Investigating Attentional Processes: Teleconferencing and Social Anxiety
Phase: NA
Conditions: Social Anxiety Disorder
Sponsor: University of Texas at Austin

 
Study Protocol 
Attention, Teleconferencing and Social Anxiety 
 
Date: 12/02/2020 
 
Identifiers: NCT04729803  
Unique Protocol ID: STUDY00000106 
 
 

 
STUDY ELEMENT IDENTIFICATION 
6 Study Elements 
 
Click on the check box (or double click and type an “X” if using Google Docs) each procedure 
included in your study. 
 
A full description of all study procedures should be provided in the Procedures (Details) section 
below and/or the applicable supplement form.  
 
 
☐ 
 
Bio-specimens 
☐ 
 
Biometrics 
☐ 
 
Registry or Repository 
 
☐ 
 
Focus Group 
☐ 
 
Genetic Analysis 
☐ 
 
Genomic Data Sharing 
 
☐ 
 
International 
Research 
☒ 
 
Interview/Survey 
☐ 
 
MRI 
 
☐ 
 
Protected Health 
Information 
☐ 
 
Observation 
☐ 
 
Record Review 
 
☐ 
 
Sensors  
(Externally Placed) 
☐ 
 
Sensors  
(Inserted) 
☒ 
 
 
Video/Audio Recording 
 
☐ 
 
X-Ray 
 
7 
Study Intervention 
 
Click on the check box (or double click and type an “X” if using Google Docs) if you will implement 
any of the following interventions. 
 
A full description of all study interventions should be provided in the Procedures (Details) section 
below and/or the applicable supplement form.  
 
 
☒ Behavioral 
☐ Device 
☐ Drug/Biologic 
 
 
8 
Clinical Trial  

 
Click on the following check box (or double click and type an “X” if using Google Docs) if the 
research meets the below definition of a clinical trial.  
 
 
 
☒ This study meets the definition of a clinical trial according to clinical 
trials.gov in that it involves one or more human subjects who are 
prospectively assigned to one or more interventions (which may 
include placebo or other control) to evaluate the effects of those 
interventions on health-related biomedical or behavioral outcomes. 
 
9 
Additional Oversight  
 
Click on the check box (or double click and type an “X” if using Google Docs) each activity that 
requires oversight from additional UT committees.  
 
 
 
☐ Biohazards, 
Recombinant 
DNA, or Gene 
Transfer  
☐ Energy 
introduced to 
the subject 
(electrical, 
magnetic, light) 
☐ Human embryonic, human 
induced pluripotent, or 
human totipotent stem 
cells; or human gametes 
or embryos 
 
☐ Radiation 
exposure without 
direct clinical 
benefit  
 
 
10 Alternatives to Participation in This Study 
To input text, click in the light grey area below. 
 
Individuals who do not wish to participate in the study will be able to leave the study 
at any time. Participants in the research pool have an alternative to completing 
research for credits (written assignment). Participants who begin Part 2 will be 
provided with referral resources. 
 
 
 
 
 
STUDY PROCEDURE DESCRIPTION  
11 Procedure Description 

 
Describe all study procedures, including a step-by-step outline of what participants will be asked to do or how 
data will be used. Be sure to describe all of the following in detail, as applicable: 
 
- Provide a description of all research procedures being performed and when they are performed, in sequential 
order. 
- All research measures/tests that will be used and state if questions or measures are standardized or published 
(upload copies of all surveys, scripts and data collection forms) 
- Secondary data or specimens that will be obtained, how they will be collected, and how they will be used 
- Where each activity will take place, the duration of each, and who will perform each activity 
- Include time commitment of participants 
 
To input text, click in the light grey area below. 
 
*All activities will be conducted online via Qualtrics and Gorilla. 
Recruitment and Eligibility. Participants (N=2,000) will be recruited via a range of online recruitment 
methods including the research pool, social media, and email. We will recruit both male and female 
participants regardless of race or ethnicity. Potential participants will complete the study in two stages, 
all online.  
Stage 1 Procedures: Participants will complete a series of questionnaires. Participants will be 
randomized to one of two groups if they are eligible for the second stage of the study. 
Positive Interaction. Participants in this condition will be prompted with a question by audience 
members who were positive in their interactions with the other audience members. 
Negative Interaction. Participants in this condition will be prompted with a question by audience 
members who were negative in their interactions with the other audience members. 
At the end of this stage of the study participants will be able to choose whether they would like to 
continue to the intervention. 
 
Stage 2 (Intervention) Procedures. Participants may be asked to wait 1-week prior to beginning the 
intervention. Participants will complete four intervention (i.e. exposure) sessions within two weeks. 
Participants will sign up for all four sessions at the start of the intervention.  
For the first session: 
1) Participants will receive a brief standardized psychoeducation module, presented via a video 
recording. This video will explain the intervention, its rationale, and the procedure. 
For each subsequent session: 
2) Participants will then complete up to 10 analogue teleconferencing calls, each lasting a maximum of 
two minutes. During each call participants will be prompted by one of the audience members. 
3) Between speeches participants will have a 1-minute break. 
4) Participants will complete the subjective units of distress scale (SUDS) before and after each speech 
trial. 
Attention Guidance Condition. The experimental attention guidance condition consists of three unique 
components: (1) the intervention rationale will include information about the importance of visually 
attending to the faces of the audience; (2) participants will be given target audience members to focus 
their gaze on during the their impromptu response. They will be told that they should look at and focus 
on the target audience member for the whole response. 
Standard Exposure Condition. Participants in the standard exposure condition will complete Steps 1-4 
above but not receive any of the attention guidance components used in the experimental condition.  

Exposure + Attention Control. Participants in the attention control condition will complete steps 1-4 
consist of a unique component where participants will be given a central region of the screen (non-
audience member) to focus on. 
 
 
 
Table 1. Measures and Assessment Schedule 
Assessment 
Part 1 
~30 min 
Part 2: 
Intervention 
~30-45 
minutes/session 
1-week 
follow-up 
~ 15 min 
2-Week 
Follow-up 
~15 min 
DEMO 
X  
 
 
 
SCID-5-SR 
X 
 
 
 
TRT 
X 
 
 
 
BAT 
X 
X 
X 
X 
LSAS 
X 
X 
X 
X 
PRCA-24 
X 
X 
X 
X 
SATI 
X 
 
 
X 
SUDS 
X 
X 
X 
X 
EYE-TRACK 
X 
X 
X 
X 
OPEN 
X 
X 
X 
X 
Note. DEMO = demographics questionnaire (age, sex, etc.); SCID5-SR = Structured Clinical Interview for 
DSM-5; TRT = current treatment assessment; BAT = Behavioral Approach Task to assess peak fear, which will 
consist of giving a three-minute speech to an audience that is different from the audience during the intervention; 
LSAS = Leibowitz Social Anxiety Scale; PRCA-24 = Personal Report of Communication Apprehension; SATI 
= Speech Anxiety Thoughts Inventory; SUDS = subjective units of distress scale (e.g. peak fear); EYE-TRACK 
= Eye tracking data. OPEN = open-ended text boxes where participants can provide their impressions of the 
study 
 
SUBJECT POPULATION 
12 Protected Subject Populations 
Click on the check box (or double click and type an “X” if using Google Docs) each population, if 
they are specifically studied for this research. 
 
 
☐ 
 
Active military 
personnel 
☐ 
 
Children 
☐ 
 
Decisionally impaired 
adults 
 
☐ 
 
Emancipated 
minors 
☐ 
 
Fetuses 
☐ 
 
Individuals with 
limited English 
proficiency 
 
☐ 
 
Neonates 
☐ 
 
Pregnant Woman 
☐ 
 
Prisoners 

 
 
 
 
☒ 
 
UT Students 
☐ 
 
UT or Seton 
Staff/Employees 
 
13* Research Participant Information 
Describe the research population. 
 
*For multiple research populations (e.g., teachers, students, and parents), copy this section as 
necessary to describe your population. 
 
a Participant Group Name 
To input text, click in the light grey area below. 
 
 
b Minimum Age 
To input text, click in the light grey area below. 
18 
 
c Maximum Age 
To input text, click in the light grey area below. 
75 
 
d Inclusion Criteria 
To input text, click in the light grey area below. 
Part 1: (1) Age 18-75, (2) fluent in English because the data collection materials have not 
yet been standardized in other languages, (3) having access to a computer with a webcam 
and ability to record audio 
Part 2: Completed Part 1 + (1) Personal Report of Communication Apprehension > 55; (2) 
Leibowitz Social Anxiety Scale > 30 and Meets DSM-5 Criteria for Social Anxiety 
Disorder or  Leibowitz Social Anxiety Scale > 60 
 
e Exclusion Criteria 
To input text, click in the light grey area below. 
Part 1: 
Significant visual impairment precluding the use of the eye tracking equipment 
Part 2: Part 1 + Current, or history of bipolar disorder; current, or history of psychosis 
 
f Additional Population Information 
To input text, click in the light grey area below. 
 
14 Total Sample Size 

 
SCREENING AND RECRUITMENT 
 
17 
Identification and/or Screening Procedures 
Describe the identification and/or screening procedures below. 
To input text, click in the light grey area below. 
 
 
 
To input text, click in the light grey area below. 
2,000 
15 Sample size rationale 
To input text, click in the light grey area below. 
To ensure sufficient enrollment and completion of part 2 of the study 
16 
Identification and Screening 
 
Click on the check box (or double click and type an “X” if using Google Docs) if true. 
 
 
☐ This study involves obtaining information or biospecimens for the 
purpose of screening, recruiting or determining eligibility of 
prospective subjects prior to informed consent by either: 
1. 
Oral or written communication with the prospective subject or 
LAR 
2. 
By accessing records containing identifiable private information 
or stored identifiable biospecimens. 
18 
Recruitment Overview 
 
Click on the check box (or double click and type an “X” if using Google Docs) all recruitment methods utilized for 
this research. 
 
 
☒ E-mail 
☐ Flyer 
 
☐ In-Person 
☐ Letter 
 
☒ Social Media 
☒ Research Pool 
 
☐ Telephone/Text 
☐ Snowball Sampling 

 
19 
Describe the recruitment process, including where recruitment will take 
place. 
Describe the recruitment procedures below. 
To input text, click in the light grey area below. 
Recruitment will take place primarily within UT Austin’s research pool, but may also involve 
recruitment of other participants using different online strategies.  
 
If participants are recruited via the research pool they will be able to sign up for the 
study via SONA (the undergraduate research pool portal). 
 
If participants are recruited through social media they will be able to click a link in post 
(no information will be collected about the participant through social media)  
 
If participants are recruited through email they will receive an email containing a link to 
the survey (no personal data will be collected through their email) 
 
If participants are recruited through web-post they will be able to click a link in post (no 
information will be collected about the participant through web-posting)  
 
 
 
 
OBTAINING INFORMED CONSENT 
 
☒ Web-post 
☐ Word of Mouth 
20 
Consent Overview 
 
Click on the check box (or double click and type an “X” if using Google Docs) all applicable items. 
 
 
☒ Obtaining Written Informed 
Consent 
☐ Requesting a Waiver of Documentation of 
Informed Consent 
 
☐ Requesting a Waiver of 
Informed Consent 
☐ Requesting an Alteration of the Required 
Elements of Informed Consent 

 
 
 
 
☐ Obtaining Child Assent 
☐ Obtain Consent Using a Short Form with a 
Witness 
21 
Consent and Assent Processes 
 
Provide a detailed description of the consent process including who will obtain consent, where, and when 
consent will occur in such a manner that participants have sufficient time for adequate consideration. 
 
To input text, click in the light grey area below. 
 
Participants completing part 1 will first review the part 1 study procedures and indicate their consent 
by clicking a check box before starting any study procedures. Participants who opt-in to complete part 
2 will first be provided the link to a secure Qualtrics questionnaire containing the ICD, which they will 
be able to digitally sign. For both ICDs study personnel contact information will be provided if there 
are additional questions. Copies of the ICDs are attached 
22 
Consent and Translation 
 
Click on the check box (or double click and type an “X” if using Google Docs) to indicate that consent will be 
translated. 
 
 
☐ 
The study population will likely include participants whose limited English 
speaking status requires translation of the consent form. 
 
 
Translation Process 
Click on the check box (or double click and type an “X” if using Google Docs) that best describes the translation 
process, either 21 or 22. 
 
23 
☐ 
The consent documents will be translated by a certified translator. 
 
24 
☐ 
A non-certified translator will translate the consent documents. 
If selected, complete the next two questions below. 
 
i Describe the translator’s qualifications 
To input text, click in the light grey area below. 
 
 
ii ☐ 
Another individual will confirm that the translation is accurate and 
appropriate. 
 
Waiver of Documentation of Informed Consent  

 
To approve a waiver of documentation of informed consent, one of the following options below must be 
justified by the researcher. 
 
Only complete the sections below if requesting a waiver of documentation of informed consent. If not 
requesting a waiver of documentation of consent, skip to 27. 
 
Please choose one waiver option and provide additional information as prompted. The Office of Research 
Support and Compliance recommends using Waiver Option 2 in most cases. 
 
25 
Waiver Option 1 
 
Provide confirmation for the following criteria and follow the additional instructions. 
 
Additional Instructions: 
1. Include this choice in the informed consent form.  
2. Articulate the destruction process for signed consent forms in the privacy and confidentiality section. 
 
Click on the check box (or double click and type an “X” if using Google Docs). 
  
a ☐ 
 
The only record linking the subject and the research would be the consent 
document. 
b ☐ 
 
The principal risk would be potential harm resulting from a breach of 
confidentiality. 
c ☐ 
 
Each subject will be asked whether the subject wants documentation linking the 
subject with the research, and the subject’s wishes will govern. 
26 
Waiver Option 2 
Provide confirmation for the following criteria and follow the additional instructions. 
 
Click on the check box (or double click and type an “X” if using Google Docs).  
 
a ☐ 
 
The study is minimal risk. 
b ☐ 
 
Written consent would not be required outside the research context. 
27 
Waiver Option 3 
Provide confirmation for the following criteria and provide additional information as requested. 
 
Click on the check box (or double click and type an “X” if using Google Docs).  
 

 
a ☐ 
 
The subjects or legally authorized representatives are members of a distinct 
cultural group or community in which signing forms is not the norm 
b Describe the cultural group or community. 
To input text, click in the light grey area below 
 
 
c ☐ 
 
The research presents no more than minimal risk of harm to subjects. 
d ☐ 
 
There is an appropriate alternative mechanism for documenting that informed 
consent was obtained. 
e Describe mechanism for documenting that informed consent was obtained 
To input text, click in the light grey area below 
 
 
 
Waiver or Alteration of Informed Consent  
 
To approve a waiver or alteration of informed consent all of the following criteria below must be justified by the 
researcher. 
 
Only complete the sections below if requesting a waiver of informed consent.  If not requesting a waiver or 
alteration of consent, skip to 31. 
 
28 
The research involves no more than minimal risk to the subjects. 
To input text, click in the light grey area below 
 
 
29 
The waiver or alteration will not adversely affect the rights and welfare of the 
subjects. 
To input text, click in the light grey area below 
 
 
30 
The research could not practicably be carried out without the waiver or alteration (it 
is impracticable to perform the research if obtaining informed consent is required and 
not just impracticable to obtain consent). 
To input text, click in the light grey area below 
 

 
 
 
31 
If the research involves using identifiable private information or identifiable 
biospecimens, the research could not practicably be carried out without using such 
information or biospecimens in an identifiable format. 
To input text, click in the light grey area below. 
 
 

 
BENEFITS 
36 
Benefits to Society 
Describe the scientific and societal benefit(s) below. 
 
To input text, click in the light grey area below. 
Findings will contribute to the understanding of the impact of teleconferencing 
specifically on social anxiety. This may be useful in designing effective intervention 
efforts to reduce social anxiety around teleconferencing. 
Deception and Debriefing 
Only complete the sections below if requesting an alteration of informed consent that involves deceiving 
research participants. If this study does not involve deception, skip to 35. 
 
See IRB Policies and Procedures Section 15 for a description of deception. 
 
 Click on the check box (or double click and type an “X” if using Google Docs).  
32 
☐ It is appropriate to provide additional pertinent information to the subject after 
research activities are complete (e.g., the researcher needed to deceive to subject 
to the nature of the study). 
33 
☐ Research participants will have the opportunity to withdrawal their data during 
the debriefing. 
34 
Describe the nature of deception and why it is necessary to conduct the research. 
To input text, click in the light grey area below. 
 
35 
Describe debriefing procedures. 
To input text, click in the light grey area below. 
Participants will be given additional information about the purpose of the study and 
information about treatment for social anxiety. Participants that are not eligible for or 
opt-out of the intervention will be debriefed immediately after completing part 1 of the 
study. If participants complete the intervention component they will be debriefed 
following the final assessment (week 2 follow-up) 
 

 
 
 
Benefits to Participants 
Click on the applicable check box (or double click and type an “X” if using Google Docs). 
 
37 
☒ 
There is no anticipated direct benefit to participants. 
 
38 
☐ 
There are anticipated benefits to participants. 
 
39 
If applicable, describe the potential direct benefits to participants. 
To input text, click in the light grey area below. 
 
 
 
RISKS 
40 
Describe the risks associated with each activity in this research 
To input text, click in the light grey area below. 
The research includes some risk of emotional discomfort. 
 
 
41 
Describe how each risk is mitigated/minimized. 
To input text, click in the light grey area below. 
The emotional discomfort will be related to perceived social interactions and is 
transient. Participants will be able to stop the study at any point (simply by closing 
their browser window). At any point during the study participants will be able to reach 
out to the researchers to discuss any emotional discomfort should it be persistent. At 
the end of the study participants will be debriefed and learn that the interaction was 
not live, which should mitigate any further discomfort. Furthermore, participants will 
be provided with referral resources at the end of the study.  
 
 
 
 
Data Safety Monitoring 
For additional information regarding data safety monitoring boards and data safety monitoring plans, please 
see Section 21 of our Policies and Procedures. 
 

Click on the check box (or double click and type an “X” if using Google Docs). 
 
42 
☒ 
This study is minimal risk and does not require a Data Safety Monitoring Plan 
(DSMP) or a Data Safety Monitoring Board (DMSB). 
 
43 
☐ 
This study does not have a Data Safety Monitoring Board, but researchers have 
an internal plan/policy to monitor for safety. 
Complete Data Safety Monitoring Details (44-51). 
 
44 
☐ 
This study has a Data Safety Monitoring Board (DSMB). 
Complete Data Safety Monitoring Details (44-51) or upload this study’s Data Safety Monitoring Board’s 
charter. 
 
 
Data Safety Monitoring (Details) 
 
45 
How is safety information collected? 
To input text, click in the light grey area below. 
 
 
 
46 
When will safety data collection start (for each participant or for the whole study, as 
applicable)? 
To input text, click in the light grey area below. 
 
 
 
47 
How frequently will safety data be collected? 
To input text, click in the light grey area below. 
 
 
 
48 
Who will review the data for safety? 
To input text, click in the light grey area below. 
 
 
 
49 
How frequently will data be monitored for safety concerns? 
To input text, click in the light grey area below. 
 
 
 

50 
What data will be reviewed? 
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51 
State the frequency or periodicity of the review of cumulative data? 
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52 
State any conditions that would trigger an immediate suspension of the research. 
To input text, click in the light grey area below. 
 
 
 
 
 
Early Withdrawal 
Only complete this section if there are planned conditions under which a participant will be withdrawn from 
the study. If not applicable, skip to 56. 
 
Include this information in your consent form. 
 
 
 
53 
List the criteria for withdrawing individual participants from the study (e.g., safety 
or toxicity concerns, emotional distress, inability to comply with the protocol, or 
requirements from study sponsor). 
To input text, click in the light grey area below. 
 
 
 
54 
Describe any necessary procedures for ensuring the safety of a participant who has 
withdrawn early. 
To input text, click in the light grey area below. 
 
 
 
55 
Describe any pre-specified criteria for stopping or changing the study protocol due 
to safety concerns. 
To input text, click in the light grey area below. 

 
 
 
REQUIRED DISCLOSURES 
 
 
PRIVACY AND CONFIDENTIALITY 
Required Consent Disclosures  
Identify each element below that may require additional information to be disclosed in the consent form. 
 
Click on the check box (or double click and type an “X” if using Google Docs).  
 
56 
☐ 
It is reasonable that researchers could discover or suspect child or elder abuse. 
57 
☐ 
It is reasonable that researchers could learn of an incident that could require 
reporting under Title IX. 
58 
☐ 
It is reasonable that researchers could discover incidental findings or other 
information of medical interest about a participant's previously unknown 
condition. 
59 
Articulate methods for addressing and reporting incidental findings, if applicable. 
To input text, click in the light grey area below. 
 
 
60 
Privacy 
Describe how you will protect the identity and privacy of study participants during each phase of research. 
Privacy focuses on the individual participants rather than data. In this section, researchers should focus on 
issues such as where research activities take place and how participant involvement is protected from non-
participants. 
 

 
 
Describe methods to ensure participants’ privacy during identification, recruitment, screening, the consent 
process, the conduct of the study, and dissemination of data. 
 
To input text, click in the light grey area below. 
 
All data associated with the project will be kept strictly confidential. Except for the questionnaires 
that are completed during participant screening, all data will be de-identified with a generated ID 
number. Audio data will be accessed only by researchers directly involved in the project. To further 
protect subjects’ privacy, all data will be paperless with all data being encrypted and stored securely 
on Qualtrics, Gorilla, and UT Box. Only members of the research team will have access to the project’s 
data. Publications resulting from the research will not include any personally identifiable information 
Confidentiality and Data Security Plan 
Click on the check box (or double click and type an “X” if using Google Docs) that best describes the 
confidentiality and data security plan and provide additional details regarding how you will protect the 
confidentiality of data or address confidentiality concerns.  
We will use Qualtrics/Gorilla - generated user IDs to protect confidentiality. All potential identifying 
information will be stored separately and securely on UT Box. All non-identifiable data will be stored 
in HIPAA secure, encrypted digital files in Qualtrics, Gorilla, and UT Box. Non-identifiable data will be 
saved indefinitely, whereas files containing identifiable data will be deleted on the date of project 
completion. Identifiable and non-identifiable information will be stored separately to further protect 
confidentiality.  
61 
☒ Identifiers will be coded to protect confidentiality. 
 
61a If true, state how data is coded and where identifiers are stored. 
To input text, click in the light grey area below. 
Data will be coded using a random number generator in Qualtrics and stored 
internally within Qualtrics as well as in a single spreadsheet stored separately from 
the data on UT Box. 
 
62 
☒ Identifiable data will be destroyed. 
 
62a If true, describe destruction plan and timeline 
To input text, click in the light grey area below. 
The document linking identifiers and data will be destroyed at the end of the study. 
The audio data will only be destroyed following the completion of analyses. 
 
63 
☐ Identifiable data will not be destroyed. 
 
63a If true, provide rationale for retaining identifiable data indefinitely. 
To input text, click in the light grey area below. 

 
 
64 Data Access 
 
Click on the check box (or double click and type an “X” if using Google Docs) for each group of individuals that 
will have access to study data. 
 
If you plan on creating a repository, complete the repository form as well. 
 
 
☒ Study Team 
Members 
☐ External Collaborators 
☐ Data coordinating center 
 
☒ Sponsor 
☒ Future Sharing with 
other researchers 
 
☐ Others 
Describe below. To input text, click in the light grey area below. 
 
 
65 
Describe data sharing plan for each group checked above and state whether 
researchers plan on sharing identifiable, coded, or de-identified data 
To input text, click in the light grey area below. 
Study team members and Sponsor will have direct access to UT Box and Qualtrics. 
Shared data will only include de-identified data.  
 
Certificate of Confidentiality  
Click on the check box (or double click and type an “X” if using Google Docs) to identify each element below that 
may require additional information to be disclosed in the consent form. 
 
If a Certificate of Confidentiality is not applicable for this study, skip to 68. 
 
66 
☐ The study requires a Certificate of Confidentiality. 
67 
☐ NIH has issued a Certificate of Confidentiality for this study. 
68 
☐ A Certificate of Confidentiality has not been obtained, but there are plans to 
apply for one. 

COMPENSATION AND COSTS 
 
☒ 
Cash 
☐ Check 
☐ Gift Card 
 
☒ 
Course Credit 
☐ ClinCard 
☐ Tango Card 
 
☐ 
Other 
Describe, To input text, click in the light grey area below. 
 
 
Compensation  
Click on the check box (or double click and type an “X” if using Google Docs). 
 
69 
☒ Subjects receive compensation. 
70 
☐ Subject will not receive compensation. 
Skip to question 74 if subjects will not receive compensation. 
71 
Total Amount of Compensation 
To input text, click in the light grey area below. 
Participants will receive course credit proportional with the time spent engaged in study activities (up 
to 5 credits) if participating through the undergraduate subject pool. 
 
Participants will be entered into a drawing for each part of the study they complete, participants can 
receive up to $85 if they are drawn for all three parts.  
 
 
 
 
72 
Type of Compensation 
Click on the check box (or double click and type an “X” if using Google Docs) for each form of compensation that 
will be provided. 
 
73 
Proration Schedule 
To input text, click in the light grey area below. 
Participants that are participating for course credit will receive .25 credits for every 15 
minutes of participation in the study. 
 
Participants not participating for credit will be entered into a different drawing for each part of the 
study they complete. The drawing for part 1 of the study will be for $10. The drawing for part 2 of the 
study will be $50.  There will be 5 drawings for each part. Participants can receive up to $60 that will 
be provided digitally through Venmo or Paypal. 

 
 
 
74 
☒ Amount of compensation and its form is reasonable for this population for the 
activities requested of them. 
75 
Costs 
 
Click on the check box (or double click and type an “X” if using Google Docs) each applicable item regarding 
costs. 
 
 
☒ 
Participants will have no costs associated with this study 
 
☐ 
Standard of care procedures 
contributing to study data 
 
☐ Research procedures not associated with 
standard of care 
 
☐ 
Administration of drugs / 
devices  
☐ Study drugs or devices 
 
☐ 
Transportation and parking  
76 
Describe all costs below. 
To input text, click in the light grey area below.