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uMq5VJ8gs5bfpBcoQr9BckSHwgxDD3DLteJJ3KuMTkZKrJjvtdWcDbBuLLDyraQ9B5nSSiVBX22xQ5XkqtorZriXHWTRI

Screener

We are the Laboratory for Healthy Social-Emotional Development at UT Dallas.

We invite you to answer a few brief questions (less than 5 mins) to help determine whether you or your child may be eligible to participate in our social media intervention study. Please read carefully and respond. We will contact you if you are eligible.

If you have any questions, feel free to call us at (972) 883-3832 or email us at developmentlab@utdallas.edu

Thank you!

First Name

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Last Name

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Please provide your email address:

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Please provide your phone number:

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Are you a parent answering questions for your child?

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Yes

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Please enter your parents first and last name.

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Please enter your child's first and last name.

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Please enter your parents email.

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Please enter your parents phone number.

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Please enter your child's email.

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Please enter your child's phone number.

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How did you hear about us?

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Social Media

UT Dallas

Coffee Shop

Through a Friend

Other

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If other, please specify:

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Have you participated in our lab's social media study?

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Yes

Not sure

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Are you interested in participating in the social media intervention study?

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Yes

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CONSENT TO PARTICIPATE IN SCREENING PROCEDURE OF RESEARCH

Title of Research Project: Neural mechanisms in processing personalized social media content (UTD IRB: IRB-23-573)
Principal Investigator: Alva Tang
Contact Number: 972-883-3832

Invitation to Answer Questions and See If You or Your Child Is Eligible for a Research Study: You are providing information to questions that will determine your own eligibility (if you are over age 18) or your child's eligibility (if you are a parent) for a research study. This consent form will help you choose whether you will provide information in this initial screening process.

Purpose of Screening and Description of Study: To determine your own eligibility or your child's eligibility (if you are a parent) for a study examining brain processes during social evaluation and relations with behavior in adolescence. We will ask you several questions about yourself (if you are over age 18 and interested in participating) or about your child (if you are a parent interested in participating with your child). The question will ask about demographics (e.g., age), history of head trauma, and neurological disorders.

Number of Participants: If you or your child are eligible to participate in the actual study, you will be one of approximately 100 people in this research study.

Duration of Questions in Screener: The screening questions will take less than 5 minutes to complete.

Possible Risks: There is minimal risk associated with participation in this study. The questions include information about demographic and health information.

Possible Benefits: You may not directly benefit from this screening procedure of this study, but others may benefit by applying the knowledge from the data gathered to design further prevention and intervention studies.

Alternatives to Participation: You may choose not to participate in this screening procedure.

Voluntary Participation: Participation is voluntary. All individuals have the right to agree or refuse to participate in this screening process. Individuals who consent to participate also have the right to change their minds at any time during the procedure by not submitting the information online or by telling the researcher that you no longer wish to be included. Refusal to participate will not affect your legal rights or the quality of healthcare and education you may wish to receive at any healthcare setting or higher education institution.

If UTD students are involved: Your participation (or decision not to participate) will not affect your grades or education in any way.

Records of Participation in this Research:
All of the information participants provide to investigators as part of this research will be protected and held in confidence within the limits of the law and institutional regulation. All electronic data will be kept on password protected computers on a server that can only be accessed by the Laboratory for Healthy Socio-emotional Development staff and graduate students. The key file that links directly identifying information (name and contact information) to the code will be stored in a password-protected file on a secure computer network. If a subject is eligible and has agreed to be contacted for follow-up studies, the key file will include the link between name, contact information, and study code.

Information Available to Others: Only trained research personnel within the lab, who are working on the study will have access to the data. Collaborators who work on the study will only have access to deidentified data.

UT Dallas Institutional Review Board (IRB): Members and associated staff of the IRB of the University of Texas at Dallas may review the records of your participation in this research. An IRB is a group of people who are responsible for assuring the community that the rights of participants in research are respected. A representative of the UTD IRB may contact you to gather information about your participation in this research. If you wish, you may refuse to answer questions the representative of the IRB may ask.

Publications Associated with this Research: The results of this research may appear in publications but individual participants will not be identified.

Contact People:
If you want more information about this research, contact the researchers listed on the first page of this form. Participants who want more information about their rights as a participant or who want to report a research related injury may contact:

The University of Texas at Dallas Human Subjects Research Office 972-883-4575
UTD Office of Research and Innovation

Signatures
A participant's signature indicates that they have read, or listened to, the information provided above and that they have received answers to their questions. The signature also indicates that they have freely decided to participate in this research procedure and that they know they have not given up any of their legal rights.

If you agree to the above, please sign:

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Add signature

About you (if you are between 13 to 16 years old) or your child (if parent is filling out for your child):

How old are you?

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Do you use TikTok?

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Yes

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Upload a photo showing how much time you spend on TikTok weekly by submitting a screen time screenshot.

Directions through the IOS Settings on your device:

Go to the "settings" App
Go to "Screen Time"
Click "See All App & Website Activity"
Click "Week" at the top to get a weekly summary and then click "TikTok"
Screenshot of that page, displaying the weekly screen time (showing data from all 7 days of the week).

Directions through the App:

Go to the Tiktok App
Go to your profile at the bottom right-hand corner of the screen and click the three lines in the top right hand corner
Select "settings and privacy"
Scroll down and select "screen time". Once here you will see your current weekly screen time. To get data from all 7 days of the week...Under "summary" select the week prior (showing all 7 days). Take a screenshot of that graph. The image you upload must show TOTAL, DAY TIME, and NIGHT TIME for all 7 days.

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Upload file

Do you use Instagram reels?

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Yes

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Please upload photo identifying how much time you spend on Instagram weekly by submitting a screen time screenshot. You can only access weekly screen time data through the settings app!

Directions through the IOS Settings on your device: (Perferred Method - less work)

Go to the "settings" App
Go to "Screen Time"
Click "See All App & Website Activity"
Click "Week" at the top to get a weekly summary, then click "Instagram"
Take a screenshot of that page, displaying the weekly screen time (showing data from all 7 days of the week).

Directions through the App:

Click on your profile icon, click the three lines on the side
Click "your activity"
Scroll down to "time spent"
Take a screen shot and upload that BUT (If you chose this option you will have to hover over each day and add the times together and send an email to developmentlab@utdallas.edu with that information. Since it only displays a daily average not weekly time spent).

EX: "Weekly screentime = 430 minutes"

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Upload file

Do you have a history of head trauma and/or seizures that have led to loss of consciousness?

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Yes

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Do you have any neurological disorders (e.g., epilepsy, encephalitis)?

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Yes

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Do you have any neurosensory disorders? (e.g., deaf and hard of hearing, vision, intellectual disabilities)

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Yes

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Do you currently use psychotropic medications (e.g. anti-depressants, anxiolytics, anti-psychotics) or stimulants (e.g., for ADHD)

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Yes

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If yes, what kinds of psychotropic medications? (please list)

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Do you have a hairtype (e.g., braids, fake hair) that would make it difficult to put a swim cap on?

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Yes

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Are you willing to take out these braids and fake hair for the experiment so that we can place an EEG net on the head to measure brain activity?

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Yes

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Are you allergic to soap or latex?

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Yes

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Do you have any questions about the study?

Thank you for signing up! We will contact you about your eligibility and the next steps.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.