We appreciate your interest in ScreenU Alcohol. Your answers are anonymous unless you choose to share them. If you are completing this screening in the company of a healthcare professional, they can help you interpret your score and the feedback we provide. Otherwise, your answers are completely anonymous and your individual score will not be reported to anyone.
This resource can help you identify if you are experiencing negative consequences because of your alcohol use. Based on your responses, you will receive non-judgmental feedback encouraging you to think about your choices that may be putting you at risk for harmful consequences. It can also provide ways for you to keep yourself and your friends safer. If necessary, you may be referred to our campus and community resources.
Please complete the following questions to gain a better understanding about your level of risk for experiencing problems from the misuse of alcohol.
Whatever you decide to do with the information provided to you during this activity is ultimately your choice. You are the expert on you.
CONSENT DOCUMENT (E-Version)
Purpose and Significance
The primary objective of this program tool is to give students feedback about their personal use of alcohol, marijuana and prescription drugs and to inform them of campus and local community resources related to alcohol and other drugs that are available to them. Another objective of the program tool is to explore the desire and readiness to change and to help students who are interested in making changes in their personal use of alcohol, marijuana, and prescription drugs toward more healthy choices. Students will be given the opportunity to explore both their motivation and confidence around change. In addition, during the grant period, the tool will be used to look at aggregate State System responses to see if there were any overall reductions in use, misuse or abuse of alcohol, marijuana, and prescription drugs by those participating.
The ScreenU program tool is designed to affect behavior by screening, giving feedback about personal scores on the screening, providing an electronic form of a brief intervention which consists of open-ended questions about the desire and readiness to change, and lastly providing helpful resources in the event that a participant would like more support or information related to alcohol and other drugs.
Please read over the instructions at the beginning of the program before you are asked any questions. Doing so indicates your willingness to participate. The survey will take approximately 5-10 minutes to complete. Please do not type your name or initials anywhere in the program. If you are pregnant or under the age of 18 you cannot participate in the survey. This is an anonymous program that cannot be tracked back to you. Please keep a copy of this Consent Document. If you agree to participate in the program after reading over this document, please click on the link highlighted in this email correspondence.
This last purpose listed above (looking for a change in aggregate responses) consists of obtaining information from voluntary participants and evaluating responses regarding use of alcohol, marijuana, and prescription drugs on an aggregate level. As a PASSHE university student who completed a ScreenU program between March, 2019 and December, 2019 you will be/are being invited to participate in our study by electronically completing the same program again. As a result of voluntarily providing your email, if you complete this survey, you will be emailed a voluntary follow-up survey in about one year.
Your email address will never be tied to your answers in the first or subsequent program completions. A Student Affairs Professional at your university will be given an excel document with just the email addresses of those students who are interested in being contacted to complete the program again, and the professional will follow up with an invitation to complete the program again at that time.
Survey results will be de-identified and accessible to the contact at your university through a dashboard for program administrators. At no time will your university contact have access to yours or any students responses connected to your email address.
No information that can identify you will be collected during this research study. Please do not type your name on any parts of the program. All program data will be secured electronically and viewed by investigators as a group of data so your results will not be singled out. Your privacy will be protected and your identity unknown to us.
Potential Risks and Benefits
There are no major foreseeable risks associated with your participation. Minor risks include the inconvenience of completing the program and/or how you infer information from taking the survey. If at any time you feel you would benefit from further evaluation of your alcohol or other drug use feel free to contact your university student counseling center or any of the other resources listed at the end of the program.
By anonymously providing your candid responses to the program questions, you may contribute to the knowledge base of interventions that can assist university students in reducing the risk of harm caused by alcohol and other drug use or misuse.
Costs of Participation
There are no costs of participation in this study. Participation or non-participation in the project will not impact your grades in courses.
There is no compensation for participating in this study.
Sources of Information
The investigators will be available to answer any questions concerning this research, now or in the future. You may contact investigator Donna George at 724-938-5515. If you have questions about your rights as a research subject, you may contact the Chair of the Cal U Institutional Review Board at firstname.lastname@example.org.
Consent to Participate
Title of Research Study: Pennsylvania State System of Higher Education (PASSHE)
“Changing the Culture with 2 Forms of SBIRT”
Participation in this study is voluntary. If you decide not to be in this study after it has already started, you may stop at any time. You may stop at any time you choose without penalty.