1a. Are there any adults who you admire and would want to be like?
… Yes … No
1b. If yes‚ please check any of the following categories that include adults you admire.
… Mother or stepmother
… Father or stepfather
… Older sister
… Older brother
… Other female relative
… Other male relative
… Other female adult in community
… Other male adult in community
… Sports or entertainment star
… Other _______________________
2a. If you needed some information or advice about something‚ is there someone you could talk with?
… Yes … No
2b. If yes‚ please check any of the categories that include persons you could go to for advice.
… Mother or stepmother
… Father or stepfather
… Older sister
… Older brother
… Other female relative
… Other male relative
… Other female adult in community
… Other male adult in community
… Sports or entertainment star
… Other _______________________
3a. If you were having trouble at home‚ is there someone you could talk to?
… Yes … No
3b. If yes‚ please check any of the categories that include persons you could talk to.
… Mother or stepmother
… Father or stepfather
… Older sister
… Older brother
… Other female relative
… Other male relative
… Other female adult in community
… Other male adult in community
… Sports or entertainment star
… Other _______________________
4a. If you got an award or did something well‚ is there someone you would tell?
… Yes … No
4b. If yes‚ please check any of the categories that include persons you would tell.
… Mother or stepmother
… Father or stepfather
… Older sister
… Older brother
… Other female relative
… Other male relative
… Other female adult in community
… Other male adult in community
… Sports or entertainment star
… Other _______________________
5. Of all the teachers you have known‚ how many have you liked?
a. None of them
b. A few
c. Half of them
d. Most of them
e. All of them
(Items 2-5 were added by the Institute of Behavioral Science‚ 1990.)
These items measure the extent to which there are adults in the home or community that the youth admires and goes to for guidance. Youths are asked to check the response that corresponds to their beliefs.
This tool touches on the following keywords:
This instrument can be found on pages 70¬-71 of Measuring Violence-Related Attitudes‚ Behaviors‚ and Influences Among Youths: A Compendium of Assessment Tools‚ available online at:http://www.cdc.gov/violenceprevention/pdf/YV_Compendium.pdf
.
Middle school age youth‚ although this could be used for older youth‚ as well. Has been used in previous research with African-American males aged 12-16.
Pencil and paper self-report. Items should be considered separately‚ since they do not constitute a scale.
Originally developed by: Nakkula MJ‚ et al. (1990). Teenage risk prevention questionnaire and interview: an integrative assessment of adolescent high-risk behavior. Piscataway‚ NJ: Rutgers University‚ Graduate School of Applied and Professional Psychology. (Unpublished)