Bullying For Students Pre-Test

Mental Health Across the Lifespan Initiative - A DST and NIMH collaborative

Thank you for taking time to complete this survey for Delta Sigma Theta. We are interested in understanding your thoughts and opinions about the workshop attended today. This survey should take approximately 10 minutes to complete.

This assessment is designed to collect your feedback about the following modules: Postpartum Depression, Depression in College Students, and/or Bullying and Successful Aging. In addition, demographic information is being collected to help us identify who participated in the modules sessions, and to help plan future programs. When asked to enter your Date of Birth (DOB) in question #12, please be sure to enter it as requested. Also, for question #13 when asked to enter your initials, please remember to use those same initials when completing the Bullying for Students (Post Test). This will help to ensure that we are able to cross-reference both of your surveys.

You will be asked to decide how much you agree or disagree with each statement. For example, if you believe that the statement is correct, select agree; if you believe it’s incorrect, select disagree. If you really agree with the statement, select strongly agree; if you really disagree, select strongly disagree. If you don’t know how you feel about the statement, select don’t know. Please do not skip any questions. If you have any questions, please feel free to ask your presenter. Please complete the sections based on the program attended.

* 1. What is your gender?

* 2. How old are you?

* 3. Please indicate the highest level of education completed.

* 4. What is your primary language (i.e.., the one you speak most of the time)?

* 5. Are you employed: (select only one)

* 6. What state do you live in?

* 7. I can protect myself and children from cyberbullying by being careful about what I post on websites and social

* 8. A bystander (or someone who witnesses a bullying episode) should try to be a friend to the person being bullied.

* 9. If I tell one adult about a bullying episode and it appears nothing has changed, I should talk to other adults to get them involved.

* 10. If you don't give a bully any attention, it may help stop his or her behavior.

* 11. There are things a bystander can do to help a person being bullied get away from the situation while a bullying episode is occurring.

* 12. Month and year of birth? (MM-YYYY)

* 13. Please enter your Initials: