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Online Consent to Participate in a Research Study

Title of Study: Maternity Care Experiences and Infant Side-Car Bassinets
Principal Investigator:  Dr. Kristin Tully, University of North Carolina at Chapel Hill




You are being invited to take part in a research study. To help you decide whether or not to take part, please read the following information about why the research is being done.

What is the purpose of the study?
The purpose of this research study is to understand experiences of maternity care and inform the design of postnatal unit infant side-car bassinets.


Who is eligible to participate in this study?
You are eligible to participate in this study if you are at least 18 years and English speaking. We are seeking mothers, fathers, grandparents, health care professionals, hospital staff, designers, and others.


Do I have to participate?
No. This study is voluntary. It is up to you to decide whether or not to participate. If you choose not to participate
, please go on to the first question and answer "No." Then, you will be directed to end of the survey.


What will happen next if I participate?
If you agree to participate in this research study, you will be asked to complete an electronic online survey. The survey includes questions about your background, birthing facility, maternity care experiences, and infant bassinets. This survey will take approximately take 20-30 min to complete. If you would like to receive updates about the side-car bassinet project, you may provide your email address in a separate survey. Additionally, if you are willing to be contacted to participate in a follow-up interview, you will be asked to indicate interest and provide contact information in the separate survey. Contact information is not linked to the maternity care and infant bassinet survey responses.


Are there benefits to particiating in this study?
You will not benefit personally from participating in this study. Research is designed to benefit society by gaining new knowledge. You may skip any questions you prefer not to answer.


Will you receive anything for being in this study? Will it cost anything?

If you provide your email address, you will be eligible to receive one of five $40 gift cards for participating in this study. We will use a random-number generator to select gift card recipients. We are very appreciative of your time and willingness to share your experiences. You do not need to indicate interest in receiving project updates or volunteering for a follow up interview to be eligible for the gift card drawing. There are no costs associated with being in the study.

Will what I report in this study be kept confidential?
This survey is anonymous and all the data we collect is completely confidential, unlinked to your contact information, and stored in a secure database.


What will happen to the results?

Results will be disseminated through the Carolina Global Breastfeeding Institute website:


Who is funding the research?

The study is funded by the North Carolina Institute of Translational and Clinical Sciences, Award #IHHAR41602.


Contact for further information

For further information regarding this study please contact the lead investigator Dr. Kristin Tully at The study has been reviewed by the UNC Non-Biomedical Institutional Review Board, #16-2531 and approved on 11/4/16.


What if you have questions about your rights as a research participant?

All research on human volunteers is reviewed by a committee that works to protect your rights and welfare. If you have questions or concerns, or if you would like to obtain information or offer input, please contact the Institutional Review Board at 919-966-3113 or by email to


Survey instructions

We encourage you to take the survey in one sitting; however, If you need to leave for any reason, your responses will be saved when you click the next page button (>>), and you can come back and restart from where you left off. 


To be able to return to the survey, make sure that you use the same computer and same browser, and do not delete the browsing history and/or cookies.  Otherwise you may have to restart and complete the survey from the beginning. We encourage you to take the survey on a computer or a tablet, as some of the questions do not work on Smart Phones.

Would you like to participate in this research study?