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Survey Instructions:

The Rhode Island Department of Health is asking for you to share your voice and tell us about health concerns that you have. Your responses will help us better understand your health needs and come up with solutions to improve the health and well-being of Rhode Island youth.

The survey is completely anonymous and will not be linked to your name in any way. Participation in the survey is voluntary. You may skip any question you do not wish to answer or stop at any time.

Thank you for your participation! 

Completed surveys will be entered in a raffle to win a $30 gift card!  When you complete the survey, you will be directed to a separate link to enter your information for the raffle.

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* 1. What are the top four (4) things you are most concerned about on a day to day basis? 

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* 2. When you are having a hard time, who do you talk to about any issues and/or your feelings? Check all that apply:

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* 3. Where do you usually get health information for yourself? Check all that apply:

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* 4. Some schools have a school-based health center, also called a wellness center, where students can get health care such as sports physicals or prescriptions for medicine, on school property. This is not the same as the school nurse’s office. During the past 12 months, how many times did you go to the school-based health center at your school? Choose one answer:

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* 5. In the past 12 months, have you visited the doctor or other healthcare provider?

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* 6. If you answered no, what are some of the reasons you don’t go to the doctor or other medical appointments? Check all that apply:

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* 7. Do you feel comfortable with the following activities related to managing your own health? Check all that apply:

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* 8. How are you treated when getting medical care? Choose one answer:

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* 9. What would you like to see in your neighborhood to make it a better place to live? Check all that apply:

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* 10. What do you see as the top four (4) priorities that should be addressed to improve the health and well-being of teens?

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* 11. On an average school day, how many hours do you play video or computer games or use a computer for something that is not schoolwork? (Count time spent playing games, watching videos, texting, and/or using social media on your smartphone, computer, Xbox, PlayStation, iPad, or other tablet). Choose one answer:

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* 12. If you have a smartphone, what are the three apps you use the most?

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* 13. Do you have trouble getting information you need because of slow or limited wi-fi?

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* 14. Would you be interested in being part of a youth-led group that talks about the health and well-being of teens?

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* 15. If yes, where would it make the most sense for a group of teens to meet to talk about health? Check all that apply:

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* 16. How old are you?

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* 17. What grade are you in?

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* 18. What is your zip code?

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* 19. What is your gender identity? Check all that apply:

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* 20. Which of the following best describes you?

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* 21. Are you Hispanic or Latino/Latina/Latinx?

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

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* 23. Do you have any feedback about the survey or additional thoughts you would like to share? (Optional)

Thank you for your participation!

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* 24. If someone referred you to the survey, please enter their REFERRAL CODE below:

0 of 24 answered
 

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