Informed consent form for a Survey checking the citizens’ attitude and behavioural changes
TITLE of STUDY: The awareness of citizens about the mercury-containing household goods, behavioural biases, and their reasons.
You are invited to participate in a research study about awareness of citizens about the harmfulness of mercury-containing household goods. The study is part of LIFE MERCURY-FREE project cofunded by the European Commission/European Climate, Infrastructure and Environment Executive Agency LIFE Programme under grant agreement no101074412.
The project is coordinated by the Politechnika Lodzka, Poland. Innovation Hive - Kypseli Kainotomias, Greece, Universita Degli Studi di Camerino, Italy, Virtual Angle Bv, The Netherlands, Universidade de Evora, Portugal, Akademia Gorniczo-Hutnicza im. Stanislawa Staszica w Krakowie, Poland, Lviv Polytechnic National University, Ukraine, Private Higher Education Institution Ivano-Frankivsk Academy of Ivan Zolotoustoy, Ukraine are also involved in the project.
This form contains important information about the reasons for undertaking this study, what you will be asked to do if you decide to participate in the study, and the way information about you will be used if you choose to participate.
Purpose of the Research
The goal of this research study is to measure awareness of citizens about the harmfulness of mercury-containing household goods The received statistics will be used to prepare recommendations, which will allow to rid mercury-containing goods from our homes in a relevant way and thus avoid environmental pollution caused by harmful waste. Additionally, survey results may improve the pro-ecological awareness of European citizens.
Type of Research Intervention
This research will involve your participation in an online survey that will take approximately 15 minutes of your time to complete our survey. Participation is voluntary and anonymous. We hope for your sincerity in your answers. All your responses will be kept confidential within reasonable limits.
Participating in this study may not benefit you directly, but it will help to avoid eventual harmful contamination of European environment from harmful mercury waste.
We hope that answering some of the questions will be not upsetting, and we expect that this would not be different from the kinds of things you discuss with family or friends.
There are no limitations to participate in this study, but please note: You must be 18 or older to participate in this study.
To the best of our knowledge, the things you will be doing have no more risk of harm than you would experience in everyday life. However, you do not have to answer any question if you do not wish to do so, and that is also fine. You do not have to give us any reason for not responding to any question or for refusing to take part in the online survey.
Information We Collect & How We Use It
Owing to the relationship with you, we will collect from you the personal information, such as: age; gender, education, country/region, IP address. All these personal data information will be stored in life-mercuryfree.eu. Access to the information is password protected and secured. We will not share IP address, or any information which may personally identify you.
Your personal data will be handled as confidentially as possible adhering to all pertinent international, European and national legislation. Whenever results of this study are published or presented, any personally identifiable information will not be used; i.e. the data will be anonymized.
To minimize the risks of breaching confidentiality, we will collect only personal data that we need for the purposes of the described research project. All partner institutions involved in the LIFE MERCURY-FREE project adhere to the European Union’s General Data Protection Regulation (GDPR) and other pertinent international, European and national legislation. In particular, we ensure the following:
- Personal data are collected on a need to know basis only.
- Withdrawal rights and oblivion rights made compulsory by the European Court of Justice in 2014 are guaranteed.
- The merger of datasets containing personal data will be avoided in order to prevent any unforeseen personal information disclosure. Data may be made available for reuse by other researchers only if personal data has been anonymised or erased from the dataset.
Hence, we will make sure that no answers you give can be traced back to you. All information you give will be assigned a number (a unique code). Your personal data will not be shared with or given to anyone. Your data will be stored until 01.11.2030.
We may share the data we collect from you for use in future research studies or with other researchers or journal editors. If we share the data that we collect about you, we will remove any personal information before we share it; i.e., only anonymized data will be shared.
Right to Refuse or Withdraw
Participation in this study is voluntary. You do not have to answer any question you do not want to answer. If at any time and for any reason, you would prefer not to participate in this study, please feel free not to do it. It is possible to take a break, stop and continue at a later date or stop altogether. You may withdraw from this study at any time. You will not be penalized in any way for deciding to stop participation.
Please note, that our service uses technologies like cookies to store and/or access device information (More about our cookies policy you can find here https://life-mercuryfree.eu/privacy-policy/
Who to Contact
If you have any questions about this study, please contact [Joanna Jojczyk, +48 42 6312750 firstname.lastname@example.org]. If you have any questions about your rights as a research participant, please contact: Inspektor Ochrony Danych, 90-924 Lodz, Zeromskiego Str. 116, phone:+48 42 631 20 39, email@example.com
* Please print or save a copy of this form for your records. *
We are sorry but you can't proceed without first agreeing to our survey data policy.