Purpose: The purpose of this survey is to see if you meet criteria for taking part in a behavioral weight loss research study for young adults at Virginia Commonwealth University (VCU).

How long will it take me? It will take you approximately 5 minutes to complete this survey on a secure website.

What will you ask me? You will be asked to provide contact information, optional demographic information, and information that will help to determine whether or not you appear to be eligible to participate in this research study.

Do I have to answer all the questions? You may choose not to answer the questions, or you may choose to complete the questions over the phone or in person. There is no penalty for not completing the survey, and your decision will not change your future medical care at VCU.

Does completing this survey mean I am enrolled in the study? No. You are not committing to participating in the study at this time. If you appear eligible based on this survey, you will have a chance to speak with our research team to learn more about the study and ask any questions you may have before making a decision about whether you want to participate.

How do you protect my confidentiality? If you complete the survey, then you are authorizing the study investigators and staff access to the private information about yourself that you have provided. This information will only be used to determine potential eligibility for the study and to contact you. Your answers to these questions will be kept as confidential as possible, as required by law. Your information will only be available to study investigators and research staff who are provided with a password to access a secure server where the responses are stored. However, as with any electronic record, there is always a slight risk that your responses could be accessed by someone outside of our research team. It is also possible that regulatory agencies or legal authorities may inspect this record, including review boards at VCU. Once your health information has been disclosed to anyone outside of this study, the information may no longer be protected under this authorization. This authorization will expire when the research study is closed, or there is no need to review, analyze and consider the data generated by the research project, whichever is later. If you are not eligible, or if you decide not to participate in the study, identifiable information about you will be removed from the survey database. However, researchers may still use or disclose deidentified health information they have already collected.

If you're interested in participating and willing to answer these questions online through this secure website, please click yes below.

If you prefer to answer these questions in person or over the phone, or have questions about this research, please contact Megan Henderson, Research Coordinator, at 804-827-2250, or Megan.M.Henderson@vcuhealth.org.

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