Informed Consent to Participate in a Research Study
Northeastern University, College of Arts, Media & Design (CAMD)
Name of Investigator(s): Dr. Diane Francis, Jessica Roseman
Title of Project: Double Thumb Hug
Funded by: Cambridge Community Foundation, Cambridge Arts for Social Justice Grant
Version date: May 26, 2025
Key Information
You are invited to take part in a research study. This form is for individuals who choose to participate in the research component of the project.
You do not need to participate in the study to experience the installation.
If you would like to engage with the artwork without being part of the research, you are welcome to do so; no form is required.
If you choose to join the study, your participation is entirely voluntary. You may decline to answer any question, skip any activity, or stop at any time without penalty. The researcher will provide you with a copy of this form to keep.
You are welcome to ask any questions before or during your participation. When you’re ready to decide, simply let the researcher know whether you’d like to participate.
If you consent, you will be invited to observe and engage with an installation, then share feedback through writing, conversation, or both.
Your participation will take approximately 30 minutes, depending on your interest and level of engagement.
Risks may include mild physical movement and emotional discomfort due to self-reflection.
Benefits may include personal insight, creative exploration, and reflective engagement.
Why are we doing this research study?
We are exploring the ways people interact with a somatic (body-based) art installation. The goal is to understand how this type of art engagement may support movement, reflection, agency, and embodied awareness.
What will you be asked to do?
If you agree to participate, you will:
Meet the researcher outside the gallery window. All prompts and images are visible from the sidewalk, and you may engage while standing or sitting in a provided chair.
View and interact with a movement-based art installation displayed in the gallery window. You’ll see five photographic prints showing a sequence of hand gestures, along with a printed sheet of written instructions and reflective questions. You’re invited to mirror the gestures using your own body, in a self-directed way. You may stand or sit in a chair provided nearby.
Focus on your own experience while moving—this includes noticing your internal sensations, emotional responses, and bodily awareness as you engage with the gestures.
Be observed by the researcher, who will remain outside the gallery window. They may take notes on your interaction with the images and gestures as part of the study. These notes will not include your name or identifying details and will be stored securely for research analysis only.
Decide whether or not to be recorded. You can choose to be video recorded, audio recorded, or photographed, but only with your separate written consent.
Reflect after the experience. You may write a short response, talk with the researcher, or do both. This conversation will explore how the gestures felt, what you noticed internally, and how clear or meaningful the instructions were.
Your written and verbal reflections may be quoted in research publications or presentations. If you prefer not to be quoted or identified in any way, you can indicate that on the consent form.
Join an optional follow-up discussion about one week later, lasting about 10–15 minutes.
You may also choose to reflect individually or, in some settings, with a small group.
All activities are optional. You may participate in as much or as little as feels comfortable, and you may stop at any time. You can also request that your responses not be used or withdrawn from the study at any point before your data is de-identified.
Any data you provide, including observational notes, written reflections, or optional recordings, will be used to better understand how people engage with the gestures and prompts. Some of this material may be quoted or referenced in research presentations or publications. You will have the option to indicate your preferences on the consent form, including whether or not you wish to be quoted, photographed, video or audio recorded, or identified by name. No identifying information will be shared without your explicit, written permission.
Where will this take place?
This study will take place at ONE of the following locations:
The Tender Art Space, Concord, MA – Installation and discussion (June/July 2025)
The Dance Complex, Cambridge, MA – Movement workshop and reflection (July/August 2025)
Bearnstow Arts Retreat, Mt. Vernon, ME – Showings and feedback (July/August 2025)
Will being in this research help you?
You may gain insight into your body awareness or feel inspired to reflect in new ways. There is no guaranteed benefit from participation.
Will there be any risk or harm to you?
Some people may feel emotional or reflective during movement-based activities. You are free to pause or stop at any time. The experience is designed to be gentle and supportive; possible benefits include personal insight, reflection, and engaging in a unique creative experience.
Another possible risk is that your confidentiality could be lost: that is, people outside the study might access information about you. We will do everything we can to minimize this risk, as described below.
Who will see the information about you?
For the most part, only the research team will see the information about you. We won’t use any identifiable information in reports or publications.
Your name and any other identifying information will be immediately removed from the data, unless you have agreed to be quoted by name.
Sometimes, authorized people may ask to see research information about you and other people in this study. They would only look at the information to make sure that the research is done properly. We would only permit people to see this information if they are authorized by organizations such as the Northeastern University Institutional Review Board
We will keep identifying information separate from our research data, to make it harder for anybody to tell who you are. We will have a code key that can be used to link research data to your identifying information. Any direct quotes used in writing or presentations will be anonymized unless you explicitly agree to be named. We will store your information on secure servers with password protections. We plan to keep the identifiable information for about four years.
Future Use of Data
After we remove identifying details, we might re-use information about you for future research studies or share it with other researchers without additional informed consent from you. Your de-identified responses may be used in future research without additional consent from you.
If you do not want to take part in the study, what other choices do you have?
You can still take part in the session even if you don’t want us to use your worksheet responses for our research. We will only use your worksheet for the research if you sign this consent form.
Can you stop your participation in this study?
Yes, you can quit the study at any time. You can also refuse to answer any questions you don’t want to answer. If you do not participate or if you decide to quit, there will be no penalty as a student, employee, or otherwise.
If you leave the study or the researcher removes you from the study, then any information already collected from you will not still be used for the study.
Will you be paid for your participation?
There is no payment for participating in the study.
Who can you contact if you have questions or problems?
If you have any questions about this study, please contact Jessica Roseman, roseman.j@northeastern.edu, the person mainly responsible for the research. You can also contact Diane Francis, di.francis@northeastern.edu, the Principal Investigator.
Who can you contact about your rights as a participant?
If you have any questions about your rights in this research, you can contact the Northeastern University Department of Human Research at Tel: (773) 396-2327, or Email: IRBReview@northeastern.edu . You may call anonymously if you want.
Reviewed and approved by the Northeastern University Institutional Review Board.
Consent & Follow-Up Preferences
Participation & Use of Responses
I consent ☐ I do not consent ☐ to participate in this study.
I consent ☐ I do not consent ☐ to my responses being quoted anonymously.
I consent ☐ I do not consent ☐ to being quoted with my name.
I consent ☐ I do not consent ☐ to being quoted in any way.
Audio Recording (research use only)
I consent ☐ I do not consent ☐ to my voice being recorded for internal research and transcription purposes only.
Note: separate permission is required for public use via the Media Consent Form.
Optional Follow-Up
I consent ☐ I do not consent ☐ to a 10–15 minute follow-up conversation (Zoom, phone, or in person).
Preferred contact method (optional):
☐ Email: ______________________________________________
☐ Phone/Text: __________________________________________
Consent to Participate:
I agree to take part in this research.
________________________________________________________________
Signature of person agreeing to take part Date
____________________________________________________
Printed name of person above
________________________________________________________________
Signature of person who explained the study to the Date
participant above and obtained consent
____________________________________________________
Printed name of person above
Media Consent Release Form
Project Title: Double Thumb Hug
Researcher: Jessica Roseman, Northeastern University
Location: The Tender Art Space, The Dance Complex, Bearnstow
You are invited to participate in an artistic research project that may include photo, video, or audio documentation. You may choose whether and how your image, voice, or name is used. With your consent, these materials may be used for:
Internal research and study documentation
Academic presentations or publications
Public exhibitions or installations
Digital platforms, including social media
Media coverage (e.g., articles, interviews)
Other public-facing uses related to this project
Notes on Use & Withdrawal
Academic publications and digital media may be accessed internationally and are often archived permanently. Once published, materials cannot be withdrawn.
Photo Consent
☐ I agree to be photographed during this study (for documentation and research use only).
☐ I consent to use of my photographs in academic contexts (e.g., conference slides, academic publications, university archives).
☐ I consent to use of my photographs in public-facing media (e.g., exhibitions, project website, social media, press).
Video Consent
☐ I agree to be video recorded during my participation.
☐ I consent to use of video clips in academic contexts (e.g., presentations, lectures, artistic research portfolios).
☐ I consent to use of video clips in public-facing media (e.g., exhibitions, websites, social platforms).
Voice & Audio Consent
☐ I agree to allow my voice to be recorded for research documentation.
☐ I consent to my voice (or excerpts) being used in academic contexts (e.g., presentations, podcasts, installations).
☐ I consent to public use of my voice (e.g., video/audio shared online or in exhibitions).
☐ I do not consent to public use of my voice.
Social Media
☐ I consent to selected content (photo, video, or audio) being shared on social media channels related to this project.
☐ I do not consent to any media of me being shared on social media.
Identification Preferences
☐ I consent to being identified by first name in academic or public uses of media.
☐ I prefer to remain anonymous in all uses of media.
Withdrawal Reminder
You may change your preferences or withdraw consent for media use any time before publication or posting by contacting the researcher: roseman.j@northeastern.edu
Once materials are published or archived (e.g., in journals or online platforms), they may not be retrievable.
Your media will be used only in accordance with your selections.
This form does not affect your ability to participate in the study.
Participant Signature: ____________________________________ Date:_______________
Printed Name: ___________________________________________
Jessica Roseman Signature: ______________________________ Date: _______________