For Parents and Guardians of Students in Grades 7 and 9: A Message from the Nurse
Dear Parents and Guardians of Students in Grades 7 and 9:
We would like to invite your child to participate in two short electronic surveys to evaluate their behaviors, attitudes, and beliefs regarding alcohol and drug use and related harms. As you may know, the state of Massachusetts has recently passed legislation that requires the administration of a Screening, Brief Intervention and Referral to Treatment Program (SBIRT) in all middle and high schools in the Commonwealth. Mount Greylock, school nurse, Nichole Russell will briefly survey students on their substance use behaviors and provide education regarding alcohol and drug use to two grades during the 2018-2019 school year. The feedback from both staff and students in past years has been very positive, and the district is now partnering with Dr. Sharon Levy, Dr. Elissa Weitzman, and Dr. Lauren Wisk, researchers at Boston Children’s Hospital, to evaluate the SBIRT program across schools and learn more about the differences between grades who receive SBIRT this school year versus those who may receive the screening in subsequent grades.
The Protection of Pupil Rights Amendment (PPRA), 20 U.S.C. § 1232h, requires Mount Greylock Regional School District to notify you and allow you to opt your child out of participating in a student survey. The surveys, one baseline survey and one follow-up survey, take approximately 15 minutes each. The baseline survey will be administered onOctober 17, 2018 for Grade 7 students and October 18, 2018 for Grade 9 and the follow-up survey will be administered three months later in January. The surveys are anonymous and ask students questions about drug and alcohol use behaviors in addition to questions about their perspectives on screening. The surveys also ask questions of a demographic nature concerning the number of parents/guardians that the student lives with and their highest levels of education completed. All parents/guardians have the right, upon request, to review a copy of this survey. You may submit a request email@example.com to review the survey template.
This survey is optional for each student. If you do not wish for your child to participate in the survey, please read and complete the parent/guardian opt-out form attached. If we do not receive notification that you would like to opt-out your child from participation, your permission will be implied and your child will be contacted to complete the survey. Your child will also be given the choice to opt out of the survey for themselves at the time the survey is administered. Choosing to decline participation in this research will in no way affect your child’s education or relationship with the school. If your child does participate, all responses will be strictly confidential. We will not collect any of your child’s personal information (name, birthday, etc.). Data will be stored securely at Boston Children’s Hospital. The survey questions will be reviewed by the school district and approved by the Institutional Review Board (IRB) at Boston Children’s Hospital.
Nichole Russell, R.N.
SBIRT survey AY2019.pdf