ACHA National College Health Assessment
Spring, 2003
Informed Consent
The National College Health Assessment survey (NCHA) was designed by the American College Health Association (ACHA) to assess student health, protective behaviors, risk behaviors, and perceived norms on a national level. The Community Health Education Department at CU- Boulder's Wardenburg Health Center (WHC) in collaboration with the ACHA is conducting this on-line survey. Your responses will greatly assist CU-Boulder and other universities in assessing college student health and safety issues, and will help ACHA to measure progress on national health objectives.
You could win one of five $500 cash awards for participating in the study. Your chances of winning one of these awards are approximately 1 in 200.
$20 cash will be awarded to 50 of the first 100 students who respond. In addition, all respondents will be eligible for a drawing in which five people will receive $500. You must be 18 years or older to participate in this survey.
Please note this survey contains items concerning illegal behaviors. A sample of questions regarding illegal activities is: "Within the last 30 days, on how many days did you use cocaine?" A sample question regarding sensitive questions such as sexual activity is: "Within the last 30 days, if you are sexually active, how many times did you have: oral sex, vaginal intercourse, anal intercourse?"
This survey will be done online; you may indicate your responses by clicking with your computer mouse. The online survey process was selected to save you time, and it also saves paper and mailing expenses.
Benefits of Participating: You may benefit by knowing that you have assisted in providing accurate information regarding health behaviors on this campus. This information will be used in program development for students at risk.
Risks of Participating: There may be some risks (e.g., personal discomfort with the content of certain questions). If this occurs, you may always discontinue the survey and seek professional assistance from:
- CU Office of Victim Assistance: 303-492-8855
- CU Psychiatry Clinic at Wardenburg Health Center: 303-492-5654
- CU Counseling and Career Services: 303-492-6766
Your participation is completely voluntary and confidential. We expect it will take about 20-25 minutes to complete the survey. All of your responses will be kept strictly confidential in that your name will never be associated with your responses. You may omit answers to any questions you so choose and you have the right not to participate.
YOUR QUESTIONNAIRE ID NUMBER (QID number)
You have been assigned a randomly generated 6-digit
Questionnaire ID (QID) number by CU-Boulder's Office of Planning,
Budget, and Analysis (PBA). This QID number is listed on both the e-
mail invitation and postcard that were sent to you by PBA. Before
you can begin the survey, you will need to enter your QID number.
Your responses are associated with your QID number (but not with
your name or Social Security Number). QIDs are used to ensure
confidentiality.
WHAT HAPPENS TO THE DATA
The completed survey data
will be sent to a secure, confidential server with a firewall,
located in PBA. All names and any other identifying information
will be stored on a completely separate secure server. Access to the
data, by PBA staff, will be monitored by PBA's Assistant Director of
Institutional Analysis. To prevent the linking of survey responses
with any identifying information (e.g., your name), the randomly
assigned QIDs and identifying information will be deleted from all
data files after the data collection and preparation of the final
data file has been completed.
The final data file of survey responses only will be sent to ACHA for analysis, and will not include the QID. After analysis, ACHA will forward the compiled results and dataset to the researcher in the Community Health Education Department.
QUESTIONS
If you have any questions about the
confidentiality of your responses or technical aspects of
participating in the on-line survey, please call Cathy Kerry at 303-
492-3763 or email cathy.kerry@colorado.edu.
If you have questions regarding your rights as a subject, any concerns regarding this project or any dissatisfaction with any aspect of this study, you may report them --confidentially, if you wish -- to the Executive Secretary, Human Research Committee, Office of the Vice Chancellor for Research, 026 UCB, Regent Administrative Center 308, University of Colorado at Boulder, Boulder, CO 80309-0026 or by telephone to (303) 492-7401. Copies of the University of Colorado Assurance of Compliance to the federal government regarding human subject research are available upon request from the Graduate School address listed above.
If you have questions about the survey items, contact Rebecca Carlson at 303-492-8704, Manager of the Community Health Education Department, or email rebecca.carlson@colorado.edu.
Results of this survey will be available through the Community Health Education Department, at 303-492-5101.
AGREE TO PARTICIPATE
By clicking on the YES button below, you are acknowledging that you are
18 years of age or older and are agreeing to participate in the
National College Health Assessment. Please print a copy of this
statement for your records. Thank you for participating!