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Community Assessment Questionnaire
1.
Are you a resident of Pinal County?
Yes – Casa Grande
No
Yes – Other area in Pinal County- tell us were
2.
Which best describes you? Select all that apply.
Parent/caregiver
Youth or young adult
School staff
Behavioral health provider
Healthcare provider
Law enforcement, court, or probation professional
Person in recovery
Family member of someone affected by substance use
Social service provider
Local resident
Veterans
Active Duty
Reserves
National Guard
None of the above
Prefer not to answer
Other (please specify)
3.
In your opinion, which substance-related issues are causing the greatest concern or harm in your community? Select up to three.
Alcohol use among youth
Alcohol use among adults
Youth vaping/nicotine use
Youth cannabis/marijuana use
Fentanyl or counterfeit pills
Opioid overdose
Methamphetamine use
Prescription drug misuse
Impaired driving
Substance use among people experiencing homelessness
Substance use among justice-involved individuals
Lack of treatment or recovery resources
Not sure
Other (please specify)
4.
Which groups do you believe are most affected by these concerns? Select up to three.
Middle school students
High school students
Young adults
Parents/caregivers
Families affected by substance use
People experiencing homelessness
Justice-involved individuals
Veterans
Older adults
Not sure
Other (please specify)
5.
Which community conditions increase substance use risk or make prevention more difficult? Select all that apply.
Stress, trauma, or untreated mental health needs
Easy access to alcohol, nicotine, cannabis, or other substances
Family substance use
Lack of adult supervision or parental monitoring
Lack of structured youth activities
Peer influence or pressure
Poverty or lack of employment opportunities
Housing instability or homelessness
Transportation barriers
Stigma around asking for help
Lack of local services
Lack of culturally appropriate or bilingual services
Not sure
Other (please specify)
6.
What substance use prevention, treatment, or recovery resources are most needed in the community? Select up to five.
Youth prevention programs
Parent/caregiver education
Mental health services
Substance use treatment
Peer support or recovery coaching
Recovery housing or sober living options
Transportation to services
Naloxone/Narcan access and training
Family support groups
Crisis services
Spanish-language services
Help navigating available services
Not sure
Other (please specify)
7.
What substance use prevention topics would be most useful for you, your family, or the people you serve? Select up to five.
Fentanyl and counterfeit pills
Naloxone/Narcan use and overdose response
Youth vaping/nicotine use
Cannabis/marijuana and youth brain development
Alcohol misuse
Current and emerging drug trends, including new substances, changing risks, and warning signs
Social media, internet safety, and online access to substances
How to talk with youth about substance use
Recognizing signs of substance use
Safe medication storage and disposal
Local treatment and recovery resources
How to support someone in recovery
Stress, trauma, mental health, and substance use
Not sure
Other (please specify)
8.
Is there a substance use-related issue, population, or barrier that you think is often overlooked? If so, please explain.
9.
Who recommended this survey to you?
10.
Would you like to be entered into the raffle drawing?
If yes, please provide your contact information below.
Send me a copy of my responses via email
