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DOCUMENTS


The Tentacle


December 3, 2014

CDC Questionnaire for Students Isn’t Academic – Part 3 – Middle School

John W. Ashbury

Here are questions 67 through 83.

 

67. During the past 12 months, did you have any asthma symptoms?

A. I do not have asthma

B. Yes, I have had asthma symptoms during the past 12 months

C. No, I have not had asthma symptoms during the past 12 months

 

68. On an average school night, how many hours of sleep do you get?

A. 4 or less hours

B. 5 hours

C. 6 hours

D. 7 hours

E. 8 hours

F. 9 hours

G. 10 or more hours

 

69. How do you describe your health in general?

A. Excellent

B. Very good

C. Good

D. Fair

E. Poor

 

70. During the past 12 months, how many times did you use an indoor tanning device such as a sunlamp, sunbed, or tanning booth? (Do not count getting a spray-on tan.)

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

 

71. During the last school year, were you taught in any of your classes about the dangers of tobacco use?

A. Yes

B. No

C. Not sure

 

The next 3 questions ask about your attitudes and beliefs about tobacco use.

 

72. Do you think young people who smoke have more friends?

A. Definitely yes

B. Probably yes

C. Probably not

D. Definitely not

73. Do you think smoking makes young people look cool or fit in?

A. Definitely yes

B. Probably yes

C. Probably not

D. Definitely not

 

74. Do you think smokers have shorter lives than non-smokers?

A. Definitely yes

B. Probably yes

C. Probably not

D. Definitely not

 

The next 3 questions ask about your attitudes and beliefs about drinking alcohol.

 

75. How wrong do your parents feel it would be for you to drink beer, wine, or hard liquor (such as vodka, whiskey, or gin) at least once or twice a month?

A. Very wrong

B. Wrong

C. A little wrong

D. Not at all wrong

 

 

76. How much do people risk harming themselves (physically and in other ways) if they have one or two drinks of alcohol (beer, wine, or liquor) nearly every day?

A. No risk

B. Slight risk

C. Moderate risk

D. Great risk

 

77. How much do people risk harming themselves (physically and in other ways) if they have five or more drinks of alcohol (beer, wine, or liquor) once or twice a week?

A. No risk

B. Slight risk

C. Moderate risk

D. Great risk

 

The next 4 questions ask about whether adults are available for you to talk to when you need to.

 

78. Outside of school, is there an adult you can talk to about things that are important to you?

A. Yes

B. No

 

79. Besides your parents, how many adults would you feel comfortable seeking help from if you had an important question affecting your life?

A. 0 adults

B. 1 adult

C. 2 adults

D. 3 adults

E. 4 adults

F. 5 or more adults

 

80. During the past 12 months, did you talk to a teacher or other adult in your school about a personal problem you had?

A. Yes

B. No

 

81. Do you agree or disagree that your teachers really care about you and give you a lot of encouragement?

A. Strongly agree

B. Agree

C. Not sure

D. Disagree

E. Strongly disagree

 

The next 2 questions ask about your school life.

 

82. Do you participate in any extracurricular activities at school such as sports, band, drama, clubs, or student government?

A. Yes

B. No

 

83. During the past 12 months, how would you describe your grades in school?

A. Mostly A's

B. Mostly B's

C. Mostly C's

D. Mostly D's

E. Mostly F's

F. None of these grades

G. Not sure

 

 

 

 



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