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  2. 2014
  3. December
  4. C
  5. CSUF YRBS CONFIDENTIAL SURVEY FALL 2014
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Exit Survey
 
 
Hello:
You are invited to participate in our survey on college student behaviors.  In this survey, you will be asked questions about your social, health, mood, and activities. The survey includes questions about college student activities including alcohol and drug use. Your responses are completely anonymous. If you do not feel comfortable answering a question please leave it blank. It will take approximately 5-10 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from participation at any point. Your information will be grouped and will not be identifiable. If you have questions at any time about the survey or the procedures, you may contact the student administering the survey to you or email [email protected]. 
Thank you very much for your time and support. Checking the box below indicates you understand the information contained in this introduction and voluntarily consent to participation.
 
 
 
 
Which group has invited you to participate in this survey?
   
 
 
 
What is your gender?
 
Female
 
Male
 
 
 
What is your race/ethnicity?
 
American Indian or Alaskan Native
 
Asian
 
Black or African American
 
Native Hawaiian or Other Pacific Islander
 
White
 
Hispanic/Latino
 
Multiple race Hispanic
 
Multiple race Non Hispanic
 
 
 
What is your height in inches?
   
 
 
 
What is your weight in pounds?
   
 
 
 
During the past 30 days,  how many times did you ride in a car or other vehicle driven by someone who had been drinking alcohol?
 
0 times
 
1 time
 
2 or 3 times
 
4 or 5 times
 
6 or more times
 
 
 
During the past 30 days, on how many days did you text or email while driving a car or other vehicle?
 
I did not drive a car or other vehicle during the past 30 days
 
0 days
 
1 or 2 days
 
3 to 5 days
 
6 to 9 days
 
10 to 19 days
 
20 to 29 days
 
All 30 days
 
 
 
During the past 12 months, have you ever been electronically bullied? (Count being bullied through e-mail, chat rooms, instant message, websites, twitter, facebook, or texting)
 
Yes
 
No
 
 
 
During the past 12 months, did you ever seriously consider attempting suicide?
 
Yes
 
No
 
 
 
During the past 30 days, on how many days did you smoke cigarettes?
 
0 days
 
1 or 2 days
 
3 to 5 days
 
6 to 9 days
 
10 to 19 days
 
20 to 29 days
 
All 30 days
 
 
 
During your life, on how many days have you had at least one drink of alcohol?
 
0 days
 
1 or 2 days
 
3 to 9 days
 
10 to 19 days
 
20 to 39 days
 
40 to 99 days
 
100 or more days
 
 
 
During your life, how many times have you used marijuana?
 
0 days
 
1 or 2 days
 
3 to 9 days
 
10 to 19 days
 
20 to 39 days
 
40 to 99 days
 
100 or more days
 
 
 
During the past 30 days, did you go without eating for 24 hours or more to lose weight, or keep from gaining weight?
 
Yes
 
No
 
 
 
During your life, how many times have you used a needle to inject any illegal drug into your body?
 
0 times
 
1 time
 
2 or more times
 
 
 
During the past 12 months, how many times did someone you were dating or going out with , force you to do sexual things you did not want to do?
 
I did not date or go out with anyone during the past 12 months
 
0 times
 
1 time
 
2 or 3 times
 
4 or 5 times
 
6 or more times
 
 
 
During your life, how many times have you taken a prescription drug without a doctor's prescription?
 
0 times
 
1 or 2 times
 
3 to 9 times
 
10 to 19 times
 
20 to 39 times
 
40 or more times
 
 
 
During the past 30 days, how many days did you carry a weapon such as a gun, knife or club?
 
0 days
 
1 day
 
2 or 3 days
 
4 or 5 days
 
6 or more days
 
 
 
On the average school night, how many hours of sleep do you get?
 
4 or less hours
 
5 hours
 
6 hours
 
7 hours
 
8 hours
 
9 hours
 
10 or more hours