Download:
pdf |
pdfDRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
Attachment E. Survey Instrument
SECTION 1. (DEMOGRAPHICS, SCHOOL CONNECTEDNESS, AND GENERAL CLIMATE))
This section asks you some basic demographic questions.
D1.
How old are you?
DROP-DOWN LIST: under 18, 18, 19, 20, 21, 22, 23, 24, 25+
D1a.
[if under 18 in D1] We are sorry, but you are not eligible to participate in the study.
D2.
What is your current student status?
o
o
o
o
o
D3.
First year student (freshman)
Second year student (sophomore)
Third year student (Junior)
Fourth year student (Senior)
Other (specify: _______________________________)
What is your current gender identity?
o
o
o
o
Female
[R RECEIVES FEMALE FILL IN EC1 AND ILF2]
Male
[R RECEIVES MALE FILL IN EC1 AND ILF2]
Transgender
[R RECEIVES TRANSGENDER/SOMETHING ELSE FILL IN EC1 AND ILF2]
Something else (please specify) _________________________ [R RECEIVES
TRANSGENDER/SOMETHING ELSE FILL IN EC1 AND ILF2]
The next questions ask about this school, meaning [UNIVERSITY SHORT NAME].
SC1.
When did you first enroll as a student at this school?
DROP DOWN MENU FOR MONTH ________
DROP DOWN MENU FOR YEAR ______
SC2. Please indicate how much you agree or disagree with each of the following statements. Please
provide an answer that best reflects how you feel.
SA A
D
SD
a. I feel valued as an individual at this school
○
○
○
○
b. I feel close to people at this school
○
○
○
○
c. I feel like I am a part of this school
○
○
○
○
d. I am happy to be a student at this school
○
○
○
○
e. I feel safe when I am on this school’s campus
○
○
○
○
1
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
f.
I believe there is a clear sense of appropriate and inappropriate
behavior among students at this school
○
○
○
○
g. I believe alcohol abuse is a big problem at this school
○
○
○
○
h. I believe this school is trying hard to protect the rights of ALL students
○
○
○
○
i.
I believe this school is trying hard to make sure that ALL students are
treated equally and fairly
○
○
○
○
j.
I believe this school is trying hard to make sure that ALL students are
safe
○
○
○
○
k. I believe that students at this school trust one another
○
○
○
○
l.
○
○
○
○
I believe that students at this school respect one another
The next questions ask your views about three groups at this school: 1) Campus police/security, 2)
Faculty, and 3) School Leadership. Please indicate how much you agree with each of the following
statements, and answer as best as you can.
GC1. Overall, the campus police/security at this school…
SA A
D
SD
a. Are genuinely concerned about my well-being
○
○
○
○
b. Are doing all they can to protect students from harm
○
○
○
○
c. Treat students fairly
○
○
○
○
d. Are more interested in protecting the reputation of this school than
the students they serve
○
○
○
○
GC2. Overall, the faculty at this school…
SA A
D
SD
a. Are genuinely concerned about my well-being
○
○
○
○
b. Are doing all they can to protect students from harm
○
○
○
○
c. Treat students fairly
○
○
○
○
d. Are more interested in protecting the reputation of this school than
the students they serve
○
○
○
○
GC3. Overall, the President/Chancellor, Deans, and other leadership staff
at this school…
SA A
D
SD
a. Are genuinely concerned about my well-being
○
○
○
○
b. Are doing all they can to protect students from harm
○
○
○
○
c. Treat students fairly
○
○
○
○
d. Are more interested in protecting the reputation of this school than
the students they serve
○
○
○
○
You have completed 1 out of 6 sections of the survey.
2
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
SECTION 2. (EXPERIENCES WITH HARASSMENT AND EMOTIONAL COERCION)
SH1. Since the beginning of the current academic year in [FILL: month and year the academic years
started for particular school; for example, “August 2014”], has anyone done the following to you either
in person or by text, e-mail, or social media? Please include things regardless of where they happened.
Yes
No
a. Made sexual advances, gestures, comments, or jokes that were
unwelcome to you
○
○
b. Flashed or exposed themselves to you without your consent
○
○
c. Showed or sent you sexual pictures, photos, or videos that you
didn’t want to see
○
○
d. Showed or sent sexual photos/videos of you or spread sexual
rumors about you that you didn’t want shared
○
○
e. Watched or took photos/videos of you when you were nude or
having sex, without your consent
○
○
EC1.
Since the beginning of the current academic year in [FILL: month and year the academic years
started for particular school; for example, “August 2014”], has someone had sexual contact with
you by threatening to tell lies, end your relationship, or spread rumors about you; making promises
you knew or discovered were untrue; or continually verbally pressuring you after you said you didn’t
want to.
Sexual contact includes:
•
touching of a sexual nature (kissing, touching of private parts, grabbing, fondling, rubbing up
against you in a sexual way, even if it is over your clothes)
•
oral sex (someone’s mouth or tongue making contact with your genitals or your mouth or
tongue making contact with someone else’s genitals)
•
anal sex (someone putting their penis in your anus)
•
sexual intercourse (someone’s penis being put in someone’s vagina)
•
sexual penetration with a finger or object (someone putting their finger or an object like a
bottle or a candle in your [IF R IS FEMALE OR TRANSGENDER/SOMETHING ELSE, FILL: “vagina
or anus”; IF R IS MALE, FILL: “anus”]).
o Yes
o No
You have completed 2 out of 6 sections of the survey.
3
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
SECTION 3. (SEXUAL ASSAULT VICTIMIZATION)
This section asks about times when you may have experienced unwanted sexual contact. In these
questions, unwanted sexual contact is sexual contact that you did not consent to and that you did not
want to happen. Remember that sexual contact includes touching of your sexual body parts, oral sex,
anal sex, sexual intercourse, and penetration of your vagina or anus with a finger or object.
Unwanted sexual contact could happen when:
•
someone touches or grabs your sexual body parts (e.g., your butt, breasts, or crotch);
•
someone uses force against you, such as holding you down with his or her body weight, pinning
your arms, hitting or kicking you;
•
someone threatens to hurt you or someone close to you; or
•
you are unable to provide consent because you are incapacitated, passed out, unconscious,
blacked out, or asleep. This could happen after you voluntarily used alcohol or drugs, or after
you were given a drug without your knowledge or consent.
Please keep in mind that anyone – regardless of gender – can experience unwanted sexual contact. Also,
the person who does this could be a stranger or someone you know, such as a friend, family member, or
person you were dating or hanging out with.
When you answer the questions in this section, please count any experience of unwanted sexual contact
since the beginning of the current academic year, regardless of where it happened.
P1. Since the beginning of the current academic year in [FILL: month and year the academic years
started for particular school; for example, “August 2014”], has anyone had unwanted sexual contact
with you?
o Yes
o No
P2. How many separate incidents of unwanted sexual contact have you experienced since the beginning
of the current academic year in [FILL: month and year the academic years started for particular
school; for example, “August 2014”]?
o
o
o
o
o
o
0 incidents [IF P2 = 0 IINCIDENTS, SKIP TO LCA2b]
1 incident
2 incidents
3 incidents
4 incidents
5 or more incidents
The next questions ask about [FILL # REPORTED IN #P2 AND “this incident” IF #P2 = 1 OR “these
incidents” IF #P2 = 2 OR MORE] of unwanted sexual contact that you experienced since the beginning of
the current academic year in [FILL: month and year the academic years started for particular school; for
4
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
example, “August 2014”]. The questions ask when the incidents happened, if/how you know the person
who did it, and whether you sought services after the incident. [IF #P2 = 2 OR MORE, FILL: “The
questions refer to the incidents as incident #1, incident #2, and so on.”]
ILF1.
[IF #P2 = 2 OR MORE, FILL: “Please think about incident #1”]. In what month did this incident of
unwanted sexual contact occur?
o
o
o
o
o
o
o
o
o
o
o
ILF2.
August, 2014
September, 2014
October, 2014
November, 2014
December, 2014
January, 2015
February, 2015
March, 2015
April, 2015
May, 2015
Unsure/Don’t know
During [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE], which occurred in
[FILL THE MONTH REPORTED IN #ILF1, e.g., “February, 2014.”], which of the following types of
unwanted sexual contact happened? Please select all types of unwanted sexual contact that
happened during this incident.
Yes
No
a. Forced touching of a sexual nature (forced kissing, touching of
private parts, grabbing, fondling, rubbing up against you in a
sexual way, even if it is over your clothes)
○
○
○
b. Oral sex (someone’s mouth or tongue making contact with your
genitals or your mouth or tongue making contact with someone
else’s genitals)
○
○
○
c. Anal sex (someone putting their penis in your anus)
○
○
○
d. [RESPONSE WILL NOT DISPLAY UNLESS THE RESPONDENT IS
FEMALE OR TRANSGENDER/SOMETHING ELSE] Sexual intercourse
someone putting their penis in your vagina)
○
○
○
e. Sexual penetration with a finger or object (someone putting their
finger or an object like a bottle or a candle in your [IF R IS FEMALE
OR TRANSGENDER/SOMETHING ELSE, FILL: “vagina or anus”; IF R
IS MALE, FILL: “anus”])
○
○
○
5
Unsure
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
ILF3.
ILF4.
During [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE] in [FILL THE MONTH
REPORTED IN #ILF1, e.g., “February, 2014”], how did the person(s) have unwanted sexual
contact with you? Please select all that apply.
Yes
No
Unsure
a. Touched or grabbed your sexual body parts (e.g., your butt,
breasts, or crotch)
○
○
○
b. Threatened to hurt you or someone you care about
○
○
○
c. Used physical force against you, such as holding you down with his
or her body weight, pinning your arms, hitting or kicking you;
○
○
○
d. You were unable to provide consent or stop what was happening
because you were incapacitated, passed out, unconscious, blacked
out, or asleep
○
○
○
e. Other. Please describe how the incident happened: ____________
_______________________________________________________
○
○
○
Where did [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE] occur?
o
o
o
o
ILF5.
During [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE], how many people
had unwanted sexual contact with you?
o
o
o
ILF6.
1 person
2 or more people
Unsure/Don’t know
[IF #ILF5 = 1] What was the gender of the person who had unwanted sexual contact with you?
o
o
o
o
ILF7.
On [UNIVERSITY SHORT NAME] campus
Off-campus but in the same city or town
In a different city or town
Unsure/Don’t know
Male
Female
Transgendered/Other
Unsure/Don’t know
[IF #ILF5 = 2+] What were the genders of the people who had unwanted sexual contact with
you? Please select all that apply.
Male
6
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
o
Female
Transgendered/Other
Unsure/Don’t know
ILF10. [IF #ILF5 = 1] Was the person a student, professor, or other employee at this school?
o
o
o
Yes
No
Unsure/Don’t know
ILF11. [IF #ILF5 = 2+] How many of the people were students, professors, or other employees at this
school?
o
o
o
o
All of them
Some of them
None of them
Unsure/Don’t know
ILF12. [IF #ILF5 = 1] Who was the person who had unwanted sexual contact with you during [FILL “the
incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE]? Please select all that apply.
A stranger
Someone you had seen or heard about but not talked to
An acquaintance, friend of a friend, or someone that you had just met
A professor or teaching assistant
A current or ex friend or roommate
A current or ex dating partner or spouse
Someone else (please specify relationship: ________________________________________)
Unsure/Don’t know
ILF13. [IF #ILF5 = 2+] Who were the people who had unwanted sexual contact with you during [FILL
“the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE]? Please select all that apply.
A stranger
Someone you had seen or heard about but not talked to
An acquaintance, friend of a friend, or someone that you had just met
A professor or teaching assistant
A current or ex friend or roommate
A current or ex dating partner or spouse
7
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
Someone else (please specify relationship: ________________________________________)
Unsure/Don’t know
ILF14. [IF #ILF5 = 1] Had the person who had unwanted sexual contact with you been drinking alcohol
or using drugs?
o
o
o
Yes
No
Unsure/Don’t know
ILF15. [IF #ILF5 = 2+] How many of the people who had unwanted sexual contact with you had been
drinking alcohol or using drugs?
o
o
o
o
All of them
Some of them
None of them
Unsure/Don’t know
ILF16. In the hours prior to [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE], had
you consumed alcohol or drugs? Please keep in mind that you are NOT responsible for what
happened, even if you had been drinking or using drugs or had been given a drug without your
knowledge or consent. Remember that your answers will remain completely confidential.
o
o
o
Yes
No
Unsure/Don’t know
The next questions ask about whether you have told anyone about [FILL “the incident” IF #P2 = 1 OR
“incident #1” IF #P2 = 2 OR MORE] that occurred in [FILL THE MONTH REPORTED IN # ILF1, e.g.,
“February, 2014”].
R1.
Have you told any of your roommates, friends, or family members about [FILL “the incident” IF
#P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE]?
o
o
R2.
Yes
No
Please indicate whether each of the following groups or organizations have been notified about
[FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE], whether it was by you or
someone else.
8
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
Group or organization
Were they notified?
a. Administrators, faculty, or other officials or staff at this school
o
Yes
o
No
b. A crisis center or helpline, or a hospital or health care center at
this school
o
Yes
o
No
c. A crisis center or helpline, or a hospital or health care center
NOT at this school
o
Yes
o
No
d. Campus police or security at this school
o
Yes
o
No
e. Local police not at this school, such as the county or city
police department
o
Yes
o
No
R3.
[DISPLAY ORGANIZATIONS FOR WHICH “YES” IS CHECKED IN #R2] Who notified the groups or
organizations about [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE]?
Group or organization
Who notified the group?
a. Administrators, faculty, or other officials or staff at this school
You
Someone else
b. A crisis center or helpline, or a hospital or health care center at
this school
You
Someone else
c. A crisis center or helpline, or a hospital or health care center NOT
at this school
You
Someone else
d. Administrators, faculty, or other officials or staff at this school
You
Someone else
e. Campus police or security at this school
You
Someone else
f.
You
Someone else
R4.
Local police not at this school, such as the county or city police
department
[DISPLAY ORGANIZATIONS FOR WHICH “YES” IS CHECKED IN #R2] When each of the following
groups or organizations were notified about [FILL “the incident” IF #P2 = 1 OR “incident #1” IF
#P2 = 2 OR MORE], were they helpful or not?
Group or organization
Were they helpful?
a. Administrators, faculty, or other officials or staff at this school
o
Yes
o
No
b. A crisis center or helpline, or a hospital or health care center at this school
o
Yes
o
No
c. A crisis center or helpline, or a hospital or health care center NOT at this
school
o
Yes
o
No
d. Campus police or security at this school
o
Yes
o
No
e. Local police not at this school, such as the county or city police
department
o
Yes
o
No
9
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
[FOR EACH ORGANIZATIONS FOR WHICH “NO” IS CHECKED IN #R2 OR FOR WHICH “SOMEONE ELSE” IS
CHECKED FOR #R3]
There are many reasons why students might not notify certain groups or organizations about incidents
like this.
R5a. For each of the groups or organizations below,
have you not contacted the group because you didn’t
know how to contact them?
Yes, this was a
reason for not
contacting group
No, this was not
a reason for not
contacting group
a. Administrators, faculty, or other officials or staff at
this school
○
○
b. A crisis center or helpline, or a hospital or health
care center at this school
○
○
c. A crisis center or helpline, or a hospital or health
care center NOT at this school
○
○
d. Campus police or security at this school
○
○
e. Local police not at this school, such as the county
or city police department
○
○
R5b. For each of the groups or organizations below,
have you not contacted the group because you were
concerned that the group would not keep your
situation confidential?
Yes, this was a
reason for not
contacting group
No, this was not
a reason for not
contacting group
○
○
g. A crisis center or helpline, or a hospital or health
care center at this school
○
○
h. A crisis center or helpline, or a hospital or health
care center NOT at this school
○
○
i.
Campus police or security at this school
○
○
j.
Local police not at this school, such as the county
or city police department
○
○
R5c.
For each of the groups or organizations below,
have you not contacted the group because you were
concerned that the group would treat you poorly, not
respond effectively, or not take any action?
Yes, this was a
reason for not
contacting group
No, this was not
a reason for not
contacting group
k. Administrators, faculty, or other officials or staff at
this school
○
○
f.
Administrators, faculty, or other officials or staff at
this school
10
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
l.
A crisis center or helpline, or a hospital or health
care center at this school
○
○
m. A crisis center or helpline, or a hospital or health
care center NOT at this school
○
○
n. Campus police or security at this school
○
○
o. Local police not at this school, such as the county
or city police department
○
○
R5d. For each of the groups or organizations below,
have you not contacted the group because you did not
need assistance, did not think the incident was
serious enough to report, or did not want any action
taken?
Yes, this was a
reason for not
contacting group
No, this was not
a reason for not
contacting group
p. Administrators, faculty, or other officials or staff at
this school
○
○
q. A crisis center or helpline, or a hospital or health
care center at this school
○
○
r.
○
○
s. Campus police or security at this school
○
○
t.
○
○
R5e. For each of the groups or organizations below,
have you not contacted the group because you felt
that other people might think that what happened
was at least partly your fault or that you might get in
trouble for some reason?
Yes, this was a
reason for not
contacting group
No, this was not
a reason for not
contacting group
u. Administrators, faculty, or other officials or staff at
this school
○
○
v. A crisis center or helpline, or a hospital or health
care center at this school
○
○
w. A crisis center or helpline, or a hospital or health
care center NOT at this school
○
○
x. Campus police or security at this school
○
○
y. Local police not at this school, such as the county
or city police department
○
○
A crisis center or helpline, or a hospital or health
care center NOT at this school
Local police not at this school, such as the county
or city police department
11
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
I1.
R5f. For each of the groups or organizations below,
have you not contacted the group because you were
worried that either the person who did this to you or
other people might find out and do something to get
back at you??
Yes, this was a
reason for not
contacting group
No, this was not
a reason for not
contacting group
z. Administrators, faculty, or other officials or staff at
this school
○
○
aa. A crisis center or helpline, or a hospital or health
care center at this school
○
○
bb. A crisis center or helpline, or a hospital or health
care center NOT at this school
○
○
cc. Campus police or security at this school
○
○
dd. Local police not at this school, such as the county
or city police department
○
○
How upsetting was [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE] for you?
o
o
o
o
I2.
Very upsetting
Upsetting
Not very upsetting
Not at all upsetting
Did [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE] lead you to have
problems with your…
Yes
No
a. schoolwork or your grades?
○
○
b. friends, roommates, or peers, such as getting into more arguments or
fights than you did before, not feeling you could trust them as much, or
not feeling as close to them as you did before?
○
○
c. family members, such as getting into more arguments or fights than you
did before, not feeling you could trust them as much, or not feeling as
close to them as you did before?
○
○
d. job or with your boss or coworkers?
○
○
I4.
As a result of [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE], did you move
or change where you live?
o
o
Yes
No
12
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
I4a.
[IF I4 = No] Did you want to move or change where you live as a result of [FILL “the incident” IF
#P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE]?
o
o
I5.
As a result of [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE], did you drop
any classes or change your class schedule?
o
o
I5a.
Yes
No
Did you think about taking some time off from school, transferring to another school, or
dropping out of school as a result of [FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2
OR MORE]?
o
o
VQ.
Yes
No
[IF I5 = No] Did you want to drop any classes or change your class schedule as a result of [FILL
“the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE]?
o
o
I6.
Yes
No
Yes
No
Thank you for answering these questions. If there is anything else you would like to tell us about
[FILL “the incident” IF #P2 = 1 OR “incident #1” IF #P2 = 2 OR MORE] of unwanted sexual
contact, which occurred in [FILL THE MONTH REPORTED IN # ILF1, e.g., “February, 2014”], please
do so in the space provided below. Please do not include any names or other personally
identifying information in your description.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
[IF #P2 = 2 OR MORE, REPEAT ILF1-VQ FOR UP TO 3 INCIDENTS]
LCA2. Just to confirm, since the beginning of the current academic year in
[FILL: month and year the academic years started for particular school; for
example, “August 2014”], has someone had unwanted sexual contact with
you by
Yes
No
a. touching or grabbing your sexual body parts (e.g., your butt, breasts, or
crotch)?
○
○
13
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
b. by threatening to hurt you or someone you care about?
○
○
c. by using physical force against you?
○
○
d. when you were unable to provide consent or stop what was happening
because you were incapacitated, passed out, unconscious, blacked out,
or asleep?
○
○
LCA3. Thinking about your whole life, when was the last time you experienced unwanted sexual
contact?
o Never
DROP DOWN MENU FOR MONTH ________
DROP DOWN MENU FOR YEAR ________
LCA4. [skip IF #P1 = yes or P1 GE1 or LCA2a=yes or LCA2b=yes or LCA2c=yes or LCA2d=yes] For the
final question in this section, please think about the time since you entered college. If you have
attended more than one school, please think about the time since you first entered any college
or university. At any point since you entered college, has anyone had unwanted sexual contact
with you?
o
o
Yes
No
You have finished 3 out of 6 sections of the survey.
SECTION 4. (IPV)
IPV1. This section asks more about your experiences since the beginning of the current academic year.
These questions asks about things that an intimate partner may have done to you. An intimate partner
might be a boyfriend, girlfriend, spouse, or anyone you were in an intimate relationship with or hooked
up with, including exes and current partners. As you answer the questions, please do not include times
you knew they were joking around.
Since the beginning of the current academic year in [FILL: month and year the academic years started for
particular school; for example, “August 2014”], has an intimate partner…
Yes
No
a. threatened to hurt you and you thought you might really get hurt?
○
○
b. pushed, grabbed, or shook you?
○
○
c. hit you, kicked you, slapped you, or beat you up?
○
○
14
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
You have finished 4 out of 6 sections of the survey.
SECTION 5. (SEXUAL HARASSMENT AND SEXUAL ASSAULT PERPETRATION)
This section of the survey asks about things you may have done to other people.
SHP1. Since the beginning of the current academic year in [FILL: month and year the academic years
started for particular school; for example, “August 2014”], have you done the following to anyone either
in person or by text, e-mail, or social media…
Yes
No
a. Made sexual advances, gestures, comments, or jokes to someone
that were unwelcome to them
○
○
b. Flashed or exposed yourself to someone without their consent
○
○
c. Showed or sent someone sexual pictures, photos, or videos that
they didn’t want to see
○
○
d. Showed or sent sexual photos/videos of someone or spread sexual
rumors about someone that they didn’t want shared
○
○
e. Watched or took photos/videos of someone when they were nude
or having sex, without their consent
○
○
SAP1. The final questions in this section ask about times when you may have engaged in sexual contact
with someone without their consent and that they did not want to happen. Sometimes this happens
with a stranger or with someone you know, such as a friend or someone you were dating or hanging out
with. It often happens when people have been drinking, but it can also happen when people are sober.
Please answer these questions honestly. Remember that your answers will not be linked to any
identifying information about you and will remain completely confidential.
Since the beginning of the current academic year in [FILL: month and year the academic years started for
particular school; for example, “August 2014”], how many times have you had unwanted sexual contact
with someone (i.e., sexual contact without their consent and that they did not want to happen, including
touching of their sexual body parts, oral sex, anal sex, sexual intercourse, and penetration of their vagina
or anus with a finger or object)…
0
1
2
3
4
Times Time Times Times Times
a. By touching or grabbing the person’s sexual
body parts (e.g., your butt, breasts, or crotch)
○
15
○
○
○
○
5 or
more
Times
○
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
b. by threatening to hurt the person or someone
they cared about?
○
○
○
○
○
○
c. by using physical force against the person, such
as holding them down with your body weight,
pinning their arms, hitting or kicking them?
○
○
○
○
○
○
d. when the person was incapacitated, passed out,
unconscious, blacked out, or asleep and unable
to provide consent?
○
○
○
○
○
○
You have finished 5 out of 6 sections of the survey.
SECTION 6. (SCHOOL CLIMATE FOR SEXUAL HARASSMENT AND ASSAULT PREVENTION)
The next questions ask your opinion about this school’s efforts related to sexual harassment and sexual
assault.
SAC1. Please indicate how much you agree or disagree with each of the following statements. Please
answer as best as you can when thinking about your school.
SA A
D
SD
a. Sexual harassment is not tolerated at this school
○
○
○
○
b. This school takes training in sexual assault prevention seriously
○
○
○
○
c. This school is doing a good job of educating students about sexual
assault (e.g., what consent means, how to define sexual assault, how
to look out for one another)
○
○
○
○
d. This school is doing a good job of trying to prevent sexual assault from
happening
○
○
○
○
e. This school is doing a good job of providing needed services to victims
of sexual assault
○
○
○
○
f.
This school is doing a good job of investigating incidents of sexual
assault
○
○
○
○
g. This school is doing a good job of holding people accountable for
committing sexual assault
○
○
○
○
SAC2. Have you attended an assembly, workshop, or received any
other type of training or classes offered by this school that covered…
Yes
No
a. The legal definition of sexual assault?
○
○
b. What the definition of “consent” is and how to obtain it from a
sexual partner?
○
○
c. This school’s policy on sexual assault?
○
○
16
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
d. How to report sexual assault?
○
○
e. What services are available for survivors of sexual assault?
○
○
f.
○
○
○
○
How to intervene as a bystander to protect other students from
sexual assault?
g. Other strategies for preventing sexual assault?
SAC3. Please indicate how much you agree or disagree with each of the following statements,
answering as best as you can when thinking about your school.
SA A
D
SD
a. I am aware of and understand this school’s procedures for dealing
with reported incidents of sexual assault
○
○
○
○
b. I know what services are available for people who experience sexual
assault
○
○
○
○
c. If a friend of mine were sexually assaulted, I know where to take my
friend to get help
○
○
○
○
d. At this school, students who are accused of perpetrating a sexual
assault are treated fairly
○
○
○
○
e. At this school, when it is determined that sexual assault has happened,
the perpetrator gets punished appropriately
○
○
○
○
SAC4.
SA A
D
SD
a. Take my case seriously.
○
○
○
○
b. Protect my privacy.
○
○
○
○
c. Treat me with dignity and respect.
○
○
○
○
d. Enable me to continue my education without having to interact with
the person who assaulted me.
○
○
○
○
SAC5. How likely or unlikely would you be to go to or
get in touch with the following groups or
organizations at your school if you were sexually
assaulted?
If I were sexually assaulted I believe this school would…
Very
likely
Likely
Not
likely
Not at
all likely
a. Administrators, faculty, or other officials at this
school
○
○
○
○
b. A crisis center or helpline, or a hospital or health
care center at this school
○
○
○
○
c. A crisis center or helpline, or a hospital or health
care center NOT at this school
○
○
○
○
17
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
d. Campus police or security at this school
○
○
○
○
e. Local police not at this school, such as the county
or city police department
○
○
○
○
SAC6-7.
Please indicate how likely or unlikely you are to do each of the following things.
Please think about the situation and answer as best as you can.
Very
likely
Likely
Not
likely
Not at
all likely
a. If your friends are sending sexual pictures, web
pages, or messages to someone who didn’t ask
for them, how likely are you to say something to
try to get them to stop?
○
○
○
○
b. If people you don’t know very well are making
unwanted sexual comments, jokes, or gestures,
how likely are you to say something to try to get
them to stop?
○
○
○
○
c. If you see one of your friends leading someone
who is obviously drunk away to have sex with
them, how likely are you to say or do something
to get them to stop?
○
○
○
○
d. If you suspect that one of your friends might be in
an abusive relationship, how likely are you to ask
them if they are being mistreated?
○
○
○
○
e. If someone tells you that they had sex with
someone who was passed out, how likely are you
to report the incident to an administrator or the
police?
○
○
○
○
f.
○
○
○
○
○
○
○
○
If you see someone you don’t know who looks
uncomfortable and is being touched, grabbed, or
pinched in a sexual way, how likely are you to
speak up or help in some other way?
g. When you go out with your friends, how likely are
you to come up with a plan for checking in with
one another throughout the evening?
SAC8-9. Please indicate how much you agree or disagree with each of the following statements. As you
consider these statements, please think about the overall population of students at this school and try
to answer as best as you can.
SA A D SD
18
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
a. At this school, it is common for students to spread sexual comments,
photos, or videos that people don’t want shared, either in person or
by text, e-mail, or social media
○
○
○
○
b. At this school, it is common for students to call people who are gay or
lesbian a negative name
○
○
○
○
c. At this school, when students make sexual comments, jokes, or
gestures , other students stand up to them
○
○
○
○
d. A lot of sexual assault happens among students at this school when
students are physically forced, threatened, or unable to provide
consent because they are incapacitated, passed out, unconscious,
blacked out, or asleep
○
○
○
○
e. Many students at this school initiate or lead campus efforts to raise
awareness about sexual assault
○
○
○
○
f.
○
○
○
○
g. At this school, it is common for students to make jokes about sexual
assault or rape
○
○
○
○
h. At this school, if students see someone trying to have unwanted
sexual contact with someone, they will try to stop them
○
○
○
○
Most students at this school are knowledgeable about the topic of
sexual assault, including how it is defined, how often it occurs, and
what the legal consequences are
SAC10-11. Please indicate how much you agree or disagree with each of the following statements.
SA A D SD
a. People get too offended by sexual comments, jokes, or gestures
○
○
○
○
b. It doesn’t really hurt anyone to post sexual comments or photos of
people without their consent through e-mail, text, or social media
○
○
○
○
c. A person who is sexually assaulted while he/she is drunk is at least
somewhat responsible for putting themselves in that position
○
○
○
○
d. If one of your friends told you that someone had unwanted sexual
contact with them, you would encourage him/her to report the
incident to campus or local police
○
○
○
○
e. It is not necessary to get consent before sexual activity if you are in a
relationship with that person
○
○
○
○
f.
○
○
○
○
○
○
○
○
Accusations of sexual assault are often used by one person as a way to
get back at the other
g. A lot of times, what people say is rape is actually consensual sex that
they regretted afterwards
D5.
What is your ethnicity (as you define it)?
19
DRAFT DOCUMENT – FOR INTERNAL USE ONLY – PLEASE DO NOT CIRCULATE
o
o
D4.
Hispanic or Latino
Not Hispanic or Latino
What is your race (as you define it)? Select one or more.
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
D6.
Which of the following best represents how you think of yourself?
Lesbian or gay
Straight, that is, not lesbian or gay
Bisexual
Something else (please specify) _________________________
You have completed all 6 sections of the survey.
20
| File Type | application/pdf |
| Author | RTI/BJS |
| File Modified | 2015-03-20 |
| File Created | 2015-03-20 |