Consent Form for Participation in a Research Study
Danube University Krems
"Factors influencing feasibility and implementation of a ketogenic or low-carb diet in cancer patients."
Description of the research and your participation
My name is Julia Tulipan, I am a biologist working in the field of nutritional science for the past 4 years. I am currently working on my master thesis in clinical nutrition. This study is part of my master thesis.
I need your help!
You are invited to participate in a research study conducted by Julia Tulipan and Prof. Dr. Barbara Kofler. The purpose of this research is to identify factors that influence the patients’ decision to follow a ketogenic (or LCHF, Paleo, LOGI or Atkins) diet during cancer treatment. Which factors influence feasibility and implementation of a ketogenic or low-carb diet in cancer patients. What obstacles face patients, who try to implement a low-carb or ketogenic diet?
Your participation will involve
You will be asked to fill out an online questionnaire. This will take about 15 – 20 minutes. To be part of this study, you have to accept this Consent Form. You will find a check box at the bottom of this site. As soon as you have given your consent, a button “> to the questionnaire” is going to appear. Click on that button, and you will be forwarded to the questionnaire.
Who can be part of this study?
Inclusion criteria for participants are that they are either currently diagnosed with cancer or have been diagnosed in the past and are eating or have been eating a ketogenic or low-carb diet during cancer treatment (even it was just for a very short periode).
Risks and discomforts
There are no known risks associated with this research. There are no costs involved.
Protection of confidentiality
The online questionnaire will be built with GravityForms, a WordPress application (http://www.gravityforms.com). All the data will be hosted on a private and secure server. This enables us to guarantee data safety and anonymized analysis of the data, since every form entry is appointed a unique serial number. In that case we guarantee that only personnel directly involved in the study has access to the data. Analysis would than be pseudonymised.
Your participation in this research study is voluntary. You may choose not to participate, and you may withdraw your consent to participate at any time. You will not be penalized in any way should you decide not to participate or to withdraw from this study.
If you have any questions or concerns about this study or if any problems arise, please contact Julia Tulipan (firstname.lastname@example.org; 0043 680 3284544)
I have read this consent form and have been given the opportunity to ask questions. I give my consent to participate in this study.