Consent Form for Anonymous Surveys Study Title: Weight status, metabolic syndrome perception and eating habits in a sample of CMU students Research Investigators’ Names and Departments (include Advisor, if researcher is a student): Dr. Najat Yahia, Department of Human Environmental Studies Ms. Melyssa Rapley, senior dietetic student Contact information for researcher (and Advisor, if researcher is a student): Dr. Najat Yahia, yahia1n@cmich.edu Ms. Melyssa Rapley, raple1ma@cmich.edu Introductory Statement This study will provide a preliminary understanding of students’ knowledge about nutrition and components of metabolic syndrome in relation to eating habits in a sample of CMU students. Results of this study will be used to develop health awareness campaign related to nutrition and metabolic syndrome risk factors, tailored to students’ knowledge and understanding, to promote healthy eating habits among students and reduce possible development of future diet-related chronic diseases. Data collection will include an online questionnaire and body measurements (height, weight, waist circumference, and percentage body fat). As a participant, you will fill out an online questionnaire via “survey monkey” related to metabolic syndrome, nutrition and eating habits, and at a later date, you will have to come to Wightman Hall 116 where anthropometric measurements related to weight status will be taken. Anthropometric measurements include: height, weight, body fat percentage, and waist circumference. Your part in this study will be very helpful in providing useful data to carry out research. If you have any questions about this study or your part in it, please feel free to direct any question to the researchers: Dr. Najat Yahia at yahia1n@cmich.edu or Melyssa Rapley at 248-830-5799 or by email at raple1ma@cmich.edu What is the purpose of this study? The purpose of this study is to assess weight status and knowledge of metabolic risk factors in relation to eating habits in a sample of CMU students. Outcomes of this study will be used to develop health awareness campaign related to nutrition and metabolic syndrome risk factors to improve students’ eating habits and reduce potential diet-related chronic diseases in students’ adult-life. What will I do in this study? There are two steps for this project. As a participant in this study, in step one, you will provide responses to an online questionnaire. The questionnaire will pose questions about your knowledge of metabolic syndrome risk factors components, nutrition, eating habits and other lifestyle variables. In step two, you will also make an appointment to come to a lab on campus at a later date. On that date, the researchers will take anthropometric measurements, including height, weight, body fat percentage, and waist circumference. These measurements will be taken with the use of a scale, bioelectrical impedance analyzer, and tape measure. How long will it take me to do this? The online questionnaire will take about 30 minutes of your time. The process of taking anthropometric measurements will take about 30 minutes as well. Are there any risks of participating in the study? There is no risk in this study. What are the benefits of participating in the study? As a participant, you will have the benefit of having free anthropometric measurements taken, including body fat percentage. Also, you will be contributing to a study that will help educators to develop appropriate nutritional education materials to assist students in adopting healthy lifestyle habits. This will help to reduce the prevalence of overweight and obesity and metabolic syndrome among the college population. Will anyone know what I do or say in this study (Confidentiality)? The data collected during this study will be strictly confidential. Only the primary researcher and the advisor will have access to your questionnaire responses and anthropometric data. When writing a research paper about this study, no participant’s name will be disclosed. Will I receive any compensation for participation? You will not receive any compensation for participation. Who can I contact for information about this study? Please contact the researchers: Dr. Najat Yahia at yahia1n@cmich.edu or Melyssa Rapley with any questions about this study. Melyssa Rapley can be reached at 248-830-5799 or by email at raple1ma@cmich.edu You are free to refuse to participate in this research project or to withdraw your consent and discontinue participation in the project at any time without penalty or loss of benefits to which you are otherwise entitled. Your participation will not affect your relationship with the institution(s) or the course that you are involved in this research project. My return of this survey implies my consent to participate in this research and I have been given a second copy of this form to keep for my records.. If you are not satisfied with the manner in which this study is being conducted, you may report (anonymously if you so choose) any complaints to the Institutional Review Board by calling 989-774-6777, or addressing a letter to the Institutional Review Board, 251 Foust Hall Central Michigan University, Mt. Pleasant, MI 48859. Note: Please be aware that this research may bring up eating habits issues. If you need to talk to somebody about any issues or concerns, the free counseling services are available in the Counseling Center to all CMU students. They can be contacted at 989-774-3381 and are located in Foust 102.