PUBS-WL
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1)  Are you at least 18 years of age? 
2)  Have you been participating in a weight loss program for the last 5 consecutive weeks? 
3)  Have you been in a committed, cohabitating relationship for the last two years? 
4)  Do you ever feel like your partner/spouse gets in the way of your weight loss? 

If you answered yes to all four of these questions, then you’re invited to participate in this anonymous, online survey to learn more about undermining (or sabotaging) by romantic partners during weight loss.  If there are any questions that you believe may cause discomfort or that you do not want to answer for any reason, please feel free to skip over these questions. We hope that you will respond honestly to all of the items, as this will give us the most accurate results. The process should take approximately 30-45 minutes to complete.

Your responses to this survey are anonymous and cannot be traced back to you. You should not include any identifying information about yourself on this survey (such as your full name or address).  Participation is voluntary and may be withdrawn at any time. 

At the end of this survey, you may select to have $1 donated by the researcher to your choice of 1 of 5 charities (Playworks, The Carter Center, Teach for America, Susan G. Komen for the Cure, or MAP International).  You will also be provided with an email address to enter a lottery for a chance to win 1 of 10 gift cards (one $100 gift card and nine $25 gift cards will be awarded - winners may also request the full amount be donated to one of the above charities).  Participation in the charity selection or lottery is optional. Your survey responses will remain anonymous as your email entry to the lottery will not be able to be connected to your survey results.

This study is being conducted by Amanda G. Harp, M.A., who is a graduate student in the Psychology Department at Clark University under the supervision of James V. Cordova, Ph.D. If you have any questions about this study, please contact Amanda Harp (aharp@clarku.edu) or Dr. Cordova (jcordova@clarku.edu).

 This study has been approved by the Clark Committee for the Rights of Human Participants in Research and Training Programs (IRB). Any questions about human rights issues should be directed to the IRB Chair, Dr. James P. Elliott, 508-793-7152.
If you would like to find a therapist in your area, please click on the following website:  https://aabt.org/members/Directory/Find_A_Therapist.cfm
Statement of Consent:  I am satisfied that I understand what will be expected of me as a participant in this study.  Any data I provide will remain anonymous with respect to my identity.  Additionally, I will not include any self-identifying information (such as my full name or mailing address) in my answers to open-ended questions.  Furthermore, I understand that I am free to withhold answers to any specific questions, and I am free to withdraw from the survey at any time.  Withdrawing from the survey will not result in the loss of any benefit to which I am otherwise entitled.  
Do you agree with this statement?