Exit this survey THE GUTS TO BE GOOD Project 1. Default Section Question Title * 1. Hello, Thank you for taking this survey. You have been selected to help design, implement and evaluate a video project focusing on positive solutions to prevent sexual violence before it begins. The Arizona Department of Health Services, Our Family in Tucson and Peer Solutions in Phoenix/Tempe are working together to help you with this project. Please take a few minutes to answer the following questions. We will use your results to help define next steps. Name School/Organization Year in School If applicable City you live in Email Phone Are you on Facebook? Question Title * 2. On a scale of 1-4, 1 (the first circle) being “a very great concern” and 4 (the last circle)being “not a concern”, please click on the circle that best describes how much of a concern you think each issue is affecting your community? A very great concern A great concern A concern Not a concern Sexual Violence Sexual Violence A very great concern Sexual Violence A great concern Sexual Violence A concern Sexual Violence Not a concern Bullying Bullying A very great concern Bullying A great concern Bullying A concern Bullying Not a concern Child Abuse Child Abuse A very great concern Child Abuse A great concern Child Abuse A concern Child Abuse Not a concern Substance Abuse Substance Abuse A very great concern Substance Abuse A great concern Substance Abuse A concern Substance Abuse Not a concern Suicide Suicide A very great concern Suicide A great concern Suicide A concern Suicide Not a concern Gang/Gun Violence Gang/Gun Violence A very great concern Gang/Gun Violence A great concern Gang/Gun Violence A concern Gang/Gun Violence Not a concern Depression Depression A very great concern Depression A great concern Depression A concern Depression Not a concern Eating Disorders Eating Disorders A very great concern Eating Disorders A great concern Eating Disorders A concern Eating Disorders Not a concern Homelessness Homelessness A very great concern Homelessness A great concern Homelessness A concern Homelessness Not a concern Harassment/Discrimination Harassment/Discrimination A very great concern Harassment/Discrimination A great concern Harassment/Discrimination A concern Harassment/Discrimination Not a concern High School Drop Out Rates High School Drop Out Rates A very great concern High School Drop Out Rates A great concern High School Drop Out Rates A concern High School Drop Out Rates Not a concern Question Title * 3. Please answer the following questions. Yes Maybe No I dont know Would you like to particpate in this video project? Would you like to particpate in this video project? Yes Would you like to particpate in this video project? Maybe Would you like to particpate in this video project? No Would you like to particpate in this video project? I dont know Are you willing to meet with other students in Phoenix, Tucson and Casa Grande to make the video? Are you willing to meet with other students in Phoenix, Tucson and Casa Grande to make the video? Yes Are you willing to meet with other students in Phoenix, Tucson and Casa Grande to make the video? Maybe Are you willing to meet with other students in Phoenix, Tucson and Casa Grande to make the video? No Are you willing to meet with other students in Phoenix, Tucson and Casa Grande to make the video? I dont know Are you willing to use humor to get the message across? Are you willing to use humor to get the message across? Yes Are you willing to use humor to get the message across? Maybe Are you willing to use humor to get the message across? No Are you willing to use humor to get the message across? I dont know Question Title * 4. Please identify any concerns or barriers to participating in this project. Question Title * 5. What are some areas that you would like to focus on your video project? (Please be specific: e.g. I would like to work on stereotyping/oppression) Question Title * 6. Do you think this video project is a good idea? Why or Why not? Question Title * 7. Please share any video project ideas you may already have. No need to hold back. All ideas very appreciated! Question Title * 8. Are you part of a sexual violence prevention program? Yes No Other Question Title * 9. If you answered yes to question 8, what is the name of the sexual violence program you participate in. If OTHER: Please describe. Question Title * 10. Anything else you would like to add? Done