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St. Vrain Valley Schools: 2019-20 Wellness, Culture and Safety Inventory

Purpose of the Inventory:
Thank you for taking the time today to complete this inventory. We are assessing the topics of wellness, culture and safety in our school community. This inventory asks questions about different things that can impact our school. This is not a test. There are no wrong answers. Your answers are CONFIDENTIAL and your participation is VOLUNTARY. This inventory is also ANONYMOUS - you do not provide your name on this inventory. You do not have to answer every question, however, we hope you will answer as many questions as you can. Your answers will help us understand how we can improve, and we will use the information to understand your thoughts and concerns about what life is like in our school community.


Instructions:
Please read each question carefully before selecting your answer. If you are not comfortable answering a question, just leave it blank. There are 67 total questions. Thank you for completing the inventory.

DEMOGRAPHIC/BACKGROUND INFORMATION:

1.

What grade are you in?

INVENTORY QUESTIONS:

School Culture (16)

2.

I like my school.
3.

I feel like I am part of my school.
4.

There is an adult at my school I can talk to if I have a serious problem.
5.

Students at my school have lots of chances to get involved in school-related group activities - for example, sports, band, drama, clubs or student government.
6.

I participate in school-related group activities - for example, sports, band, drama, clubs, or student government.
7.

Students help decide class activities or expectations at my school.
8.

Everyone knows what student behavior expectations are at my school.
9.

Expectations at my school are fair and consistently applied.
10.

Students at my school treat each other with respect.
11.

Students at my school are respected and valued regardless of (check all that apply):
12.

Adults at my school respect and/or care about students.
13.

Adults at my school have high expectations for student success.
14.

My school tries to involve all families in school activities.
15.

Graduating from high school is important to me.
16.

I have goals, plans, and/or hopes for my future.
17.

After high school graduation:

Home and Community (5)

18.

There is an adult in my home I can talk to if I have a serious problem.
19.

There is an adult I can talk to about my goals, plans and hopes for my future.
20.

I feel safe in my community and/or neighborhood.
21.

During the past 12 months, how many times have you moved?
22.

Have you been homeless - for example, stayed with another family or been in temporary housing in the past 12 months?

Health and Wellness (6)

23.

I eat breakfast.
24.

During a typical day, how many hours do you spend on a media device for homework - for example, media devices such as a phone, computer, laptop/tablet?
25.

During a typical day, how many hours do you spend on a media device for a purpose other than homework - for example, media devices such as a phone, computer, laptop/tablet?
26.

During a typical school night, how many hours do you sleep?
27.

Do you have access to a dentist and/or doctor when needed?
28.

During the past 7 days, on how many days have you been physically active for 60 minutes or more?

Mental Health (10)

29.

I am good at recognizing my feelings.
30.

I am comfortable talking about my feelings with other people.
31.

I have healthy ways to manage stress in my life.
32.

During the past 30 days, on how many days have you felt worried, tense, stressed out, or anxious, making it hard for you to eat or sleep, do your school work, take care of your responsibilities or get along with other people?
33.

During the past 12 months, did you ever feel so sad or hopeless, almost every day for two weeks or more in a row, that you stopped doing some usual activities?
34.

During the past 12 months, have you been concerned enough about your weight or body image that you have engaged in self-destructive behaviors?
35.

During the past 12 months, have you ever hurt or injured yourself on purpose (without meaning to end your life)?
36.

During the past 12 months, have you ever seriously considered attempting suicide?
37.

During the past 12 months, if you have ever seriously thought about attempting suicide, did you tell anyone about these thoughts (check all that apply)?
38.

During the past 12 months, have you ever attempted suicide?

School Safety (2)

39.

I feel safe at my school.
40.

I feel safe to express who I am at my school.

Bullying* (4)

*Bullying is intentional, negative, repeated and aggressive actions between students or groups such as: threats, rumors, attacking physically or verbally and/or excluding someone on purpose.

41.

Have you ever been bullied on school property?
42.

During the past 12 months, have you been bullied one or more times?
43.

During the past 12 months, have you taken part in bullying other students on school property?
44.

During the past 12 months, have you experienced cyberbullying - for example, has someone used the computer, the internet, a cell phone, or other device to do something mean or hurtful to you on purpose?

Violence (5)

45.

During the past 12 months, have you been in a physical fight on school property?
46.

During the past 12 months have other students threatened, harassed or hurt you one or more times on school property?
47.

During the past 12 months, have other students threatened, harassed or hurt you with a weapon on school property?
48.

During the past 12 months, have you threatened, harassed or hurt other students on school property?
49.

During the past 12 months, have you threatened, harassed or hurt other students with a weapon on school property?

Tobacco Use (4)

50.

Have you ever smoked a whole cigarette?
51.

During the past 30 days, how many cigarettes have you smoked?
52.

Have you ever used e-cigarettes or chewing tobacco?
53.

During the past 30 days, how many days have you used e-cigarettes or chewing tobacco?

Alcohol Use (5)

54.

Have you ever had at least one drink - for example, 1 full beer, 1 full glass of wine, or other alcohol?
55.

During the past 30 days, how many days have you had at least one drink of alcohol?
56.

Have you ever driven a car or other vehicle while under the influence of alcohol?
57.

During the past 30 days, on how many days did you have 5 or more drinks of alcohol in a row, within a couple of hours?
58.

Have your ever ridden in a car or other vehicle driven by someone under the influence of alcohol?

Marijuana (4)

59.

Have you ever used marijuana (this includes smoking marijuana cigarettes, consuming edibles, and using vaporized forms of marijuana)?
60.

During the past 30 days, how many times have you used marijuana?
61.

Have you ever driven a car or other vehicle while under the influence of marijuana?
62.

Have you ever ridden in a car or other vehicle driven by someone under the influence of marijuana?

Other Drugs (2)

63.

Have you ever used drugs other than alcohol and marijuana to get high?
64.

During the past 30 days, how many times have you used other drugs to get high?

DEMOGRAPHIC/BACKGROUND INFORMATION:

Gender Identity/Expression

65.

Are you:

Race/Ethnicity

66.

Which of the following groups describe your race/ethnicity?

Sexual Orientation

67.

Which of the following best describes you?

This is the end of this inventory. Thank you for completing - your response is very important. If you have any questions about this inventory or would like to discuss, your teachers, counselors, principal and interventionist are here to support you.