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 Post In-hospital P.A.R.T.Y. Program Evaluation Questionnaire

Student Participant Demographics

1.Student initials & Year of birth (JS1999 i.e. John Smith 1999)(Required.)
2.What is your age?(Required.)
3.What is your gender?(Required.)
4.What school do (did) you attend? Select from Dropdown box
5.Have you attended 'Road Ready' driver education?(Required.)
6.Have you attended 'Partysafe' education during classes at school?(Required.)
Scenario One-
You're at a party with friends; there is alcohol and drugs available. A group of people start an argument which quickly escalates to include violence. They have been drinking heavily and are pretty 'out of it'.
7.How likely would it be for you to become involved in this situation?(Required.)
1- Quite likely
2
3
4
5- Not at all
8.Do you think getting involved would be?(Required.)
1- Safe
2
3
4
5- Dangerous
9.Do you think getting involved would be?
1- Beneficial
2
3
4
5- Harmful
10.In this situation, how likely is it that your Male friends would become involved?(Required.)
1- Quite likely
2
3
4
5- Not at all
11.In this situation, how likely is it that your Female friends would become involved?(Required.)
1- Quite likely
2
3
4
5- Not at all
12.Becoming involved in this situation would be?(Required.)
1- Very easy
2
3
4
5- Very difficult
13.I would feel?(Required.)
1- In control
2
3
4
5- Out of control
The fight settles down and your close mates are ready to chill and have fun, one of them offers you a 'pinga' (Ecstasy/MDMA)
14.How likely is it that you would take it?(Required.)
1- Quite likely
2
3
4
5- Not at all
15.Your usual group of friends thinks that party drugs (MDMA, marijuana) are ok because they are safe?(Required.)
1- Quite true
2
3
4
5- Not true
16.Would your friends approve if you took party drugs in this situation?(Required.)
1- Quite likely
2
3
4
5- Not at all
17.Would your family approve if you took party drugs in this situation?(Required.)
1- Quite likely
2
3
4
5- Not at all
18.Thinking about the scenario, use the following scale to indicate the likelihood of you to:(Required.)
1 - Quite likely
2
3
4
5 - Not at all
Take drugs
Drink Alcohol
Fight
In the next set of questions we ask you to assume you have your driving license

Scenario Two-
The next day you're out driving with your friends. You're pretty tired after the party and want to get something to eat. You're driving on a straight stretch of road  where the speed limit is 90km/hr. 
Your friends tell you that you're driving too slow even though you are at the speed limit.
19.How likely is it for you to increase your speed in this situation?(Required.)
1- Quite likely
2
3
4
5- Not at all
20.Most of your mates would think that you should drive at 100km/hr in this situation?(Required.)
1- Quite true
2
3
4
5- Not true
You decide to increase your speed up to 100km/hr
21.Do you think that driving at 100km/hr to be?(Required.)
1
2
3
4
5
1= Pleasant- 5= Unpleasant
1= Safe- 5= Dangerous
1= Beneficial- 5= Harmful
22.Driving faster than 100km/hr in this situation would be?(Required.)
1
2
3
4
5
1= Very easy 5= Very difficult
1= Within your range of abilities 5= Not within your abilities
1= Feel in control 5= Not feel in control
One of your friends in the car gets a text message and gives you the phone to read and respond
23.How likely is it for you to respond to the text in this situation?(Required.)
1- Quite likely
2
3
4
5- Not at all
24.Do you think that driving in this situation would be?(Required.)
1
2
3
4
5
1= Very easy 5= Very difficult
1= Within my abilities 5= Not within my abilities
1= Safe 5= Dangerous
1= Beneficial 5= Harmful
25.People whose opinion you value (such as your family and friends) would approve of you using your mobile phone in this situation?(Required.)
1- Quite true
2
3
4
5- Not true
Family
Friends
26.Would your ____________ use their mobile phone in this situation? (Leave blank if not applicable, i.e. no brother/ sister/parent in your family)
1- Quite likely
2
3
4
5- Not at all
Mother
Father
Brother
Sister
27.Thinking about the scenario, use the following scale to indicate the likelihood of you to;
1- Quite likely
2
3
4
5- Not at all
Drive while potentially over the legal alcohol limit
Speed
Use your mobile phone or other device
1 / 1
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