Upson Adult Intercept Survey - Beyond The Bell

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Upson Adult Intercept Survey

This survey is voluntary. If you choose to take this survey, you may skip any question you do not want to answer.

Upson Adult Intercept Survey

1. Have you ever seen the above message (ad) before?
(If answered No or Don’t Recall then skip to Question 3)
- Yes
- No
- Don't recall
2. Where have you previously seen this message (poster)?
(Mark places)
- Back of Store Receipt
- Beyond The Bell Office
- Facebook
- Ephesians Deliverance Center
- Thomaston-Upson Civic Center
- Don't Recall
- Other
If "Other" please specify.
3. Before today, have you heard about the Beyond The Bell’s campaign to reduce underage drinking and substance use among youth and increase awareness?
- Yes
- No
- Don't recall
4. Has the message(s) helped to change your thoughts and views about underage drinking and substance use among youth?
- Strongly Agree
- Agree
- Neither
- Disagree
- Strongly Disagree
- Do not know
5. Do you believe that underage drinking and substance abuse among youth has a bad effect on their mental and physical health?
- Strongly Agree
- Agree
- Neither
- Disagree
- Strongly Disagree
- Do not know
6. Does parental involvement (by setting rules, frequent communication, etc.) benefit in reducing alcohol and substance abuse among teenagers?
- Strongly Agree
- Agree
- Neither
- Disagree
- Strongly Disagree
- Do not know
7. Do you believe that alcohol supply should be monitored if there are youth living in the home?
- Strongly Agree
- Agree
- Neither
- Disagree
- Strongly Disagree
- Do not know
8. Would you approve of a teenager using alcohol or marijuana if they were in your home or a friend’s home under parent supervision?
- Strongly Agree
- Agree
- Neither
- Disagree
- Strongly Disagree
- Do not know
9. Do you believe teens have easy access to alcohol?
- Strongly Agree
- Agree
- Neither
- Disagree
- Strongly Disagree
- Do not know
10. Which of the following could do more to prevent alcohol and other drug use among teens in your community?
(Mark places)
- Faith-based communities (churches, mosques, etc.),
- law enforcement
- Schools
- Employers
- Local organization
- Other
If "Other" please specify.
DEMOGRAPHICS
1. What is your zip code?
2. What is your gender?
- Male
- Female
- Prefer not to say
3. What is your age?
4. What is your race?
- Black or African American
- White or Caucasian
- Hispanic
- Asian
- Bi-Racial
- Multi-Racial
- Hawaiian or Pacific Islander
- Alaska Native
- Native American
- Do not know
- Prefer not to say
5. What was the last year or grade in school you completed?
- Less Than High School
- High School
- Associates Degree
- Bachelors’ Degree
- Masters’ Degree
- Doctoral Degree
6. What is your current marital status?
- Single
- Married
- Separated
- Divorced
- Widowed

Thank you for agreeing to participate in this survey!

COMPETENCIES

Leadership
Ethical Standards
Integrity
Knowledge
Skills
Personal Characteristics
Family & Community Partnerships

DeKalb County/
Rockdale County

990 Iris Dr. SW Ste 301,
Conyers, GA 30094
(770) 285-6037

Upson County

310 N. Church St. Ste C
Thomaston, GA 30286
(706) 938-6100

City of Savannah

5618 White Bluff Rd. Ste B,
Savannah, GA 31405
(912) 335-8332

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