UNIVERSITY OF WISCONSIN-MADISON
Research Participant Information and Consent Form

Title of the Study: Interactive Narrative and Health Behavior Change
Principal Investigator: Dhavan Shah
Email: dshah@wisc.edu

DESCRIPTION OF THE RESEARCH
You are invited to participate in a research study about interactive narrative health intervention. This study is being conducted to understand the relationship between story and health behavior. Participating in this study will help us learn more about how people process and respond to flu vaccination stories. You must be 18 or over to participate in this study.

WHAT WILL MY PARTICIPATION INVOLVE?
You will first answer some questions about yourself. Then you will be exposed to one of several stories about flu vaccination. All stories consist of video versions (about 23 minutes long) and script versions (about 3800 words long), so you can select either of them based on your preference. Afterward, you will answer some questions about your experience while watching or reading the story and some more questions about yourself. The entire study should take less than 40 minutes.

ARE THERE ANY RISKS TO ME?
There is a minimal risk of a breach of confidentiality. However, we are not asking for any identifiable information in this study, such as your name or email address.

ARE THERE ANY BENEFITS TO ME?
There are no anticipated benefits to your participation in this study.

WILL I BE COMPENSATED FOR MY PARTICIPATION?
You will be compensated for this study per your agreement with DocuHut and Amazon Mechanical Turk. There is no compensation granted by the University of Wisconsin-Madison for participating in this study.

HOW WILL MY CONFIDENTIALITY BE PROTECTED?
No individually identifying data will be collected as a part of this study. The research record is password-protected, and all data collected during this study is transmitted via an encrypted connection.
While there will probably be publications as a result of this study, only group characteristics will be published.

WHOM SHOULD I CONTACT IF I HAVE QUESTIONS?
You may ask any questions about the research at any time. If you have questions about the research, you should contact the Principal Investigator Dhavan Shah at dshah@wisc.edu.

If you are not satisfied with the research team’s response, have more questions, or want to talk with someone about your rights as a research participant, you should contact the Education and Social/Behavioral Science IRB Office at 608-265-4312.

By clicking “I agree and wish to participate” below, you indicate that you have read this consent form, had an opportunity to ask any questions about your participation in this research, and voluntarily consent to participate. You are also indicating that you are the age of 18 or over and are able to provide your own consent. Please print a copy of this form for your records.

I agree and wish to participate.
I do NOT agree and do not wish to participate (End Survey).