Dear Participant,

We are asking for your participation in a research study investigating how social determinants of health affect Eosinophilic GI disorders (EGIDs) patients and caregivers of EGID patients.

Things you should know:

  • Taking part in this research study is voluntary. You do not have to participate and you can stop at any time.
  • The purpose of this study is to identify how social determinants of health affect patients with Eosinophilic GI disorders.
  • If you choose to participate, you will complete a 36-question survey as an adult EGID patient or as an adult caregiver for an EGID patient. It will take approximately 20-25 minutes to complete this survey. Your answers will be kept confidential and will not be linked to you. We will be collecting demographic information such as age, gender, ethnicity, zip code, education status, employment status, insurance, and duration of disease.
  • There are no direct benefits to you during this study and no monetary compensation for participation in study. The aggregate data could help us better care for patients with EGIDs.
  • Participation in this study involves minimal risk. You may experience some discomfort from the questions.You can stop participation at any time or skip questions.
  • Instead of being in this study, you have other options including not participating in the study and not answering the questions

You will not receive any monetary compensation for participation in this study. Only authorized study personnel will have access to this information. The data collected during this study will be maintained until research purpose have been served for this project, at which point it will be destroyed and will not be used for future research. Only authorized study personnel will have access to this information. Refusing to participate or deciding to later withdraw will involve no penalty or loss of benefits to which you are otherwise entitled.

By proceeding further, you agree that you are of 18 years of age or older and are giving consent for the researcher to use your answers and information. If you do not wish to participate, please do not proceed further.

Should have any questions, concerns or complaints about the study, you may contact Dr. Sandeep Gupta at (309) 655-4242.

For any questions regarding research subject rights, you may contact the Peoria Institutional Review Board at (309) 680- 8630.

Sincerely,

Sandeep Gupta, MD

Visiting Professor, Department of Pediatrics University of Illinois College of Medicine at Peoria Principal Investigator

Saad Kothawala, BS James Scholar

University of Illinois College of Medicine at Peoria.

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