The Ashtabula County Prevention Coalition seeks to work with the community to promote and support healthy lifestyles for all residents and to eliminate underage use and harmful use of drugs and alcohol. To be successful, the Coalition needs the opinions and the involvement of our residents. If you are a resident of Ashtabula County, Ohio, age 18 or older, please take 5-10 minutes to complete the following survey.

Your answers are anonymous and confidential and will be added to those from several hundred other responses by Ashtabula County residents. There is no way for your personal answers to be linked to you and only the total results will be analyzed and shared. Your opinion is very important to us! Thank you in advance for taking your time to help us with this project.

If you would like information about the Coalition, please contact Kaitie Park, Coalition Coordinator at 440-992-3121.

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* 1. My school district is:

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* 2. My age is:

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* 3. My gender is:

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* 4. My impressions about alcohol and drug use in my community:

  Strongly Agree Agree Undecided Disagree Strongly Disagree
Alcohol use by persons under the age of 21 is a problem
It is easy for persons under the age of 21 to obtain alcohol.
The legal system consistently enforces penalties for underage alcohol use.
The legal system consistently enforces penalties to stores and individuals that provide alcohol to underage youth.
Schools consistently enforce penalties for underage drinking at school or school sponsored events.
There are some adults in my community who provide alcohol to youth under the age of 21.
Local bars and stores that sell alcohol do a good job checking IDs and upholding their part in preventing underage sales.
Laws Related to Underage Drinking:
It is illegal in Ohio to provide alcohol to underage youth, other than your own children, even in your home and even if the youth who are not your children have their parent’s permission.
It is illegal in Ohio to allow underage youth, other than your own children to remain in your home or on your property while the youth consume or possess alcohol.
You can be sued if you give alcohol to any underage youth including your own child, and they in turn hurt themselves, hurt anyone else, or damage property.

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* 5. Underage Drinking Laws

  Yes No Unsure
I was aware of these laws before I read them on this survey.
I support these laws.

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* 6. Do you support the minimum drinking age of 21?

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* 7. If you do not support the minimum legal drinking age of 21, what age do you recommend?

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* 8. My opinions about underage drinking are:

  Strongly Agree Agree Unsure Disagree Strongly Disagree
Youth under the age of 21 should never drink alcohol.
It is ok for underage youth to drink alcohol as long as their parents permit it.
It is ok for underage youth to drink alcohol as long as it does not interfere with school, work, or home responsibilities.
Underage drinking is a part of growing up, and there isn’t much that can be done to stop it.
The younger a person is when he/she first uses alcohol, the more likely he is to develop alcohol dependency at some point in his/her life.

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* 9. About alcohol use in my home:

  Yes Unsure No
At times, there is alcohol in my home. (If answer is no, proceed to Question 10.)
Underage youth are sometimes in my home. (If the answer is no, proceed to Question 10)
I secure the alcohol to make sure underage youth do not use it.
I keep track of the alcohol to make sure underage youth do not use it.
I instruct underage youth not to use alcohol in my home.
I take other actions to keep underage youth from using alcohol in my home.
I have provided alcohol to underage youth in my home.

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* 10. Where do underage youth get alcohol? (Check all that you think are true in Ashtabula County.)

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* 11. What would discourage adults from providing alcohol to underage youth? (Check all that you think would work.)

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* 12. Information

  Strongly Agree Agree Unsure Disagree Strongly Disagree
I know the penalties for my children consuming alcohol.
I know where to get information to help me educate my children about alcohol.
What I say to my children about alcohol will influence their decisions about drinking.
My drinking habits and those of other adults in the family will influence my children’s decisions about drinking.
In the past 30 days, I suspect one or more of my children has consumed alcohol
I don't think there is much risk in having more than 5 drinks on one occasion
In the past 30 days, I suspect one or more of my children has misused a prescription drug
I don't think there is much risk in using medications that aren't prescribed for me

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* 13. IF YOUR CHILDREN ARE UNDER 21, PLEASE ANSWER THE FOLLOWING THREE QUESTIONS: The last time I talked to my children about alcohol and drug use was:

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* 14. Rules about alcohol:  Please check the answers to the next two questions that best reflect your rules about alcohol use:

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* 15. Rules about alcohol:

We are interested in learning about three types of prescription medications in our community: Opioids/Pain relievers or pain killers (OxyContin, Hydrocodone, Percocet, Methadone); Sedatives or Tranquilizers (Xanax, Valium, Librium) and Stimulants (Adderall, Concerta, Ritalin). Please think about these types of prescription medications when you answer the questions below.

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* 16. My impressions about prescription drug use in my community...

  Strongly Agree Agree Unsure Disagree Strongly Disagree
The misuse of prescription drugs by persons under the age of 21 is a problem
The misuse of prescription drugs by adults 21 and older is a problem
It is easy to obtain the above listed prescription drugs from a doctor
It is easy for underage youth to obtain the above listed prescription medications from family or friends
At times there are the above listed prescription drugs in my home
I keep my prescription drugs locked and secure
I dispose of unused prescription drugs in the trash or toilet
I have used the prescription drug drop-off boxes located in Ashtabula County
I keep prescription drugs that I don't currently need for future use
I don't think there is much risk in sharing my prescription drugs with family members or friends
The legal system is doing enough to reduce prescription drug misuse and abuse
I know the penalties for giving someone my prescription drugs

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* 17. People in my neighborhood know each other

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* 18. People in my neighborhood are willing to help one another

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* 19. There are fun and safe things in my community for families to do:

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* 20. I feel close to other people in my community

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* 21. What do you believe are the main factors that contribute to underage substance abuse by Ashtabula County youth?

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* 22. What do you believe the Ashtabula County Prevention Coalition could do to assist youth in building assets and reducing risky behaviors?

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* 23. Additional Comments:

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* 24. Please provide your e-mail address if you would like to added to the Prevention Coalition's list-serve:

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