Introduction to the survey

1. Study Purpose: Montachusett Opportunity Council (MOC) and the University of Massachusetts in Lowell are working together on a research project to evaluate local services aimed at helping teens to prevent pregnancy in your community. The purpose of this questionnaire is to hear your opinion about teen pregnancy and programs in your community.

2. What to do and time it will take: You are being asked to take a 21 question on-line survey that will take you 10 minutes to complete. It asks you questions and your opinions on teen pregnancy in your community and ways you think we can prevent it from happening. If you agree to continue, please check the ‘I agree to participate’ option and it will take you to the questionnaire. Your participation is completely voluntary and even if you start the survey, you are free to stop at any time or not answer any questions that might make you feel uncomfortable. No personal information will be collected about you and no one will know if you participated or if you answered any questions or how you answer the questions. We will ask you questions about your age race, ethnicity, and sex. We do not want to know who you are and the survey will not be linked to any information that could be used to identify you.

3. Potential Risks and Discomfort: There are no risks associated with your participating in the on-line survey. You can decide not to answer a questions or not complete an answer to a question at any time or skip any questions that you don’t want to answer at any time.

4. Will I get anything from answering the questions: There will be no benefit to you from participating in the survey. In the spring, the Montachusett Opportunity Council will sponsor a youth celebration and some of the information learned from this survey will be shared to help your community.

5.Will it help you or other teens like you?: Your answers will help you and other teens like you to learn more about how to prevent teen pregnancy in your community. Your opinion will count in developing special programs for teens that you and your friends could participate.


6. If you have more questions: If you have any questions regarding this questionnaire please email Ainat Koren, PhD, University of Massachusetts, Lowell, School of Health and Environment, Nursing Department at Ainat_koren@uml.edu or call 978-934-4429 or Jessica Diaz at Jdiaz@Mocinc.org or call 978-343-6259 ext.243

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* 1. How old are you?

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* 2. Do you live in Fitchburg?

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* 3. What best describes you?

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* 4. Are you:

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* 5. Where do you get information about sex and the risk of pregnancy? (check all that you use)

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* 6. At what age do you think teens should receive information or education on sex and the risk of pregnancy?

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* 7. At what age do you think teens are starting to have sex?

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* 8. Does your city offer a clinic/program that provides pregnancy program/services to teens?

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* 9. If you answered yes to question #8, is the program or services

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* 10. Do teens have access to condoms or other forms of birth control?

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* 11. If so, where are condoms available? (Check all what you know)

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* 12. Where do you think teens should be able to get contraceptives (birth control)? (Check all where you think)

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* 13. Do you believe that teaching teens about abstinence (not having sex at all until marriage) will reduce the number of teen girls that get pregnant?

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* 14. How involved do you think your school is in teaching teens about sex and the risk of pregnancy?

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* 15. Being a teen mother in your community is?

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* 16. Who should be the source of information for questions about sex? (Check all who you think)

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* 17. Do you think parents talk to their teens about sex and the risk of pregnancy......?

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* 18. Of the following reasons, which do you think explain(s) why parents do not talk to their teens about sex and the risk of pregnancy? (check all you think apply)

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* 19. Have you been taught about sex and the risk of pregnancy by.... ? (check all that apply)

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* 20. Are there any teen groups or teen coalitions in your community that participate in teen pregnancy prevention activities?

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* 21. Would hearing from teens who have dealt with the difficulties of pregnancy help prevent future teen pregnancies?

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