Azalea Prevention Project

Azalea Prevention Curriculum

Form Approved

OMB No. 0990-0379

Exp. Date 09/30/2020

The Northeast Florida Center for Community Initiatives at the University of North Florida is doing a research study on the Azalea Prevention Project to see if it works and if it can be made better. We are asking people who attended the workshop to take a short anonymous survey.

The survey is voluntary and should take less than 10 minutes. The questions are about reducing stigma related to opioid use. There are no penalties for not taking the survey, skipping questions, or stopping your participation. There are no foreseeable risks or direct benefits to participating in the survey. We do not know your name and your email address will not be connected to any of your responses.

If you have questions about this study, you can contact Jeffry Will by calling (904) 620-2463 or emailing [email protected]. If you have questions about your rights as a participant in the study, you can contact the chair of the UNF Institutional Review board by calling (904) 620-2498 or emailing [email protected].

You can print this information for your records by pressing Ctrl and the letter p at the same time.

By clicking on “Next”, you agree that you are at least 18 years old.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0379 . The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

Select all of the topics, if any, you have discussed with others since attending the Azalea workshop.

	Yes
Model of addiction as a disease	
Risks associated with substance use, such as heredity and environment	
Resources available	
Treatment and support options	
Stigma reducing language	

	Yes
Azalea Project	
Substance Exposed Newborn Task Force	
Healthy Start	
County Health Department	
Heroin and Opioid Task Force	
Drug Prevention Coalitions	
Treatment Centers	
24/7 “Access to Care” Hotline: 877-229-9098	
SAMHSA Treatment Locator	

Select all of the resources, if any, you have referred anyone to since attending the Azalea workshop.

For the Statements below, please mark whether you Agree, Disagree, or are Neutral.

	Agree	Neutral	Disagree
I would willingly accept someone who has been treated for substance use as a close friend.			
I feel that entering treatment for substance use is a sign of personal failure.			
I think less of a person who has been in treatment for substance use.			
I would treat someone who has been treated for substance use just as I would treat anyone else.			
I believe that someone who has been treated for substance use is just as trustworthy as the average citizen.			
I believe that a person who has been treated for substance use is just as intelligent as the average person.			