Lafayette Communities That Care Project Assessment - Youth

This information is being collected by the Lafayette Communities That Care (CTC) project. It will be used to help understand our community and make changes to improve things for young people and adults. Your answers are voluntary and confidential. The information you share will be combined with other people’s information so that you are not identified. The combined results will be reviewed by Boulder County Public Health, Communities That Care staff, and participants of a future discussion on the topic.

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* 1. Directions
Select (the BIG) YES! if you think the statement is definitely true for you.
Select (the little) yes if you think the statement is mostly true for you.
Select (the little) no if you think the statement is mostly not true for you.
Select (the BIG) NO! if you think the statement is definitely not true for you.

	NO!	no	yes	YES!
a. There lots of adults in my neighborhood I could talk to about something important.	a. There lots of adults in my neighborhood I could talk to about something important. NO!	a. There lots of adults in my neighborhood I could talk to about something important. no	a. There lots of adults in my neighborhood I could talk to about something important. yes	a. There lots of adults in my neighborhood I could talk to about something important. YES!
b. There are people in my neighborhood who are proud of me when I do something well.	b. There are people in my neighborhood who are proud of me when I do something well. NO!	b. There are people in my neighborhood who are proud of me when I do something well. no	b. There are people in my neighborhood who are proud of me when I do something well. yes	b. There are people in my neighborhood who are proud of me when I do something well. YES!
c. There are people in my neighborhood who encourage me to do my best.	c. There are people in my neighborhood who encourage me to do my best. NO!	c. There are people in my neighborhood who encourage me to do my best. no	c. There are people in my neighborhood who encourage me to do my best. yes	c. There are people in my neighborhood who encourage me to do my best. YES!
d. My neighbors notice when I am doing a good job and let me know about it.	d. My neighbors notice when I am doing a good job and let me know about it. NO!	d. My neighbors notice when I am doing a good job and let me know about it. no	d. My neighbors notice when I am doing a good job and let me know about it. yes	d. My neighbors notice when I am doing a good job and let me know about it. YES!
e. I like my neighborhood.	e. I like my neighborhood. NO!	e. I like my neighborhood. no	e. I like my neighborhood. yes	e. I like my neighborhood. YES!
f. I’d like to get out of my neighborhood.	f. I’d like to get out of my neighborhood. NO!	f. I’d like to get out of my neighborhood. no	f. I’d like to get out of my neighborhood. yes	f. I’d like to get out of my neighborhood. YES!
g. If I had to move, I would miss the neighborhood I now live in.	g. If I had to move, I would miss the neighborhood I now live in. NO!	g. If I had to move, I would miss the neighborhood I now live in. no	g. If I had to move, I would miss the neighborhood I now live in. yes	g. If I had to move, I would miss the neighborhood I now live in. YES!
h. I feel safe in my neighborhood.	h. I feel safe in my neighborhood. NO!	h. I feel safe in my neighborhood. no	h. I feel safe in my neighborhood. yes	h. I feel safe in my neighborhood. YES!
I. It is important to be honest with your parents, even if they become upset or you get punished.	I. It is important to be honest with your parents, even if they become upset or you get punished. NO!	I. It is important to be honest with your parents, even if they become upset or you get punished. no	I. It is important to be honest with your parents, even if they become upset or you get punished. yes	I. It is important to be honest with your parents, even if they become upset or you get punished. YES!
j. I think it is okay to cheat at school.	j. I think it is okay to cheat at school. NO!	j. I think it is okay to cheat at school. no	j. I think it is okay to cheat at school. yes	j. I think it is okay to cheat at school. YES!
k. I think it is okay to take something without asking if you can get away with it.	k. I think it is okay to take something without asking if you can get away with it. NO!	k. I think it is okay to take something without asking if you can get away with it. no	k. I think it is okay to take something without asking if you can get away with it. yes	k. I think it is okay to take something without asking if you can get away with it. YES!
l. It is all right to beat up people if they start the fight.	l. It is all right to beat up people if they start the fight. NO!	l. It is all right to beat up people if they start the fight. no	l. It is all right to beat up people if they start the fight. yes	l. It is all right to beat up people if they start the fight. YES!

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* 2. How much do each of the following statements describe your neighborhood?

	NO!	no	yes	YES!
a. Crime and/or drug selling	a. Crime and/or drug selling NO!	a. Crime and/or drug selling no	a. Crime and/or drug selling yes	a. Crime and/or drug selling YES!
b. Fights	b. Fights NO!	b. Fights no	b. Fights yes	b. Fights YES!
c. Lots of empty or abandoned buildings	c. Lots of empty or abandoned buildings NO!	c. Lots of empty or abandoned buildings no	c. Lots of empty or abandoned buildings yes	c. Lots of empty or abandoned buildings YES!
e. Lots of graffiti	e. Lots of graffiti NO!	e. Lots of graffiti no	e. Lots of graffiti yes	e. Lots of graffiti YES!

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* 3. Select the answer that is true for you.

	Never	1 or 2 times	3 or 4 times	5 or 6 times	7 or more times
a. How many times have you changed homes since kindergarten?	a. How many times have you changed homes since kindergarten? Never	a. How many times have you changed homes since kindergarten? 1 or 2 times	a. How many times have you changed homes since kindergarten? 3 or 4 times	a. How many times have you changed homes since kindergarten? 5 or 6 times	a. How many times have you changed homes since kindergarten? 7 or more times
b. How many times have you changed schools (including changing from elementary to middle, middle to high school) since Kindergarten?	b. How many times have you changed schools (including changing from elementary to middle, middle to high school) since Kindergarten? Never	b. How many times have you changed schools (including changing from elementary to middle, middle to high school) since Kindergarten? 1 or 2 times	b. How many times have you changed schools (including changing from elementary to middle, middle to high school) since Kindergarten? 3 or 4 times	b. How many times have you changed schools (including changing from elementary to middle, middle to high school) since Kindergarten? 5 or 6 times	b. How many times have you changed schools (including changing from elementary to middle, middle to high school) since Kindergarten? 7 or more times
c. Have you changed schools (including changing from elementary to middle or middle to high school) in the past year?	c. Have you changed schools (including changing from elementary to middle or middle to high school) in the past year? Never	c. Have you changed schools (including changing from elementary to middle or middle to high school) in the past year? 1 or 2 times	c. Have you changed schools (including changing from elementary to middle or middle to high school) in the past year? 3 or 4 times	c. Have you changed schools (including changing from elementary to middle or middle to high school) in the past year? 5 or 6 times	c. Have you changed schools (including changing from elementary to middle or middle to high school) in the past year? 7 or more times
d. Have you changed homes in the past year?	d. Have you changed homes in the past year? Never	d. Have you changed homes in the past year? 1 or 2 times	d. Have you changed homes in the past year? 3 or 4 times	d. Have you changed homes in the past year? 5 or 6 times	d. Have you changed homes in the past year? 7 or more times

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* 4. Select the answer that is true for you.

	Very false	Somewhat false	Somewhat true	Very true
a. I like to see how much I can get away with.	a. I like to see how much I can get away with. Very false	a. I like to see how much I can get away with. Somewhat false	a. I like to see how much I can get away with. Somewhat true	a. I like to see how much I can get away with. Very true
b. I ignore rules that get in my way.	b. I ignore rules that get in my way. Very false	b. I ignore rules that get in my way. Somewhat false	b. I ignore rules that get in my way. Somewhat true	b. I ignore rules that get in my way. Very true
c. I do the opposite of what people tell me, just to get them mad.	c. I do the opposite of what people tell me, just to get them mad. Very false	c. I do the opposite of what people tell me, just to get them mad. Somewhat false	c. I do the opposite of what people tell me, just to get them mad. Somewhat true	c. I do the opposite of what people tell me, just to get them mad. Very true

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* 5. What are the chances you would be seen as cool if you…

	No or very little chance	Somewhat chance	Pretty good chance	Very good chance
a. worked hard at school?	a. worked hard at school? No or very little chance	a. worked hard at school? Somewhat chance	a. worked hard at school? Pretty good chance	a. worked hard at school? Very good chance
b. defended someone who was being verbally abused at school?	b. defended someone who was being verbally abused at school? No or very little chance	b. defended someone who was being verbally abused at school? Somewhat chance	b. defended someone who was being verbally abused at school? Pretty good chance	b. defended someone who was being verbally abused at school? Very good chance
c. regularly volunteered to do community service?	c. regularly volunteered to do community service? No or very little chance	c. regularly volunteered to do community service? Somewhat chance	c. regularly volunteered to do community service? Pretty good chance	c. regularly volunteered to do community service? Very good chance

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* 6. How often do you attend religious services or activities?

Never

Rarely

1-2 times a month

About once a week or more

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* 7. How many times in the past year (12 months), have you…

	Never	1 or 2 times	3 to 5 times	6 to 9 times	10 to 19 times	20 to 29 times	30 to 39 times	40+ times
a. participated in clubs, organizations, or activities at school?	a. participated in clubs, organizations, or activities at school? Never	a. participated in clubs, organizations, or activities at school? 1 or 2 times	a. participated in clubs, organizations, or activities at school? 3 to 5 times	a. participated in clubs, organizations, or activities at school? 6 to 9 times	a. participated in clubs, organizations, or activities at school? 10 to 19 times	a. participated in clubs, organizations, or activities at school? 20 to 29 times	a. participated in clubs, organizations, or activities at school? 30 to 39 times	a. participated in clubs, organizations, or activities at school? 40+ times
b. done extra work on your own for school?	b. done extra work on your own for school? Never	b. done extra work on your own for school? 1 or 2 times	b. done extra work on your own for school? 3 to 5 times	b. done extra work on your own for school? 6 to 9 times	b. done extra work on your own for school? 10 to 19 times	b. done extra work on your own for school? 20 to 29 times	b. done extra work on your own for school? 30 to 39 times	b. done extra work on your own for school? 40+ times
c. volunteered to do community services?	c. volunteered to do community services? Never	c. volunteered to do community services? 1 or 2 times	c. volunteered to do community services? 3 to 5 times	c. volunteered to do community services? 6 to 9 times	c. volunteered to do community services? 10 to 19 times	c. volunteered to do community services? 20 to 29 times	c. volunteered to do community services? 30 to 39 times	c. volunteered to do community services? 40+ times

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* 8. Please state your gender.

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* 9. Are you Hispanic or Latino?

Yes

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* 10. What is your race? (Select one or more responses.)

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Other

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* 11. Are you a Lafayette resident?

Yes

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* 12. Please provide the year you were born.

Thank you for completing this survey!