Family Health Study
“Understanding the Health Behaviors of Families in San Luis Obispo and Santa Barbara Counties"
A needs assessment to investigate the health behaviors of children and families in San Luis Obispo and Santa Barbara Counties is being conducted by Alison K. Ventura, PhD, in the Department of Kinesiology, and Kari D. Pilolla, PhD, RD, in the Department of Nutrition, at Cal Poly, San Luis Obispo. The purpose of the study is to better understand the dietary, physical activity, and sleep patterns of children in San Luis Obispo and Santa Barbara Counties.
You are being asked to take part in this study by completing the following questionnaire. You will be asked a series of questions pertaining to family demographics and health history, your child’s dietary intake, sleep patterns and physical activity and your own parental feeding practices. Your participation will take approximately 30 minutes to 1 hour. Please be aware that you are not required to participate in this research and you may discontinue your participation at any time without penalty. You may also omit any questions you prefer not to answer.
The possible risks associated with participation in this study are minimal, however, you may feel uncomfortable answering questions pertaining to your attitudes and concerns for your feeding practices, or your child’s eating behaviors and weight gain patterns. If you should experience this feeling, please be aware that you may contact Dr. Ventura at akventur@calpoly.edu or (805) 756-5693 for assistance. Your responses will be provided confidentiality to protect your privacy. Your name will not be used in any reports of this research without your permission. All caregivers who complete our study will receive a $10 Target gift card.
If you have questions regarding this study or would like to be informed of the results when the study is completed, please feel free to contact Dr. Ventura at akventur@calpoly.edu or (805) 756-5693. If you have concerns regarding the manner in which the study is conducted, you may contact Dr. Michael Black, Chair of the Cal Poly Human Subjects Committee, at (805) 756-2754, mblack@calpoly.edu, or Ms. Debbie Hart, Compliance Officer, at (805) 756-1508, dahart@calpoly.edu.
If you agree to voluntarily participate in this research project as described, please indicate your agreement by clicking on the link below and submitting the following questionnaire. Please print a copy of this consent form now for your reference, and thank you for your participation in this research.