The University of British Columbia

Consent Agreement

Pilot Launch of Men's Health Risk Assessment Tool ("YouCheck")

Who is conducting the study?

Men's Health Risk Assessment Tool ("YouCheck") is developed and maintained in partnership between the University of British Columbia and the Canadian Men's Health Foundation.

Principal Investigator: Dr. S. Larry Goldenberg, CM, OBC, MD, FRCSC, FCAHS
Professor, Department of Urologic Sciences
Stephen A. Jarislowsky Chair in Urologic Sciences
Mohammad H. Mohseni Chair in Men’s Health

Co-Investigator: Dr. Kendall Ho
Director, eHealth Strategy Office; and Professor, Dept. of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia

Study Coordinator: Dr. Farshad Pourmalek
Research Associate, Department of Urologic Sciences; Lecturer, School of Population and Public Health; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia

Who is funding this study?

The study is funded by Sun Life Financial Canada.

Why are we doing this study?

The purpose of Men's Health Risk Assessment Tool (“YouCheck”) is to estimate 10-year risk of developing 5 important diseases for Canadian men in broad categories of low, medium, or high risk, as well as 20-year risk of colon cancer, current risk-factor profile for prostate cancer, and the current risk of depression (using Center for Epidemiologic Studies Depression Scale, CESD). Objectives are awareness raising about men's health, its determinants, and improvement, as well as decrease in health risk factors' level and distribution and disease incidence through healthy life style improvement. The ultimate goal is betterment of men's health in Canada.

Why should you take part in this study?

You are being invited to take part in this research study because you are a Canadian man 18 years or older. This tool provides information about your health risk factors and healthy life style improvement.

What happens if you say, “Yes, I want to be in the study”?

Upon consent to use the tool, you answer 19 health-related questions and the above-mentioned results are provided for you along with recommendations for healthy life style behaviour improvement related to your top health risk factors. The entire process should take about 10 minutes to complete.

How the results will be reported?

Your personal results will be provided to once you finish answering the questions. The main study findings will be published in academic journal articles, and will be anonymous.

Is there any way being in this study could be bad for you?

We do not think there is anything in this study that could harm you or be bad for you. Some of the questions we ask might upset you. Please let one of the study staff know if you have any concerns. Some of the questions we ask may seem sensitive or personal. You do not have to answer any question if you do not want to. You can benefit from learning about your health situation and how to improve it.

How will your identity be protected and your privacy maintained?

You use the tool anonymously and your answers remain anonymous. There are no personal identifiers in the questions and identity of respondents is unknown and remains unknown. Survey information is kept on secure computers at University of British Columbia. Anonymized data from the survey will be kept and used for research on upgrading and further improvement of the tool.

Will you be paid for your time/ taking part in this research study?

There is no remuneration, compensation or other benefit to participating.

Who can you contact if you have questions about the study?

If you have any questions or concerns about what we are asking of you, please contact the study coordinator, Dr. Farshad Pourmalek (phone: 604-737-2990)

Who can you contact if you have complaints or concerns about the study?

If you have any concerns or complaints about your rights as a research participant and/or your experiences while participating in this study, contact the Research Participant Complaint Line in the UBC Office of Research Services at 604-822-8598 or if long distance e-mail or call toll free 1-877-822-8598

Health Risk Assessment Tool and Your Health

Health risk assessment tools do not intend to substitute health care and health care workers and physicians' visits, check-ups, prescriptions, and advice. Always talk to your physician and do not alter or discontinue any recommendations or medications given by your physician. Health risk assessment tools cannot tell if a person does or does not have a disease or condition now or if a person will or will not develop a disease or condition in future.

Health risk assessment tool's contents and recommendations are based on valid scientific evidence at the time of publication and are updated periodically. Medicine is an ever-evolving science. What makes people healthier or unhealthier originates from many factors, some of which are not known to the scientists. Therefore, following the health recommendations in this tool cannot guarantee disease prevention. They are provided on an “as-is” basis with their inherent probability of inaccuracy and typographical errors. Hence, completeness or usefulness of the information and recommendations cannot be guaranteed.

Participant Consent

Using this tool and its results and recommendations is entirely voluntary and up to you. You are free to withdraw at any time. Your participation will not affect any health care services you receive currently or in the future. By proceeding to use this tool, you signify that you have read this information and consent form, understood its contents, accept the contents, and agree with the contents. A copy of this consent can be printed from this page. If the questionnaire is completed, it will be assumed that consent has been given.