Parent / Adult Survey 2017

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* 1. Do you have a child in:

Elementary School (PreK-5)

Middle School (6-8)

High School (9-12)

Out of School

No Childen

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* 2. What school district do your children attend/ do you live in?

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* 3. On a scale of 1-5 How big of a problem is the following in your community?

	Not a problem at all		Problem		Extremely big problem
Underage Drinking	Underage Drinking Not a problem at all	Underage Drinking	Underage Drinking Problem	Underage Drinking	Underage Drinking Extremely big problem
Marijuana	Marijuana Not a problem at all	Marijuana	Marijuana Problem	Marijuana	Marijuana Extremely big problem
Prescription Drug use (without prescription)	Prescription Drug use (without prescription) Not a problem at all	Prescription Drug use (without prescription)	Prescription Drug use (without prescription) Problem	Prescription Drug use (without prescription)	Prescription Drug use (without prescription) Extremely big problem
Heroin	Heroin Not a problem at all	Heroin	Heroin Problem	Heroin	Heroin Extremely big problem
Other drugs	Other drugs Not a problem at all	Other drugs	Other drugs Problem	Other drugs	Other drugs Extremely big problem

Other (please specify)

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* 4. Which of the following best describes your attitude about alcohol use by underage youth (under 21)?

Should not use until they are 21

Should be allowed to use before they are 21 with adult supervision

Should be taught to use responsibly before they are 21

Should be allowed to use before they are 21

Other (please specify)

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* 5. Do you think parents/adults host parties, in your community, where alcohol/drugs is available or provided to youth under the age of 21?

Yes

Unsure

Other (please specify)

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* 6. How much do you think young people risk harming themselves if they

	No risk	slight risk	moderate risk	great risk
Use alcohol before age 21	Use alcohol before age 21 No risk	Use alcohol before age 21 slight risk	Use alcohol before age 21 moderate risk	Use alcohol before age 21 great risk
Use Marijuana	Use Marijuana No risk	Use Marijuana slight risk	Use Marijuana moderate risk	Use Marijuana great risk
Use Prescription Drugs without prescription	Use Prescription Drugs without prescription No risk	Use Prescription Drugs without prescription slight risk	Use Prescription Drugs without prescription moderate risk	Use Prescription Drugs without prescription great risk

Other (please specify)

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* 7. How wrong do you feel it would be for someone under the age of 21 to

	Not wrong at all	A little wrong	Wrong	Very Wrong
Drink alcohol	Drink alcohol Not wrong at all	Drink alcohol A little wrong	Drink alcohol Wrong	Drink alcohol Very Wrong
Use marijuana	Use marijuana Not wrong at all	Use marijuana A little wrong	Use marijuana Wrong	Use marijuana Very Wrong
Use Prescription drugs without prescription	Use Prescription drugs without prescription Not wrong at all	Use Prescription drugs without prescription A little wrong	Use Prescription drugs without prescription Wrong	Use Prescription drugs without prescription Very Wrong

Other (please specify)

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* 8. If a young person under 21 in your community wanted to get the following how easy would it be

	Very Difficult	Difficult	Easy	Very Easy	Not Sure
Alcohol	Alcohol Very Difficult	Alcohol Difficult	Alcohol Easy	Alcohol Very Easy	Alcohol Not Sure
Marijuana	Marijuana Very Difficult	Marijuana Difficult	Marijuana Easy	Marijuana Very Easy	Marijuana Not Sure
Prescription Drugs	Prescription Drugs Very Difficult	Prescription Drugs Difficult	Prescription Drugs Easy	Prescription Drugs Very Easy	Prescription Drugs Not Sure
Heroin	Heroin Very Difficult	Heroin Difficult	Heroin Easy	Heroin Very Easy	Heroin Not Sure
Other Drugs	Other Drugs Very Difficult	Other Drugs Difficult	Other Drugs Easy	Other Drugs Very Easy	Other Drugs Not Sure

Other (please specify)

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* 9. What influences a young person's decision to drink alcohol or use drugs or not?

Parents

Friends

Media advertising

Social media

Adults they know that use

Other (please specify)

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* 10. Where would you go for help if you're having concerns with a young person's use of alcohol or drugs?

Other Parent

School

Doctor

Counselor

Police

Local agency/organization

Other (please specify)

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* 11. For the general population (adults), I believe marijuana use is okay under the following condition

Never

For a medical condition

Any reason

Other (please specify)

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* 12. If you were aware of underage drinking or teen drug use happening in your community, what action would you take?

Talk to friends of the youth

Do nothing – it’s not my child or my business

Talk with the youth’s parents

Contact school officials

Speak directly to the youth

Call the police

Other (please specify)

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* 13. In your opinion, which of the following offenses need more severe penalties?

Parents who serve alcohol to youth under 21

Friends over 21 who buy alcohol for youth

Bars/restaurants/liquor stores who sell alcohol to youth under 21

Adults who hold parties where alcohol and/or drugs are used

Youth who use alcohol/drugs

I am satisfied with the current penalties for these offenses

I don't know

Other (please specify)

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* 14. Have you talked with your child about the following

	Yes	No
Underage Drinking	Underage Drinking Yes	Underage Drinking No
Marijuana Use	Marijuana Use Yes	Marijuana Use No
Prescription drug	Prescription drug Yes	Prescription drug No
Other drugs	Other drugs Yes	Other drugs No

Other (please specify)

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* 15. How would you like to receive information on current youth drug/alcohol trends and prevention information for parents/families?

Online- school websites, agency websites

Printed materials

Smart Phone/Tablet App

Social Media

Community presentation

Other (please specify)

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* 16. How likely are you to read drug/alcohol prevention material given to you through local community
prevention coalitions/substance abuse prevention organizations?

Very Unlikely

Unlikely

Maybe

Likely

Very Likely

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* 17. Would you be interested in receiving information about drug and alcohol trends, prevention tips and upcoming parent, community and/or youth events? IF YES please fill out the following information

Name

Parent / Adult Survey 2017