Community Readiness Assessment

The following survey will assist the Fayette County Prevention Coalition with determining where Fayette County is in terms of readiness for the implementation of the Drug Free Communities Grant Program.  Your answers will inform the coalition's methods for addressing youth substance abuse in our communities.  Thanks in advance for your participation.

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* 1. Agency/Organization Name: (if applicable)

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* 2. Name & Contact Information: (optional)

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* 3. Does your agency/organization have specialized services for substance abuse prevention activities?

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* 4. Does your agency/organization have substance abuse treatment services?

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* 5. I am aware of programs in my community which address alcohol and other substance abuse prevention

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* 6. I believe preventing alcohol and other substance abuse among youth is important

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* 7. I am interested in becoming actively involved in improving alcohol and other substance abuse prevention programs in my community

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* 8. I know which alcohol and other substance abuse prevention programs serve my community

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* 9. I can distinguish the type of services offered by the different alcohol and other substance abuse programs in my community

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* 10. I am concerned about whether my community has sufficient alcohol and other substance abuse prevention programs

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* 11. My agency/organization has a written policy concerning the use of alcohol or other substances by employees

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* 12. Is there ever a time or circumstance in which members of your community think that substance abuse should be tolerated?

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* 13. On a scale from 1 to 10, how much of a concern is substance abuse in your community, with 1 being "no concern" and 10 being "very large concern"?

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* 14. On a scale from 1 to 10, what is your community's attitude about substance abuse prevention, with 1 being "not important" and 10 being "very important"?

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* 15. On a scale from 1 to 10, how important is it to your community to prevent substance abuse among youth, with 1 being "not important" and 10 being "very important"?

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* 16. On a scale from 1 to 10, how supportive are the local businesses in your community of substance abuse prevention efforts (such as volunteering time, making financial donations, providing space, workplace policies, etc), with 1 being "not supportive" and 10 being "very supportive"?

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* 17. On a scale from 1 to 10, how supportive are the citizens in your community of substance abuse prevention efforts, with 1 being "not supportive" and 10 being "very supportive"?

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* 18. On a scale from 1 to 10, how much collaboration occurs among public and private agencies involved in substance abuse prevention, with 1 being "no collaboration" and 10 being "extensive collaboration"?

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* 19. On a scale from 1 to 10, rate the following substances on the number of problems they cause individuals 18 years of age and younger in Fayette County, with 1 being "causing no problems" and 10 being "causing many problems".

  1 2 3 4 5 6 7 8 9 10
Alcohol
Cocaine
Crack
Hallucinogens
Heroin
Inhalants
Marijuana
Methamphetamine
Prescription Drugs
Ecstacy, MDMA, GHB
Tobacco

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* 20. On a scale from 1 to 10, rate the following substances on the number of problems they cause individuals 19 years of age and older in Fayette County, with 1 being "causing no problems" and 10 being "causing many problems".

  1 2 3 4 5 6 7 8 9 10
Alcohol
Cocaine
Crack
Hallucinogens
Heroin
Inhalants
Marijuana
Methamphetamine
Prescription Drugs
Ecstacy, MDMA, GHB
Tobacco

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* 21. Is there any other input you would like to provide the Fayette County Prevention Coalition in regards to addressing substance abuse in our community?

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* 22. Interpersonal factors that contribute to substance abuse are listed below.  Please rank these factors from 1-7, with 1 being the most influential factor and 7 being the least.

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