Alcohol, Tobacco, and Other Drugs Survey

Dear Student:

What is this about? We’re asking you to complete a short, web-based survey that is going out to Penn State Altoona students, specifically PSU-3 classes, to find out the real answers to the questions regarding the use, misuse, and consequences of alcohol use. We want to know what you think so that we can work to change our environment to make it better for you. Your responses will remain completely confidential. The research project involves evaluating your responses to determine effectiveness of program design and instruction.

Why should I participate? Because without your help we can’t accurately assess what is going on and why.

What do I have to do? Complete the short survey and click onto “Send.” Completing and returning the survey will indicates your implied consent to participate. You should only complete the survey if you are eighteen years of age or older. Your name will not be used to associate you in anyway with the results.

Will my answers be shared outside of the research? No. In answering the questions, you may be admitting to illegal behavior; however, the intent of the research is not assess underage drinking. Since names will not be linked to responses, you would not be identified in any publication or presentation of the research records. Your confidentiality is maintained to the degree permitted by the technology used, with the understanding that no guarantees can be made regarding the interception of data sent via the Internet by any third parties. The technology of the Internet produces limitations in confidentiality assurance. The following may review and copy records related to this research: The Office of Human Research Protections in the U.S. Dept. of Health and Human Services; The Penn State University Social Science Institutional Review Board (IRB); The Penn State University Office for Research Protections.

How long does it take? This survey will only take about seven to ten minutes to complete. There is no risk, other than the possibility of triggering potential emotions in answering questions regarding consequences.

Is my participation voluntary? Yes, your decision to be in this research is voluntary. You can stop at any time. You do not have to answer any questions you do not want to answer. Refusal to take part in or withdrawing from this study will involve no penalty or loss of benefits you would receive otherwise.

Where do I go for questions about the research? You have a right to ask questions about this research. Contact Joy Himmel, Director Health and Wellness Center and principal Project Coordinator with any questions at jyh1@psu.edu, 814-949-5540, or at 3000 Ivyside Park, Altoona, PA 16601. You can also call this number is you have complaints or feel that the research has harmed you. If you have questions about your rights as a research participant, or you have concerns or general questions about the research, contact Penn State University’s Office for Research Protections at 814-865-1755. You may also call this number if you cannot reach the research team or wish to talk to someone else.

Please print off this informed consent form for your records.

This informed consent form was reviewed and approved by the Research Protections Review Board (IRB 24589, Doc.#1 DWM) at the Pennsylvania State University on December 13, 2007 and expires on December 12, 2008.