West Haven Public Schools & West Haven Prevention Council Healthy Habits Forum 2021 PARENT/GUARDIAN Survey

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* 1. What is your gender?

Male

Female

Transgender

Non-binary/non-conforming

Prefer not to respond

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* 2. How do you describe yourself? (Mark all that apply)

Black or African-American

White or Caucasian

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Prefer not to respond

Other (please specify)

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* 3. As a result of viewing the four presentations, what do you think you are more likely to do:

	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree
Speak to my child about underage drinking	Speak to my child about underage drinking Strongly Agree	Speak to my child about underage drinking Somewhat Agree	Speak to my child about underage drinking Somewhat Disagree	Speak to my child about underage drinking Strongly Disagree
Speak to my child about marijuana and substance use	Speak to my child about marijuana and substance use Strongly Agree	Speak to my child about marijuana and substance use Somewhat Agree	Speak to my child about marijuana and substance use Somewhat Disagree	Speak to my child about marijuana and substance use Strongly Disagree
Speak to my child about the various strategies to help rebuild resiliency	Speak to my child about the various strategies to help rebuild resiliency Strongly Agree	Speak to my child about the various strategies to help rebuild resiliency Somewhat Agree	Speak to my child about the various strategies to help rebuild resiliency Somewhat Disagree	Speak to my child about the various strategies to help rebuild resiliency Strongly Disagree
Speak to my child about social media use and various strategies to combat its influence	Speak to my child about social media use and various strategies to combat its influence Strongly Agree	Speak to my child about social media use and various strategies to combat its influence Somewhat Agree	Speak to my child about social media use and various strategies to combat its influence Somewhat Disagree	Speak to my child about social media use and various strategies to combat its influence Strongly Disagree
Ensure that alcohol, marijuana products and prescription drugs are not available to anyone underage in my home	Ensure that alcohol, marijuana products and prescription drugs are not available to anyone underage in my home Strongly Agree	Ensure that alcohol, marijuana products and prescription drugs are not available to anyone underage in my home Somewhat Agree	Ensure that alcohol, marijuana products and prescription drugs are not available to anyone underage in my home Somewhat Disagree	Ensure that alcohol, marijuana products and prescription drugs are not available to anyone underage in my home Strongly Disagree
Check to see if a parent is present at the homes that my child visits	Check to see if a parent is present at the homes that my child visits Strongly Agree	Check to see if a parent is present at the homes that my child visits Somewhat Agree	Check to see if a parent is present at the homes that my child visits Somewhat Disagree	Check to see if a parent is present at the homes that my child visits Strongly Disagree

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* 4. As a result of viewing the four Healthy Habits forum presentations:

	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree
I understand that underage drinking is dangerous at any level of consumption	I understand that underage drinking is dangerous at any level of consumption Strongly Agree	I understand that underage drinking is dangerous at any level of consumption Somewhat Agree	I understand that underage drinking is dangerous at any level of consumption Somewhat Disagree	I understand that underage drinking is dangerous at any level of consumption Strongly Disagree
I am more aware of the long- and short-term risks of drinking, marijuana and substance use	I am more aware of the long- and short-term risks of drinking, marijuana and substance use Strongly Agree	I am more aware of the long- and short-term risks of drinking, marijuana and substance use Somewhat Agree	I am more aware of the long- and short-term risks of drinking, marijuana and substance use Somewhat Disagree	I am more aware of the long- and short-term risks of drinking, marijuana and substance use Strongly Disagree
I am more aware of the physical, emotional and mental health strategies of becoming more resilient	I am more aware of the physical, emotional and mental health strategies of becoming more resilient Strongly Agree	I am more aware of the physical, emotional and mental health strategies of becoming more resilient Somewhat Agree	I am more aware of the physical, emotional and mental health strategies of becoming more resilient Somewhat Disagree	I am more aware of the physical, emotional and mental health strategies of becoming more resilient Strongly Disagree
I am more aware of the impact of social media on emotional and mental health	I am more aware of the impact of social media on emotional and mental health Strongly Agree	I am more aware of the impact of social media on emotional and mental health Somewhat Agree	I am more aware of the impact of social media on emotional and mental health Somewhat Disagree	I am more aware of the impact of social media on emotional and mental health Strongly Disagree

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* 5. Overall, how helpful did you find the presentations?

Extremely helpful

Somewhat helpful

Somewhat unhelpful

Extremely unhelpful

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* 6. What is the most important thing you learned from all of the presentations you have viewed?

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* 7. Do you have any comments regarding the presentations that you would like to share?

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* 8. Is there anything that you would like to see included as a topic for the Healthy Habits forum next year?

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* 9. The West Haven Prevention Council (WHPC) sponsors and coordinates events, educational forums, marketing materials and other activities in the community to promote awareness about underage drinking and substance use. Prior to this forum, were you aware of the West Haven Prevention Council?

Yes

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* 10. Please indicate if you have attended or are aware of the following West Haven Prevention Council activities within the past year:

	Attended or participated in	Aware of but did not participate in	Not aware of
WHPC Social Media Sites (Facebook/Twitter/Instagram)	WHPC Social Media Sites (Facebook/Twitter/Instagram) Attended or participated in	WHPC Social Media Sites (Facebook/Twitter/Instagram) Aware of but did not participate in	WHPC Social Media Sites (Facebook/Twitter/Instagram) Not aware of
WHPC Youth Coalition/Club	WHPC Youth Coalition/Club Attended or participated in	WHPC Youth Coalition/Club Aware of but did not participate in	WHPC Youth Coalition/Club Not aware of
12th Grade Senior Forum/Senior University	12th Grade Senior Forum/Senior University Attended or participated in	12th Grade Senior Forum/Senior University Aware of but did not participate in	12th Grade Senior Forum/Senior University Not aware of
WHPC Monthly Coalition Meetings (currently via zoom)	WHPC Monthly Coalition Meetings (currently via zoom) Attended or participated in	WHPC Monthly Coalition Meetings (currently via zoom) Aware of but did not participate in	WHPC Monthly Coalition Meetings (currently via zoom) Not aware of
WHPC BIllboards	WHPC BIllboards Attended or participated in	WHPC BIllboards Aware of but did not participate in	WHPC BIllboards Not aware of
WHPC displays/information/flyers found in West Haven	WHPC displays/information/flyers found in West Haven Attended or participated in	WHPC displays/information/flyers found in West Haven Aware of but did not participate in	WHPC displays/information/flyers found in West Haven Not aware of
WHPC Presentations	WHPC Presentations Attended or participated in	WHPC Presentations Aware of but did not participate in	WHPC Presentations Not aware of
Drug Take Back Day	Drug Take Back Day Attended or participated in	Drug Take Back Day Aware of but did not participate in	Drug Take Back Day Not aware of
Prescription Drug Drop Box at the West Haven Police Station	Prescription Drug Drop Box at the West Haven Police Station Attended or participated in	Prescription Drug Drop Box at the West Haven Police Station Aware of but did not participate in	Prescription Drug Drop Box at the West Haven Police Station Not aware of
Volunteer Opportunities	Volunteer Opportunities Attended or participated in	Volunteer Opportunities Aware of but did not participate in	Volunteer Opportunities Not aware of

Other (please specify)

Did you know...WHPC has a Youth Committee? High School Youth join the Committee to work on and develop various town-wide projects to impact our community, while gaining leadership skills and community service hours! Youth who join have an ability to shape this committee to address the issues that matter most to youth today and make a positive impact. Develop podcasts, PSAs, TED Students Talks, Fundraising and more!

Are you interested in learning more about the youth committee?

Please contact Kendra Epps at kepps@bridgesmilford.org or http://tinyurl.com/WHYouthGroup-more information