• Johnson & Wales University / JWU

    Consent To Participate In A Research Study
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    Title of Research Study: Wellness in Practice: Counselor Educators' Approaches to Including Wellness Activities in Teaching
    Investigator(s):

    Name: Jessica Paulhus & Jesim Giresunlu
    Department: Counselor Education
    E-mail: jessica.paulhus@jwu.edu  yesim.giresunlu@jwu.edu
    Telephone: 401-598-4780;  401-598-2432

    1. Introduction
      1. You are being asked to participate in the research study described above (“Study”) by Johnson & Wales University (“JWU”) because you
        1. hold a full-time acadcemic position as a core-faculty in Master's-level Counselor Education program,
        2. have taught for a minimum of three (3) academic years at instituions located within the Northease or Mid-Atlantic regions of the United States and
        3. hold a doctoral degree in counselor education or related field (e.g., psychology, social work).
      2. Please read this form. You may also request that the form be read to you. The purpose of this form is to give you information about this Study, and if you choose to participate, document that choice.

      3. You are encouraged to ask any questions that you may have about this Study now and during or after the Study is complete. You can take as much time as you need to decide whether or not you want to participate.

      4. Your participation in the Study is wholly voluntary, and you may withdraw at any time.

    2. Why is this Study being done? What is the purpose of this Study?
      1. Limited research has examined how wellness is operationalized and integrated into counselor education courses, despite its importance to the counseling professiong (Branco & Patton-Scott, 2010).  Recent studies have attempted to embed wellness into counselor education curricula by utilizing structured wellness models to support student development; however, these studies are note challenges with consistency, and clarity in how specific wellness components are taught (Branco & Patton-Scott, 2020; Kim & Mumbauer-Pisano, 2022).  Therefore, we are seeking to explore how counselor educators understand wellness, incorporate wellness activities into their teaching as well as what challeneges they encounter implementing in teaching activities.  Our research questions are:

        1. How do counselor educators understand wellness and how does this understanding influence the integration of wellness activities into their teaching?
        2. In what ways do counsleor educators incorporate wellness activities into their teaching and what challenges they encounter implementing in teaching activities.
      2. Ultimately, this Study may be published as a manuscript in a journal and/or presented in a conference.

    3. What will I be asked to do?
      If you agree to be in this Study, you will be asked to do the following things: (1) complete a short demographic survey, (2) attend a 30 - 40 minute semi-structured interview.

    4. What are the risks and/or discomforts of being in this Study?
      There are no reasonably foreseeable (or expected) risks.


    5. What are the benefits of being in this Study?
      Although there may be no direct benefits to you as a result of taking part in this Study, the results may indirectly benefit you.  Sharing your perspectives may indirectly contribute to improving wellness teaching practices in counselor education programs and support future faculty and curriculum development.

    6. Will I be compensated for participating in this Study?
      1. You will receive the following payment/reimbursement: You will receive a total of $25 gift card to Amazon for participating.  You will receive your gift card after participating in the interview.  You will not receive any incentives if you do not participate in the interview fully.

    7. How will my privacy be protected? How will my data be kept confidential?
      The records of this Study will be kept strictly confidential. Research records will be kept in a locked file, and all electronic information will be coded and secured using a password-protected file. Specifically, we will use Zoom to record and transcribe the interviews.  All interview recordings and transcripts will be stored securely on the Zoom Cloud, which is encrypted in transit and at rest.  Access will be restricted to the PI and co-PI via two-step authentication on the university's secure account.  Cloud recordings will be deleted automatically after they have been stored for 120 days.  Transcripts will be de-identified by removing names and other personal identifiers during transcription.  Any coded data will be stored separately from identifiers.  We will not include any information in any report we may publish that would make it possible to identify you unless you provide additional consent.


    8. Will my information be used in future research?
      Your de-identified information will not be used or shared with other researchers.

    9. May I refuse to participate in the Study?
      1. Yes. The decision to participate in this Study is entirely up to you. You may refuse to take part in the Study at any time without affecting your relationship with the investigators of this Study or Johnson & Wales University. You have the right not to answer any single question, and you have the right to request that the researcher not use any of your data. Your participation is wholly voluntary. Your decision to participate will have no impact on your current or future relations with the university. You may skip or refuse to answer any question for any reason. If you choose not to participate there is no penalty to you, and you will not lose any benefits that you are otherwise entitled to receive. 

    10. What if I decide I no longer want to participate in the Study? May I withdraw?
      1. You are free to withdraw from this research Study at any time, for any reason. If you choose to withdraw from the research Study there will be no penalty to you, and you will not lose any benefits that you are otherwise entitled to receive.

      2. If you are not satisfied with the way in which this Study was conducted, you may convey your concerns to the chair of the JWU IRB at institutionalreviewboard@jwu.edu or 401-598-1467 and/or the principal investigator, Jessica Paulhus at jessica.paulhus@jwu.edu or 401-598-4780

    11. What are my rights as a research participant?
      1. You will be informed of any significant findings developed during the course of the Study that may affect your willingness to participate in the Study.

      2. If you sustain an injury while participating in this Study, your participation may be ended. Should you need additional care or treatment, any and all costs associated with your care will be your responsibility, not the investigators or JWU.

      3. If you have any concerns about your rights as a Study participant, please contact the principal investigator Jessica Paulhuus at jessica.paulhus@jwu.edu If you have any other concerns about your rights as a Study participant that have not been answered by the investigator(s), you may contact the chair of the JWU IRB at institutionalreviewboard@jwu.edu or 401-598-1467.

    12. Whom may I contact with questions?
      1. For more information regarding this Study, please contact the principal investigator Jessica Paulhus at jessica.paulhus@jwu.edu or the chair of the JWU IRB at institutionalreviewboard@jwu.edu or 401-598-1467. 

      2. If you choose to participate in this research Study and believe you may have suffered a research-related injury, please contact the principal investigator Jessica Paulhus at jessica.paulhus@jwu.edu. Additionally, you may contact the chair of the JWU IRB at institutionalreviewboard@jwu.edu or 401-598-1467.

      3. If you have any concerns or problems that you believe occurred as a result of your participation, you may report them to the chair of the JWU IRB at institutionalreviewboard@jwu.edu or 401-598-1467

    13. Will I receive a copy of this consent form?
      1. You will be given an electronic copy of this consent form. 

    14. Will I be informed of the findings from this Study?
      1. If you would like, a summary of the results of the Study will be sent to you.

    15. Consent
      1. I understand the above description of this Study and the risks and benefits associated with my participation as a research subject. I agree to take part in the Study and do so voluntarily. My signature below indicates:

        1. I understand the information;
        2. I consent to particpate in this study; and
        3. I am 18 years of age or older.
  • Clear
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  • Principle Investigator's Statement:

    The participant named above had sufficient time to consider the above information, had an opportunity to ask questions, and voluntarily agreed to be in this Study.

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  • Johnson & Wales University / JWU

    Consent to Audio Recording/Video Recording and Transcription
  • The study involves the audio recording/video recording of the interviews. Neither the name nor other identifying information about the participant will be associated with the recordings or with the transcript. Only the researcher(s) will listen to or view the recordings.

    The recordings will be transcribed by the researcher(s) (or by someone to whom the identity of the participant is unknown). Once the transcription is checked for accuracy, the recordings will be erased or destroyed. Interview transcripts may be reproduced in whole or in part for use in presentations or written documents that result from the study; however, neither the name or any other identifying information (such as voice or picture) of the participant will be used in such presentations or documents. Further, immediately following the interview, the participant will be given the opportunity to have the recordings destroyed, either in whole or in part.

    Please check one of each of these pairs of options:

  • Clear
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  • I hereby agree to abide by the particpants instructions as indicated above.

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  • Johnson & Wales University / JWU

    Special Considerations for Vulnerable Populations
  • Certain populations are considered “vulnerable” due to their members’ possible lack of autonomy or capacity to make informed decisions regarding their own participation. For JWU’s purposes, these populations include children, prisoners, pregnant women, fetuses, neonates, and individuals participating in some AIDS-related studies.

    Other populations may also be vulnerable. These include educationally or economically or educationally disadvantaged individuals, individuals with impaired decision making abilities, individuals who are illiterate or have low fluency in the research study’s language, or students or employees of the institution(s) involved in the research.

    Researchers must take special care when considering how to engage, and obtain informed consent from, members of these populations.  For example:

    • When the participant is a minor, space for the minor’s signature and the parent/guardian’s signature should be provided.

    • In the case of child participants, two consent forms are required: parent/guardian consent form and a separate child assent form (in language appropriate for age and reading ability).

    • When working with children as participants, a statement must be included in the consent form under the confidentiality section that the law mandates reporting instances of physical and sexual abuse. The statement must be to the following effect:  No information about you or your family will be given to anyone outside the study personnel, except, as federal and state law mandates, for example in the case of a child who is being abused or who is in imminent danger.
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