Youth Survey Overview

Youth Survey Overview

Distribution Instructions Download PDF

Task Force Instructions for Survey Distribution Download PDF
Student Survey Download PDF
School Letter Requesting Parent Consent with Instructions Download PDF

Survey Administrator Instructions (Back to top)

Once you have identified the high school and all of the logistics for distributing the survey, the attached sheet is to distribute to those who will be administering the survey to the students such as teachers, counselors, etc. Please make ample copies for those individuals.

OHIO BRIDGEBUILDERS
Survey Distribution Directions

Thank you for helping us to distribute this survey! The purpose of this evaluation is to assess student involvement in alcohol and drugs. Please follow the directions listed below when distributing your surveys.

1) Distribute the surveys to all students (9th – 12th grades) at the beginning of their first morning class.
2) Before handing out the surveys, tell the students the following:

“We are conducting this survey as part of an overall community program. All of your responses will be kept anonymous and strictly confidential. No one will be able to link your responses to you. This is not a test and you will not be graded on it. Please answer all questions honestly. It is very important that you answer every question.
If you have any questions while filling out this survey, quietly raise your hand and I will come around to help you. It will take you about 10 minutes to complete. After you have completed the survey, place it face down on your desk. I will wait until all surveys are completed and then pick them up.”

3) Hand out the surveys to the students.
4) Once the survey is completed go around the room and personally collect the surveys from each of the students.
5) Place the completed surveys in a manila envelope
6) Give the envelope with the completed surveys to your school secretary.
7) Have the secretary take the surveys out of the envelopes and place them into one or two large envelopes to be sent to the University of Cincinnati.
8) The secretary should also type up your school name, city, and county on a cover letter that is placed on top of the surveys in the large envelope(s).
9) Mail the envelope(s) with the completed surveys to:

Dr. Keith King
Director of Evaluation and Research
Center for Prevention Studies, ML 0002
University of Cincinnati
Cincinnati, OH 45221-0002

If you have any questions with the survey or the survey distribution steps, please feel free to contact Dr. Keith King via telephone (513/556-3859) or email keith.king@uc.edu.

Thank you very much for your help !

Task Force Instructions for Survey Distribution (Back to top)

Youth Survey Instructions
In March of 2003: (Pre-Test)
- As a task force, select one public high school in your area that will be directly affected by the Bridgebuilders project activities
- Work with school officials to allow this survey to be completed by all of the students (Freshman, Sophomore, Junior and Senior). The survey will take approximately 10 minutes to fill out and should be distributed at the same time to all grade levels. The recommended time would be the homeroom period.
- Attached in this packet is a parental awareness letter that must be distributed to all parents of students taking the survey. Again, work with school officials to distribute this letter to parents.
- Once the date and time are chosen and the parental letter has been sent, copy the survey for each of the students. This cost will come out of your project funds.
- For those administering the survey, please make copies of the instructions attached within this packet.
- Once the surveys are complete, please make sure that all surveys are sent to:

Dr. Keith King
Director of Evaluation And Research
Center For Prevention Studies, ML 0002
Cincinnati, OH 45221-0002

- If you have any questions with the survey or survey distribution steps, please feel free to contact Dr. Keith King at 513-556-3859 or at keith.king@uc.edu. In March of 2004: (Post-Test)
- The same youth survey must be administered to the same high school in March of 2004. This youth survey will serve as a posttest to measure the effect of project programming.
- Work with school officials to allow this survey to be completed by all of the students (Freshman, Sophomore, Junior and Senior). The survey will take approximately 10 minutes to fill out and should be distributed at the same time to all grade levels. The recommended time would be the homeroom period.
- Attached in this packet is a parental awareness letter that must be distributed to all parents of students taking the survey. Again, work with school officials to distribute this letter to parents.
- Once the date and time are chosen and the parental letter has been sent, copy the survey for each of the students. This cost will come out of your project funds.
- For those administering the survey, please make copies of the instructions attached within this packet.
- Once the surveys are complete, please make sure that all surveys are sent to:

Dr. Keith King
Director of Evaluation And Research
Center For Prevention Studies, ML 0002
Cincinnati, OH 45221-0002

- If you have any questions with the survey or survey distribution steps, please feel free to contact Dr. Keith King at 513-556-3859 or at keith.king@uc.edu

Ohio Bridgebuilders Student Survey (Back to top)

Directions: Please answer each question. The answers you provide will be kept private and no one will know what you wrote. Answer each question based on what you really think and what you really do. THANK YOU for your participation in completing this survey.

STUDENT INFORMATION

School Name: ______________________________________

First two letters of your first name: ____ ____

First two letters of your last name: ____ ____

Your Age: ____years

Your Grade: ____Freshman ____Sophomore ____Junior ____Senior

Your Sex: ____Male ____Female

Your Race/Ethnicity: ____African American ____Asian ____Hispanic

____White ____Other

Think of where you live most of the time. Which of the following people live there with you?

(Check all that apply).

____Mother ____Brother(s) ____Grandmother ____Other adults

____Father ____Sister(s) ____Grandfather ____Other children

____Stepmother ____Stepbrother(s) ____Aunt

____Stepfather ____Stepsister(s) ____Uncle

During the past year, how would you describe your grades?

___Mostly AÕs ___Mostly BÕs ___Mostly CÕs ___Mostly DÕs ___Mostly FÕs

During the past 30 days, were you ever suspended from school? ____Yes ____No

During the past 30 days how many days of school did you skip? ____

Do you have either a permanent or temporary driverÕs license? ____Yes ____No

How close do you feel to . . .	Not Close at All	A Little Close	Moderately Close	Extremely Close
Your parent(s)/legal guardian(s)?	1	2	3	4
Your friend(s)?	1	2	3	4
Your teachers?	1	2	3	4
Your community?	1	2	3	4

STUDENT BEHAVIORS

During the past 30 days, how many times did you drink alcohol? _____

During the past 30 days, how many times did you drink 5 or more _____

alcoholic beverages during one occasion? _____

During the past 30 days, how many times did you drive a vehicle _____

after drinking alcohol?

During the past 30 days, how many times did you ride with a driver _____

who had been drinking alcohol?

During the past 30 days, how many days did you smoke a cigarette? _____

During the past 30 days, how many days did you smoke marijuana? _____

During the past 30 days, how many days did you use Ecstacy? _____

During the past 30 days, how many days did you sniff inhalants to get high? _____

During the past 30 days, how many days did you use heroin? _____

PERCEIVED RISKS OF ALCOHOL AND DRUG USE

How much do you think youth risk harming themselves (physically or in other ways) if they:	No Risk	Slight Risk	Moderate Risk	Great Risk
Drink five alcoholic beverages on one occasion?
Drink alcohol to try to get drunk?
Drive a vehicle after they have been drinking alcohol?
Ride in a vehicle with a driver who has been drinking alcohol?
Smoke at least one cigarette each day?
Smoke one or more packs of cigarettes each day?
Smoke marijuana at least once each day?
Smoke marijuana at least once each month?
Use Ecstacy?
Sniff items to try to get high?
Use heroin?

Where do you get most of your information ___Internet ___School ___TV

about alcohol and other drugs? (check one) ___Parent(s) ___Friend(s) ___Books

___Movies ___Other (specify)______

What do you think is the most effective way to

prevent kids from using alcohol or drugs? ________________________________

What do you think your community should do

to prevent kids from using alcohol or drugs? ________________________________

LIKELIHOOD TO . . .

How likely are you to . . .	Extremely Unlikely	Unlikely	Neutral	Likely	Extremely Likely
Talk to your parent/legal guardian about your problems?	1	2	3	4	5	--
Talk to an adult in school about your problems?	1	2	3	4	5	--
Talk to a friend about your problems?	1	2	3	4	5	--
Talk to your parent/legal guardian about alcohol and drugs?	1	2	3	4	5	--
Drink alcohol?	1	2	3	4	5	--
Drink five alcoholic beverages on one occasion?	1	2	3	4	5	--
Drink alcohol to try to get drunk?	1	2	3	4	5	--
Drive a vehicle after you have been drinking alcohol?	1	2	3	4	5	I do not drive
Say no to a friend who asks you to drive after drinking?	1	2	3	4	5	I do not drive
Stop a friend from driving after he/she has been drinking?	1	2	3	4	5	--
Ride with a driver who has been drinking alcohol?	1	2	3	4	5	--
Smoke cigarettes once or twice?	1	2	3	4	5	--
Smoke one or more packs of cigarettes each day?	1	2	3	4	5	--
Smoke marijuana once or twice?	1	2	3	4	5	--
Smoke marijuana at least once each month?	1	2	3	4	5	--
Use Ecstacy once or twice?	1	<font face="Arial, Helvetica, sans-serif" size="2">2	3	4	5	--
Use Ecstacy at least once each month?	1	2	3	4	5	--
Sniff items to get high at least once each month?	1	2	3	4	5	--
Use heroin?	1	2	3	4	5	--

DIFFICULT OR EASY TO . . .

How difficult or easy would it be for you to . . .	Extremely Difficult	Difficult	Neutral	Easy	Extremely Easy
Get alcohol from a store if you wanted some?	1	2	3	4	5
Get alcohol from home if you wanted some?	1	2	3	4	5
Get alcohol from a friend if you wanted some?	1	2	3	4	5
Get cigarettes from a store if you wanted some?	1	2	3	4	5
Get cigarettes from home if you wanted some?	1	2	3	4	5
Get cigarettes from a friend if you wanted some?	1	2	3	4	5
Get marijuana if you wanted some?	1	2	3	4	5
Get Ecstacy if you wanted some?	1	2	3	4	5
Get heroin if you wanted some?	1	2	3	4	5

SCENARIOS

Circle how likely or unlikely you are to perform each of the behaviors.

Scenario	Extremely Unlikely	Unlikely	Neutral	Likely	Extremely Likely
At a party your friend hands you a glass of alcohol and jokes that since you arrived late you need to catch up. How likely would you be to drink the alcohol?	1	2	3	4	5
While at a party, you see your friend who is your designated driver drinking alcohol. How likely would you be to allow this friend to drive?	1	2	3	4	5
Your friends pick you up on Saturday night to go out. When you get in the car you realize that they all have been drinking. How likely would you be to continue riding in this car?	1	2	3	4	5
While hanging with a group of classmates, one of them pulls a pack of cigarettes from his jacket. If he offers you one, how likely would you be to smoke?	1	2	3	4	5
While at a dance club a peer your age offers you Ecstacy. How likely would you be to accept the Ecstacy and use it?	1	2	3	4	5
You are crashing at a friendÕs house and his/her parents are not home. Your friend opens the liquor cabinet and asks you if you want some alcohol. How likely would you be to drink?	1	2	3	4	5
After drinking alcohol at a party you feel a bit shaky and know you shouldnÕt drive. How likely would you be to drive home?	1	2	3	4	5

HOW EFFECTIVE IS . . .

In your opinion, how effective is/are . . .	Extremely Ineffective	Ineffective	Neutral	Effective	Extremely Effective
Your community in preventing youth from using alcohol?	1	2	3	4	5
Your community in preventing youth from using tobacco?	1	2	3	4	5
Your community in preventing youth from using marijuana?	1	2	3	4	5
Your community in preventing youth from using Ecstacy?	1	2	3	4	5
Your community in preventing youth from using heroin?	1	2	3	4	5
Your community in preventing youth from buying alcohol?	1	2	3	4	5
Your community in preventing youth from buying tobacco?	1	2	3	4	5
Your community in preventing youth from buying marijuana?	1	2	3	4	5
Your community in preventing youth from buying Ecstacy?	1	2	3	4	5
Your community in preventing youth from buying heroin?	1	2	3	4	5

THANK YOU J

School Letter Requesting Parent Consent with Instructions
(Back to top)

Parental Awareness

Once you have identified a high school and have the permission to survey the students. You must present the attached letter to the principal to pass out to the parents of each student. This form is for those parents who do not wish to take the survey. If the parent does not return the form, assume that the parent is content with his/her child taking the survey. Please take note of how many parents return this form.

SCHOOL LETTERHEAD

Date
Dear Parent:
We have been awarded a grant by the Ohio Resource Network to assist in preventing underage drinking among youth. Part of this grant includes a student survey. This survey will assess high school students’ involvement in alcohol, tobacco and other drug use. This survey is extremely important and will be used to evaluate the effectiveness of our programs. We intend to distribute this survey to all of our high school students on <insert date>. We are asking your permission to let your child participate in this survey.
The survey is voluntary and all responses will be kept anonymous and confidential. There are no foreseeable risks to your child’s completion of this survey. It will take approximately 10 minutes to complete. If you do not wish to allow your child to participate in this survey, simply sign your name on the line below and instruct your child to return the signed form to school. If we do not receive a signed form from you, then your consent for allowing your child to complete the survey will be assumed.
If you have any questions, please feel free to contact <insert school contact person> at <insert school phone number>. Thank you very much for your time and consideration.
Sincerely,

------------------------------------------------------------------------------------------------------------
I, the undersigned, do not wish my child to complete the survey on alcohol, tobacco and other drug use.

Student Name:
Parent Signature:
Date:

NotASingleDrop

Youth Survey Overview

STUDENT INFORMATION

HOW EFFECTIVE IS . . .

THANK YOU J