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Copyright Catalyst Evaluation Group

If you choose to complete this survey, you will be eligible for a random drawing for local gift cards. Your answers will not be matched to your name or contact information.

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* 1. Which sector best categorizes your involvement in substance use prevention?

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* 2. What substance do you think should be the first priority for the coalition to address?

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* 3. Please rank the following substances in order of negative impact on youth in the community

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* 4. What root causes do you think are most commonly affecting underage alcohol use?

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* 5. When and where do youth use alcohol?

  Parties Their own home alone Their own home with parents Their own home with friends Friend's house Park Parking lot Bars/Restaurants School Secluded place in the community
Before school
During school
After school
Nights
Weekends

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* 6. How do youth get alcohol?

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* 7. What root causes do you think are most commonly affecting underage Tobacco/Nicotine (including vaping)?

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* 8. When and where do youth use Tobacco/Nicotine (including vaping)?

  Parties Their own home alone Their own home with parents Their own home with friends Friend's house Park Parking lot Bars/Restaurants School Secluded place in the community
Before school
During school
After school
Nights
Weekends

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* 9. How do youth get Tobacco/Nicotine (including vaping) products?

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* 10. What root causes do you think are most commonly affecting underage marijuana/cannabis use (including vaping)?

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* 11. When and where do youth use marijuana/cannabis (including vaping)?

  Parties Their own home alone Their own home with parents Their own home with friends Friend's house Park Parking lot Bars/Restaurants School Secluded place in the community
Before school
During school
After school
Nights
Weekends

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* 12. How do youth get marijuana/cannabis?

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* 13. What root causes do you think are most commonly affecting prescription opioid misuse?

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* 14. When and where do youth use prescription opioids?

  Parties Their own home alone Their own home with parents Their own home with friends Friend's house Park Parking lot Bars/Restaurants School Secluded place in the community
Before school
During school
After school
Nights
Weekends

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* 15. How do youth get prescription opioids?

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* 16. Would you like to enter a random drawing for local gift cards? Your name will not be matched with your answers.

0 of 19 answered
 

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