1. Default Section

Thank you for participating in this survey. The study which you will be taking consists of a questionnaire. The questionnaire is concerned with your views on your levels of life satisfaction along with current daily habits and your views of current social issues. If you do not feel like responding to any question please leave that question blank.
The questionnaire takes approximately fifteen minutes.
Your responses will be kept totally confidential. Your questionnaire will be given a random identification number. There will be no request for personal information (such as name, social security number, etc.) which would enable anyone to trace your responses back to you. The data will be stored on a secured server at Indiana University Southeast. At the end of the study all the data will be destroyed.
If you have questions at any time about the study or the procedures, you may contact the researcher, Richard Jenks, at Indiana University Southeast, New Albany, In. 47150, phone number: 812-941-2294.
If you feel you have not been treated according to the descriptions in this form, or your rights as a participant in research have not been honored during the course of this project, you may contact the Indiana University Southeast Institutional Review Board for the Protections of Human Subjects in Research, c/o Academic affairs, UC-152, 4201 Grant Line Rd., New Albany, In. 47150, 812-941-2210.
Your participation in this study is voluntary, you may refuse to participate without penalty. If you withdraw from the study before data collection data is completed your data will be returned to you or destroyed. In the case of this study, since there are no identifiers which appear with the questionnaire, then once your participation is complete your information will not be identifiable to return or destroy.
IRB approved; Approval date: 03/13/2008; Expires: 03/12/2009

* 1. I am 18 years of age or older. I have read the information above and:

First of all, I would like to ask some questions about your day-to-day activities and habits such as entertainment and reading, group membership, volunteering, physical and emotional health, etc. Please check the circle which best fits your situation.

* 2. How many hours per day (on average) would you say that you watch television?

* 3. Primarily, I watch television to:

* 4. How many clubs/organizations do you belong to?

* 5. Are the clubs/organizations to which you belong

* 6. Please specify the name or nature of the group from the above question.

* 7. If you do belong to any clubs or organizations, how many hours in a typical month would you say that you devote to each of these groups:

* 8. In a typical month, how many times would you say that you engage in informal socializing (that is, going out to eat with friends; having people over; playing cards, going bowling, or doing other recreational activities with others, etc.)

* 9. Do you have a computer either at home or work:

* 10. How much time would you estimate that you spend on the computer (in an average day) working on business

* 11. How much time would you estimate that you spend on the computer (in an average day) engaging in entertainment (playing games, etc.)

* 12. How much time would you estimate that you spend on the computer (in an average day) corresponding with friends

* 13. How much time would you estimate that you spend on the computer (in an average day) doing things other than business, entertainment, or corresponding with friends

* 14. Do you subscribe to a daily newspaper?

* 15. Do you subscribe to any magazines

* 16. In the past month have you donated money to any charitable or non-profit organization:

* 17. In the past month have you volunteered in some capacity for a charitable or non-profit organization?

* 18. In the past year have you volunteered in some capacity for a charitable or non-profit organization?

* 19. What type of group has your money or time gone to?
(check all that apply)

* 20. If, within the past year you have donated your time to a religious/spiritual/church group, has your volunteering primarily been:

* 21. How much time would you say that you have devoted to volunteering of any type in the past month:

* 22. Regarding your diet, would you say that you:

* 23. How concerned would you say that you are eating healthy?

* 24. In a typical week, how many days (out of the seven) do you engage in exercise for at least 30 minutes during that day?

* 25. How concerned would you say that you are concerned about exercising enough?

* 26. Which description below is characteristic of your situation

* 27. What is your situation regarding the use of alcohol?

* 28. What is your situation regarding the use of other drugs (i.e., substances other than alcohol or prescription drugs)?

* 29. Have you had severe enough personal, emotional, behavioral, or mental problems (for example, depression or anxiety) during the past year that you felt you needed help?

* 30. Approximately how many times have you seen a therapist in the past year?

* 31. If you had to guess about what your mental and emotional health will be like five years from now, what would you say?

* 32. Have you been bothered by any illness, bodily disorder or physical pains during the past year?

* 33. How many times during the past year have you had to visit a physician, hospital or emergency care unit for some physical problem?

* 34. If you had to guess about what your physical health will be like five years from now, what would you say?

* 35. This question refers to the extent and quality of your social relationships. Please indicate how often you have felt the way described in each of the statements during the past year.

  Never Rarely Sometimes Often Very Often
I get a lot of satisfaction from the groups I participate in:
There are good people around me who understand my views and beliefs:
I belong to a network of friends:
There are good people I can count on for companionship:

* 36. This question deals with your current feelings about yourself and your own situation. Please indicate the extent of your agreement or disagreement with each of the statements.

  Strongly Agree Agree No Opinion Disagree Strongly Disagree
I have so much to be thankful for:
The things I own say a lot about how well I am doing in life:
I am bothered when I see people buy anything they want:
I feel like a failure:
When friends do better than me in competition it usually makes me happy:
In most ways, my life is close to my ideal:
I like a lot of luxury in my life:
I wish I could change some part of my life:
I am completey satisfied with my life:
I feel that I will be worse off financially five years from now:
I often feel lonely:
Overall, I am satisfied with my job/occupation:
Overall, I am satisfied with my physical health:
Overall, I am satisfied with my emotional/mental health:
Overall, I am satisfied with my financial condition:

* 37. If you were to rate yourself on a 1 to 10 scale on Happiness with 1 being totally unhappy and 10 being totally happy, what number would you assign yourself?

* 38. Below you will find some values (listed in alphabetical order) which people find to be important in their personal lives. Please try and rank these as best you can in order of their importance to you. For example, if Self-Respect is most important to you, place a 1 there, and so forth until you have them ranked from 1 through 10.

* 39. The following questions deal with your personal beliefs about human nature. For each of the questions please indicate your agreement or disagreement with the statement.

  Strongly Agree Agree No Opinion Disagree Strongly Disagree
Many of the unhappy things in people's lives are partly due to bad luck:
In the long run, people get the respect they deserve in this world:
Most people are honest:
Getting a job depends mainly on being in the right place at the right time:
What happens to me is my own doing:
In the long run, the bad things that happen to us are balanced by the good ones:
People are lonely because they don't try to be friendly:
Most people cannot be trusted:

* 40. The following questions also ask some of your personal opinions. Please indicate whether you think the following behaviors are Morally Acceptable, Morally Wrong or if you have No Opinion.

  Morally Acceptable Morally Wrong No Opinion
The death penalty:
Buying and wearing clothing made of animal fur:
Sex between an unmarried man and woman:
Having a baby outside of marriage:
Homosexuality as a lifestyle:
Same sex marriage:
The following questions (41 through 53) ask about some matters relating to your religious and/or spiritual beliefs. Place a check in the circle which best matches your situation.

* 41. Which comes closest to describing your beliefs relating to religion/spirituality:

* 42. How important would you say that the previous question (# 41) is to you:

* 43. Which of the following statements comes closest to describing your belief about God:

* 44. Do you currently belong to a church/synagogue/mosque:

* 45. In a typical week, how much time would you say that you engage in prayer?

* 46. What is your current denominational affiliation?

* 47. Denomination or Other: please specify

* 48. In which religious denomination were you raised?

* 49. Denomination or Other (Please specify)

* 50. Is your current religious affiliation different from the religion in which you were born and raised?

If your religious affiliation is now different from the religion in which you were born and raised please repond to this question (#50) If you have the same religious affiliation now as the one in which you were raised go to Question 53

* 51. The following are some reasons why people switch religions. Please indicate to what extent each had an influence on your changing religions. Please indicate if the factor was a: Major Reason, Minor Reason, or had No Influence on your decision to switch religions.

  Major Reason Minor Reason No Influence
Disagreement with the teachings of your original religion:
You found a new religion that is more fulfilling:
You grew dissatisfied with your local church:
You disliked the fact tht the leaders were struggling with each other to control the direction of the church:
You married someone from another religion:
You moved and could not find a church of your religion that you liked:
Other: (please give reason in box below (Q52)

* 52. Other (please specify):

* 53. How often would you say that you currently attend religious services in a typical month?

* 54. How many church affiliated groups do you belong to:

While reading these descriptions of hypothetical situations (Questions 55-57), imagine yourself in each of them and check the action that best describes what you would do:

* 55. You have come across a lost wallet with a large sum of money in it, as well as identification of the owner. You

* 56. A neighbor calls you and asks for a ride to a store that is six blocks away. You

* 57. When asked to volunteer for a task in which you will receive no pay and have no interest in, you

Finally, Questions 58 through 71 ask about some of your personal characteristics.

* 58. How many years of education do you have:

* 59. In what year were you born:

* 60. Gender:

* 61. What is your race or ethnicity? (Note: if more than one, check the one you consider the most important in your background).

* 62. What was your total family income last year (2007) before taxes?

* 63. What is your current employment status? (check one)

* 64. If you are currently employed, approximately how many hours a week do you put in at your job(s)?

* 65. What is your family status currently? (check one)

* 66. How long have you been in this category (i.e., family status)?

* 67. Do you have children?

* 68. If you have children,how many:

* 69. What are their ages:

* 70. If you had to choose one word or phrase to describe your political beliefs, which of the following would you use:

* 71. If you had to place yourself into a political party, with which one would you most closely identify:

* 72. What is your zip code?

Thank you very much for completing the survey. If you should have any questions please do not hesitate to contact me. I can be reached at: rjjenks@ius.edu
Richard Jenks
Professor of Sociology
Number 73 is to be completed only if you have been given a course or code number.

* 73. student code: