Stay SMART Pre and Post Tests
Stay SMART Pre-Test Instructions
Instructions for administering the pre-test:
1. 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.
2. Respond to any questions participants might have about this process.
3. Read the questions out loud (optional).
4. Remind participants to fill in their ID numbers on the survey.
5. 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 old |
|I am a: ( Boy ( Girl |
|I 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 member |
|I come to the Club: |
|( Once a week or less |
|( 2 or 3 times a week |
|( 4 or more times a week |
|I have other family members who come to the Club. |
|( Yes |
|( No |
|For office use only |
| |
|TOTAL NUMBER CORRECT _____ (only tabulate correct answers for questions 8-24) |
Stay SMART Pre-Test (continued)
True/False
8. A teen needs a prescription to buy condoms.
True False
9. The younger you are when you start drinking, the more likely you are to become an alcoholic.
True False
10. Meth can cause overheating, convulsions and comas.
True False
11. A girl cannot get pregnant the first time she has sex.
True False
12. Tobacco can cause lung, mouth, throat, bladder and kidney cancer.
True False
13. Fentanyl is a prescription drug that, when abused, can lead to death.
True False
Multiple Choice
14. A possible side effect of using inhalants is:
a) Slurred speech b) Vomiting c) Brain damage d) All of the above
15. 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
16. 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
17. 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)
18. Users of methamphetamines can sometimes become extremely:
a) Violent b) Calm c) Thirsty d) Hungry
19. The approximate number of teen pregnancies in the U.S. each year is:
a) 750 b) 750,000 c) 7,500 d) 75
Survey
20. Drinking wine coolers does not make young people look cool or fit in.
Strongly Agree Agree Disagree Strongly Disagree
21. I can say “no” to people I really like who want me to get high with them.
Strongly Agree Agree Disagree Strongly Disagree
22. Before I make a decision, I think about what might happen because of my decision.
Strongly Agree Agree Disagree Strongly Disagree
23. It is not okay to use prescription drugs to relax.
Strongly Agree Agree Disagree Strongly Disagree
24. 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:
1. 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.
2. Respond to any questions participants might have about this process.
3. Read the questions out loud (optional).
4. Remind participants to fill in their ID numbers on the survey.
5. 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 old |
|I am a: ( Boy ( Girl |
|I 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 member |
|I come to the Club: |
|( Once a week or less |
|( 2 or 3 times a week |
|( 4 or more times a week |
|I have other family members who come to the Club. |
|( Yes |
|( No |
|For office use only |
| |
|TOTAL NUMBER CORRECT _____ (only tabulate correct answers for questions 8-24) |
Stay SMART Post-Test (continued)
True/False
8. A teen needs a prescription to buy condoms.
True False
9. The younger you are when you start drinking, the more likely you are to become an alcoholic.
True False
10. Meth can cause overheating, convulsions and comas.
True False
11. A girl cannot get pregnant the first time she has sex.
True False
12. Tobacco can cause lung, mouth, throat, bladder and kidney cancer.
True False
13. Fentanyl is a prescription drug that, when abused, can lead to death.
True False
Multiple Choice
14. A possible side effect of using inhalants is:
a) Slurred speech b) Vomiting c) Brain damage d) All of the above
15. 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
16. 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
17. 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)
18. Users of methamphetamines can sometimes become extremely:
a) Violent b) Calm c) Thirsty d) Hungry
19. The approximate number of teen pregnancies in the U.S. each year is:
a) 750 b) 750,000 c) 7,500 d) 75
Survey
20. Drinking wine coolers does not make young people look cool or fit in.
Strongly Agree Agree Disagree Strongly Disagree
21. I can say “no” to people I really like who want me to get high with them.
Strongly Agree Agree Disagree Strongly Disagree
22. Before I make a decision, I think about what might happen because of my decision.
Strongly Agree Agree Disagree Strongly Disagree
23. It is not okay to use prescription drugs to relax.
Strongly Agree Agree Disagree Strongly Disagree
24. Teens who try alcohol, tobacco and marijuana are more likely to try other drugs.
Strongly Agree Agree Disagree Strongly Disagree
Program Quality
25. I like coming to Stay SMART.
Strongly Agree Agree Disagree Strongly Disagree
26. I would recommend Stay SMART to my friends.
Strongly Agree Agree Disagree Strongly Disagree
27. Adult leaders in the Stay SMART program care about me.
Strongly Agree Agree Disagree Strongly Disagree
28. The Stay SMART program teaches important things that all teens should know about.
Strongly Agree Agree Disagree Strongly Disagree
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