidelines for my behavior.
  • As I was growing up my mother would get very upset if I tried to disagree with her.

2. Description of Risks:
Some of the nature of the material included in this research may make some people uncomfortable. If you feel uncomfortable with any of the items, please make your best effort to continue, but you may also withdraw from participation at any time. This research does not foresee placing the participant in any physical risk.

In case of experiencing any discomfort with the subject matter, below are two free or low cost resources that may be helpful.

  1. The City has many free and low-cost services for people with drug and/or alcohol problems. In addition to the listings below, you can call New York City’s 24-hour-a-day, seven-day-a-week hotline at 1-888-NYC-WELL (1-888-692-9355) or visit NYC Well online.
  2. SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

3. Description of Benefits:
This research will help fill existing gaps in the body of knowledge concerning parenting styles and their impact on young people’s perceptions and attitudes about alcohol use.

There will be no monetary benefits for completion.
4. Disclosure of Alternative Procedures:
There are no alternative procedures for this research except for non-participation.


5. Confidentiality of Records:
Records will be kept of participant data from this study, but will NOT include your name, address, school ID number, or any other personal information. The records will include age, sex and race. Records will only be open to the principal investigator and 3 committee members.


6. Statement of Voluntary Participation:
If you choose to complete the two surveys that follow, your participation will be voluntary. You can withdraw from the research project at any time. If you decide to withdraw from participating, there will be no penalty.


7. Significance
The study will provide useful insight regarding different parenting styles and their effect on drinking behavior among the Jewish students aged 19 to 27 years. In addition, the study will also provide insight into the effect of alcohol behavior on the students’ GPA.

Should you have any further questions about this study now or at a later time, please feel free to contact me.

Thomas Gross, PhD Candidate
Clinical Psychology
917-843-4146
Thomas.gross2@waldenu.edu

A Walden representative can be contacted directly in reference to questions about your rights as participants at irb@mail.waldenu.edu. Walden University’s approval number for this study is 07-31-18- 0266676 and it expires July 30, 2019.

Please print or save a copy of this consent form for your records.

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* Based on the Information I provided, do you consent to participate in this study?

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* I understand that this study focuses on Jewish students living in the United States. As such, I confirm that I am a Jewish student living in the U.S.

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* In addition, I confirm that I am 19 - 27 years of age.

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* Finally, I confirm that I am attending college or rabbinical college, having completed at least my first year.

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