Communities That Care Youth Survey-Australian adaptation

1. How old are you? / 11 / 12 / 13 / 14 / 15 / 16
2. What year are you in? / Year 6 / Year 8
3. Are you: / Male / Female
4. In which country were you born? / Australia / Another country (please specify)…………………………………….
5. In which country was your mother born? / Australia / Another country (please specify)…………………………………….
6. In which country was your father born? / Australia / Another country (please specify)…………………………………….
7. Are you or your family Aboriginal or Torres Strait Islander? / Yes / No
8. What language do you speak at home? Please put a cross in one box only
/ English / Another language (please specify)…………………………………………….….
/ English and another language (please specify)……………………….………….
9. (a) Have you changed homes in the past year? / Yes / No
(b) What is the name and postcode of the suburb/town/area where you live now?
Suburb/town/area: _______________________ Postcode:
10. Have you changed schools (including changing from primary to secondary school) in the past year? / Yes / No
11. How many times have you changed schools (including changing from primary to secondary school) since kindergarten?
 Never
 1 or 2 times
 3 or 4 times
 5 or 6 times
 7 or more times
12. How many times have you changed homes since kindergarten?
 Never
 1 or 2 times
 3 or 4 times
 5 or 6 times
 7 or more times
13. How often do you attend religious services or activities (such as going to church‚ temple‚ or mosque‚ or taking part in religious youth groups)?
 Never
 Rarely
 1-2 times a month
 About once a week or more
 14. How important is religion or spirituality in your life?
 Extremely important
 Very important
 Somewhat important
 Not very important
 Not important at all
This section asks about your experiences at school.
15. Putting them all together‚ what were your marks like last year?
 Very good / Good / Average / Poor / Very Poor
16. During the last 4 weeks‚ when school was in session‚ how many whole days have you missed because you skipped or “wagged”?
None / 1/ 2/ 3 / 4 – 5 / 6 - 10 / 11 or more
Please choose BIG YES!‚ little yes‚ little no‚ or BIG NO! for each statement. Mark only one answer for each question.
17. In my school‚ students have lots of chances to help decide things like class activities and rules.
YES! /yes /no /NO!
18. Teachers ask me to work on special classroom projects.
YES! /yes /no /NO!
19. My teachers notice when I am doing a good job and let me know about it.
YES! /yes /no /NO!
20. There are lots of chances for students in my school to get involved in sports‚ clubs‚ organizations‚ or other school activities outside of class.
YES! /yes /no /NO!
21. There are lots of chances for students in my school to talk with a teacher one-on-one.
YES! /yes /no /NO!
22. I feel safe at my school.
YES! /yes /no /NO!
23. The school lets my parents know when I have done something well.
YES! /yes /no /NO!
24. My teachers praise me (tell me I’m doing well) when I work hard in school.
YES! /yes /no /NO!
25. I have lots of chances to be part of class discussions or activities.
YES! /yes /no /NO!
26. Are your school marks better than the marks of most students in your class?
YES! /yes /no /NO!
***
27. How often do you feel that the schoolwork you are assigned is meaningful and important?  Almost always/Often/Sometimes/Seldom/Never
28. How interesting are most of your courses to you?
Very interesting and stimulating/Quite interesting/Fairly interesting/Slightly dull/Very dull
29.How important do you think the things you are learning in school are going to be for your later life?
Very important/Quite important Fairly important/Slightly important/Not at all important
***
30.Now‚ thinking back over the past year in school‚ how often did you:
1.    Enjoy being in school? Al most always/ Often/ Sometimes/Seldom/Never
2.    Hate being in school? Al most always/ Often/ Sometimes/Seldom/Never
3.    Try to do your best work in school? Al most always/ Often/ Sometimes/Seldom/Never
***
YOUR FRIENDS & EXPERIENCES
For this next set of questions‚ think of your four best friends (the friends you feel closest to). These questions will ask about things that have happened in the past year
31. In the past year (12 months)‚ how many of your four best friends have:
None of my friends=1‚ 1 of my friends =2‚ 2 of my friends=3‚ 3 of my friends=4‚ 4 of my friends=5
A. Smoked cigarettes? 1 2  3  4  5 
B. Tried alcohol (like beer‚ wine‚ or spirits) when their parents didn’t know about it? 1 2  3  4  5 
C. Used marijuana (pot‚ weed‚ grass)? 1 2  3  4  5 
D. Used other illegal drugs (like cocaine‚ heroin‚ ecstasy‚ or amphetamines/speed)? 1 2  3  4  5 
E. Tried to do well in school? 1 2  3  4  5 
F. Been involved in sports‚ clubs‚ organizations‚ or other activities at school? 1 2  3  4  5 
G. Been suspended from school? 1 2  3  4  5 
H. Carried a weapon? 1 2  3  4  5 
I. Stolen something worth more than $10? 1 2  3  4  5 
J. Sold illegal drugs? 1 2  3  4  5 
K. Stolen or tried to steal a motor vehicle such as a car or motorcycle? 1 2  3  4  5 
L. Been arrested? 1 2  3  4  5 
M. dr‎opped out of school? 1 2  3  4  5 
N. Been members of a gang? 1 2  3  4  5 
O. Attacked someone with the idea of seriously hurting them? 1 2  3  4  5 
***
32. How many times have you:
Never =1‚ I’ve done it‚ but not in the past year =2‚ Less than once a month =3‚ About once a month =4‚ 2 or 3 times a month=5‚ Once a week or more=6
A. Done crazy things‚ even if they are a little dangerous? 1 2  3  4  5  6
B. Done something dangerous because someone dared you to do it? 1 2  3  4  5  6
C. Done what feels good no matter what? 1 2  3  4  5  6
***
33. In the past year‚ did you belong to a gang?  Yes  No
34. If you did belong to a gang‚ did that gang have a name?
 Yes  No  I have never belonged to a gang.
***
Never=1‚ 1 or 2 times=2‚ 3 to 5 times=3‚ 6 to 9 times=4‚ 10 or more times=5
35. How many times in the past year (12 months) have you:
A. Looked forward to going to school? 1 2  3  4  5 
B. Been involved in sports‚ clubs‚ organizations or other activities at school? 1 2  3  4  5 
C. Been involved in sports‚ clubs‚ organizations‚ or other activities outside of school? 1 2  3  4  5 
D. Made a personal effort to care for the environment in your daily life (like recycled waste or reduced energy use)? 1 2  3  4  5 
E. Gotten back at another student by not letting them be in your group of friends? 1 2  3  4  5 
F. Told lies or started rumours about other students to make other kids not like them? 1 2  3  4  5 
G. Called another student mean names‚ made fun of or teased him or her in a hurtful way? 1 2  3  4  5 
H. Carried a weapon? 1 2  3  4  5 
I. Been suspended from school? 1 2  3  4  5 
J. Stolen something worth more than $10? 1 2  3  4  5 
K. Sold illegal drugs? 1 2  3  4  5 
L. Stolen or tried to steal a motor vehicle such as a car or motorcycle? 1 2  3  4  5 
M. Been arrested? 1 2  3  4  5 
N. Attacked someone with the idea of seriously hurting them? 1 2  3  4  5 
O. Been drunk or high at school? 1 2  3  4  5 
P. Beaten up someone so badly that they probably needed to see a doctor or nurse? 1 2  3  4  5 
Q. Threatened someone with a weapon? 1 2  3  4  5 
***
36. Have you been bullied recently (teased or called names‚ had rumours spread about you‚ been deliberately left out of things‚ threatened physically‚ or actually hurt)?
 No  Yes‚ less than once a week  Yes‚ about once a week  Yes‚ most days
37. Have you taken part in bullying another student(s) at school recently?
 No  Yes‚ less than once a week  Yes‚ about once a week  Yes‚ most days
***
The next questions are about how you get along with others and manage your feelings.
Very bad at this=1‚ Poor at this=2‚ Good at this=3‚ Very good at this=4
38. How are you at…
A. Letting friends know you like them by telling them or showing them? 1 2  3  4 
B. Introducing yourself to someone for the first time? 1 2  3  4 
C. Helping someone feel better when they are upset? 1 2  3  4 
D. Showing that you care when someone talks about their problems? 1 2  3  4 
E. Letting someone really get to know you? 1 2  3  4 
F. Staying friends with people? 1 2  3  4 
***
39. During the past 12 months how often have you done volunteer work to help other people‚ such as helping out at a hospital or raising money for ch‎arity?
Never  Once  Twice  3 or 4 Times  5 or more times
***
YOUR OPINIONS
Next‚ please give us your opinion about the following statements by answering BIG YES!‚ little yes‚ little no‚ BIG NO!
40. It is important to be honest with your parents‚ even if they become upset or you get punished. YES! /yes /no /NO!
41. I think sometimes it’s okay to cheat at school. YES! /yes /no /NO!
42. I think it is okay to take something without asking if you can get away with it. YES! /yes /no /NO!
43. It is alright to beat up people if they start the fight. YES! /yes /no /NO!
44. It’s important to think before you act. YES! /yes /no /NO!
45. I rush into things‚ starting before I know what to do. YES! /yes /no /NO!
46. I answer without thinking about it first. YES! /yes /no /NO!
***
Very good chance=1‚ Pretty good chance=2‚ Some chance=3‚ Very little or no chance=4
47. What are the chances you would be seen as cool if you:
A. Smoked cigarettes? 1 2  3  4 
B. Began drinking alcoholic beverages regularly‚ that is‚ at least once or twice a month? 1 2  3  4 
C. Used marijuana (pot‚ weed‚ grass)? 1 2  3  4 
D. Carried a weapon? 1 2  3  4 
***
Not wrong at all=1‚ A little bit wrong=2‚ Wrong=3‚ Very wrong=4
48. How wrong do you think it is for someone your age to:
A. Smoke cigarettes? 1 2  3  4 
B. Drink beer or wine regularly? 1 2  3  4 
C. Drink spirits regularly? 1 2  3  4 
D. Use marijuana (pot‚ weed‚ grass)? 1 2  3  4 
E. Use other illegal drugs (like cocaine‚ heroin‚ ecstasy‚ or amphetamines/speed)? 1 2  3  4 
F. Stay away from school all day when their parents think they are at school?
1 2  3  4 
G. Steal something worth more than $10? 1 2  3  4 
H. Pick a fight with someone? 1 2  3  4 
I. Attack someone with the idea of seriously hurting them?
1 2  3  4 
J. Take a weapon to school? 1 2  3  4 
***
No risk=1‚ Slight risk=2‚ Moderate risk=3‚ Great risk=4
49. How much do you think people risk harming themselves (physically or in other ways) if they:
A. Smoke one or more packs of cigarettes a day? 1 2  3  4 
B. Try marijuana (pot‚ weed‚ grass) once or twice? 1 2  3  4 
C. Use marijuana (pot‚ weed‚ grass) regularly? 1 2  3  4 
D. Take one or two drinks of an alcoholic beverage (like beer‚ wine‚ or spirits) nearly every day? 1 2  3  4 
***
YOUR FEELINGS
Please tell us how true each of the following statements are for you by answering BIG YES!‚ little yes‚ little no‚ BIG NO!
50. I do the opposite of what people tell me‚ just to get them mad. YES! /yes /no /NO!
51. I ignore rules that get in my way. YES! /yes /no /NO!
52. I like to see how much I can get away with. YES! /yes /no /NO!
53. I know how to relax when I feel tense. YES! /yes /no /NO!
54. I am always able to keep my feelings under control. YES! /yes /no /NO!
55. I know how to calm down if I am feeling nervous. YES! /yes /no /NO!
56. I control my temper when people are angry with me. 1 2  3  4 
***
57. When I have a problem …
A. I blame myself. YES! /yes /no /NO!
B. I criticize myself or lecture myself. YES! /yes /no /NO!
C. I think about the best ways to handle the problem. YES! /yes /no /NO!
D. I am good at working it out. 1 2  3  4 
***
Please indicate how true each of the following statements has been for you during the past 2 weeks:
True=1‚ Sometimes=2‚ true Not true=3
58. In the past 2 weeks:
A. I felt miserable or unhappy. 1 2  3 
B. I didn’t enjoy anything at all. 1 2  3 
C. I felt so tired I just sat around and did nothing. 1 2  3 
D. I was very restless. 1 2  3 
E. I felt I was no good anymore. 1 2  3 
F. I cried a lot. 1 2  3 
G. I found it hard to think properly or concentrate. 1 2  3 
H. I hated myself. 1 2  3 
I. I was a bad person. 1 2  3 
J. I felt lonely. 1 2  3 
K. I thought nobody really loved me. 1 2  3 
L. I thought I could never be as good as other kids. 1 2  3 
M. I did everything wrong. 1 2  3 
***
TOBACCO‚ ALCOHOL & OTHER DRUGS
The next section asks about your experience with tobacco‚ alcohol‚ and other drugs.
Remember‚ your answers will be kept confidential.
For the next group of questions‚ please think about your entire lifetime. If you haven’t ever used the drug in your lifetime‚ please mark “Never” for that questions.
 Never=1‚ 1 or 2 times=2‚ 3 to 5 times=3‚ 6 to 9 times=4‚ 10 or more times=5
59. In your lifetime have you ever:
A. Smoked cigarettes? 1 2 3 4 5
B. Had more than just a few sips of an alcoholic beverage (like beer‚ wine or spirits)? 1 2 3 4 5
C. Used marijuana (pot‚ weed‚ grass)? 1 2 3 4 5
D. Sniffed glue‚ breathed the contents of an aerosol spray can‚ or inhaled other gases or sprays‚ in order to get high? 1 2 3 4 5
E. Used phenoxydine (pox‚ PX‚ breeze)? 1 2 3 4 5
F. Used other illegal drugs (like cocaine‚ heroin‚ ecstasy‚ or amphetamines/speed)? 1 2 3 4 5
***
60. Have you smoked cigarettes in the past year?
 Never  Regularly‚ but less than every day  Once or twice  Almost every day or every day  Once in a while but not regularly
***
Never=1‚ 1 or 2 times=2‚ 3 to 5 times=3‚ 6 to 9 times=4‚ 10 or more times=5
61. In the past 30 days‚ have you:
A. Smoked cigarettes? 1 2 3 4 5
B. Had more than just a few sips of an alcoholic beverage (like beer‚ wine or spirits)? 1 2 3 4 5
C. Used marijuana (pot‚ weed‚ grass)? 1 2 3 4 5
D. Sniffed glue‚ breathed the contents of an aerosol spray can‚ or inhaled other gases or sprays‚ in order to get high? 1 2 3 4 5
E. Used phenoxydine (pox‚ PX‚ breeze)? 1 2 3 4 5
F. Used other illegal drugs (like cocaine‚ heroin‚ ecstasy‚ or amphetamines/speed)? 1 2 3 4 5
***
62. How frequently have you smoked during the past 30 days?
 Not at all  10-19 cigarettes per day  Less than one cigarette per day  20-29 cigarettes per day  1-5 cigarettes per day  30-39 cigarettes per day  6-9 cigarettes per day  40 or more cigarettes per day
***
If you have never had more than a few sips of alcohol in your lifetime please skip to the beginning of the next section “Health & Personal Experiences”‚ Question 65.
63. The last time you did have alcohol‚ where did you get it? Please choose only one answer.
 I bought it.
 I didn’t buy it.
Where did you buy it?
How did you get it?
 Hotel‚ pub or tavern
 Licensed store or supermarket
 Walk-in-bottle-shop
 Club
 Restaurant
 Disco or dance
 Sporting event
 Other __________________
 My parent(s) gave it to me
 My brother or sister gave it to me
 I took it from home without my parents’ permission
 Friends gave it to me
 I got someone to buy it for me
 Other _________________
64. Think back over the past 2 weeks. How many times have you had five or more alcoholic drinks in a row?  None  Once  Twice  3-5 times  6-9 times
 10 or more times
HEALTH & PERSONAL EXPERIENCES
65. In general‚ how would you describe your health?
 Excellent  Very good  Good  Fair Poor
***
For the next questions‚ you will be asked about your physical activity.
Physical activity is any activity that increases your heart rate and makes you get out of breath some of the time. Some examples are: running‚ fast walking‚ riding a bike‚ dancing‚ skateboarding‚ swimming‚ soccer‚ basketball‚ football & surfing.
Add up all the time you spend in physical activity each day (don’t include your PE or gym classes):
66. Over the past 7 days on how many days were you physically active for a total of at least 60 minutes per day?
0 days 1 2 3 4 5 6 7 days
67. Over a normal week‚ on how many days were you physically active for a total of at least 60 minutes per day?
0 days 1 2 3 4 5 6 7 days
68. How much do you enjoy physical activity or exercise?
 Not at all  A bit  Quite a lot A lot
69. How do you mainly get to school on most days? (please mark only one answer)
 Walk  Bike  Car  Bus/tram/train Other
70. How do you mainly get home from school on most days? (please mark only one answer)
 Walk  Bike  Car  Bus/tram/train Other
71. About how far is it from your home to your school?
 Less than 1 km  1 to 2 kms  2 to 3 kms  3 to 4 kms 5 km or more
72. Name the two streets that are closest to your home:
(Note: This will help us to estimate the distance you travel to school each day.)
***
73. What do you usually do at recess/playtime? (“Usually” means 3 or more days a week) (Tick one only)
 Sit and talk to friends
 Walk around the school
 Run around playing sports/games
 Read/study for the next class
 Nothing much
 Other
74. What do you usually do at lunch time? (“Usually” means 3 or more days a week) (Tick one only)
 Sit and talk to friends
 Walk around the school
 Run around playing sports/games
 Read/study for the next class
 Nothing much
 Other
75. In an average week when you are at school‚ on how many days do you go to physical education (PE) classes?
 0 1  2  3  4 5
76. In the last school week‚ during your physical education (PE) classes‚ how often were you very active (playing hard‚ running‚ jumping‚ throwing‚ dancing)? (Tick one only)
 I don’t do PE  Hardly ever  Sometimes  Quite often Always
77. In the last school week on how many days after school (e.g. end of school until bed-time) did you do sports‚ dance‚ or play games in which you were very active? (Tick one only)
 None 1 2 3 4 5
78. On the last weekend‚ how many times did you do sports‚ dance‚ or play games in which you were very active? (Tick one only)
None 1 2 3 4 5 or more
79. Were you sick in the last week‚ or did anything stop you from doing your normal physical activities?
 Yes  No
80. During the past 12 months‚ on how many sports teams did you play at school?
None 1 2 3 4 5 or more
81. During the past 12 months‚ on how many sports teams did you play outside of school?
None 1 2 3 4 5 or more
***
 Strongly disagree  Somewhat disagree  Neutral  Somewhat agree  Strongly agree
82. How much do you agree with the following statements? (tick one box for each item)
A. At home there are enough supplies and pieces of sports equipment (like balls‚ bicycles‚ skates)to use for physical activities.
B. There are playgrounds‚ parks or gyms close to my home or that I can get to easily.
C. It is safe to walk or jog alone in my neighborhood during the day
D. It is difficult to walk or jog in my neighbourhood because of things like traffic‚ no footpaths‚ dogs‚ gangs‚ etc.
***
 Never
 Once
 Some-times
 Almost Everyday
 Everyday
83. DURING A NORMAL WEEK‚ how often has someone you live with (e.g. father‚ mother‚ brother‚ sister‚ grandparent‚ or other relative):
A. Encouraged you to do physical activity or play sports?
B. Done a physical activity or played sports with you?
C. Provided transportation to a place where you can do physical activities or play sports?
D. Watched you participate in physical activities or sports?
E. Told you that you are doing well in physical activities or sports?
84. DURING A NORMAL WEEK‚ how often (tick one answer)
A. Do you encourage your friends to do physical activity or play sports?
B. Do your friends encourage you to do physical activity or play sports?
C. Do your friends do physical activities or play sports with you?
D. Do other kids tease you for not being good at physical activity or sports?
E. Do friends tell you that you are doing well in physical activities or sports?
***
85. On school days for how many hours do you usually watch TV?
 None  Less than one hour  1 to 2 hours  2 to 4 hours  4 to 6 hours More than 6 hours
86. On weekend days for how many hours do you usually watch TV?
 None  Less than one hour  1 to 2 hours  2 to 4 hours  4 to 6 hours More than 6 hours
87. On school days how many hours do you usually spend on a computer or playing video games such as gamecube‚ xbox‚ PS2‚ PSP‚ GBA‚ etc.?
 None  Less than one hour  1 to 2 hours  2 to 4 hours  4 to 6 hours More than 6 hours
88. On weekend days how many hours do you usually spend on a computer or playing video games such as gamecube‚ xbox‚ PS2‚ PSP‚ GBA‚ etc.?
 None  Less than one hour  1 to 2 hours  2 to 4 hours  4 to 6 hours More than 6 hours
***
Number of serves per day
 None 1  2  3  4  5 or more
The next questions are about what you eat.
Meals and snacks
  None 1  2  3  4  5 or more
Full cream milk‚ yoghurt or dairy food (include milk used on cereal)
 None 1  2  3  4  5 or more
Reduced fat milk‚ yoghurt or dairy food (include milk used on cereal)
 None 1  2  3  4  5 or more
100% Fruit juice (don’t count cordial or fruit drinks)
 None 1  2  3  4  5 or more
Hamburger‚ hot dog‚ or sausage
 None 1  2  3  4  5 or more
Potato crisps or savoury snacks
 None 1  2  3  4  5 or more
Bread (slices)
 None 1  2  3  4  5 or more
Biscuits‚ doughnuts‚ cake‚ pie or chocolate
 None 1  2  3  4  5 or more
Water‚ bottled or from the tap.
 None 1  2  3  4  5 or more
Sweet drinks such as soft drinks‚ cordial‚ Big M‚ flavoured mineral water‚ etc.
 None 1  2  3  4  5 or more
Fruit‚ 1 serve =- 1 piece of fruit‚ such as apple or pear OR - 1 small packet dried fruit‚ like sultanas OR - ½ cup of fruit salad or canned fruit
 None 1  2  3  4  5 or more
Vegetables‚ 1 serve =- ½ cup cooked vegetables OR - 1 cup salad OR - 1 medium-size potato
 None 1  2  3  4  5 or more
***
90. On how many days per week do you eat breakfast or something before school starts?
 None  1  2  3  4  5  6  7
91. How often do you usually eat food from a takeaway? (e.g. McDonalds‚ KFC‚ Hungry Jacks‚ Subway‚ Fish and Chips‚ Hamburgers‚ etc.)
 Less than once a month
 Once a month
2 – 3 times a month
 Once a week
2 – 3 times a week
 Most days
92. How do you describe your weight?
 Very underweight
 Slightly underweight
 About the right weight
 Slightly overweight
 Very overweight
93. How would you describe your mother’s/female guardian’s weight?
 Very underweight
 Slightly underweight
 About the right weight
 Slightly overweight
 Very overweight
94. How would you describe your father’s/male guardian’s weight?
 Very underweight
 Slightly underweight
 About the right weight
 Slightly overweight
 Very overweight
95. Which of the following are you trying to do about your weight?
 Lose weight
 Gain weight
 Stay the same weight
 I am not trying to doanything about my weight
***
96. How would you feel if you gained one or two kilograms in weight?
 It would please me
 It wouldn’t bother me
 I’d be a little concerned
 It would worry me
 It would really upset me
***
97.
 Seldom / never
 Sometimes
 Often
 Almost always
A. Do you try to avoid ‘fattening’ foods or foods with sugar in them?
B. Do you deliberately (on purpose) eat low calorie foods to help you to slim?
C. Do you try to eat less than a certain number of calories as a means of controlling weight?
D. Do you try to leave food at meal times in order to avoid putting on weight?
E. When you have eaten too much‚ do you eat less than usual on the following days?
F. Do you deliberately take small helpings at meals to keep your weight under control?
G. Do you avoid snacks between meals because you are watching your weight?
H. Do you skip meals other than breakfast because you are watching your weight?
***
The next questions are about changes that may be happening to your body. These changes normally happen to different people at different ages. If you are unsure of which answer to choose‚ just give your best guess.
 Has not started yet
 Has barely started
 Has definitely started
 Seems complete
98. Would you say that your growth in height (growth spurt):
99. And how about the growth of your body hair? (“Body hair” means hair in any place other than your head‚ such as under your arms). Would you say that your body hair growth:
100. Have you noticed any skin changes‚ especially pimples?
If you are female‚ please skip to Question 101f.
If you are male‚ please continue
101m. Have you begun to grow hair on your face?
102m. Have you noticed a deepening of your voice?
103. Have you ever had sex?
No___ If no‚ skip to Question 104.
Yes___ 103a. If yes‚ how old were you when you first had sex?
_______ Years and _________ Months old
***
YOUR FAMILY
104. Think of where you live most of the time. Who lives there with you?
Please choose ALL that apply:
Please choose ALL that apply:
Mother /Father /Aunt /Sister(s) /Stepmother /Stepfather /Uncle /Brother(s) /Foster Mother /Foster Father /Stepbrother(s) or stepsister(s) /Other Children /Grandmother /d. Grandfather /Other Adults /I don’t live with anyone at the moment /Other (please explain): _________________________________
105. Is the house or flat you live in owned by your family or rented?
Owned (or being paid off) /Rented
***
The rest of the questions in this section are about your family. When we ask about your mother and father‚ we want you to think about who you live with most of the time - this could include step-parents‚ foster parents or guardians.
106. What is your mother’s highest level of education?
Didn’t complete high school (year 12) /Completed high school (year 12) /Has a degree from a University /I don’t know.
107. What is your father’s highest level of education?
Didn’t complete high school (year 12) /Completed high school (year 12) /Has a degree from a University /I don’t know.
108. Is your mother in paid work?
No‚ not working /Yes‚ full-time /No‚ retired /Yes‚ part-time /My mother/stepmother doesn’t live with me
109. Is your father in paid work?
No‚ not working /Yes‚ full-time /No‚ retired /Yes‚ part-time /My father/stepfather doesn’t live with me
110. My parents notice when I am doing a good job and let me know about it.
All of the time /Often /Sometimes /Never or almost never
111. How often do your parents tell you they’re proud of you for something you’ve done?
All of the time /Often /Sometimes /Never or almost never
***
Please answer the following items about your family by choosing YES!=1‚ little yes=2‚ little no=3‚ BIG NO!=4
112. Do you feel very close to your mother?
YES! /yes /no /NO!
113. Do you share your thoughts and feelings with your mother?
YES! /yes /no /NO!
114. Do you enjoy spending time with your mother?
YES! /yes /no /NO!
115. Do you feel very close to your father?
YES! /yes /no /NO!
116. Do you share your thoughts and feelings with your father?
YES! /yes /no /NO!
117. Do you enjoy spending time with your father?
YES! /yes /no /NO!
118. If I had a personal problem‚ I could ask my mum or dad for help.
YES! /yes /no /NO!
119. My parents give me lots of chances to do fun things with them.
YES! /yes /no /NO!
120. My parents ask if I’ve done my homework.
YES! /yes /no /NO!
121. Would your parents know if you did not come home on time?
YES! /yes /no /NO!
122. The rules in my family are clear.
YES! /yes /no /NO!
123. My parents ask me what I think before most family decisions affecting me are made.
YES! /yes /no /NO!
124. When I am not at home‚ one of my parents knows where I am and who I am with.
YES! /yes /no /NO!
125. My parents want me to call if I’m going to be late getting home.
YES! /yes /no /NO!
126. My family has clear rules about alcohol and drug use.
YES! /yes /no /NO!
127. My parents try to control everything I do.
YES! /yes /no /NO!
128. My parents treat me like a baby and try to protect me from everything.
YES! /yes /no /NO!
129. We argue about the same things in my family over and over.
YES! /yes /no /NO!
130. People in my family have serious arguments.
YES! /yes /no /NO!
131. People in my family often insult or yell at each other.
YES! /yes /no /NO!
132. If you drank some alcohol (like beer‚ wine‚ or spirits) without your parents’ permission‚ would you be caught by your parents?
YES! /yes /no /NO!
133. If you carried a weapon without your parents’ permission‚ would you be caught by your parents?
YES! /yes /no /NO!
134. If you skipped school without your parents’ permission‚ would you be caught by your parents?
YES! /yes /no /NO!
***
135. Does your mother smoke?
 Never / Occasionally / Most days / Every day / Ex-smoker
136. Does your father smoke?
 Never / Occasionally / Most days / Every day / Ex-smoker
137. Does your mother drink alcohol?
 Never / Occasionally / Most days / Every day
138. Does your father drink alcohol?
 Never / Occasionally / Most days / Every day
***
139.
Have any of your brothers or sisters ever:
A.   Smoked cigarettes?
Yes /No /Don’t Know /I don’t have any brothers or sisters
B.    Drunk alcohol (like beer‚ wine or spirits)?
Yes /No /Don’t Know /I don’t have any brothers or sisters
C.   Used marijuana (pot‚ weed‚ grass)?
Yes /No /Don’t Know /I don’t have any brothers or sisters
D.   Taken a weapon to school?
Yes /No /Don’t Know /I don’t have any brothers or sisters
E.    Been suspended or expelled from school?
Yes /No /Don’t Know /I don’t have any brothers or sisters
***
140. How wrong do your parents feel it would be for you to:
Not wrong at all /A little bit wrong /Wrong /Very wrong
A.    Smoke cigarettes?
Not wrong at all /A little bit wrong /Wrong /Very wrong
B.    Drink beer or wine regularly (at least once or twice a month)?
Not wrong at all /A little bit wrong /Wrong /Very wrong
C.    Drink spirits regularly (at least once or twice a month)?
Not wrong at all /A little bit wrong /Wrong /Very wrong
D.    Use marijuana (pot‚ weed‚ grass)?
Not wrong at all /A little bit wrong /Wrong /Very wrong
E.     Steal something worth more than $10?
Not wrong at all /A little bit wrong /Wrong /Very wrong
F.     Draw graffiti‚ or write things or draw pictures on buildings or other property (without the owner’s permission)?
Not wrong at all /A little bit wrong /Wrong /Very wrong
G.    Pick a fight with someone?
Not wrong at all /A little bit wrong /Wrong /Very wrong
***
141. Has anyone in your family ever had a severe alcohol or drug problem?
 Yes  No
***
YOUR NEIGHBOURHOOD
The next section asks about the neighbourhood and community where you live.
142. How much do each of the following statements describe your neighbourhood
YES! /yes /no /NO!
A.   Lots of empty or abandoned buildings.
YES! /yes /no /NO!
B.    Lots of graffiti.
YES! /yes /no /NO!
C.   Fights.
YES! /yes /no /NO!
D. rime and/or drug selling
YES! /yes /no /NO!
***
143. Are the following activities available for people your age in your community?
Yes /No
A. Sports teams.
Yes /No
B. Scouting (Scouts‚ Cubs‚ Girl Scouts‚ Brownies‚ etc.).
Yes /No
C. Youth groups (boys’ and girls’ clubs‚ church groups‚ etc.).
Yes /No
D. Community service (visiting or helping people‚ environmental projects‚ fundraising for ch‎arity‚ service clubs).
Yes /No
***
144. There are lots of adults in my neighbourhood that I could talk to about something important.
YES! /yes /no /NO!
145. There are people in my neighbourhood who are proud of me when I do something well.
YES! /yes /no /NO!
146. There are people in my neighbourhood who encourage me to do my best.
YES! /yes /no /NO!
147. My neighbours notice when I am doing a good job and let me know about it.
YES! /yes /no /NO!
148. In my neighbourhood‚ kids can help decide which activities are provided or how they are run.
YES! /yes /no /NO!
149. In my neighbourhood‚ adults pay attention to what kids have to say.
YES! /yes /no /NO!
150. I feel safe in my neighbourhood.
YES! /yes /no /NO!
151. I’d like to get out of my neighbourhood.
YES! /yes /no /NO!
152. If I had to move‚ I would miss the neighbourhood I now live in.
YES! /yes /no /NO!
153. I like my neighbourhood.
YES! /yes /no /NO!
154. If a kid drank some alcohol (like beer‚ wine‚ or spirits) in your neighbourhood‚ would he or she be caught by the police?
YES! /yes /no /NO!
155. If a kid used marijuana in your neighbourhood‚ would he or she be caught by the police?
YES! /yes /no /NO!
156. If a kid carried a weapon in your neighbourhood‚ would he or she be caught by the police?
YES! /yes /no /NO!
***
157. If you wanted to get some cigarettes‚ how easy would it be for you to get some?
Very easy /Sort of easy /Sort of hard /Very hard
158. If you wanted to get some alcohol (like beer‚ wine‚ or spirits)‚ how easy would it be for you to get some?
Very easy /Sort of easy /Sort of hard /Very hard
159. If you wanted to get some marijuana (pot‚ weed‚ grass)‚ how easy would it be for you to get some?
Very easy /Sort of easy /Sort of hard /Very hard
160. If you wanted to get a drug like cocaine‚ heroine‚ ecstasy or amphetamines (speed)‚ how easy would it be for you to get some?
Very easy /Sort of easy /Sort of hard /Very hard
161. If you wanted to get a handgun‚ how easy would it be for you to get one?
Very easy /Sort of easy /Sort of hard /Very hard
***
162. About how many adults (over 21) have you known personally who in the past year have:
None /1 adult /2 adults /3 or 4 adults /5 or more adults
A. Gotten drunk or high?
None /1 adult /2 adults /3 or 4 adults /5 or more adults
B. Used marijuana (pot‚ weed‚ grass) or other illegal drugs?
None /1 adult /2 adults /3 or 4 adults /5 or more adults
C. Sold or dealt drugs?
None /1 adult /2 adults /3 or 4 adults /5 or more adults
D.   Done other things that could get them in trouble with the police like stealing‚ selling stolen goods‚ mugging or assaulting others (beaten someone up) etc.?
None /1 adult /2 adults /3 or 4 adults /5 or more adults
***
163. How wrong would most adults (over 21) in your neighbourhood think it is for kids your age to:
Not wrong at all /A little bit wrong /Wrong /Very Wrong
A. Smoke cigarettes?
Not wrong at all /A little bit wrong /Wrong /Very Wrong
B. Drink alcohol?
Not wrong at all /A little bit wrong /Wrong /Very Wrong
C. Use marijuana (pot‚ weed‚ grass)?
Not wrong at all /A little bit wrong /Wrong /Very Wrong
***
SURVEY SUMMARY
The following two questions ask about the survey as a whole.
164. How important were these questions to you?
 Very Important /Important /Fairly important /Not too important
165. How honest were you in filling out this survey?
 I was honest all of the time
 I was honest most of the time
 I was honest some of the time
 I was honest once in a while
 I was not honest at all
  • Community
  • High risk behavior
  • Family
  • Delinquency
  • Peer
Contact: Professor John Toumbourou‚ PhD‚ Chief ex‎ecutive Officer‚ Communities That Care Ltd (Australia). Email: [email protected]
Mobile: 0419 582 889