Say Something Youth Initiative: Session 5 Pre-Test

Mid-Session Survey

Welcome to year two of Say Something Youth LABs! We have a few questions about LABs that will help us improve the program. We also use this information to report to our funder, but we only report for the program as a whole and do not share any personal information. This survey is anonymous. This survey will take 10-15 minutes. Thank you, your feedback is important!

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* 1. Please enter the name of the street where you lived when you were first born plus the number of siblings(that is, brothers and sisters) you have and your birth order. For example, if you lived on a street called“Elm Street” and you have four siblings and you are the second born, you would enter “Elm42” in this box (This should be the same identifier used on

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* 2. Did you have the Say Something Youth Initiative LABs during health class in 9th grade (session 1-4 of the 8 session curriculum)? classes focused on noticing, judgement, boundaries, and consent.

Yes

Not Sure

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* 3. Have you ever been in a dating relationship or been on a date? [By dating relationship, we mean having been in a romantic relationship with someone else, having been on a date with someone, or having had a physical relationship with someone by your choice]

Yes

I prefer not to answer

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* 4. When deciding whether or not to intervene as a bystander, it is important to..

Stop the person doing harm immediately.

Yell louder than the person causing harm so they feel intimidated.

Judge our own emotional and physical safety before deciding to intervene

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* 5. Assertive communication looks like..

Loud tone, taking up a lot of space, piercing eye contact

Firm tone, head up, shoulders square, steady eye contact

Quiet tone, downcast eyes, head down, shoulders slumped

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* 6. I believe that it’s okay to treat someone differently because of their gender.

Yes

I am not sure

I prefer not to answer

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* 7. Empathy means... (check all that apply)

Imagining how someone else feels in a situation.

Taking action to fix a situation after we are told about it.

Knowing how someone else feels because I went through something similar.

Seeing situations from another person's point of view.

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* 8. Which of the following about consent is not true.

Consent is important because it is how we tell other people what is and isn't okay within our relationship

If I give someone consent I cannot change my mind later

Consent only applies in sexual relationships

Consent is important when building a relationship that both people feel respected in

It is important to ask for consent in advance

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* 9. Some examples of unhealthy behaviors in a relationship are... (Check all that apply)

Being told what to, or not to, wear by a partner

Using name-calling or insults towards a partner when they upset you

Your partner encourages you to do things you love

Cancelling plans with friends because my partner doesn't like them

Being confident in bringing up hard conversations with my partner

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* 10. When deciding whether or not to intervene as a bystander, it is important to..

Stop the person doing harm immediately.

Yell louder than the person causing harm so they feel intimidated.

Judge our own emotional and physical safety before deciding to intervene

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* 11. The next section asks about your opinions, beliefs, and knowledge. For each of the following statements, please indicate how strongly you agree with each of the statements.

	1 Strongly Disagree	2	3	4	5	6	7 Strongly Agree
I know an adult I would feel comfortable talking to about dating relationships	I know an adult I would feel comfortable talking to about dating relationships 1 Strongly Disagree	I know an adult I would feel comfortable talking to about dating relationships 2	I know an adult I would feel comfortable talking to about dating relationships 3	I know an adult I would feel comfortable talking to about dating relationships 4	I know an adult I would feel comfortable talking to about dating relationships 5	I know an adult I would feel comfortable talking to about dating relationships 6	I know an adult I would feel comfortable talking to about dating relationships 7 Strongly Agree
I would be able to communicate respectfully with a dating partner if there were a problem between us	I would be able to communicate respectfully with a dating partner if there were a problem between us 1 Strongly Disagree	I would be able to communicate respectfully with a dating partner if there were a problem between us 2	I would be able to communicate respectfully with a dating partner if there were a problem between us 3	I would be able to communicate respectfully with a dating partner if there were a problem between us 4	I would be able to communicate respectfully with a dating partner if there were a problem between us 5	I would be able to communicate respectfully with a dating partner if there were a problem between us 6	I would be able to communicate respectfully with a dating partner if there were a problem between us 7 Strongly Agree
I feel confident in my ability to set boundaries with adults in my life	I feel confident in my ability to set boundaries with adults in my life 1 Strongly Disagree	I feel confident in my ability to set boundaries with adults in my life 2	I feel confident in my ability to set boundaries with adults in my life 3	I feel confident in my ability to set boundaries with adults in my life 4	I feel confident in my ability to set boundaries with adults in my life 5	I feel confident in my ability to set boundaries with adults in my life 6	I feel confident in my ability to set boundaries with adults in my life 7 Strongly Agree
When I set a limit in a relationship, it is usually respected	When I set a limit in a relationship, it is usually respected 1 Strongly Disagree	When I set a limit in a relationship, it is usually respected 2	When I set a limit in a relationship, it is usually respected 3	When I set a limit in a relationship, it is usually respected 4	When I set a limit in a relationship, it is usually respected 5	When I set a limit in a relationship, it is usually respected 6	When I set a limit in a relationship, it is usually respected 7 Strongly Agree
I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 1 Strongly Disagree	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 2	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 3	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 4	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 5	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 6	I would feel comfortable telling a dating partner that they have crossed one of my personal boundaries 7 Strongly Agree
I feel confident in my ability to communicate my sexual needs in my relationship	I feel confident in my ability to communicate my sexual needs in my relationship 1 Strongly Disagree	I feel confident in my ability to communicate my sexual needs in my relationship 2	I feel confident in my ability to communicate my sexual needs in my relationship 3	I feel confident in my ability to communicate my sexual needs in my relationship 4	I feel confident in my ability to communicate my sexual needs in my relationship 5	I feel confident in my ability to communicate my sexual needs in my relationship 6	I feel confident in my ability to communicate my sexual needs in my relationship 7 Strongly Agree
There are times when it is okay to blame someone who has been sexually assaulted for what happened to them	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 1 Strongly Disagree	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 2	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 3	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 4	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 5	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 6	There are times when it is okay to blame someone who has been sexually assaulted for what happened to them 7 Strongly Agree
I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 1 Strongly Disagree	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 2	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 3	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 4	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 5	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 6	I can identify the differences between healthy, unhealthy, and abusive behaviors in a relationship 7 Strongly Agree
I have the skills to help a friend who is experiencing violence	I have the skills to help a friend who is experiencing violence 1 Strongly Disagree	I have the skills to help a friend who is experiencing violence 2	I have the skills to help a friend who is experiencing violence 3	I have the skills to help a friend who is experiencing violence 4	I have the skills to help a friend who is experiencing violence 5	I have the skills to help a friend who is experiencing violence 6	I have the skills to help a friend who is experiencing violence 7 Strongly Agree
I feel confident assessing a situation and deciding to Say Something when I see someone causing harm	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 1 Strongly Disagree	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 2	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 3	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 4	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 5	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 6	I feel confident assessing a situation and deciding to Say Something when I see someone causing harm 7 Strongly Agree
I feel like I have strong leadership skills	I feel like I have strong leadership skills 1 Strongly Disagree	I feel like I have strong leadership skills 2	I feel like I have strong leadership skills 3	I feel like I have strong leadership skills 4	I feel like I have strong leadership skills 5	I feel like I have strong leadership skills 6	I feel like I have strong leadership skills 7 Strongly Agree
It is okay to use violence to express my feelings	It is okay to use violence to express my feelings 1 Strongly Disagree	It is okay to use violence to express my feelings 2	It is okay to use violence to express my feelings 3	It is okay to use violence to express my feelings 4	It is okay to use violence to express my feelings 5	It is okay to use violence to express my feelings 6	It is okay to use violence to express my feelings 7 Strongly Agree
People of all genders deserve the same opportunities in life	People of all genders deserve the same opportunities in life 1 Strongly Disagree	People of all genders deserve the same opportunities in life 2	People of all genders deserve the same opportunities in life 3	People of all genders deserve the same opportunities in life 4	People of all genders deserve the same opportunities in life 5	People of all genders deserve the same opportunities in life 6	People of all genders deserve the same opportunities in life 7 Strongly Agree
It is ok to assume that you know someone’s gender by looking at them	It is ok to assume that you know someone’s gender by looking at them 1 Strongly Disagree	It is ok to assume that you know someone’s gender by looking at them 2	It is ok to assume that you know someone’s gender by looking at them 3	It is ok to assume that you know someone’s gender by looking at them 4	It is ok to assume that you know someone’s gender by looking at them 5	It is ok to assume that you know someone’s gender by looking at them 6	It is ok to assume that you know someone’s gender by looking at them 7 Strongly Agree
I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 1 Strongly Disagree	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 2	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 3	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 4	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 5	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 6	I can help to create a culture of acceptance, respect, and healthy relationships at Easthampton High School 7 Strongly Agree

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* 12. Since taking the Say Something Youth LABS in health class last year, has there been a situation where you had the opportunity to Say Something?

Yes, but I did not feel emotionally or physically safe to do so

Yes, and I successfully Said Something in the situation

Yes, I wanted to but didn’t know what to say

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* 13. What is your self-identified race/ethnicity?

American Indian/Alaska Native

Asian

Black

Native Hawaiian/Pacific Islander

White

Hispanic or Latino

Cape Verdean

Multiracial

Other (please specify)

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* 14. What is your current gender identity?

Male

Female

Nonbinary, Genderqueer, not exclusively male or female

I am questioning/not sure of my gender identity

I don’t understand what this question is asking

I prefer not to answer

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* 15. Some people describe themselves as transgender when how they think about their gender is different from the sex they were assigned at birth. Are you transgender or of transgender experience?

Yes

I’m not sure

I don’t understand what this question is asking

I prefer not to answer

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* 16. What is your sexual orientation?

Lesbian

Gay

Bisexual

Queer

Asexual

Straight

Other (please specify)

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* 17. Do you have any of the following disabilities? (Select all that apply)

mobility

visual

hearing

developmental

learning

mental health/psychiatric

substance use

I prefer not to answer

I do not have a disability

Other (please specify)