LETTER OF INFORMATION/CONSENT - Concussion Research

LETTER OF INFORMATION/CONSENT

The Impact of Concussions on Children’s Mental Health

You are invited to participate in a study that is being done by researchers at the University of

Toronto, OISE. The study will be run in collaboration with Honsberger Physiotherapy Clinic and

athletes whom suffer from concussions will be asked to partake in the study.

My name is Megan Mueller and I am a student at the University of Toronto, completing my

Masters in Developmental Psychology and Education. My supervisor is Dr. Richard Volpe, who

is a professor at the University. If you have any questions about the study please do not hesitate

to contact myself of my supervisor. Our information is below:

Researchers: Megan Mueller
519-841-9531
Megan.mueller@mail.utoronto.ca

Principle Investigator: Dr. Richard Volpe
416-934-4511
Richard.volpe@utoronto.ca

University of Toronto, OISE
Toronto, Ontario, Canada

Purpose of the Study: The purpose of this study is to determine the impact that suffering a

concussion has on the depressive symptoms of child athletes and how active rehabilitation

impacts symptoms.

Role as a Participant:

Following your child’s visit to the clinic you will be asked through email

if you are interested in participating in the study. If you do not wish to be a part of the study,

there will be no punishment and your service from the clinic will not be altered. If you choose to

participate in the study, you and your child will fill out a short questionnaire. 4-6 weeks postconcussion

you and your child will fill out the survey a second time, after they have gone

through their rehabilitation. Researchers will also have access to your child’s baseline

concussion testing if available (the SCAT-5). If you and your child choose, you may take part in

an optional follow up interview after their final assessment.

Your child will be given a corresponding code when they participate in the study and therefore

their names will not be connected to their data. Only myself and my supervisor will have access

to the names and the codes. Once the study is complete all names will be deleted and only the

codes will remain. If at any point during the study you choose to remove you and your child

from the study, you may do so by contacting either of the numbers mentioned above. Your

child’s information will then be deleted and removed from the study If you are uncomfortable

answering any questions in the assessment you may refuse to do so. Data collection will be done

online through an encrypted secure web survey host approved by the Toronto Research Ethics

Guidelines. The Toronto Research Program may have confidential access to the data to ensure

participant protection procedures are followed.

If you have any questions about your child’s rights as a participant please contact the Office of Research Ethics at: ethics.review@utoronto.ca or 416-946-327.

Potential Harms, Risks, or Discomforts:

There is medium risk associated with this study. Children

and parents may feel uncomfortable answering questions and may bring up certain topics causing

psychological discomfort. If this is the case we encourage parents and children to let the researcher

know and the correct steps will be taken to ensure you and your child are comfortable. Children

and parents can remove themselves from the study if they feel uncomfortable. Children and

parents may use this assessment to become more open to being aware and talking about symptoms

mentioned in the assessment. This could be helpful in the child’s coping and recovery.

Publication: When the study is complete, we are hoping to publish the result. If you would like to

receive a copy of a summary of these results, please check the box and leave your email address

below.

Available External Resources: If at any time children are in need of contacting external resources

in regards to their depressive symptoms or any kind of upset, the following resources are suggested

for participants. Children are also encouraged to contact their family doctor or school guidance

counsellor if they wish.

Sunnybrook Youth Program

https://sunnybrook.ca/content/?page=pyschiatry-youth-programs 

Skylark

https://www.skylarkyouth.org 

Kids Help Phone

Phone: 1-800-668-6868

Text: send the work “text”to 686868

Distress Centres of Greater Toronto

Website: https://www.torontodistresscentre.com 

Phone: 416-408-4357

Text: 45645

To learn more about the specific details of the study, please visit this link: https://www.honsbergerphysio.com/blog/Concussion-Research-Impact-of-Concussions-on-Children-s-Mental-Health~6910.html 


CONSENT

• I have read and understand the information presented in the information letter about the

study conducted by Dr. Richard Volpe and Megan Mueller from University of Toronto,

OISE.

• If I have any questions I have been given the contact information of those running the

study and will contact them for additional details if needed.

• I understand that if myself and my child participate in the study, I can withdraw at any

time up until May 1st, 2020.

• I agree that myself and my child will participate in the study.

Child’s Name: Date:

Name of Parent/Guardian:

Signature:

Email Address:

I would like to receive an email about the results once the study has been complete.

My child and I are interested in participating in the follow-up interview after they have

recovered from their concussion.

Phone Number:

Orthopedic Rehabilitation
105-675 Cochrane Drive, Markham, ON L3R 0B8 P (905) 940-2627 F (905) 940-3136 HONSBERGER@HONSBERGERPHYSIOPLUS.COM
81 Temperance Street, Aurora, ON L4G 2R1 P (905) 841-0411 F (905) 841-7311 AURORA@HONSBERGERPHYSIOPLUS.COM