STUDENT SURVEY OF RISK FACTORS

STUDENT SURVEY OF RISK AND PROTECTIVE FACTORS AND PREVALENCE OF ALCOHOL‚ TOBACCO‚ & OTHER DRUG USE
 
Prepared by:
Michael W. Arthur‚ Ph.D.
J. David Hawkins‚ Ph.D.
Rich‎ard F. Catalano‚ Ph.D.
 This work has been supported by the National Institute on Drug Abuse‚ Center for Substance Abuse Prevention‚ U.S. Department of Education‚ and the Office of Juvenile Justice and Delinquency Prevention.
INSTRUCTIONS
1. This is not a test‚ so there are no right or wrong answers; we would like you to work quickly‚ so that you can finish.
 2. All of the questions should be answered by marking one of the answer spaces. If you do not find an answer that fits exactly‚ use the one that comes closest. If any question does not apply to you‚ or you are not sure what it means‚ just leave it blank.
 3. Your answers will be read automatically by a computer. Please follow these instructions carefully:
Use only a blue or black pen or pencil.
Make heavy marks inside the circles.
Erase cleanly any answer you wish to change.
Make no other markings or comments on the answer pages‚ since they interfere with the automatic reading. (If you want to add a comment about any questions‚ please use the space provided on the last page.)
 4. Some of the questions have the following format:
 EXAMPLE:
The Boston Celtics (or some local team) are a good basketball (or other sport) team.
 Mark (the BIG) YES! if you think the statement is definitely true for you.
Mark (the little) yes if you think the statement is mostly true for you.
Mark (the little) no if you think the statement is mostly not true for you.
Mark (the BIG) NO! if you think the statement is definitely not true for you.
 
In the example above‚ the student marked yes because he or she thinks the statement is mostly true.
 Please mark only one answer.
These questions ask for some general information about the people completing the survey. Please check the response that best describes you.
1. How old are you? 10 11 12 13 14 15 16 17 18 19 or older
2. What grade are you in? 6th 8th 10th 12th
3. Are you: Female Male
4. What do you consider yourself to be? (Choose one best answer.)
White‚ not of Hispanic Origin
Black or African American
American Indian/Native American‚ Eskimo or Aleut
Spanish/Hispanic/Latino
Mexican American Chicano
Mexican Puerto Rican
Cuban Central or South American
Other Spanish
Asian or Pacific Islander
Chinese Japanese
Filipino Asian Indian
Hawaiian Samoan
Korean Guamanian
Vietnamese Cambodian
Other Asian or Pacific Islander
Other (Please Specify ______________________)
 5. What is the zip code where you live? __________
 
6. Where are you living now?
 On a farm
 In the country‚ not on a farm
 In a city‚ town‚ or suburb
 7. Which one of the following schools is closest to where you live?
  (List all elementary‚ middle‚ jr. high‚ and high schools in the community)
This section asks about your experiences at school.
8. Putting them all together‚ what were your grades like last year?
Mostly F’s‚ Mostly D’s‚ Mostly C’s‚ Mostly B’s‚ Mostly A’s
 9. During the LAST FOUR WEEKS how many whole days of school have you missed because you skipped or “cut”? 
None‚ 1‚ 2‚ 3‚ 4-5‚ 6-10‚ 11 or more
10. In my school‚ students have lots of chances to help decide things like class activities and rules.
NO! no‚ yes‚  YES!
11. Teachers ask me to work on special classroom projects.
NO! no‚ yes‚ YES!
12. My teacher(s) notices when I am doing a good job and lets me know about it.
NO! no‚ yes‚ YES!
13. There are lots of chances for students in my school to get involved in sports‚ clubs‚ and other school activities outside of class.
NO! no‚ yes‚ YES!
14. There are lots of chances for students in my school to talk with a teacher one-on-one.
NO! no‚ yes‚ YES!
15. I feel safe at my school.
NO! no‚ yes‚ YES!
16. The school lets my parents know when I have done something well.
NO! no‚ yes‚ YES!
17. My teachers praise me when I work hard in school.
NO! no‚ yes‚ YES!
18. Are your school grades better than the grades of most students in your class?
NO! no‚ yes‚ YES!
19. There are lots of chances to be part of class discussions or activities.
NO! no‚ yes‚ YES!
 20. How often do you feel that the school work you are assigned is meaningful and important?
Never‚ Seldom‚ Sometimes‚ Often‚ Almost Always
21. How interesting are most of your courses to you?
Very interesting and stimulating‚ Quite interesting‚ Fairly interesting‚ Slightly dull‚ Very dull
22. How important do you think the things you are learning in school are going to be for your later life?
Very important‚ Quiet important‚ Fairly important‚ Slightly important‚ Not at all important
23. Now thinking back over the past year in school‚ how often did you…
a. enjoy being in school? Never‚ Seldom‚ Sometimes‚ Often‚ Almost Always
b. hate being in school? Never‚ Seldom‚ Sometimes‚ Often‚ Almost Always
c. try to do your best work in school? Never‚ Seldom‚ Sometimes‚ Often‚ Almost Always
 These questions ask about your feelings and experiences in other parts of your life.
24. Think of your four best friends (the friends you feel closest to). In the past year (12 months)‚ how many of your best friends have…
a. smoked cigarettes? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
b. tried beer‚ wine or hard liquor (for example‚ vodka‚ whiskey or gin) when their parents didn’t know about it? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
c. used marijuana? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
d. used LSD‚ cocaine‚ amphetamines‚ or other illegal drugs? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
e. been suspended from school? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
f. carried a handgun? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
g. sold illegal drugs? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
h. stolen or tried to steal a motor vehicle such as a car or motorcycle? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
i. been arrested? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
j. dr‎opped out of school? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
 k. been members of a gang? None of my friends‚ 1 of my friends‚ 2 of my friends‚ 3 of my friends 4 of my friends
How old were you when you first:
a. smoked marijuana? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
b. smoked a cigarette‚ even just a puff? Never Have 10 or Younger 11 12 13 14 15 16 17 or Older
c. had more than a sip or two of beer‚ wine or hard liquor (for example‚ vodka‚ whiskey‚ or gin)? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
 d. began drinking alcoholic beverages regularly‚ that is‚ at least once or twice a month? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
e. got suspended from school? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
f. got arrested? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
g. carried a handgun? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
h. attacked someone with the idea of seriously hurting them? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
i. belonged to a gang? Never Have‚ 10 or Younger‚ 11‚ 12‚ 13‚ 14‚ 15‚ 16‚ 17 or Older
 26.  How wrong do you think it is for someone your age to:
a. take a handgun to school? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
b. steal anything worth more than $5? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
c. pick a fight with someone? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
d. attack someone with the idea of seriously hurting them? Very Wrong- Wrong- A Little Bit Wrong- Not wrong at All
e. stay away from school all day when their parents think they are at school? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
f. drink beer‚ wine or hard liquor (for example‚ vodka‚ whiskey or gin) regularly? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
g. smoke cigarettes? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
h. smoke marijuana? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
 i. use LSD‚ cocaine‚ amphetamines or another illegal drug? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
 27. I ignore rules that get in my way. Very False‚ Somewhat False‚  Somewhat True‚  Very True
28. It is all right to beat up people if they start the fight. NO! no‚ yes‚ YES!
29. It is important to be honest with your parents‚ even if they become upset or you get punished. NO! no‚ yes‚ YES!
30. I do the opposite of what people tell me‚ just to get them mad. Very False‚  Somewhat False‚ Somewhat True‚ Very True
31. I think it is okay to take something without asking if you can get away with it. NO! no‚ yes‚ YES!
32. How many times have you done the following things?
a. Done crazy things even if they are a little dangerous. Never-  I’ve done it‚ but not in the past year- Less than once a month- About once a month- 2 or 3 times a month- Once a week or more
b. Done something dangerous because someone dared you to do it. Never- I’ve done it‚ but not in the past year- Less than once a month- About once a month- 2 or 3 times a month Once a week or more
 c. Done what feels good no matter what. Never- I’ve done it‚ but not in the past year- Less than once a month- About once a month- 2 or 3 times a month Once a week or more
 33. Have you ever belonged to a gang? Yes‚ No
34. If you have ever belonged to a gang‚ did the gang have a name? Yes‚ No‚ I have never belonged to a gang
 35. How many times in the past year (12 months) have you:
a. been suspended from school?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
b. carried a handgun?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
c. sold illegal drugs?
Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
d. stolen or tried to steal a motor vehicle such as a car or motorcycle?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
e. been arrested?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
f. attacked someone with the idea of seriously hurting them?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
g. been drunk or high at school?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
h. taken a handgun to school?
 Never 1 or 2 Times 3 to 5 Times 6 to 9 Times 10 to 19 Times 20 to 29 Times 30 to 39 Times 40+ Times
 36. What are the chances you would be seen as cool if you:
a. smoked cigarettes? No or Very Little Chance‚ Little Chance‚ Some Chance‚ Pretty Good Chance‚ Very Good Chance
b. began drinking alcoholic beverages regularly‚ that is‚ at least once or twice a month?
No or Very Little Chance‚ Little Chance‚ Some Chance‚ Pretty Good Chance‚ Very Good Chance
c. smoked marijuana? No or Very Little Chance‚ Little Chance‚ Some Chance‚ Pretty Good Chance‚ Very Good Chance
d. carried a handgun? No or Very Little Chance‚ Little Chance‚ Some Chance‚ Pretty Good Chance‚ Very Good Chance
37. You’re looking at CD’s in a music store with a friend. You look up and see her slip a CD under her coat. She smiles and says “Which one do you want? Go ahead; take it while nobody’s around.” There is nobody in sight‚ no employees and no other customers. What would you do now?
 Ignore her
Grab a CD and leave the store
Tell her to put the CD back
Act like it’s a joke‚ and ask her to put the CD back
 38. It’s 8:00 on a weeknight and you are about to go over to a friend’s home when your mother asks you where you are going. You say “Oh‚ just going to go hang out with some friends.” She says‚ “No‚ you’ll just get into trouble if you go out. Stay home tonight.” What would you do now?
Leave the house anyway
Explain what you are going to do with your friends‚
tell her when you’d get home‚ and ask if you can go out
Not say anything and start watching TV
Get into an argument with her
 39. You are visiting another part of town‚ and you don’t know any of the people your age there. You are walking down the street‚ and some teenager you don’t know is walking toward you. He is about your size‚ and as he is about to pass you‚ he deliberately bumps into you and you almost lose your balance. What would you say or do?
Push the person back
Say “Excuse me” and keep on walking
Say “Watch where you’re going” and keep on walking
Swear at the person and walk away
40. You are at a party at someone’s house‚ and one of your friends offers you a drink containing alcohol. What would you say or do?
Drink it
Tell your friend “No thanks‚ I don’t drink” and sugges
t that you and your friend go and do something else Just say “No‚ thanks” and walk away
Make up a good excuse‚ tell your friend you had something else to do‚ and leave
 41. I think sometimes it’s okay to cheat at school. NO! no‚ yes‚ YES!
42. How often do you attend religious services or activities? Never‚ Rarely‚ 1-2 Times a Month‚ About Once a Week or More
43. I like to see how much I can get away with. Very False‚ Somewhat False‚ Somewhat True‚ Very True
44. Sometimes I think that life is not worth it. NO! no‚ yes‚ YES!
45. At times I think I am no good at all. NO! no‚ yes‚ YES!
46. All in all‚ I am inclined to think that I am a failure. NO! no‚ yes‚ YES!
47. In the past year‚ have you felt depressed or sad MOST days‚ even if you felt OK sometimes? NO! no‚ yes‚ YES!
48. How much do you think people risk harming themselves (physically or in other ways) if they:
a. smoke one or more packs of cigarettes per day? No Risk‚ Slight Risk‚ Moderate Risk‚ Great Risk
b. try marijuana once or twice? No Risk‚ Slight Risk‚ Moderate Risk‚ Great Risk
c. smoke marijuana regularly? No Risk‚ Slight Risk‚ Moderate Risk‚ Great Risk
d. take one or two drinks of an alcoholic beverage (beer‚ wine‚ liquor) nearly every day? No Risk‚ Slight Risk‚ Moderate Risk‚ Great Risk
The next section asks your experience with tobacco‚ alcohol‚ and other drugs. Remember‚ your answers are confidential.
49. Have you ever used smokeless tobacco (chew‚ snuff‚ plug‚ dipping tobacco‚ chewing tobacco)?
Never‚ Once or twice‚ Once in a while but not regularly‚ Regularly in the past‚ Regularly now
50. How frequently have you used smokeless tobacco during the past 30 days? Never‚ Once or twice‚ Once or twice per week‚ About once a day‚ More than once a day
 51. Have you ever smoked cigarettes? Never‚ Once or twice‚ Once in a while but not regularly‚ Regularly in the past‚ Regularly now
52. How frequently have you smoked cigarettes during the past 30 days? Not at all‚ Less than one cigarette per day‚ One to five cigarettes per day‚ About one-half pack per day‚ About one pack per day‚ About one and one-half packs per day‚ Two packs or more per day
53. On how many occasions (if any) have you had alcoholic beverages (beer‚ wine or hard liquor) to drink in your lifetime –- more than just a few sips? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚ 10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
54. On how many occasions (if any) have you had beer‚ wine or hard liquor during the past 30 days? 0Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
55. Think back over the last two 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
56. On how many occasions (if any) have you used marijuana in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions ‚20-39 Occasions‚ 40 or More Occasions
57. On how many occasions (if any) have you used marijuana during the past 30 days? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
58. On how many occasions (if any) have you used LSD or other psychedelics in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
 59. On how many occasions (if any) have you used LSD or other psychedelics during the past 30 days? 0Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚ 10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
60. On how many occasions (if any) have you used cocaine or crack in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
61. On how many occasions (if any) have you used cocaine or crack during the past 30 days? 0Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
62. On how many occasions (if any) have you sniffed glue‚ breathed the contents of an aerosol spray can‚ or inhaled other gases or sprays‚ in order to get high in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
63. On how many occasions (if any) have you sniffed glue‚ breathed the contents of an aerosol spray can‚ or inhaled other gases or sprays‚ in order to get high during the past 30 days? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
64. On how many occasions (if any) have you used stimulants (“amphetamines”‚ “meth”‚ “crystal”‚ “crank”) in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
65. On how many occasions (if any) have you used stimulants (“amphetamines”‚ “meth”‚ “crystal”‚ “crank”) during the past 30 days? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
66. On how many occasions (if any) have you used derbisol in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
67. On how many occasions (if any) have you used derbisol in the past 30 days? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
68. On how many occasions (if any) have you used other illegal drugs in your lifetime? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
69. On how many occasions (if any) have you used other illegal drugs in the past 30 days? 0 Occasions‚ 1-2 Occasions‚ 3-5 Occasions‚ 6-9 Occasions‚10-19 Occasions‚ 20-39 Occasions‚ 40 or More Occasions
 These questions ask about the neighborhood and community where you live.
70. If you wanted to get some beer‚ wine or hard liquor (for example‚ vodka‚ whiskey‚ or gin)‚ how easy would it be for you to get some? Very Hard‚ Sort of Hard‚ Sort of Easy‚ Very Easy
71. If you wanted to get some cigarettes‚ how easy would it be for you to get some? Very Hard‚ Sort of Hard‚ Sort of Easy‚ Very Easy
 72. If a kid smoked marijuana in your neighborhood would he or she be caught by the police? NO! no‚ yes‚ YES!
 73. If you wanted to get a drug like cocaine‚ LSD‚ or amphetamines‚ how easy would it be for you to get some? Very Hard‚ Sort of Hard‚ Sort of Easy‚ Very Easy
 74. If a kid drank some beer‚ wine or hard liquor (for example‚ vodka‚ whiskey‚ or gin) in your neighborhood would he or she be caught by the police? NO! no‚ yes‚ YES!
 75. If a kid carried a handgun in your neighborhood would he or she be caught by the police? NO! no‚ yes‚ YES!
 76. If you wanted to get some marijuana‚ how easy would it be for you to get some? Very Hard‚ Sort of Hard‚ Sort of Easy‚ Very Easy
 77. How wrong would most adults (over 21) in your neighborhood think it is for kids your age:
 a. to use marijuana? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
b. to drink alcohol? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
c. to smoke cigarettes? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
 78. About how many adults (over 21) have you known personally who in the past year have:
 a. used marijuana‚ crack‚ cocaine‚ or other drugs? None‚ 1 adult‚ 2 adults‚ 3 or 4 adults‚ 5 or more adults
b. sold or dealt drugs? None‚ 1 adult‚ 2 adults‚ 3 or 4 adults‚ 5 or more adults
c. done other things that could get them in trouble with the police like stealing‚ selling stolen goods‚ mugging or assaulting others‚ etc? None‚ 1 adult‚ 2 adults‚ 3 or 4 adults‚ 5 or more adults
d. gotten drunk or high? None‚ 1 adult‚ 2 adults‚ 3 or 4 adults‚ 5 or more adults
79. Sometimes we don’t know what we will do as adults‚ but we may have an idea. Please answer how true these statements may be for you:
 When I am an adult…
a. I will smoke cigarettes NO! no‚ yes‚ YES!
 b. I will drink beer‚ wine‚ or liquor NO! no‚ yes‚ YES!
 c. I will smoke marijuana NO! no‚ yes‚ YES!
 80. If I had to move‚ I would miss the neighborhood I now live in. NO! no‚ yes‚ YES!
81. My neighbors notice when I am doing a good job and let me know about it. NO! no‚ yes‚ YES!
82. I like my neighborhood. NO! no‚ yes‚ YES!
83. There are lots of adults in my neighborhood I could talk to about something important. NO! no‚ yes‚ YES!
 84. How much do each of the following statements describe your neighborhood?
a. crime and/or drug selling NO! no‚ yes‚ YES!
b. fights NO! no‚ yes‚ YES!
c. lots of empty or abandoned buildings NO! no‚ yes‚ YES!
d. lots of graffiti NO! no‚ yes‚ YES!
85. 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
86. There are people in my neighborhood who are proud of me when I do something well. NO! no‚ yes‚ YES!
87. Which of the following activities for people your age are available in your community?
a. sports teams Yes No
b. scouting Yes No
c. boys and girls clubs Yes No
d. 4-H clubs Yes No
e. service clubs Yes No
88. Have you changed schools (including changing from elementary to middle and middle to high school) in the past year? No Yes
 89. I feel safe in my neighborhood. NO! no‚ yes‚ YES!
 90. How many times have you changed schools (including changing from elementary to middle and middle to high school) since kindergarten? Never‚ 1 or 2 times‚ 3 or 4 times‚ 5 or 6 times‚ 7 or more times
 91. I’d like to get out of my neighborhood. NO! no‚ yes‚ YES!
 92. Have you changed homes in the past year? No Yes
 93. There are people in my neighborhood who encourage me to do my best. NO! no‚ yes‚ YES!
 The next set of questions asks about your family. When answering these questions please think about the people you consider to be your family. For example‚ parents‚ stepparents‚ grandparents‚ aunts‚ uncles‚ etc.
 94. How wrong do your parents feel it would be for you to:
a. drink beer‚ wine or hard liquor (for example‚ vodka‚ whiskey or gin) regularly? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
b. smoke cigarettes? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
c. smoke marijuana? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
d. steal something worth more than $5? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
e. draw graffiti‚ or write things or draw pictures on buildings or other property (without the owner
‘s permission)? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
f. pick a fight with someone? Very Wrong- Wrong- A Little Bit Wrong- Not Wrong at All
95. Have any of your brothers or sisters ever:
a. drunk beer‚ wine or hard liquor (for example‚ vodka‚ whiskey or gin)? No‚ Yes‚ I Don’t Have Any Brothers or Sisters
b. smoked marijuana? No‚ Yes‚ I Don’t Have Any Brothers or Sisters
c. smoked cigarettes? No‚ Yes‚ I Don’t Have Any Brothers or Sisters
d. taken a handgun to school? No‚ Yes‚ I Don’t Have Any Brothers or Sisters
e. been suspended or expelled from school? No‚ Yes‚ I Don’t Have Any Brothers or Sisters
 96. The rules in my family are clear. NO! no‚ yes‚ YES!
97. Has anyone in your family ever had a severe alcohol or drug problem? No Yes
 98. People in my family often insult or yell at each other. NO! no‚ yes‚ YES!
99. When I am not at home‚ one of my parents knows where I am and who I am with. NO! no‚ yes‚ YES!
100. We argue about the same things in my family over and over. NO! no‚ yes‚ YES!
101. If you drank some beer or wine or liquor (for example‚ vodka‚ whiskey‚ or gin) without your parents’ permission‚ would you be caught by your parents? NO! no‚ yes‚ YES!
102. My family has clear rules about alcohol and drug use. NO! no‚ yes‚ YES!
103. If you carried a handgun without your parents’ permission‚ would you be caught by your parents? NO! no‚ yes‚ YES!
104. If you skipped school would you be caught by your parents? NO! no‚ yes‚ YES!
105. My parents notice when I am doing a good job and let me know about it. Never or Almost Never‚ Sometimes‚ Often All the Time
106. Do you feel very close to your mother? NO! no‚ yes‚ YES!
 107. Do you share your thoughts and feelings with your mother? NO! no‚ yes‚ YES!
108. My parents ask me what I think before most family decisions affecting me are made. NO! no‚ yes‚ YES!
109. How often do your parents tell you they’re proud of you for something you’ve done? Never or Almost Never‚ Sometimes‚ Often All the Time
110. Do you share your thoughts and feelings with your father? NO! no‚ yes‚ YES!
111. Do you enjoy spending time with your mother? NO! no‚ yes‚ YES!
112. Do you enjoy spending time with your father? NO! no‚ yes‚ YES!
113. If I had a personal problem‚ I could ask my mom or dad for help. NO! no‚ yes‚ YES!
114. Do you feel very close to your father? NO! no‚ yes‚ YES!
115. My parents give me lots of chances to do fun things with them. NO! no‚ yes‚ YES!
116. My parents ask if I’ve gotten my homework done. NO! no‚ yes‚ YES!
117. People in my family have serious arguments. NO! no‚ yes‚ YES!
118. Would your parents know if you did not come home on time? NO! no‚ yes‚ YES!
119. Think of where you live most of the time. Which of the following people live there with you? (Choose all that apply.)
Mother‚ Grandfather‚ Stepmother‚ Uncle‚ Foster mother‚ Other adults‚ Grandmother Brother(s)‚ Aunt Stepbrother(s)‚ Father Sister(s)‚ Stepfather Stepsister(s)‚ Foster father‚ Other children
120. How many brothers and sisters‚ including stepbrothers and stepsisters‚ do you have that are older than you? 0‚ 1‚ 2‚ 3‚ 4‚ 5‚ 6 or more
 121. How many brothers or sisters‚ including stepbrothers and stepsisters‚ do you have that are younger than you? 0‚ 1‚ 2‚ 3‚ 4‚ 5‚ 6 or more
 122. What is the language you use most often at home? English‚ Spanish‚ Another Language
123. What is the highest level of schooling your father completed?
Completed grade school or less
Some high school
Completed high school
Some college
Completed college
Graduate or professional school after college
Don’t know
Does not apply
 
124. What is the highest level of schooling your mother completed?
Completed grade school or less
Some high school
Completed high school
Some college
Completed college
Graduate or professional school after college
Don’t know
Does not apply
 125. How important were these questions? Not too important‚ Fairly important‚ Important‚ Very Important
 126. How honest were you in filling out this survey? I was very honest‚ I was honest pretty much of the time‚ I was honest some of the time‚ I was honest once in a while‚ I was not honest at all
 
 

 • School and Academics
• Personal Attitudes and Beliefs
• Peer Relationships
• Family Relationships
• Drug and Alcohol Use/Attitudes
• Communities and Neighborhoods
Available through the Compendium of Research and Assessment Tools (CART) at:http://cart.rmcdenver.com/instruments/communities_that.pdf

Social Development Research Group
University of Washington 9725 3rd Ave. NE‚ Suite 401
Seattle‚ WA 98115-2024
Online at: http://staff.washington.edu/sdrg/
[email protected]

Pollard‚ J.A.‚ Catalano‚ R.F.‚ Hawkins‚ J.D.‚ Arthur‚ M.W. Development of a School-Based Survey Measuring Risk and Protective Factors Predictive of Substance Abuse‚ Delinquency‚ and Other Problem Behaviors in Adolescent Populations. Unpublished Paper‚ 1998.

Arthur‚ M.W.‚ Hawkins‚ J.D.‚ Pollard‚ J.A.‚ Catalano‚ R.F.‚ & Baglioni‚ A.J. (2001). Measuring risk and protective factors for substance use‚ delinquency‚ and other adolescent problem behaviors: The Communities That Care Youth Survey. Manuscript submitted for publication.

Hawkins‚ J.D.‚ Arthur‚ M.W.‚ & Catalano‚ R.F. (1997). Six State Consortium for Prevention Needs Assessment Studies: Final Report. Seattle: University of Washington‚ Social Development Research Group.

Pollard‚ J.A.‚ Hawkins‚ J.D.‚ & Arthur‚ M.W. (1999). Risk and protection: Are both necessary to understand diverse behavioral outcomes in adolescence? Social Work Research‚ 23 (3)‚ pp. 129-208.

 

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