Health and Home COVID-19 Study

Health and Home COVID-19 Study:
Consent Form

Health and Home COVID-19 Study

Principle Investigator

Marla Morden, Instructor of Psychology

Vancouver Island University


I am an instructor of psychology at Vancouver Island University (VIU). I would like to invite you to take part in my study, entitled “Health and Home COVID-19 Study” which aims to identify the foundational factors reflecting the shared home-life experiences of Canadian adults during COVID-19. My hope is that my research will contribute to the knowledge of how exceptional world events impacts family and life stage.


You are being asked to voluntarily complete this online survey. The survey includes questions on topics such as taking care of the home, social interactions, sleep, stress and mood, etc. The survey should take about 15-20 minutes to complete.You are being asked to voluntarily complete this online survey. The survey includes questions on topics such as taking care of the home, social interactions, sleep, stress and mood, etc. You will also be asked about your feelings towards various factors related to COVID-19, such as what aspect is the most stressful (for example, health or economic factors) as well as some basic information such as age, education, and income, that will be used solely for group comparison purposes. As we are interested in tracking how Canadian adults’ respond to COVID-19 over time, you will be asked to take the survey every three months for twelve months. Each time, you will be asked to consent, and each time the survey should take about 30-35 minutes to complete. The first time may take a bit longer as you familiarize yourself with the consent form and questions. You are welcome to take a break if needed.

Participants will be invited to enter a draw for a $100 gift card for a major grocery store at all four study time periods. Please note that withdrawal from the study, for whatever reason, does not exclude your ability to participate in the draw. All participants, including those who complete and those who do not complete the study, are eligible to enter. Winners will be contacted via email.

Benefits and Harm

There is no direct benefit to you for taking part in this study. It is hoped that the research will contribute salient information to Canadian adults in regards to home and life experiences during a global pandemic. As we are asking questions related to COVID-19, there is a risk that some of the survey questions may make you uncomfortable. You may experience feelings of increased vulnerability, or a sense of distress or loss. There are local support-resources listed at the start and end of the survey ( Furthermore, answering these questions may pose a perceived or actual risk to your privacy. To mitigate both of these risks, please remember that you are free to decline to answer any question that you do not wish to answer. Also note that you may withdraw from participation at any time by closing your browser. If you close your browser prior to clicking the ‘submit’ button at the end of the survey, information you provide will not be used in the study.

Your privacy is important to us. Therefore, no personally identifiable information will be collected EXCEPT for your email. Your email will solely be used for the purposes of tracking your responses over time, and so that we can include you in the quarterly draws. Email addresses will be scrubbed from the data before we run analyses. Please do not include your name or contextual information that might directly or indirectly identify you. If you agree to be quoted in the products of the research (see checkbox below) quotes will be attributed to a pseudonym or code (e.g., ‘participant #3’).

SurveyMonkey ( is being used to collect your survey responses. SurveyMonkey survey responses will be stored on SurveyMonkey’s regional servers located in Canada, and thus are subject to Survey Monkey’s data management and privacy policies. Some of the data associated with this survey may also be stored on servers located outside of Canada (the United States). In those instances, data you provide would not be protected by Canadian privacy legislation, and may be accessed by the government of the United States in accordance with its laws. For information on Survey Monkey’s privacy policy, see [].

Management of Research information/Data

I will delete all survey data from SurveyMonkey’s servers not more than one month after completion of data collection, which I expect will be March 2021. Data stored by the researcher will be password protected. Only the researcher will have access to the data as collected. All data as collected will be destroyed after completion of the study, approximately May 2021. Coded data will be securely stored and preserved for two years after the end of the project; it will be deleted and shredded by approximately May 2023.

Use of Research information

The results of this study may be used for conference publications, presentations, and published in academic journals. Products of the research will include only aggregate data unless you explicitly consent to be quoted.

Participation and withdrawal

You have the right to withdraw from the study at any time where practicable. You will be asked to complete the survey four times (a reminder email will be sent to you), and at each stage you may choose not to continue with the study. While the survey is in progress, you are able to revise your answers at any time. After each time you submit your survey answers (T1-T4) you may contact the principle investigator should you wish to revise your answers. Approximately 2 weeks after you complete the survey for the 4th time you will no longer be able to revise your answers as your data will have been scrubbed of all identifying information. At that time you will no longer be able to withdraw from the study as we will no longer be able to identify individual responses.

Consent and Conditions of Consent

I consent to participate in this research in accordance with the conditions described above. 
Yes                                    No              
I consent to being quoted in the products of the research.
Yes                                    No              


If you have any concerns about your treatment as a research participant in this study, please contact the Vancouver Island University Research Ethics Board at or (250) 740-6631.