0920-0493 ABES Questionnaire

Form Approved*

OMB No.: 0920-0493

Expiration Date:

2021 Adolescent Behaviors and Experiences Survey

This survey is about health behavior. It has been developed so you can tell us what you do that may affect your health. The information you give will be used to improve health education for young people like yourself.

The answers you give will be kept private. No one will know how you answer the questions. Answer the questions based on what you really do.

Completing the survey is voluntary. Whether or not you answer the questions will not affect your grade in this class. If you are not comfortable answering a question, just leave it blank.

The questions that ask about your background will be used only to describe the types of students completing this survey. The information will not be used to find out your name. No names will ever be reported.

Make sure to read every question. Please begin.

Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC Reports Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN:PRA (0920-0493)

*Note: This form is a draft, currently pending OMB review. There may be changes or revisions based on the outcome of OMB’s review, and thus, this document is meant as a means of preparing for, but not completing the 2021 Adolescent Behaviors and Experiences Survey. This form will be revised with an updated expiration date and OMB control number once OMB review has been completed.

Thank you very much for your help.

1. How old are you?

A. 12 years old or younger

B. 13 years old

C. 14 years old

D. 15 years old

E. 16 years old

F. 17 years old

G. 18 years old or older

2. What is your sex?

A. Female

B. Male

3. In what grade are you?

A. 9th grade

B. 10th grade

C. 11th grade

D. 12th grade

E. Ungraded or other grade

4. Are you Hispanic or Latino?

A. Yes

B. No

5. What is your race? (Select one or more responses.)

A. American Indian or Alaska Native

B. Asian

C. Black or African American

D. Native Hawaiian or Other Pacific Islander

E. White

6. How tall are you without your shoes on? (Fill in your height in the blank boxes.)

Feet Inches

7. How much do you weigh without your shoes on? (Fill in your weight in the blank box.)

Pounds

The next 4 questions ask about safety.

8. How often do you wear a seat belt when riding in a car driven by someone else?

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

9. 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?

A. 0 times

B. 1 time

C. 2 or 3 times

D. 4 or 5 times

E. 6 or more times

10. During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol?

A. I did not drive a car or other vehicle during the past 30 days

B. 0 times

C. 1 time

D. 2 or 3 times

E. 4 or 5 times

F. 6 or more times

11. During the past 30 days, on how many days did you text or e-mail while driving a car or other vehicle?

A. I did not drive a car or other vehicle during the past 30 days

B. 0 days

C. 1 or 2 days

D. 3 to 5 days

E. 6 to 9 days

F. 10 to 19 days

G. 20 to 29 days

H. All 30 days

The next 11 questions ask about violence-related behaviors and experiences.

12. During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or club on school property?

A. I have not attended school in-person during the past 30 days

B. 0 days

C. 1 day

D. 2 or 3 days

E. 4 or 5 days

F. 6 or more days

13. During the past 12 months, on how many days did you carry a gun? (Do not count the days when you carried a gun only for hunting or for a sport, such as target shooting.)

A. 0 days

B. 1 day

C. 2 or 3 days

D. 4 or 5 days

E. 6 or more days

14. During the past 30 days, on how many days did you not go to school because you felt you would be unsafe at school or on your way to or from school?

A. I have not attended school in-person during the past 30 days

B. 0 days

C. 1 day

D. 2 or 3 days

E. 4 or 5 days

F. 6 or more days

15. During the past 12 months, how many times has someone threatened or injured you with a weapon such as a gun, knife, or club on school property?

A. I have not attended school in-person during the past 12 months

B. 0 times

C. 1 time

D. 2 or 3 times

E. 4 or 5 times

F. 6 or 7 times

G. 8 or 9 times

H. 10 or more times

16. During the past 12 months, how many times were you in a physical fight?

A. 0 times

B. 1 time

C. 2 or 3 times

D. 4 or 5 times

E. 6 or 7 times

F. 8 or 9 times

G. 10 or 11 times

H. 12 or more times

17. During the past 12 months, how many times were you in a physical fight on school property?

A. I have not attended school in-person during the past 12 months

B. 0 times

C. 1 time

D. 2 or 3 times

E. 4 or 5 times

F. 6 or 7 times

G. 8 or 9 times

H. 10 or more times

18. Have you ever seen someone get physically attacked, beaten, stabbed, or shot in your neighborhood?

A. Yes

B. No

19. Have you ever been physically forced to have sexual intercourse when you did not want to?

A. Yes

B. No

20. During the past 12 months, how many times did anyone force you to do sexual things that you did not want to do? (Count such things as kissing, touching, or being physically forced to have sexual intercourse.)

A. 0 times

B. 1 time

C. 2 or 3 times

D. 4 or 5 times

E. 6 or more times

21. During the past 12 months, how many times did someone you were dating or going out with force you to do sexual things that you did not want to do? (Count such things as kissing, touching, or being physically forced to have sexual intercourse.)

A. I did not date or go out with anyone during the past 12 months

B. 0 times

C. 1 time

D. 2 or 3 times

E. 4 or 5 times

F. 6 or more times

22. During the past 12 months, how many times did someone you were dating or going out with physically hurt you on purpose? (Count such things as being hit, slammed into something, or injured with an object or weapon.)

A. I did not date or go out with anyone during the past 12 months

B. 0 times

C. 1 time

D. 2 or 3 times

E. 4 or 5 times

F. 6 or more times

The next 2 questions ask about bullying. Bullying is when 1 or more students tease, threaten, spread rumors about, hit, shove, or hurt another student over and over again. It is not bullying when 2 students of about the same strength or power argue or fight or tease each other in a friendly way.

23. During the past 12 months, have you ever been bullied on school property?

A. I have not attended school in-person during the past 12 months

B. Yes

C. No

24. During the past 12 months, have you ever been electronically bullied? (Count being bullied through texting, Instagram, Facebook, or other social media.)

A. Yes

B. No

The next question asks about times that you felt you were treated badly or unfairly.

25. During your life, how often have you felt that you were treated badly or unfairly in school because of your race or ethnicity?

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

The next 5 questions ask about sad feelings and attempted suicide. Sometimes people feel so depressed about the future that they may consider attempting suicide, that is, taking some action to end their own life.

26. 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?

A. Yes

B. No

27. During the past 12 months, did you ever seriously consider attempting suicide?

A. Yes

B. No

28. During the past 12 months, did you make a plan about how you would attempt suicide?

A. Yes

B. No

29. During the past 12 months, how many times did you actually attempt suicide?

A. 0 times

B. 1 time

C. 2 or 3 times

D. 4 or 5 times

E. 6 or more times

30. If you attempted suicide during the past 12 months, did any attempt result in an injury, poisoning, or overdose that had to be treated by a doctor or nurse?

A. I did not attempt suicide during the past 12 months

B. Yes

C. No

The next 4 questions ask about cigarette smoking.

31. Have you ever tried cigarette smoking, even one or two puffs?

A. Yes

B. No

32. How old were you when you first tried cigarette smoking, even one or two puffs?

A. I have never tried cigarette smoking, not even one or two puffs

B. 8 years old or younger

C. 9 or 10 years old

D. 11 or 12 years old

E. 13 or 14 years old

F. 15 or 16 years old

G. 17 years old or older

33. During the past 30 days, on how many days did you smoke cigarettes?

A. 0 days

B. 1 or 2 days

C. 3 to 5 days

D. 6 to 9 days

E. 10 to 19 days

F. 20 to 29 days

G. All 30 days

34. During the past 30 days, on the days you smoked, how many cigarettes did you smoke per day?

A. I did not smoke cigarettes during the past 30 days

B. Less than 1 cigarette per day

C. 1 cigarette per day

D. 2 to 5 cigarettes per day

E. 6 to 10 cigarettes per day

F. 11 to 20 cigarettes per day

G. More than 20 cigarettes per day

The next 3 questions ask about electronic vapor products, such as JUUL, SMOK, Suorin, Vuse, and blu. Electronic vapor products include e-cigarettes, vapes, vape pens, e-cigars, e-hookahs, hookah pens, and mods.

35. Have you ever used an electronic vapor product?

A. Yes

B. No

36. During the past 30 days, on how many days did you use an electronic vapor product?

A. 0 days

B. 1 or 2 days

C. 3 to 5 days

D. 6 to 9 days

E. 10 to 19 days

F. 20 to 29 days

G. All 30 days

37. During the past 30 days, how did you usually get your electronic vapor products? (Select only one response.)

A. I did not use any electronic vapor products during the past 30 days

B. I got or bought them from a friend, family member, or someone else

C. I bought them myself in a vape shop or tobacco shop

D. I bought them myself in a convenience store, supermarket, discount store, or gas station

E. I bought them myself at a mall or shopping center kiosk or stand

F. I bought them myself on the Internet, such as from a product website, vape store website, or other website like eBay, Amazon, Facebook Marketplace, or Craigslist

G. I took them from a store or another person

H. I got them in some other way

The next 2 questions ask about other tobacco products.

38. During the past 30 days, on how many days did you use chewing tobacco, snuff, dip, snus, or dissolvable tobacco products, such as Copenhagen, Grizzly, Skoal, or Camel Snus? (Do not count any electronic vapor products.)

A. 0 days

B. 1 or 2 days

C. 3 to 5 days

D. 6 to 9 days

E. 10 to 19 days

F. 20 to 29 days

G. All 30 days

39. During the past 30 days, on how many days did you smoke cigars, cigarillos, or little cigars?

A. 0 days

B. 1 or 2 days

C. 3 to 5 days

D. 6 to 9 days

E. 10 to 19 days

F. 20 to 29 days

G. All 30 days

The next question asks about all tobacco products. Please consider cigarettes, electronic vapor products, smokeless tobacco (chewing tobacco, snuff, dip, snus, or dissolvable tobacco products), cigars (including little cigars or cigarillos), shisha or hookah tobacco, and pipe tobacco when answering this question.

40. During the past 12 months, did you ever try to quit using all tobacco products?

A. I did not use cigarettes, electronic vapor products, smokeless tobacco, cigars, shisha or hookah tobacco, or pipe tobacco during the past 12 months

B. Yes

C. No

The next 5 questions ask about drinking alcohol. This includes drinking beer, wine, flavored alcoholic beverages, and liquor such as rum, gin, vodka, or whiskey. For these questions, drinking alcohol does not include drinking a few sips of wine for religious purposes.

41. How old were you when you had your first drink of alcohol other than a few sips?

A. I have never had a drink of alcohol other than a few sips

B. 8 years old or younger

C. 9 or 10 years old

D. 11 or 12 years old

E. 13 or 14 years old

F. 15 or 16 years old

G. 17 years old or older

42. During the past 30 days, on how many days did you have at least one drink of alcohol?

A. 0 days

B. 1 or 2 days

C. 3 to 5 days

D. 6 to 9 days

E. 10 to 19 days

F. 20 to 29 days

G. All 30 days

43. During the past 30 days, on how many days did you have 4 or more drinks of alcohol in a row, that is, within a couple of hours (if you are female) or 5 or more drinks of alcohol in a row, that is, within a couple of hours (if you are male)?

A. 0 days

B. 1 day

C. 2 days

D. 3 to 5 days

E. 6 to 9 days

F. 10 to 19 days

G. 20 or more days

44. During the past 30 days, what is the largest number of alcoholic drinks you had in a row, that is, within a couple of hours?

A. I did not drink alcohol during the past 30 days

B. 1 or 2 drinks

C. 3 drinks

D. 4 drinks

E. 5 drinks

F. 6 or 7 drinks

G. 8 or 9 drinks

H. 10 or more drinks

45. During the past 30 days, how did you usually get the alcohol you drank?

A. I did not drink alcohol during the past 30 days

B. I bought it in a store such as a liquor store, convenience store, supermarket, discount store, or gas station

C. I bought it at a restaurant, bar, or club

D. I bought it at a public event such as a concert or sporting event

E. I gave someone else money to buy it for me

F. Someone gave it to me

G. I took it from a store or family member

H. I got it some other way

The next 3 questions ask about marijuana use. Marijuana also is called pot or weed. For these questions, do not count CBD-only or hemp products, which come from the same plant as marijuana, but do not cause a high when used alone.

46. During your life, how many times have you used marijuana?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 to 99 times

G. 100 or more times

47. How old were you when you tried marijuana for the first time?

A. I have never tried marijuana

B. 8 years old or younger

C. 9 or 10 years old

D. 11 or 12 years old

E. 13 or 14 years old

F. 15 or 16 years old

G. 17 years old or older

48. During the past 30 days, how many times did you use marijuana?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

The next question asks about synthetic marijuana use. Synthetic marijuana also is called Spice, fake weed, K2, or Black Mamba.

49. During your life, how many times have you used synthetic marijuana?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

The next 2 questions ask about the use of prescription pain medicine without a doctor's prescription or differently than how a doctor told you to use it. For these questions, count drugs such as codeine, Vicodin, OxyContin, Hydrocodone, and Percocet.

50. During your life, how many times have you taken prescription pain medicine without a doctor's prescription or differently than how a doctor told you to use it?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

51. During the past 30 days, how many times did you take prescription pain medicine without a doctor's prescription or differently than how a doctor told you to use it?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

The next 8 questions ask about other drugs.

52. During your life, how many times have you used any form of cocaine, including powder, crack, or freebase?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

53. During your life, how many times have you sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

54. During your life, how many times have you used heroin (also called smack, junk, or China White)?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

55. During your life, how many times have you used methamphetamines (also called speed, crystal meth, crank, ice, or meth)?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

56. During your life, how many times have you used ecstasy (also called MDMA or Molly)?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

57. During your life, how many times have you used hallucinogenic drugs, such as LSD, acid, PCP, angel dust, mescaline, or mushrooms?

A. 0 times

B. 1 or 2 times

C. 3 to 9 times

D. 10 to 19 times

E. 20 to 39 times

F. 40 or more times

58. During your life, how many times have you used a needle to inject any illegal drug into your body?

A. 0 times

B. 1 time

C. 2 or more times

59. During the past 12 months, has anyone offered, sold, or given you an illegal drug on school property?

A. I have not attended school in-person during the past 12 months

B. Yes

C. No

The next 9 questions ask about sexual behavior.

60. Have you ever had sexual intercourse?

A. Yes

B. No

61. How old were you when you had sexual intercourse for the first time?

A. I have never had sexual intercourse

B. 11 years old or younger

C. 12 years old

D. 13 years old

E. 14 years old

F. 15 years old

G. 16 years old

H. 17 years old or older

62. During your life, with how many people have you had sexual intercourse?

A. I have never had sexual intercourse

B. 1 person

C. 2 people

D. 3 people

E. 4 people

F. 5 people

G. 6 or more people

63. During the past 3 months, with how many people did you have sexual intercourse?

A. I have never had sexual intercourse

B. I have had sexual intercourse, but not during the past 3 months

C. 1 person

D. 2 people

E. 3 people

F. 4 people

G. 5 people

H. 6 or more people

64. Did you drink alcohol or use drugs before you had sexual intercourse the last time?

A. I have never had sexual intercourse

B. Yes

C. No

65. The last time you had sexual intercourse, did you or your partner use a condom?

A. I have never had sexual intercourse

B. Yes

C. No

66. The last time you had sexual intercourse with an opposite-sex partner, what one method did you or your partner use to prevent pregnancy? (Select only one response.)

A. I have never had sexual intercourse with an opposite-sex partner

B. No method was used to prevent pregnancy

C. Birth control pills (Do not count emergency contraception such as Plan B or the "morning after" pill.)

D. Condoms

E. An IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon)

F. A shot (such as Depo-Provera), patch (such as Ortho Evra), or birth control ring (such as NuvaRing)

G. Withdrawal or some other method

H. Not sure

67. During your life, with whom have you had sexual contact?

A. I have never had sexual contact

B. Females

C. Males

D. Females and males

68. Which of the following best describes you?

A. Heterosexual (straight)

B. Gay or lesbian

C. Bisexual

D. I describe my sexual identity some other way

E. I am not sure about my sexual identity (questioning)

F. I do not know what this question is asking

The next 2 questions ask about body weight.

69. How do you describe your weight?

A. Very underweight

B. Slightly underweight

C. About the right weight

D. Slightly overweight

E. Very overweight

70. Which of the following are you trying to do about your weight?

A. Lose weight

B. Gain weight

C. Stay the same weight

D. I am not trying to do anything about my weight

The next 11 questions ask about food you ate or drank during the past 7 days. Think about all the meals and snacks you had from the time you got up until you went to bed. Be sure to include food you ate at home, at school, at restaurants, or anywhere else.

71. During the past 7 days, how many times did you drink 100% fruit juices such as orange juice, apple juice, or grape juice? (Do not count punch, Kool-Aid, sports drinks, or other fruit-flavored drinks.)

A. I did not drink 100% fruit juice during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

72. During the past 7 days, how many times did you eat fruit? (Do not count fruit juice.)

A. I did not eat fruit during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

73. During the past 7 days, how many times did you eat green salad?

A. I did not eat green salad during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

74. During the past 7 days, how many times did you eat potatoes? (Do not count french fries, fried potatoes, or potato chips.)

A. I did not eat potatoes during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

75. During the past 7 days, how many times did you eat carrots?

A. I did not eat carrots during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

76. During the past 7 days, how many times did you eat other vegetables? (Do not count green salad, potatoes, or carrots.)

A. I did not eat other vegetables during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

77. During the past 7 days, how many times did you drink a can, bottle, or glass of soda or pop, such as Coke, Pepsi, or Sprite? (Do not count diet soda or diet pop.)

A. I did not drink soda or pop during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

78. During the past 7 days, how many times did you drink a can, bottle, or glass of a sports drink such as Gatorade or Powerade? (Do not count low-calorie sports drinks such as Propel or G2.)

A. I did not drink sports drinks during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

79. During the past 7 days, how many times did you drink a bottle or glass of plain water? (Count tap, bottled, and unflavored sparkling water.)

A. I did not drink water during the past 7 days

B. 1 to 3 times during the past 7 days

C. 4 to 6 times during the past 7 days

D. 1 time per day

E. 2 times per day

F. 3 times per day

G. 4 or more times per day

80. During the past 7 days, how many glasses of milk did you drink? (Count the milk you drank in a glass or cup, from a carton, or with cereal. Count the half pint of milk served at school as equal to one glass.)

A. I did not drink milk during the past 7 days

B. 1 to 3 glasses during the past 7 days

C. 4 to 6 glasses during the past 7 days

D. 1 glass per day

E. 2 glasses per day

F. 3 glasses per day

G. 4 or more glasses per day

81. During the past 7 days, on how many days did you eat breakfast?

A. 0 days

B. 1 day

C. 2 days

D. 3 days

E. 4 days

F. 5 days

G. 6 days

H. 7 days

The next 5 questions ask about physical activity.

82. During the past 7 days, on how many days were you physically active for a total of at least 60 minutes per day? (Add up all the time you spent in any kind of physical activity that increased your heart rate and made you breathe hard some of the time.)

A. 0 days

B. 1 day

C. 2 days

D. 3 days

E. 4 days

F. 5 days

G. 6 days

H. 7 days

83. During the past 7 days, on how many days did you do exercises to strengthen or tone your muscles, such as push-ups, sit-ups, or weight lifting?

A. 0 days

B. 1 day

C. 2 days

D. 3 days

E. 4 days

F. 5 days

G. 6 days

H. 7 days

84. On an average school day, how many hours do you spend in front of a TV, computer, smart phone, or other electronic device watching shows or videos, playing games, accessing the Internet, or using social media (also called "screen time")? (Do not count time spent doing schoolwork.)

A. Less than 1 hour per day

B. 1 hour per day

C. 2 hours per day

D. 3 hours per day

E. 4 hours per day

F. 5 or more hours per day

85. In an average week when you are in school, on how many days do you go to physical education (PE) classes?

A. 0 days

B. 1 day

C. 2 days

D. 3 days

E. 4 days

F. 5 days

86. During the past 12 months, on how many sports teams did you play? (Count any teams run by your school or community groups.)

A. 0 teams

B. 1 team

C. 2 teams

D. 3 or more teams

The next question asks about concussions. A concussion is when a blow or jolt to the head causes problems such as headaches, dizziness, being dazed or confused, difficulty remembering or concentrating, vomiting, blurred vision, or being knocked out.

87. During the past 12 months, how many times did you have a concussion from playing a sport or being physically active?

A. 0 times

B. 1 time

C. 2 times

D. 3 times

E. 4 or more times

Beginning in early 2020, the United States, along with the rest of the world, experienced the coronavirus disease (COVID-19) pandemic. As part of the response to this pandemic, schools and businesses were closed and people were required to stay at home. Depending on where you live, your experience with the pandemic might still be going on now, or your community and your school might be somewhat back to normal. The next 12 questions ask about your experiences during this time, whether in the past or continuing now.

88. During the COVID-19 pandemic, how often was your mental health not good? (Poor mental health includes stress, anxiety, and depression.)

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

89. During the COVID-19 pandemic, did a parent or other adult in your home lose their job even for a short amount of time?

A. My parents and other adults in my home did not have jobs before the COVID-19 pandemic started

B. Yes

C. No

90. During the COVID-19 pandemic, did you lose your paying job even for a short amount of time?

A. I did not have a paying job before the COVID-19 pandemic started

B. Yes

C. No

91. During the COVID-19 pandemic, how often did you go hungry because there was not enough food in your home?

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

92. Do you agree or disagree that doing your schoolwork was more difficult during the COVID-19 pandemic than before the pandemic started?

A. Strongly agree

B. Agree

C. Not sure

D. Disagree

E. Strongly disagree

93. During the COVID-19 pandemic, how often did a parent or other adult in your home swear at you, insult you, or put you down?

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

94. During the COVID-19 pandemic, how often did a parent or other adult in your home hit, beat, kick, or physically hurt you in any way?

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

95. Do you agree or disagree that you drank more alcohol during the COVID-19 pandemic than before it started?

A. Strongly agree

B. Agree

C. Not sure

D. Disagree

E. Strongly disagree

96. Do you agree or disagree that you used drugs more during the COVID-19 pandemic than before it started? (Count using marijuana, synthetic marijuana, cocaine, prescription pain medicine without a doctor's prescription, and other illegal drugs.)

A. Strongly agree

B. Agree

C. Not sure

D. Disagree

E. Strongly disagree

97. During the COVID-19 pandemic, did you get medical care from a doctor or nurse using a computer, phone, or other device (also called telemedicine)?

A. Yes

B. No

98. During the COVID-19 pandemic, did you get mental health care, including treatment or counseling for your use of alcohol or drugs, using a computer, phone, or other device (also called telemedicine)?

A. Yes

B. No

99. During the COVID-19 pandemic, how often were you able to spend time with family, friends, or other groups, such as clubs or religious groups, by using a computer, phone, or other device? (Do not count attending school online.)

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

The next 11 questions ask about other health-related topics.

100. Have you ever been tested for HIV, the virus that causes AIDS? (Do not count tests done if you donated blood.)

A. Yes

B. No

C. Not sure

101. During the past 12 months, have you been tested for a sexually transmitted disease (STD) other than HIV, such as chlamydia or gonorrhea?

A. Yes

B. No

C. Not sure

102. During the past 12 months, how many times have you had a sunburn? (Count the number of times even a small part of your skin turned red or hurt for 12 hours or more after being outside in the sun or after using a sunlamp or other indoor tanning device.)

A. 0 times

B. 1 time

C. 2 times

D. 3 times

E. 4 times

F. 5 or more times

103. When was the last time you saw a dentist for a check-up, exam, teeth cleaning, or other dental work?

A. During the past 12 months

B. Between 12 and 24 months ago

C. More than 24 months ago

D. Never

E. Not sure

104. During the past 30 days, how often was your mental health not good? (Poor mental health includes stress, anxiety, and depression.)

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

105. On an average school night, how many hours of sleep do you get?

A. 4 or less hours

B. 5 hours

C. 6 hours

D. 7 hours

E. 8 hours

F. 9 hours

G. 10 or more hours

106. During the past 30 days, where did you usually sleep?

A. In my parent's or guardian's home

B. In the home of a friend, family member, or other person because I had to leave my home or my parent or guardian cannot afford housing

C. In a shelter or emergency housing

D. In a motel or hotel

E. In a car, park, campground, or other public place

F. I do not have a usual place to sleep

G. Somewhere else

107. Do you agree or disagree that you feel close to people at your school?

A. Strongly agree

B. Agree

C. Not sure

D. Disagree

E. Strongly disagree

108. How often do your parents or other adults in your family know where you are going or with whom you will be?

A. Never

B. Rarely

C. Sometimes

D. Most of the time

E. Always

109. Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?

A. Yes

B. No

110. How well do you speak English?

A. Very well

B. Well

C. Not well

D. Not at all

This is the end of the survey.

Thank you very much for your help.

2 2021 ABES