SAMHSA Native Connections Tribal Youth Survey

Question Title

* 2. What is your gender?

Male

Female

Transgender

Non-Binary

Prefer not to say

Other (please specify)

Question Title

* 3. Which of the following describes your ethnicity?

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

Other (please specify)

Question Title

* 4. Are you a Saginaw Chippewa Tribal Member?

Saginaw Chippewa Tribal Member

Saginaw Chippewa Descendant

Member of another Tribe

Non-Native

Question Title

* 5. Please select the answer that best describes how much you participate in sports or working out. Artistic sports apply here (i.e; dance).

Not at all

Somewhat involved

Very involved

Question Title

* 6. Name a sport you enjoy if you answered either “somewhat involved” or “very involved” to the previous question. If your favorite sport isn’t listed below, please write your answer in the space provided. (select any that apply)

Kickboxing/MMA

Lacrosse

Dance (Non-Traditional/Modern or Traditional/Native American)

Basketball

Football

Soccer

I answered "not at all" to the previous question.

Other (please specify)

Question Title

* 7. What non-sports related activities do you enjoy? (select any that apply)

Creating Music (i.e; singing, drumming, instrument)

Painting

Writing Poetry or Stories

Drawing

Other (please specify)

Question Title

* 8. How many hours a day do you use technology? This includes social media and video games. (do NOT include technology for schoolwork)

0-5

6-11

12-17

18-23

Question Title

* 9. What events within the Tribe do you enjoy attending most, or would like to see return to our community? This could be related to culture/tradition, music, school, Ojibwe language, sports/activities, etc.

Question Title

* 10. Please select the answer that best describes how much you participate in tribal ceremonies, pow-wows, culture camps, or other cultural events.

Not at all

Somewhat involved

Very involved

Question Title

* 11. In the past 12 months, how many tribal ceremonies, pow-wows, culture camps, or other cultural events did you attend?

None

1 to 2

3 to 4

5 to 6

7 or more

Question Title

* 12. How interested are you in learning more about your Native American culture? 0 being "Not at All" and 10 being "Very Interested."

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 13. How interested are you in learning and speaking the Ojibwe language? 0 being "Not at All" and 10 being "Very Interested."

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 14. How important is it to you to maintain your Native American identity, values, and practices? 0 being "Not at All" and 10 being "Very Important."

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 15. Are you, or someone you know, a victim of cyber bullying?

Yes

Unsure

Question Title

* 16. How frequent does bullying occur in your school?

Not Often At All

Somewhat Often

Every Day

Unsure

Question Title

* 17. How important is mental health to you? 0 being "Not at All" and 10 being "Very Important."

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 18. How important is suicide prevention to you? 0 being "Not at All" and 10 being "Very Important."

100

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 19. Do you currently, or have you ever, self-harmed?

Yes

Question Title

* 20. Have you ever attempted suicide?

Yes

Question Title

* 21. If you answered “yes” to the previous question, how long ago?

6 months ago or earlier

a year ago

more than 3 years ago

I answered “no” to the previous question.

Question Title

* 22. Who would you tell if you had thoughts of suicide? (select any that apply)

parents

grandparents (or other elders)

classmate

friends

clergy/traditional healer

healthcare provider/doctor

other family (siblings, cousins, etc)

nobody

Question Title

* 23. Do you, or your family, have a suicide prevention plan?

Yes

Question Title

* 24. Who are the role models in your life? (select any that apply)

parents

grandparents (or other elders)

classmate

friends

clergy/traditional healer

healthcare provider/doctor

other family (siblings, cousins, etc)

nobody

SAMHSA Native Connections Tribal Youth Survey

Question Title

* 1. How old are you?

Question Title

* 2. What is your gender?

Question Title

* 3. Which of the following describes your ethnicity?

Question Title

* 4. Are you a Saginaw Chippewa Tribal Member?

Question Title

* 5. Please select the answer that best describes how much you participate in sports or working out. Artistic sports apply here (i.e; dance).

Question Title

* 6. Name a sport you enjoy if you answered either “somewhat involved” or “very involved” to the previous question. If your favorite sport isn’t listed below, please write your answer in the space provided. (select any that apply)

Question Title

* 7. What non-sports related activities do you enjoy? (select any that apply)

Question Title

* 8. How many hours a day do you use technology? This includes social media and video games. (do NOT include technology for schoolwork)

Question Title

* 9. What events within the Tribe do you enjoy attending most, or would like to see return to our community? This could be related to culture/tradition, music, school, Ojibwe language, sports/activities, etc.

Question Title

* 10. Please select the answer that best describes how much you participate in tribal ceremonies, pow-wows, culture camps, or other cultural events.

Question Title

* 11. In the past 12 months, how many tribal ceremonies, pow-wows, culture camps, or other cultural events did you attend?

Question Title

* 12. How interested are you in learning more about your Native American culture? 0 being "Not at All" and 10 being "Very Interested."

Question Title

* 13. How interested are you in learning and speaking the Ojibwe language? 0 being "Not at All" and 10 being "Very Interested."

Question Title

* 14. How important is it to you to maintain your Native American identity, values, and practices? 0 being "Not at All" and 10 being "Very Important."

Question Title

* 15. Are you, or someone you know, a victim of cyber bullying?

Question Title

* 16. How frequent does bullying occur in your school?

Question Title

* 17. How important is mental health to you? 0 being "Not at All" and 10 being "Very Important."

Question Title

* 18. How important is suicide prevention to you? 0 being "Not at All" and 10 being "Very Important."

Question Title

* 19. Do you currently, or have you ever, self-harmed?

Question Title

* 20. Have you ever attempted suicide?

Question Title

* 21. If you answered “yes” to the previous question, how long ago?

Question Title

* 22. Who would you tell if you had thoughts of suicide? (select any that apply)

Question Title

* 23. Do you, or your family, have a suicide prevention plan?

Question Title

* 24. Who are the role models in your life? (select any that apply)

Question Title

* 25. In what ways can the Tribal community be more helpful to our youth in regard to mental health, suicide prevention or postvention, and awareness?