Breakfast Consumption


Full Project Title: Breakfast consumption: Temporal Self-Regulation Theory and Implementation Intentions

Principal Researcher: Dr Emily Kothe, School of Psychology, Deakin University

You are invited to take part in this research project. This Plain Language Statement contains detailed information about the research project. The purpose is to explain to you, as openly and clearly as possible, all the procedures involved in this project so you can make a fully informed decision about whether you would like to participate.

Please read this Plain Language Statement carefully. Feel free to ask questions about the study by emailing Emily Kothe:

A PDF file of this form is available for download to keep for your records.

In order to take part in this study you must be:

  • Between 18 and 25 years of age
  • Be able to read English fluently

Purpose and Background

The purpose of this study is to help understand the factors that determine breakfast consumption patterns. The aim is to examine the things that influence how people are able to put plans and intentions into actual behaviour.


If you choose to participate in the study you will asked to complete two short online questionnaires one week apart.

In the each questionnaire you will be asked about your actual breakfast consumption (e.g. how often you currently eat breakfast). and your planned breakfast consumption patterns in the future (how often do you intend on eating breakfast in the next week)You will be asked to complete a few short computerised tasks, including solving simple puzzles and how quickly you recognise visual stimuli.. Some participants will also be asked to complete a short task related to their ability to plan.

You will receive the link to the second questionnaire via an email 1 week after completing the first online questionnaire. To allow researchers to send you information about the second questionnaire you will be asked to provide your first name and email address when you complete the first questionnaire. This information will be stored separately from your responses.

You will also be asked to provide demographic information (e.g. age and gender) as part of this study.

Participating in the study will take about a total of 30 minutes, with each questionnaire taking about 15 minutes to complete.

Possible Benefits and Risks

This study will help to broaden our current understanding of breakfast consumption. However, participating in the study is not expected to directly benefit you. There are no expected risks or discomforts associated with participation in the study.


Privacy, Confidentiality and Disclosure of Information
Any information obtained in connection with this project and that can identify you will remain confidential.

You will be asked to provide your email address so that the researchers can email you the link to the second questionnaire. Your email address will be stored separately to your questionnaire responses and will be deleted within ONE week of you completing the second questionnaire.

Results from this study will be published in peer-reviewed articles and presented at academic conferences. You can contact the researcher via email ( if you would like to obtain a summary of the results or have any questions about the study. A preliminary summary of results is likely to be available from December 2013.

The information obtained from this study will be kept in secure storage in digital hardcopy for at least 6 years after the final publication. If required by the publishers of journal articles arising from this study, a non-identifiable data set would be made publically available via a data repository. This data would be completely anonymous. You could not be identified from any publically available data relating to this study.

Participation is Voluntary
Participation in any research project is voluntary. If you do not wish to take part you are not obliged to. You can withdraw from the project at any time between starting the first questionnaire and submitting the second questionnaire one week later. Because your identifying information will be deleted after you submit the second questionnaire, your data cannot be withdrawn once you have submitted the second questionnaire.

Your decision whether to take part or not to take part, or to take part and then withdraw, will not affect your relationship with Deakin University.

Before you make your decision, a member of the research team will be available to answer any questions you have about the research project via email You can ask for any information you want. Only initiate the questionnaire, signifying your consent, after you have received satisfactory answers to your questions.

Ethical Guidelines
This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007) produced by the National Health and Medical Research Council of Australia. This statement has been developed to protect the interests of people who agree to participate in human research studies.

The ethics aspects of this research project have been approved by the Human Research Ethics Committee of Deakin University.

If you have any complaints about any aspect of the project, the way it is being conducted or any questions about your rights as a research participant, then you may contact: The Manager, Research Integrity, Deakin University, 221 Burwood Highway, Burwood Victoria 3125, Telephone: 9251 7129, Please quote project number [HEAG-H 153_2012].

Further Information, Queries or Any Problems
If you require further information, wish to withdraw your participation or if you have any problems concerning this project you can contact the researcher via email at

The principal researcher responsible for this project is:

Dr Emily Kothe
School of Psychology,
Deakin University,
221 Burwood Highway.
Phone: 03 9244 5599


  • I have read and I understand the attached Plain Language Statement.

    I freely agree to participate in this project according to the conditions in the Plain Language Statement.

    A copy of the Plain Language Statement was made available to me for download.

    The researcher has agreed not to reveal my identity and personal details, including when information about this project is published, or presented in any public form.

    By initiating this questionnaire I understand that I have given full and informed consent to taking part in this study.


Please register to complete this survey. Your registration details will be used to give you access to both parts of the study. You will receive an email with the link to the first half of the study now and a second email in ONE week which will give you access to the second part of the study.

Your details will be stored separately to your questionnaire responses and will be deleted within ONE week of you completing the second questionnaire.

First name:
Email address: