Directions:  Enter the paired pretest and posttest surveys for each youth.  

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* 1. What is today's date?

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* 2. Enter a code number given to you or one you'd like to use (Hint: one you can easily remember):

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* 3. School or location code (Optional):

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* 4. Are you...

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* 5. How old are you?

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* 6. In the next year, how likely are you to get physical activity most days a week?

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* 7. In the next year, how likely are you to get 8 or more hours of sleep most nights a week?

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* 8. In the next year, how likely are you to eat mostly healthy foods most days a week?

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* 9. In the next year, how likely are you to take a drink of alcohol?

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* 10. In the next year, how likely are you to puff on a cigarette?

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* 11. In the next year, how likely are you to try any marijuana?

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* 12. In the next year, how likely are you to try an e-cigarette?

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* 13. In the next year, how likely are you to practice a stress control or relaxation technique most days a week?

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* 14. In the next year, how likely are you to try any opioids for nonmedical reasons?

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* 15. In the next year, how likely are you to set goals to improve your health or fitness?

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* 16. If you were to drink alcohol often, would it harm your health or healthy habits?

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* 17. If you were to smoke cigarettes often, would they harm your health or healthy habits?

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* 18. If you were to use marijuana often, would it harm your health or healthy habits?

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* 19. If you were to use e-cigarettes often, would they harm your health or healthy habits?

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* 20. If you were to use opioids often,  would they harm your health or healthy habits?

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* 21. How many people your age currently drink alcohol?

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* 22. How many people your age currently smoke cigarettes?

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* 23. How many people your age currently use marijuana?

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* 24. How many people your age currently vape e-cigarettes?

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* 25. How many people your age currently use opioids for nonmedical reasons?

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* 26. In the next year, how likely are you to get physical activity most days a week?

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* 27. In the next year, how likely are you to get 8 or more hours of sleep most nights a week?

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* 28. In the next year, how likely are you to eat mostly healthy foods most days a week?

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* 29. In the next year, how likely are you to take a drink of alcohol?

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* 30. In the next year, how likely are you to puff on a cigarette?

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* 31. In the next year, how likely are you to try any marijuana?

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* 32. In the next year, how likely are you to try an e-cigarette?

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* 33. In the next year, how likely are you to practice a stress control or relaxation technique most days a week?

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* 34. In the next year, how likely are you to try any opioids for nonmedical reasons?

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* 35. In the next year, how likely are you to set goals to improve your health or fitness?

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* 36. If you were to drink alcohol often, would it harm your health or healthy habits?

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* 37. If you were to smoke cigarettes often, would they harm your health or healthy habits?

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* 38. If you were to use marijuana often, would it harm your health or healthy habits?

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* 39. If you were to use e-cigarettes often, would they harm your health or healthy habits?

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* 40. If you were to use opioids often,  would they harm your health or healthy habits?

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* 41. How many people your age currently drink alcohol?

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* 42. How many people your age currently smoke cigarettes?

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* 43. How many people your age currently use marijuana?

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* 44. How many people your age currently vape e-cigarettes?

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* 45. How many people your age currently use opioids for nonmedical reasons?

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* 46. What did you like BEST about this lesson?  For example, how did it affect your health behaviors, substance use, motivation, goal setting, self-esteem, etc.?

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* 47. What did you like LEAST about this lesson?  For example, what do you think should be changed or improved?

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