Community Perception Survey

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* 1.
Demographics

What is your zipcode?

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* 2. What is your gender identity?

Female

Male

Transgender

Nonbinary

Prefer not to say

Other (please specify)

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* 3. Race identification (select one or more)

American Indian or Alaska native

Asian

Black of African American

Native Hawaiian or other pacific islander

White

Other (please specify)

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* 4. Are you of Hispanic, Latino, or Spanish origin?

Yes

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* 5. Are you a caregiver/guardian?

Yes

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* 6. (If applicable) How old is/are the youth you take care of (circle all that apply)

0-4

5-10

11-13

14-17

18-10

21+

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* 7.
Personal Perception of Youth Risk Behaviors

In the last 30 days, what percent of high school students do you think have…

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* 8.
Personal Perception of Harm

What statement most represents how you feel about underage drinking?

Any kind of drinking in high school is okay.

Occasional drinking in high school is okay, as long as no one is driving.

Occasional drinking with supervision from a friend’s caregiver/ guardian, is okay.

Occasional high school student drinking, under supervision of their caregiver/ guardian, is all right.

Drinking in high school is never a good thing.

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* 9. What statement most represents how you feel about underage nicotine use?

Any kind of nicotine use in high school is okay.

Occasional nicotine use in high school is okay as long as no one is driving.

Occasional nicotine use with supervision from a friend’s caregiver/ guardian is okay.

Occasional high school student nicotine use, under supervision of their caregiver/ guardian is all right.

Nicotine use in high school is never a good thing.

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* 10. What statement most represents how you feel about underage marijuana use?

Any kind of marijuana use in high school is okay.

Occasional marijuana use in high school, as long as no one is driving, is okay.

Occasional marijuana use with supervision from a friend’s caregiver/ guardian is okay.

Occasional high school student marijuana use, under supervision of their caregiver/ guardian is all right.

Marijuana use in high school is never a good thing.

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* 11. What statement most represents how you feel about underage gambling?

Any kind of gambling in high school is okay.

Occasional gambling in high school, as long as youth are using their own money, is okay.

Occasional gambling in high school, with supervision no matter whose money is being used, is okay.

Occasional gambling in high school, with supervision of their caregiver/guardian no matter whose money is being used, is okay.

Gambling in high school is never a good thing.

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* 12.
Personal Concern

How concerned are you about high school students…

	Not Concerned 1	2	3	4	Highly Concerned 5
Drinking Alcohol	Drinking Alcohol Not Concerned 1	Drinking Alcohol 2	Drinking Alcohol 3	Drinking Alcohol 4	Drinking Alcohol Highly Concerned 5
Use of Marijuana	Use of Marijuana Not Concerned 1	Use of Marijuana 2	Use of Marijuana 3	Use of Marijuana 4	Use of Marijuana Highly Concerned 5
Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes)	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) Not Concerned 1	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 2	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 3	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 4	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) Highly Concerned 5
Playing scratch tickets/lottery/Keno	Playing scratch tickets/lottery/Keno Not Concerned 1	Playing scratch tickets/lottery/Keno 2	Playing scratch tickets/lottery/Keno 3	Playing scratch tickets/lottery/Keno 4	Playing scratch tickets/lottery/Keno Highly Concerned 5
Gambling on casino-style games with family/friends	Gambling on casino-style games with family/friends Not Concerned 1	Gambling on casino-style games with family/friends 2	Gambling on casino-style games with family/friends 3	Gambling on casino-style games with family/friends 4	Gambling on casino-style games with family/friends Highly Concerned 5
Gambling on casino-style games online	Gambling on casino-style games online Not Concerned 1	Gambling on casino-style games online 2	Gambling on casino-style games online 3	Gambling on casino-style games online 4	Gambling on casino-style games online Highly Concerned 5
Betting on sports	Betting on sports Not Concerned 1	Betting on sports 2	Betting on sports 3	Betting on sports 4	Betting on sports Highly Concerned 5
Betting on fantasy leagues	Betting on fantasy leagues Not Concerned 1	Betting on fantasy leagues 2	Betting on fantasy leagues 3	Betting on fantasy leagues 4	Betting on fantasy leagues Highly Concerned 5
Buying random/ unknown in-game items	Buying random/ unknown in-game items Not Concerned 1	Buying random/ unknown in-game items 2	Buying random/ unknown in-game items 3	Buying random/ unknown in-game items 4	Buying random/ unknown in-game items Highly Concerned 5

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* 13.
Community Concern

How concerned is your community about high school students…
OR
In your community, how tolerated is high school students…

	Not Concerned 1	2	3	4	Highly Concerned 5
Drinking Alcohol	Drinking Alcohol Not Concerned 1	Drinking Alcohol 2	Drinking Alcohol 3	Drinking Alcohol 4	Drinking Alcohol Highly Concerned 5
Use of Marijuana	Use of Marijuana Not Concerned 1	Use of Marijuana 2	Use of Marijuana 3	Use of Marijuana 4	Use of Marijuana Highly Concerned 5
Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes)	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) Not Concerned 1	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 2	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 3	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 4	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) Highly Concerned 5
Playing scratch tickets/lottery/Keno	Playing scratch tickets/lottery/Keno Not Concerned 1	Playing scratch tickets/lottery/Keno 2	Playing scratch tickets/lottery/Keno 3	Playing scratch tickets/lottery/Keno 4	Playing scratch tickets/lottery/Keno Highly Concerned 5
Gambling on casino-style games with family/friends	Gambling on casino-style games with family/friends Not Concerned 1	Gambling on casino-style games with family/friends 2	Gambling on casino-style games with family/friends 3	Gambling on casino-style games with family/friends 4	Gambling on casino-style games with family/friends Highly Concerned 5
Gambling on casino-style games online	Gambling on casino-style games online Not Concerned 1	Gambling on casino-style games online 2	Gambling on casino-style games online 3	Gambling on casino-style games online 4	Gambling on casino-style games online Highly Concerned 5
Betting on sports	Betting on sports Not Concerned 1	Betting on sports 2	Betting on sports 3	Betting on sports 4	Betting on sports Highly Concerned 5
Betting on fantasy leagues	Betting on fantasy leagues Not Concerned 1	Betting on fantasy leagues 2	Betting on fantasy leagues 3	Betting on fantasy leagues 4	Betting on fantasy leagues Highly Concerned 5
Buying random/ unknown in-game items	Buying random/ unknown in-game items Not Concerned 1	Buying random/ unknown in-game items 2	Buying random/ unknown in-game items 3	Buying random/ unknown in-game items 4	Buying random/ unknown in-game items Highly Concerned 5

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* 14.
Community Effort

How much effort in your community is there to address high school students…

	No Effort at All 1	2	3	4	Large amount of effort 5
Drinking Alcohol	Drinking Alcohol No Effort at All 1	Drinking Alcohol 2	Drinking Alcohol 3	Drinking Alcohol 4	Drinking Alcohol Large amount of effort 5
Use of Marijuana	Use of Marijuana No Effort at All 1	Use of Marijuana 2	Use of Marijuana 3	Use of Marijuana 4	Use of Marijuana Large amount of effort 5
Use of Nicotine Products (cigarettes, vaping device, Juul, hook pens, e-cigarettes)	Use of Nicotine Products (cigarettes, vaping device, Juul, hook pens, e-cigarettes) No Effort at All 1	Use of Nicotine Products (cigarettes, vaping device, Juul, hook pens, e-cigarettes) 2	Use of Nicotine Products (cigarettes, vaping device, Juul, hook pens, e-cigarettes) 3	Use of Nicotine Products (cigarettes, vaping device, Juul, hook pens, e-cigarettes) 4	Use of Nicotine Products (cigarettes, vaping device, Juul, hook pens, e-cigarettes) Large amount of effort 5
Playing scratch tickets/lottery/Keno	Playing scratch tickets/lottery/Keno No Effort at All 1	Playing scratch tickets/lottery/Keno 2	Playing scratch tickets/lottery/Keno 3	Playing scratch tickets/lottery/Keno 4	Playing scratch tickets/lottery/Keno Large amount of effort 5
Gambling on casino-style games with family/friends	Gambling on casino-style games with family/friends No Effort at All 1	Gambling on casino-style games with family/friends 2	Gambling on casino-style games with family/friends 3	Gambling on casino-style games with family/friends 4	Gambling on casino-style games with family/friends Large amount of effort 5
Gambling on casino-style games online	Gambling on casino-style games online No Effort at All 1	Gambling on casino-style games online 2	Gambling on casino-style games online 3	Gambling on casino-style games online 4	Gambling on casino-style games online Large amount of effort 5
Betting on sports	Betting on sports No Effort at All 1	Betting on sports 2	Betting on sports 3	Betting on sports 4	Betting on sports Large amount of effort 5
Betting on fantasy leagues	Betting on fantasy leagues No Effort at All 1	Betting on fantasy leagues 2	Betting on fantasy leagues 3	Betting on fantasy leagues 4	Betting on fantasy leagues Large amount of effort 5
Buying random/ unknown in-game items	Buying random/ unknown in-game items No Effort at All 1	Buying random/ unknown in-game items 2	Buying random/ unknown in-game items 3	Buying random/ unknown in-game items 4	Buying random/ unknown in-game items Large amount of effort 5

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* 15.
Community Effect

How effective do you think these efforts are at addressing high school students…

	Not effective at all 1	2	3	4	Very effective 5
Drinking Alcohol	Drinking Alcohol Not effective at all 1	Drinking Alcohol 2	Drinking Alcohol 3	Drinking Alcohol 4	Drinking Alcohol Very effective 5
Use of Marijuana	Use of Marijuana Not effective at all 1	Use of Marijuana 2	Use of Marijuana 3	Use of Marijuana 4	Use of Marijuana Very effective 5
Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes)	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) Not effective at all 1	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 2	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 3	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) 4	Use of Nicotine Products (cigarette, vaping device, Juul, hook pens, e-cigarettes) Very effective 5
Playing scratch tickets/lottery/Keno	Playing scratch tickets/lottery/Keno Not effective at all 1	Playing scratch tickets/lottery/Keno 2	Playing scratch tickets/lottery/Keno 3	Playing scratch tickets/lottery/Keno 4	Playing scratch tickets/lottery/Keno Very effective 5
Gambling on casino-style games with family/friends	Gambling on casino-style games with family/friends Not effective at all 1	Gambling on casino-style games with family/friends 2	Gambling on casino-style games with family/friends 3	Gambling on casino-style games with family/friends 4	Gambling on casino-style games with family/friends Very effective 5
Gambling on casino-style games online	Gambling on casino-style games online Not effective at all 1	Gambling on casino-style games online 2	Gambling on casino-style games online 3	Gambling on casino-style games online 4	Gambling on casino-style games online Very effective 5
Betting on sports	Betting on sports Not effective at all 1	Betting on sports 2	Betting on sports 3	Betting on sports 4	Betting on sports Very effective 5
Betting on fantasy leagues	Betting on fantasy leagues Not effective at all 1	Betting on fantasy leagues 2	Betting on fantasy leagues 3	Betting on fantasy leagues 4	Betting on fantasy leagues Very effective 5
Buying random/ unknown in-game items	Buying random/ unknown in-game items Not effective at all 1	Buying random/ unknown in-game items 2	Buying random/ unknown in-game items 3	Buying random/ unknown in-game items 4	Buying random/ unknown in-game items Very effective 5

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* 16. Have you ever talked with youth about (check all that apply):

Tobacco

Alcohol

Binge Drinking

Marijuana

Prescription Drugs

Gambling

Other Drugs

None of the above

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* 17. Do you feel you have enough information to talk with high school aged youth about substance use, mental health, and gambling?

Yes

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* 18. How comfortable do you feel discussing sensitive topics such as mental health and substance use with your child(ren)?

Very comfortable

Somewhat comfortable

Not comfortable at all

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* 19. Which communication channels do you find most effective for receiving information and support? (select all that apply)

Workshops and seminars
in-person, online, virtual

Newsletter
Emailed, posted on social media, mailed out, sent home with kids from school

Casual social media posts
Facebook, Instagram, TikTok, YouTube, Twitter

Online forums

Support groups
In-person, online, virtual

Other (please specify)

	None	Less then half	About half	More than half
Drank more than a few sips of alcohol?	Drank more than a few sips of alcohol? None	Drank more than a few sips of alcohol? Less then half	Drank more than a few sips of alcohol? About half	Drank more than a few sips of alcohol? More than half
Had 5 or more alcohol drinks in a row?	Had 5 or more alcohol drinks in a row? None	Had 5 or more alcohol drinks in a row? Less then half	Had 5 or more alcohol drinks in a row? About half	Had 5 or more alcohol drinks in a row? More than half
Used prescription medication (pain relievers, benzos, stimulants, etc.), without a prescription?	Used prescription medication (pain relievers, benzos, stimulants, etc.), without a prescription? None	Used prescription medication (pain relievers, benzos, stimulants, etc.), without a prescription? Less then half	Used prescription medication (pain relievers, benzos, stimulants, etc.), without a prescription? About half	Used prescription medication (pain relievers, benzos, stimulants, etc.), without a prescription? More than half
Used heroin?	Used heroin? None	Used heroin? Less then half	Used heroin? About half	Used heroin? More than half
Used illegal drugs?	Used illegal drugs? None	Used illegal drugs? Less then half	Used illegal drugs? About half	Used illegal drugs? More than half
Used a nicotine product, cigarette, vaping device, Juul, hookah pens, e-cigarettes?	Used a nicotine product, cigarette, vaping device, Juul, hookah pens, e-cigarettes? None	Used a nicotine product, cigarette, vaping device, Juul, hookah pens, e-cigarettes? Less then half	Used a nicotine product, cigarette, vaping device, Juul, hookah pens, e-cigarettes? About half	Used a nicotine product, cigarette, vaping device, Juul, hookah pens, e-cigarettes? More than half
Used marijuana or marijuana infused products, Dabs, edibles, tinctures, etc.?	Used marijuana or marijuana infused products, Dabs, edibles, tinctures, etc.? None	Used marijuana or marijuana infused products, Dabs, edibles, tinctures, etc.? Less then half	Used marijuana or marijuana infused products, Dabs, edibles, tinctures, etc.? About half	Used marijuana or marijuana infused products, Dabs, edibles, tinctures, etc.? More than half
Placed a bet on a sports game	Placed a bet on a sports game None	Placed a bet on a sports game Less then half	Placed a bet on a sports game About half	Placed a bet on a sports game More than half
Placed a bet on a card or other game (whether in a casino or not)	Placed a bet on a card or other game (whether in a casino or not) None	Placed a bet on a card or other game (whether in a casino or not) Less then half	Placed a bet on a card or other game (whether in a casino or not) About half	Placed a bet on a card or other game (whether in a casino or not) More than half
Scratched or played a scratch ticket	Scratched or played a scratch ticket None	Scratched or played a scratch ticket Less then half	Scratched or played a scratch ticket About half	Scratched or played a scratch ticket More than half
Played the lottery	Played the lottery None	Played the lottery Less then half	Played the lottery About half	Played the lottery More than half
Bought a scratch or lottery ticket	Bought a scratch or lottery ticket None	Bought a scratch or lottery ticket Less then half	Bought a scratch or lottery ticket About half	Bought a scratch or lottery ticket More than half
Used real-life money to purchase a random/unknown item in a video game	Used real-life money to purchase a random/unknown item in a video game None	Used real-life money to purchase a random/unknown item in a video game Less then half	Used real-life money to purchase a random/unknown item in a video game About half	Used real-life money to purchase a random/unknown item in a video game More than half
Gambled over $50	Gambled over $50 None	Gambled over $50 Less then half	Gambled over $50 About half	Gambled over $50 More than half

Community Perception Survey

Question Title

* 1. Demographics What is your zipcode?

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* 2. What is your gender identity?

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* 3. Race identification (select one or more)

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* 4. Are you of Hispanic, Latino, or Spanish origin?

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* 5. Are you a caregiver/guardian?

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* 6. (If applicable) How old is/are the youth you take care of (circle all that apply)

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* 7. Personal Perception of Youth Risk Behaviors In the last 30 days, what percent of high school students do you think have…

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* 8. Personal Perception of Harm What statement most represents how you feel about underage drinking?

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* 9. What statement most represents how you feel about underage nicotine use?

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* 10. What statement most represents how you feel about underage marijuana use?

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* 11. What statement most represents how you feel about underage gambling?

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* 12. Personal Concern How concerned are you about high school students…

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* 13. Community Concern How concerned is your community about high school students… OR In your community, how tolerated is high school students…

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* 14. Community Effort How much effort in your community is there to address high school students…

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* 15. Community Effect How effective do you think these efforts are at addressing high school students…

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* 16. Have you ever talked with youth about (check all that apply):

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* 17. Do you feel you have enough information to talk with high school aged youth about substance use, mental health, and gambling?

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* 18. How comfortable do you feel discussing sensitive topics such as mental health and substance use with your child(ren)?

Question Title

* 19. Which communication channels do you find most effective for receiving information and support? (select all that apply)

* 1.
Demographics

What is your zipcode?

* 7.
Personal Perception of Youth Risk Behaviors

In the last 30 days, what percent of high school students do you think have…

* 8.
Personal Perception of Harm

What statement most represents how you feel about underage drinking?

* 12.
Personal Concern

How concerned are you about high school students…

* 13.
Community Concern

How concerned is your community about high school students…
OR
In your community, how tolerated is high school students…

* 14.
Community Effort

How much effort in your community is there to address high school students…

* 15.
Community Effect

How effective do you think these efforts are at addressing high school students…