Please note that this survey has been designed to be completed using a computer and has not been optimized for smart phones.
*Please print a copy of the consent form to keep for your personal records.*
Participation: Thank you for your interest in participating in our study entitled Women’s Adherence to Pelvic
Floor Muscle Exercises: Antecedents and Consequences. The purpose of this information and consent form is to ensure that you understand the purpose of the study and the nature of your involvement. We want to provide you with sufficient information such that you have the opportunity to determine whether you wish to participate in the study. In order to decide if you would like to take part in this study, please read the following information carefully.
Purpose of the study. This study is part of a broader research program on women’s pelvic floor health and is supervised by Dr Elke Reissing (613-562-5800 ext 4944, Elke.Reissing@uOttawa.ca) and conducted by Emilie Eve Gravel (principal investigator, Ph.D. candidate, firstname.lastname@example.org) and Heather VanZuylen (co-investigator, graduate student heather.vanzuylen@uOttawa.ca) at the School of Psychology of the University of Ottawa. This study is also conducted in the context of a MITACS internship (https://www.mitacs.ca/en) sponsored by Standard Innovation (http://www.standardinnovation.com/).
The goal of this study is to better understand the factors that motivate women to perform pelvic floor muscle exercises (PFME), also known as Kegel exercises. Should you have any questions regarding the ethical conduct of this study, you may contact the Protocol Officer for Ethics in Research, University of Ottawa, Tabaret Hall, 550 Cumberland Street, Room 154, Ottawa, ON K1N 6N5, by phone at 613-562-5387 or by email at email@example.com.
Eligibility: We are looking for women aged 18 years and older who are currently performing PFME.
Task requirement and duration: You will be asked to respond to a variety of questions regarding different aspects of PFME, your physical health, and sexual health. Most questions are multiple choice but some ask for you to elaborate on previous answers when needed. The survey will take approximately 30 minutes to complete. Please make sure you complete in a private setting as your responses may be affected by the presence of others.
Risks: There is a possibility that you may feel uncomfortable or embarrassed answering questions about your health and/or sexuality or feel regret about having disclosed personal information. Remember that your participation is entirely voluntary, that you may choose not to answer a question should it make you feel uncomfortable, and that you may withdraw from the study at any time without penalty. Should you feel any distress, please contact Dr. Elke Reissing, a clinical psychologist specialized in sex therapy or any of the resources provided to you at the end of the questionnaire, or if you choose not to participate, when you exit this webpage.
Benefits: We hope women who complete this survey will feel positively about contributing to health research that can benefit many other women. Some women may also learn more about their physical and sexual health.
Incentive to participate: You will be given the option to enter your name in a draw to win one Visa gift certificate valued at $100CAD to thank you for your contribution to the research project. The draw is open to all research participants who enter in the draw, regardless of whether they decide to withdraw from further participating in the research project. To participate, you need to provide an email address at which we can contact you if you win the draw. Your email address will be used as a ballot. Upon data collection completion, an email address will be randomly selected amongst those who have entered and the person whose email address’ is drawn will be informed by email. To win the prize, the person must correctly answer a skill testing question. If the person cannot be reached within 14 days from the date of the draw, the prize will be awarded to the second email address that is randomly selected and so on until the prize has been awarded. The odds of winning a prize depend on the number of participants in the study. The contact information you have provided will be kept confidential and then destroyed once the prizes have been awarded. We reserve the right to cancel the draw or cancel the awarding of the prize if the integrity of the draw or the research or the confidentiality of participants is compromised. The draw is governed by the applicable laws of Canada.
Anonymity and confidentiality: Your answers will be anonymous. You will not be asked to identify yourself in the survey. No IP addresses are tracked. Any reports resulting from this study will not identify any participants. Please note that you will not be able to withdraw your data once your complete the study because its anonymous nature makes it impossible to trace your data back to you. Only group results will be reported, no individual results will be reported. Your answers will also be confidential, such that only the members of the research team (Emilie Eve Gravel, Dr Elke Ressing, Heather VanZuylen, research assistants, and Standard Innovation research and development staff) will have access to the data. All the data will be kept in password-protected files. All data on computers will be backed up on a password-protected memory sticks, which will be kept in a locked filing cabinet in Dr Reissing's laboratory and at Standard Innovation offices. After 10 years, the data will be deleted. Please note that data collected through U.S. servers is subject to the US Patriot Act.
A unique ID will be assigned to your data. The research team has no access to your identity and Crowdflower has no access to the answers you provide us.
Finally, in order to minimize the risk of security breaches and to help ensure your confidentiality we recommend that you use standard safety measures such as signing out of your account, closing your browser and locking your screen or device when you are no longer using them / when you have completed the study.
Ethics approval: This study has received ethics approval by the University of Ottawa Research and Ethics Board (File #H08-15-24).
Consent to participate
I have read the above form and understand the conditions of my participation. My participation in this study is voluntary, and if for any reason, at any time, I wish to leave the experiment I may do so without having to give an explanation and with no penalty whatsoever. Furthermore, I am also aware that the data gathered in this study are anonymous and confidential. By proceeding to answer the questions on the next page, I am indicating that I consent to participate in this study.