Write all consent forms using letterhead stationery. If the consent form is more than one page, provide a place for the subject to initial each page, and write the IRB number at the top of each page
Adult Informed Consent Form
IRB #103017-4
Title of Research Study: Comparison of Bioelectrical Impedance Analysis (BIA) and Skin Fold Measurement for Determining Body Composition in Males
Summary
The purpose of this study is to compare two different ways of measuring body composition. You might decide to participate in this study because you will learn about your body composition. You might decide not to participate in this study because it will take about 30 minutes of your time.
You are invited to participate in this research study. The following information is provided in order to help you to make an informed decision whether or not to participate. If you have any questions, please do not hesitate to ask.
You are eligible to participate because you are a healthy male between the ages of 19 and 30.
The purpose of this study is to compare bioelectrical impedance analysis (BIA) and skin fold testing in the measurement of body composition.
You will be asked to visit the Human Performance Laboratory at 8 a.m. before breakfast on one occasion to complete the tests that will estimate your body composition. The tests to be used are BIA and skin fold testing. Approximately 30 minutes of your time will be required.
BIA Testing: while lying on your back, four electrodes will be placed on the right side of your body. Two electrodes will be placed on the back of your hand and foot between the base of the third and fourth fingers and toes, respectively. The other two electrodes will be placed on the wrist between the prominences of the forearm bones and between the two bony projections on each side of your ankle. A painless electrical current will then be transmitted through your body to measure resistance to the current. This measurement, in turn, is used to estimate body composition in ohms. The average of three trials will be used to estimate your body composition.
Skin Fold Testing: In this procedure a small caliper will be used to pinch the skin over your triceps biceps, biceps, back and waist. The measurements will be repeated three times and the average of the three trials will be used to estimate your body composition.
There are less than minimal risks or discomforts associated with this research.
You may find the information about your body composition and percent of fat interesting. The knowledge gained from this study may be of value in the field of exercise science.
Any information obtained that could identify you will be kept strictly confidential. The information obtained in this study may be published in scientific journals or presented at scientific meetings; however, the data will not contain any identifying information.
Your rights as a research subject have been explained to you. If you have any additional questions concerning your rights, you may contact the University of Nebraska at Kearney Institutional Review Board (IRB), telephone (308) 865-8496.
You are free to decide not to participate in this study or to withdraw at any time without adversely affecting your relationship with the investigators or the University of Nebraska. Your decision will not result in any loss of benefits to which you are otherwise entitled.
Documentation of Informed Consent
You are voluntarily making a decision whether or not to participate in this research study. Your signature certifies that you have decided to participate having read and understood the information presented. You will be given a copy of this consent form to keep.
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Signature of Subject
____________________
Date
In my judgment the subject is voluntarily and knowingly giving informed consent to participate in this research study.
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Signature of Investigator
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Date
Identification of Investigators
Principal Investigator
John L. Smith, Ph.D.
Off: 865-1111
Secondary Investigator
Mike M. Brown, Ph.D.
Off: 865-2323
Approved 11/4/17
