Survey for Multiples: Ideas on Clinical Trials
Please read the consent form and then complete the survey that follows. The survey should take around 10 minutes to complete.
Multiple births (twins, triplets, quadruplets, etc.) have seen an increase in the past several decades and babies that are multiples make up a large number of participants in clinical research trials involving infants. Little is known, however, about how multiples and their families would prefer to be included in neonatal trials. This research study wants to find out multiples’ thoughts on being entered into clinical research trials by asking you several questions through the following survey. You are being asked to participate because you are a multiple. You can take the survey whether or not you have been in a clinical trial.
There is a small risk of loss of confidentiality, which will be protected against by not collecting identifying information such as your name, address, exact age, and other things that can identify you.
Although there is no direct benefit to participating, you will be contributing to an important and unanswered question in neonatal and perinatal research. You will also help us to design future trials in a way that is most friendly to multiples and their families.
Alternatives to Study Participation
You may choose not to fill out this survey at any time.
When you finish the survey, you will have the option of entering into a drawing for a $100 gift card to Amazon. You will be asked to enter an email address if you are interested in being entered.
The answers you provide will not be tied back to your identity. If you send us your email address, we will keep it separate from your answers and erase al emails following the drawing.
Summary of your rights as a participant in a research study
Your participation in this research study is voluntary. By completing the questionnaire you agree to participate in this study. Please complete the study only once. If you would like documentation of participation in this survey please email email@example.com. Please remember that this survey is not a request to enroll in a clinical trial.
The Principal Investigator, Dr. Anna Maria Hibbs, can be contacted at 216-844-3387. You may also contact Ms. Janine Bernardo, medical student, at firstname.lastname@example.org for any further questions.
If the researchers cannot be reached, or if you would like to talk to someone other than the researchers, please call the University Hospitals Case Medical Center’s Research Subject Rights phone line at (216) 983-4979 or write to: The Chief Medical Officer, The Center for Clinical Research, University Hospitals Case Medical Center, 11100 Euclid Avenue, Lakeside 1400, Cleveland, Ohio, 44106-7061.
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