INVESTIGATORS STATEMENT OF ASSURANCE (Attach to each copy of your proposal) The attached investigation involves the use of human

subjects. I understand the University policy concerning the use of human subjects and I agree: 1. To obtain informed consent of subjects who are to participate in this project; 2. To report to the human Subjects in Research Committee any unanticipated effects on subjects which become apparent during the course, or as a result, of experimentation and the actions taken as a result; 3. To cooperate with members of the Committee charged with the continuing review of the project; 4. To obtain prior approval from the Committee before altering or amending the scope of the project or implementing changes in the approved consent form; and 5. To maintain documentation of the consent forms and progress reports are required by institutional policy.

_______________________________________________ PRINCIPAL INVESTIGATORS SIGNATURE

SIGNATURE PAGE (Attach to each copy of your proposal) Fill in all the blanks. Does the subject group include healthy volunteers? Does the subject group include ill persons? Are subject groups excluded for medical reasons? Are there vulnerable subject groups? If yes, is the exclusion criteria for the study specified? Are any subjects under the age of 18? Are any subjects under the age of 12? Are any subjects over the age of 70? Yes __Yes __Yes __Yes __Yes Yes __Yes __Yes __No No No No __No __No No No

_____________________ _______________________________ _________________

Principal Investigators Name Principal Investigators Signature Date Department

_____________________ _______________________________ _________________

Principal Investigators email Mailing address/Mail Code/City, State, Zip Telephone

_______________________________ Student Researchers Name _______________________________ Student Researchers Name _______________________________ Student Researchers Name _______________________________ Student Researchers Name

________________________________ Department ________________________________ Department ________________________________ Department ________________________________ Department

__________________________ ______________________________________ ___________________ Department Chairs Name Department Chairs Signature Date Telephone

IRB APPLICATION INSTRUCTIONS (Please print and keep these instructions with your records) This document contains all forms required for submission of projects involving human subjects to the Institutional Review Board (IRB). Page 1 & 2: Investigators Statement of Assurance & Signature Page. The completed pages including all appropriate signatures should be submitted with the hard copy version of the application. Pages 3 & 4: Application instructions and Checklist. Use these pages to ensure the application is complete. Pages 5 8: Application. These pages comprise the bulk of the application. Each page has a major heading (A-D) and several subheadings (numbered). Each subheading is followed by a short description of what might or must be included in the application. The Principal Investigator should fill out these pages by removing the short descriptions of what might be included and filling in the information as it pertains to their particular project. If you have prior IRB approval from another institution, you do not need to fill out pages 5-8. Complete pages 1&2 and submit the full application, supporting information and approval notification from the sponsoring institution. (Hard copy submissions will be sufficient-see below). All application and renewals must include IRB training certificates from the IRB computer-based training course found on the following web site: http://cme.cancer.gov/clinicaltrials/learning/humanparticipant-protections.asp Please include only a copy of your certificate, keeping the original for your records.

Supplemental Information: All applicants should submit a copy of the information letter or signed consent form that will be distributed to each person in the study. All applications should submit signed waivers or consent forms from gourps or institutions who are sponsoring the project (example: a school board, hospital, etc), if appropriate. If an applicant is submitting a survey-based project, including a copy of the survey instrument may be required by the IRB. It is in your best interest to submit a copy of the survey instrument with the application. Submission: Application along with all appropriate forms should be sent to: Dr. Theresa S. Kay, Chair of the IRB Committee 1202 University Circle Weber State University Ogden, Utah 84408-1202 The IRB requests applicants submit their application in two different format; an electronic file on disk and a regular paper version. The electronic version is used to

expedite approval of applications requiring a full IRB review and the hard copy, including signed forms, is maintained on file as an archive. Electronic Version: Either attach an application document to an e-mail and send it to tkay@weber.edu or include a diskette containing the document with the complete hard copy. The IRB requests you submit your electronic file either in WordPerfect format (8.0 or smaller) or in Word as a .doc file. ***Macintosh Users: Please submit your application using a PC disk and document format; preferably in WordPerfect. Note: We have had mixed results reading WORD files from Macintosh computers. It is in your best interest to ensure we can read your application.

CHECKLIST FOR YOUR APPLICATION PACKAGE Investigators Statement of Assurance with Signatures (Page 1 of this document) Signature Page (Page 2 of this document) Completed Application Informed Consent Form (if applicable) Copy of all surveys, interview questions, and instruments to be used for your project. Copies of all advertising (fliers, posters, drafts of classified ads, etc.) for research subjects Copy of IRB computer-based training course certificate for all Principal Investigators, Co-Principal Investigators, and Student Researchers Electronic file of application (on diskette or by e-mail) Documentation of promised access (e.g. from a school board)(if applicable)

A. APPLICATION FORM The application form must be filled out completely so committee members may have a clear understanding of the nature and human subject implications of the research proposal. A summary paragraph for each section is sufficient. A statement referring to the attached material is not sufficient and will not be accepted. Applications submitted with incomplete forms will be returned without consideration of the proposal. 1. TITLE An Analysis of the Correlation between Stress, Self-Efficacy, Sleep, Social Support, and the Development of Eating Disorders in Students between the ages of 15-25 2. DESCRIPTION OF THE STUDY The purpose of this study will be to use the Transactional Model of Stress and Coping to analyze the relationships between stress, sleep, self-efficacy, social support, and the development of eating disorders among men and women between the ages of 15-25 years living in the United States. 3. DURATION OF THE STUDY Participant recruitment will begin on May 5, 2014. All consent forms will be received by July 4, 2014. Surveys will be sent out once a consent form is obtained. All surveys must be returned by September 5, 2014. Data analysis will be complete by February 6, 2015. 4. MULTICENTER STUDY This study obtains participants from all universities (Weber State University, University of Utah, Southern Utah University, etc.) and high schools (Roy High School, East High School, American Fork High School, etc.) in Utah. Research analysis will be completed only at Weber State University. 5. NUMBERS OF SUBJECTS A total of 2,500 students will receive an introductory letter and consent form requesting them to participate in the study. From the 2,500, we will recruit 250300 participants. 6. HEALTH STATUS OF THE SUBJECTS Participants will consist of healthy volunteers and will not be members of a vulnerable group in regards to health. 7. SUBJECT GROUPS EXCLUDED Exclusion Criteria: those younger than 15 and older than 25. 8. AGES OF THE SUBJECTS Participants will be between the ages of 15-25 years. 9. DESIGN OF THE STUDY This study will be quantitative, non-experimental survey research. It will take a cross-sectional approach, collecting data at only one point in time. 10. RISKS TO SUBJECTS

There are no risks associated with this study that are more than those experienced in everyday life. If any concerns arise from taking the survey, participants will be encouraged to seek help from Central Utah Counseling Center (435) 283-8400, Family Counseling Service of Northern Utah (801) 399-1600, Counseling Services of Southern Utah Llc (435) 673-2822 or the counseling services provided at your respective university or high school.

ANY MODERATE OR HIGH RISK STUDY MUST GO THROUGH A SEPARATE REVIEW PROCEDURE WHICH INCLUDES THE APPROPRIATE ADMINISTRATIVE OFFICER AND THE UNIVERSITY ATTORNEY.

11. BENEFITS TO SUBJECTS AND OTHERS There are no direct benefits to the subjects for participation in the study. The study could, however, help to bring a better understanding and awareness of what factors may influence the development of eating disorders which can then be confronted and addressed for future students. Upon completion of all study procedures (i.e. the informed consent and assessment survey), participants will receive a $10 Amazon gift card. 12. COSTS TO BE BORNE BY SUBJECTS There are no expected emotional costs to be borne by participants in this study. If any concerns arise from taking the survey, participants will be encouraged to seek help from Central Utah Counseling Center (435) 283-8400, Family Counseling Service of Northern Utah (801) 399-1600, Counseling Services of Southern Utah Llc (435) 673-2822 or the counseling services provided at your respective university or high school. Participants will be responsible for the time it takes to read through and complete the informed consent form and survey which is approximately 45 minutes to an hour (should they choose to participate). All mailing costs will be prepaid. 13. IS CONFIDENTIALITY ASSURED A. Stratified probability sampling will be used to select 2,500 university and high school students both male and female from the state of Utah. The only stratum will be the age limit from 15 years to 25 years. Each prospective participant will be mailed an introductory letter and consent form with pre-paid, preaddressed, and postage marked return envelopes. All participants will be required to then sign and return the informed consent form, which includes details on the nature of the study and what their involvement would entail. Some participants involved in this study will be under the age of 18 and members of a vulnerable population. Parents/guardians of participants under the age of 18 will be required to sign the informed consent form on behalf of their child. Upon retrieval of the form, the survey will then be sent via mail or email to the participant. B. All signed informed consent forms will be kept in a locked file cabinet. Each participant will be associated with an eight digit number placed on his/her survey document. Researchers assessing the surveys will not know which person is associated with which number. This survey will be mailed with pre-paid, preaddressed, and postage marked return envelopes or emailed to participants once the informed consent document is received. The survey will collect some demographic data but no identifying information. Return of the survey will be considered assent from participants under the age of 18. All completed survey and record hardcopies will be kept in a locked file cabinet. Data will be stored and analyzed in SPSS, a secure computer database. 14. CONTRACT OR GRANT NUMBER N/A 15. NAME OF PRINCIPAL INVESTIGATOR AND DEPARTMENT

Principal Investigator: Kristen Childers kristenchilders@mail.weber.edu Department: Health Promotion & Human Performance Department Chair: Jennifer Turley, PhD

B. DESCRIPTION OF THE STUDY This should be brief (no longer than two pages) and should include: 1. BACKGROUND INFORMATION Eating disorders are extremely serious conditions that can result in a multitude of negative consequences including depression, anxiety, physical impairments, and even death (Coomber & King, 2012). They affect approximately 24 million Americans90% of whom are between the ages of 12 and 25 (Alliance for Eating Disorders Awareness, 2003). Eating disorders are significantly prevalent in the United States. It is important to understand the factors influencing their occurrence in order to address and successfully promote their prevention and treatment. Several studies have shown correlations between an individuals social support system and the development of eating disorders (Bodell, Smith, Holm-Denoma, Gordon, & Joiner, 2011; Hartmann, Zeeck, & Barrett, 2010; Limbert, 2010). Social support, as defined by the American Psychological Association, is resources, including material aid, socio-emotional support, and informational aid, provided by others to help a person cope with stress (2014). Researchers have found consistent correlations between stress and eating disorders. According to the American Psychological Association, stress is the pattern of specific and nonspecific responses an organism makes to stimulus events that disturb its equilibrium and tax or exceed its ability to cope (2014). Major life events, especially sexual assault or those leading to Post Traumatic Stress Disorder (PTSD), have been associated with the development of eating disorders (Dubosc et al., 2012; Forman-Hoffman, Mengeling, Booth, Torner, & Sadler, 2012). Self-efficacy, the belief in ones own ability to accomplish a task or goal, is another variable that has been shown to mediate the development and severity of eating disorders (Glasofer et al., 2013; MacNeil, Esposito-Smythers, Mehlenbeck, & Weismoore, 2012). Sleep, according to researchers at Harvard Medical School, is a state that is characterized by more coordinated and synchronized patterns of brain waves, regular breathing patterns, restoration of energy, and other physiological functions (2007). Problems with sleep have been associated with binge eating, a type of eating disorder (Trace et al., 2012). While there have been many studies on how social support, stress, self-efficacy, and sleep are associated with the development of eating disorders individually, no studies have sought to elucidate their influence on eating disorder development in an integrated model. Most research correlating to eating disorders is done on

women. This excludes approximately 10-15% of the population suffering from eating disorders (Alliance for Eating Disorders Awareness, 2003). Eating disorders affect millions of Americans. Given the potential severity of these conditions today, it is important to understand the correlation between possible causative factors and the subsequent development of the disorders. Alliance for Eating Disorders Awareness. (2003). Eating disorders statistics. The Alliance for Eating Disorders Awareness. Retrieved from http://www.ndsu.edu/fileadmin/counseling/Eating_Disorder_Statistics.pdf. American Psychological Association. (2014). Glossary of psychological terms. American Psychological Association. Retrieved from http://www.apa.org/research/action/glossary.aspx. Bodell, L. P., Smith, A. R., Holm-Denoma, J. M., Gordon, K. H., & Joiner, T. E. (2011). The impact of perceived social support and negative life events on bulimic symptoms. Eating Behaviors, 12(1), 44-48. doi:10.1016/j.eatbeh.2010.11.002 Coomber, K., & King, R. (2012). Coping strategies and social support as predictors and mediators of eating disorder carer burden and psychological distress. Social Psychiatry & Psychiatric Epidemiology, 47(5), 789-796. doi:10.1007/s00127-011-0384-6 Dubosc, A., Capitaine, M., Franko, D. L., Bui, E., Brunet, A., Chabrol, H., & F. Rodgers, R. (2012). Early adult sexual assault and disordered eating: The mediating role of posttraumatic stress symptoms. Journal of Traumatic Stress, 25(1), 50-56. doi:10.1002/jts.21664 Glasofer, D. R., Haaga, D. F., Hannallah, L., Field, S. E., Kozlosky, M., Reynolds, J., & ... Tanofsky-Kraff, M. (2013). Self-efficacy beliefs and eating behavior in adolescent girls at-risk for excess weight gain and binge eating disorder. International Journal of Eating Disorders, 46(7), 663-668. doi:10.1002/eat.22160 Harvard Medical School. (2007). Healthy sleep: The characteristics of sleep. Division of Sleep Medicine at Harvard Medical School. Retrieved from http://healthysleep.med.harvard.edu/healthy/science/what/characteristics. Trace, S. E., Thornton, L. M., Runfola, C. D., Lichtenstein, P., Pedersen, N. L., & Bulik, C. M. (2012). Sleep problems are associated with binge eating in women. International Journal of Eating Disorders, 45(5), 695-703. doi:10.1002/eat.22003

2. EXPERIMENTAL METHODS The purpose of this study will be to use the Transactional Model of Stress and Coping to analyze the relationships between stress, sleep, self-efficacy, social support, and the development of eating disorders among men and women between the ages of 15-25 years living in the United States. This study will be quantitative, non-experimental survey research. It will take a cross-sectional approach, collecting data at only one point in time. Research Questions: a. Is there a statistically significant correlation between the amount of perceived stress and the development of eating disorders in men and women between the ages of 15-25 years living in the United States? b. Is there a statistically significant correlation between reported sleep and the development of eating disorders in men and women between the ages of 15-25 years living in the United States? c. Is there a statistically significant correlation between perceived selfefficacy and the development of eating disorders among men and women between the ages of 15-25 years living in the United States? d. Is there a statistically significant correlation between perceived social support and the development of eating disorders among men and women between the ages of 15-25 years living in the United States? Null Hypotheses: a. There is no statistically significant correlation between the amount of perceived stress and the development of eating disorders in men and women between the ages of 15-25 years living in the United States. b. There is no statistically significant correlation between reported sleep and the development of eating disorders in men and women between the ages of 15-25 years living in the United States. c. There is no statistically significant correlation between perceived selfefficacy and the development of eating disorders among men and women between the ages of 15-25 years living in the United States. d. There is no statistically significant correlation between perceived social support and the development of eating disorders among men and women between the ages of 15-25 years living in the United States. The Theory of Stress and Coping that will be used in this study is a cognitive theory established by Lazarus and Folkman (Theorienoverzicht TCW, 2014). It is a framework for the evaluation of stressors and an individuals subsequent reaction to the stressors. Stressors, which are internal or external demands experienced by an individual, stimulate reactions. An individuals reaction is mediated by his or her perception of the severity of the stressor followed by the amount of perceived control (s)he feels (s)he has over it. Quantitative data from the surveys will be analyzed using SPSS, a secure computer database. Theorienoverzicht TCW. (2014). Transactional model of stress and coping. University of Twente. Retrieved from

http://www.utwente.nl/cw/theorieenoverzicht/Theory%20Clusters/Health %20Communication/transactional_model_of_stress_and_coping/. 3. DESCRIPTION OF RECRUITMENT PROCEDURES Stratified probability sampling will be used to select 2,500 university and high school students both male and female from the state of Utah. The only stratum will be the age limit from 15 years to 25 years. Each prospective participant will be mailed an introductory letter detailing the purpose and specifics of the study and an informed consent form with pre-paid, preaddressed, and postage marked return envelopes. Return of the consent form will be considered agreement to participate. 4. MODERATE OR HIGH RISK N/A C. INFORMED CONSENT The IRB with Human Subject Research Committee in conformance with federal guidelines requires documentation of informed consent. The committee may, for some or all subjects, waive the requirement that the subject or the subjects legally authorized representative sign a written consent form. If the committee finds the research presents no more than minimal risk of harm to subjects and involves no procedures for which written consent is normally required outside the research context. In cases where the documentation requirement is waived, the committee may require the investigator to provide subjects with a written statement regarding the research. The entire consent form must be written in the second person and in language totally intelligible to an average person who has no background in science or scientific technology. BASIC ELEMENTS OF INFORMED CONSENT In seeking informed consent, the following information shall be provided to each subject: 1. A statement that the study involves research, and explanation of the purposes of the research, the expected duration of the studies expected participation, a description of the procedures to be followed, and identification of any procedures which are experimental. 2. A description of any foreseeable risks or discomforts of the subject. 3. A description of any benefits to the subject or to others which may reasonably be expected from the research. 4. A disclosure of any alternative procedures or courses of treatment, if any, that might be advantages to the subject.

5. A statement describing the extent, if any, to which confidentiality of records is maintained and that notes the possibility that the food and drug administration may inspect the records, if applicable. 6. For research involving more than minimal risk, an explanation as to whether any compensation and an explanation as to whether any medical treatments are available if injury occurs and if so, what they consist of, or where further information may be obtained. 7. An explanation of whom to contact for answers to pertinent questions about the research and research subjects rights, and whom to contact in the event of a research-related injury to the subject. 8. A statement that participation is voluntary, that refusal to participate will involve no penalty or loss of benefits to which the subject is otherwise entitled, and that the subject may discontinue participation at any time without penalty or loss of benefits to which the subject is otherwise entitled.

ADDITIONAL ELEMENTS OF INFORMED CONSENT When appropriate one or more of the following elements of information shall be provided to each subject: 1. A statement that the particular procedure may involve risks to the subject (or the embryo or fetus, if the subject is or may become pregnant) which are currently unforeseeable. 2. Anticipated circumstances under which the subjects participation bay be terminated by the investigator without regard to the subjects consent. 3. Any additional costs to the subject that may result from participation in the research. 4. The consequences of the subjects decision to withdraw from the research and procedure for orderly termination of participation by the subject. 5. A statement that significant new findings developed during the course of the research which may relate to the subjects willingness to continue participation will be provided to the subject. 6. The approximate number of the subjects involved. Except as previously stated, informed consent shall be documented by the use of a written consent form approved by the committee and signed by the subject or the subjects legally authorized representative. A copy shall be given to the person signing the form. Except as previously stated, the consent form must be either of the following: 1. A written consent form that embodies the elements of informed consent, This form may be read to the subject or legally authorized representative, but in any event, the investigator shall give either the subject or the representative adequate opportunity to read it before it is signed. 2. A short form written consent stating that the elements of consent have been presented orally to the subject or the subjects legally authorized representative. When this method is used, there shall be a witness to the oral presentation. Also, the committee shall approve a written summary of what is to be said to the subject or representative. Only the short form itself is to be signed by the subject or legal representative. However, the witness shall sign both the short form and a copy of the summary, and the person actually obtaining the consent shall sign a copy of the summary. A copy of the summary shall be given to the subject or representative in addition to a copy of the short form.