ࡱ> _ F&bjbjPP y:<\y:<\Px x 4$$$hH$%h<<"^^^999gggggggjl\g 99  g^^g F^^g ga  f^,P^ c<gg0%h\cnNnx fn f9vTDG999gg999%h    n999999999x > : Stay SMART Pre-Test Instructions Instructions for administering the pre-test: Explain to participants: Before we begin this program, we are going to ask you to take a test. The test asks you questions about yourself and your opinions about things that are important to young people your age. Your answers will be kept private. No one will know what you write. Please answer the questions truthfully. The answers you give are very important and will help us make this program better. If you have any questions, please raise your hand. Respond to any questions participants might have about this process. Read the questions out loud (optional). Remind participants to fill in their ID numbers on the survey. When the surveys are completed, collect them and file them in a safe place for later coding and matching. Stay SMART Pre-Test ID# ____________________ = the first letter of your first name + the first letter of your last name + your birthday (month/day/year) Tell us about yourself:I am _____ years oldI am a: ( Boy ( GirlI am: ( Latino/Hispanic ( White ( Asian/Pacific Islander ( Native American ( African-American ( Bi-racial/Multiracial/Mixed Heritage ( Other _____________I am in the _____ grade.I have been a member of this Club for: ( Less than a year ( 1 to 2 years ( 2 to 3 years ( More than 3 years ( I am not a memberI come to the Club: ( Once a week or less ( 2 or 3 times a week ( 4 or more times a weekI have other family members who come to the Club. ( Yes ( NoFor office use only TOTAL NUMBER CORRECT _____ (only tabulate correct answers for questions 8-24) Stay SMART Pre-Test (continued) True/False A teen needs a prescription to buy condoms. True False The younger you are when you start drinking, the more likely you are to become an alcoholic. True False Meth can cause overheating, convulsions and comas. True False A girl cannot get pregnant the first time she has sex. True False Tobacco can cause lung, mouth, throat, bladder and kidney cancer. True False Fentanyl is a prescription drug that, when abused, can lead to death. True False Multiple Choice A possible side effect of using inhalants is: a) Slurred speech b) Vomiting c) Brain damage d) All of the above The drug that blocks messages from getting to your brain and virtually all body functions is: a) Tylenol b) Alcohol c) Nicotine d) None of the above The leading preventable cause of disease, disability and death in the United States is: a) Tobacco b) Alcohol c) Marijuana d) None of the above Sexually transmitted infections and HIV can be transmitted through: a) Oral sex b) Vaginal sex c) Anal sex d) All of the above Stay SMART Pre-Test (continued) Users of methamphetamines can sometimes become extremely: a) Violent b) Calm c) Thirsty d) Hungry The approximate number of teen pregnancies in the U.S. each year is: a) 750 b) 750,000 c) 7,500 d) 75 Survey Drinking wine coolers does not make young people look cool or fit in. Strongly Agree Agree Disagree Strongly Disagree I can say no to people I really like who want me to get high with them. Strongly Agree Agree Disagree Strongly Disagree Before I make a decision, I think about what might happen because of my decision. Strongly Agree Agree Disagree Strongly Disagree It is not okay to use prescription drugs to relax. Strongly Agree Agree Disagree Strongly Disagree Teens who try alcohol, tobacco and marijuana are more likely to try other drugs. Strongly Agree Agree Disagree Strongly Disagree Stay SMART Post-Test Instructions Instructions for administering the post-test: Explain to participants: Now that we have completed the program, we are going to ask you to take a test. The test asks you questions about yourself and your opinions about things that are important to young people your age. Your answers will be kept private. No one will know what you write. Please answer the questions truthfully. The answers you give are very important and will help us make this program better. If you have any questions, please raise your hand. Respond to any questions participants might have about this process. Read the questions out loud (optional). Remind participants to fill in their ID numbers on the survey. When the surveys are completed, collect them and file them in a safe place for later coding and matching. Stay SMART Post-Test ID# ____________________ = the first letter of your first name + the first letter of your last name + your birthday (month/day/year) Tell us about yourself:I am _____ years oldI am a: ( Boy ( GirlI am: ( Latino/Hispanic ( White ( Asian/Pacific Islander ( Native American ( African-American ( Bi-racial/Multiracial/Mixed Heritage ( Other _____________I am in the_____ grade.I have been a member of this Club for: ( Less than a year ( 1 to 2 years ( 2 to 3 years ( More than 3 years ( I am not a memberI come to the Club: ( Once a week or less ( 2 or 3 times a week ( 4 or more times a weekI have other family members who come to the Club. ( Yes ( NoFor office use only TOTAL NUMBER CORRECT _____ (only tabulate correct answers for questions 8-24) Stay SMART Post-Test (continued) True/False A teen needs a prescription to buy condoms. True False The younger you are when you start drinking, the more likely you are to become an alcoholic. True False Meth can cause overheating, convulsions and comas. True False A girl cannot get pregnant the first time she has sex. True False Tobacco can cause lung, mouth, throat, bladder and kidney cancer. True False Fentanyl is a prescription drug that, when abused, can lead to death. True False Multiple Choice A possible side effect of using inhalants is: a) Slurred speech b) Vomiting c) Brain damage d) All of the above The drug that blocks messages from getting to your brain and virtually all body functions is: a) Tylenol b) Alcohol c) Nicotine d) None of the above The leading preventable cause of disease, disability and death in the United States is: a) Tobacco b) Alcohol c) Marijuana d) None of the above Sexually transmitted infections and HIV can be transmitted through: a) Oral sex b) Vaginal sex c) Anal sex d) All of the above Stay SMART Post-Test (continued) Users of methamphetamines can sometimes become extremely: a) Violent b) Calm c) Thirsty d) Hungry The approximate number of teen pregnancies in the U.S. each year is: a) 750 b) 750,000 c) 7,500 d) 75 Survey Drinking wine coolers does not make young people look cool or fit in. Strongly Agree Agree Disagree Strongly Disagree I can say no to people I really like who want me to get high with them. Strongly Agree Agree Disagree Strongly Disagree Before I make a decision, I think about what might happen because of my decision. Strongly Agree Agree Disagree Strongly Disagree It is not okay to use prescription drugs to relax. Strongly Agree Agree Disagree Strongly Disagree Teens who try alcohol, tobacco and marijuana are more likely to try other drugs. Strongly Agree Agree Disagree Strongly Disagree Program Quality I like coming to Stay SMART. Strongly Agree Agree Disagree Strongly Disagree I would recommend Stay SMART to my friends. Strongly Agree Agree Disagree Strongly Disagree Adult leaders in the Stay SMART program care about me. Strongly Agree Agree Disagree Strongly Disagree The Stay SMART program teaches important things that all teens should know about. 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The                          0'' |2 K0 test asks you questions about yourself and your opinions about things that                    0'' G2 (0 are important to young people your age.            2 0    0''  2 #H0   ------  2 60 ---  2 60  --- q2 6D0 Your answers will be kept private. No one will know what you write.                   2 60    0''  2 IH0   ------  2 \0 ---  2 \0  --- t2 \F0 Please answer the questions truthfully. The answers you give are very                      0'' Y2 o40 important and will help us make this program better.                 2 o60    0''  2 H0   ------  2 0 ---  2 0  --- )2 0 If you have any ques     82 E0 tions, please raise your hand.         2 &0    0''---  2 H0   --- 2 `0 2. ---  2 m0  --- S2 x00 Respond to any questions participants might have                2 0   (2 0 about this process.      2 d0    0''  2 `0   --- 2 `0 3. ---  2 m0  --- F2 x'0 Read the questions out loud (optional).             2 0    0''  2 x0   --- 2 `0 4. ---  2 m0  --- h2 x>0 Remind participants to fill in their ID numbers on the survey.             2 0    0''  2 H0   --- 2 (`0 5. ---  2 (m0  --- U2 (x10 When the surveys are completed, collect them and               A2 ($0 file them in a safe place for later              0''@"Calibri------ )2 :x0 coding and matching.      ---  2 :0    0''---  2 MH0    @ Arial--@"Arial- - -   "SystemF- -   00//..G՜.+,D՜.+, hp   Boys & Girls Clubs of America6 Stay SMART Pre and Post Tests!Stay SMART Pre-Test Instructions-Instructions for administering the pre-test:EYour answers will be kept private. No one will know what you write. QPlease answer the questions truthfully. The answers you give are very important 3If you have any questions, please raise your hand.QID# ____________________ = the first letter of your first name + the first lette True/FalseMultiple ChoiceSurvey"Stay SMART Post-Test Instructions.Instructions for administering the post-test:EYour answers will be kept private. No one will know what you write. QPlease answer the questions truthfully. The answers you give are very important 3If you have any questions, please raise your hand.QID# ____________________ = the first letter of your first name + the first lette True/FalseMultiple ChoiceSurveyProgram Quality Title Headingsfnz     "^fr~EmailTo EmailSender EmailFrom EmailSubjectEmailCcTaxKeywordTaxHTFieldBGCAStartDate BGCAItemDescription TaxKeyword BGCADocumentCategory !mb42b9e9521c4321a7b25ef39c422e20 BGCAExpiryDateBGCAProgramPageCategory!k4e1b6f031504b20a0b82f40eb1c80de TaxCatchAllBGCAIsVisible IconOverlayBGCADisplayOrderHealthy Lifestyles|7dfbfaf3-b536-4603-ba01-f894bdd2fa33;Pre-test|75ceac88-54d4-4350-ab83-ca39eb9b84f5;Post test|b53059ee-f2cf-4119-a53a-7428d05ab761;Pre Test|f03fc93c-0ffc-4159-b895-eacb72f7afdd;Post-test|c29db682-03e4-4593-b003-cadc476b1199;SMART Moves|e2015-02-12T00:00:00Z

​Stay SMART is the SMART Moves program for youth aged 13 to 15. These are the pre and post tests for the Stay SMART program.

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