DFC Core Measures Survey Question Title * 1. Sex: Male Female Question Title * 2. Grade: 6 7 8 9 10 11 12 Question Title * 3. Age 10 years old or less 11 years old 12 years old 13 years old 14 years old 15 years old 16 years old 17 years old 18 years old 19 years old or more Question Title * 4. During the past 30 days did you drink one or more drinks of an alcoholic beverage? Yes No Question Title * 5. During the past 30 days did you smoke part or all of a cigarette? Yes No Question Title * 6. During the past 30 days have you used marijuana or hashish? Yes No Question Title * 7. During the past 30 days have you used prescription drugs not prescribed to you? Yes No Question Title * 8. How much do you think people risk harming themselves physically or in other ways when they have five or more drinks of an alcoholic beverage once or twice a week? No Risk Slight Risk Moderate Risk Great Risk Question Title * 9. How much do you think people risk harming themselves physically or in other ways if they smoke one or more packs of cigarettes per day? No Risk Slight Risk Moderate Risk Great Risk Question Title * 10. How much do you think people risk harming themselves physically or in other ways if they smoke marijuana once or twice a week? No Risk Slight Risk Moderate Risk Great Risk Question Title * 11. How much do you think people risk harming themselves physically or in other ways if they use prescription drugs that are not prescribed to them? No Risk Slight Risk Moderate Risk Great Risk Question Title * 12. Required for STOP Act Grantees only: How much do you think people risk harming themselves (physically or in other ways) if they take one or two drinks of an alcoholic beverage nearly every day? No Risk Slight Risk Moderate Risk Great Risk Question Title * 13. How wrong do your parents feel it would be for you to have one or two drinks of an alcoholic beverage nearly every day? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 14. How wrong do your parents feel it would be for you to smoke tobacco? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 15. How wrong do your parents feel it would be for you to smoke marijuana? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 16. How wrong do your parents feel it would be for you to use prescription drugs not prescribed to you? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 17. How wrong do your friends feel it would be for you to have one or two drinks of an alcoholic beverage nearly every day? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 18. How wrong do your friends feel it would be for you to smoke tobacco? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 19. How wrong do your friends feel it would be for you to smoke marijuana? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 20. How wrong do your friends feel it would be for you to use prescription drugs not prescribed to you? Not wrong at all A little bit wrong Wrong Very wrong Question Title * 21. Required for STOP ACT grantees only: How do you feel about someone your age having one or two drinks of an alcoholic beverage nearly every day? Neither approve nor disapprove Somewhat Disapprove Strongly disapprove Don't know or can't say Question Title * 22. School Chaney High School East High School Kirkmere School Liberty High School Liberty Middle School Rayen Early College South Side Academy Valley Christian Williamson School Youngstown Rayen Early College Volney Elementary School Taft Elementary School Wilson Elementary School Question Title * 23. This survey is administered by the Coalition for Health Promotion, a Project of YUMADAOP. We are located at 1327 Florencedale Avenue, Youngstown, OH 44505 (330)743-2772. Done
