Durham Middlefield Local Wellness Coalition Community Survey 2018

The Durham Middlefield Local Wellness Coalition (DMLWC) mobilizes youth and community partners to reduce youth substance abuse and create a safe, healthy and drug-free environment where youth and families thrive. Through this survey, we will be able to better serve our youth with local prevention programming. Your answers will also help DMLWC identify ways we can support Durham/Middlefield parents and community members.

This survey is completely anonymous and does NOT ask for information which could identify you.

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* 1. What is your town of residence?

Durham

Middlefield

Other (please specify)

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* 2. Your gender:

Male

Female

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* 3. Your age:

18 to 25

26 to 35

36 to 49

50 to 64

65 or older

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* 4. Had you heard about DMLWC prior to receiving this survey?

Yes

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* 5. If one was available, would you use an anonymous Tips Line that sends ‘tips’ to the Durham Middlefield police (to report underage drinking/drug activity and other illegal activities)?

Yes

Not sure

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* 6. How familiar are you with…

	Very familiar	Somewhat familiar	Unfamiliar
the work DMLWC is involved with in the community?	the work DMLWC is involved with in the community? Very familiar	the work DMLWC is involved with in the community? Somewhat familiar	the work DMLWC is involved with in the community? Unfamiliar
the CT Social Host Law that makes it illegal for any adult to provide a place for teens to drink?	the CT Social Host Law that makes it illegal for any adult to provide a place for teens to drink? Very familiar	the CT Social Host Law that makes it illegal for any adult to provide a place for teens to drink? Somewhat familiar	the CT Social Host Law that makes it illegal for any adult to provide a place for teens to drink? Unfamiliar
The available resources in the community that would support you in dealing with a substance abuse issue (for you, your child, or another family member)?	The available resources in the community that would support you in dealing with a substance abuse issue (for you, your child, or another family member)? Very familiar	The available resources in the community that would support you in dealing with a substance abuse issue (for you, your child, or another family member)? Somewhat familiar	The available resources in the community that would support you in dealing with a substance abuse issue (for you, your child, or another family member)? Unfamiliar

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* 7. In the past year, have you disposed of unused or expired medications in any of the following methods: (check all that apply)

I have NOT needed to dispose of medications

I have brought medications to a Prescription Medication Drop Box

I have brought medications to a Drug Take Back Day event

I have properly disposed of medications at home (following CT Department of Consumer Protection guidelines.)

Other (please specify)

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* 8. When considering Durham Middlefield youth and young adults how concerned are you with…

	Not at all concerned	A little bit concerned	Somewhat concerned	Very concerned
Mental health issues (including anxiety and stress)	Mental health issues (including anxiety and stress) Not at all concerned	Mental health issues (including anxiety and stress) A little bit concerned	Mental health issues (including anxiety and stress) Somewhat concerned	Mental health issues (including anxiety and stress) Very concerned
Use of alcohol	Use of alcohol Not at all concerned	Use of alcohol A little bit concerned	Use of alcohol Somewhat concerned	Use of alcohol Very concerned
Use of marijuana	Use of marijuana Not at all concerned	Use of marijuana A little bit concerned	Use of marijuana Somewhat concerned	Use of marijuana Very concerned
Use of illicit drugs (such as heroin, cocaine)	Use of illicit drugs (such as heroin, cocaine) Not at all concerned	Use of illicit drugs (such as heroin, cocaine) A little bit concerned	Use of illicit drugs (such as heroin, cocaine) Somewhat concerned	Use of illicit drugs (such as heroin, cocaine) Very concerned
Abuse of prescription medications (including pain medications, tranquilizers, and stimulants)	Abuse of prescription medications (including pain medications, tranquilizers, and stimulants) Not at all concerned	Abuse of prescription medications (including pain medications, tranquilizers, and stimulants) A little bit concerned	Abuse of prescription medications (including pain medications, tranquilizers, and stimulants) Somewhat concerned	Abuse of prescription medications (including pain medications, tranquilizers, and stimulants) Very concerned
Vaping (e-cigs, JUULs)	Vaping (e-cigs, JUULs) Not at all concerned	Vaping (e-cigs, JUULs) A little bit concerned	Vaping (e-cigs, JUULs) Somewhat concerned	Vaping (e-cigs, JUULs) Very concerned
Use of tobacco or cigarettes	Use of tobacco or cigarettes Not at all concerned	Use of tobacco or cigarettes A little bit concerned	Use of tobacco or cigarettes Somewhat concerned	Use of tobacco or cigarettes Very concerned