0704-0635 Adolescent Follow Up Survey_with coding_23 July 2024_clean

OMB CONTROL NUMBER: 0704-0635

OMB EXPIRATION DATE: XX/XX/XXXX

2024 SOAR Adolescent Follow Up Survey

The 2024 Adolescent Follow-Up Survey is web-only. This paper survey was designed to provide the study team with an operational document as is not intended to be completed by participants or to serve as a substitute for the experience of completing the web-survey.

The web-survey uses numerous skip patterns and allows for personalization of questions. By tailoring the survey to each participant’s particular situation, we hope to increase the quality of the data collected and to enhance the user experience.

Italicized text is instructional only and will not appear on the survey.

Blue text indicates skip patterns within the survey and will not appear on the survey.

Purple text indicates the standardized instruments and measures from which the survey questions were sourced and will not appear on the survey.

Privacy Act Statement

You have rights under the Privacy Act.

The following statement describes how that Act applies to this study:

Authority: 32 CFR Part 219, Protection of Human Subjects; 45 CFR Part 46, Protection of Human Subjects; DoDD 3216.02, "Protection of Human Subjects and Adherence to Ethical Standards in DoD-Supported Research," March 25, 2002; 45 CFR Parts 160 and 164, Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules; and E.O. 9397 (SSN), as amended. Authority to request this information is granted under Title 5, U.S. Code 136, Department of Defense Regulations, Executive Order 9396. Personal identifiers will be used to link survey data with medical and other military records.

Purpose: Information is collected to enhance basic medical knowledge, or develop tests, procedures, and equipment to improve diagnosis, treatment, or prevention of illness, injury, or performance impairment under research protocol NHRC.2021.0018, entitled "Millennium Cohort Study of Adolescent Resilience (SOAR)," which includes the adolescent component.

Routine Uses: The information provided in this questionnaire will be maintained in data files at the Deployment Health Research Department at the Naval Health Research Center and used only for medical research purposes. Use of these data may be granted to other federal and non-federal medical research agencies as approved by the Naval Health Research Center's Institutional Review Board. In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, the DoD "Blanket Routine uses" under 5 U.S.C. 552a(b)(3) apply to this collection. Medical research information will be used for analysis and reports by the Department of the Navy and Defense, and other U.S. Government agencies, provided this use is compatible with the purpose for which the information was collected. Use of the information may be granted to non-Government agencies or individuals by the Navy Surgeon General following the provisions of the Freedom of Information Act or as may be indicated in the accompanying Informed Consent Form.

Anonymity: All responses will be held in confidence by the Deployment Health Research Department. Information you provide will be considered only when statistically summarized with the responses of others. Your personal identifiers (name, etc.) will only be used to link data sets and then the identifiers will be stripped from study data such that medical researchers cannot identify you individually.

Voluntary Disclosure: Completion of the questionnaire is voluntary. Failure to respond to any of the questions will NOT result in any disadvantages or penalties except possible lack of representation of your views in the final results and outcomes.

PUBLIC BURDEN STATEMENT: Public reporting burden for this collection of information is estimated at 30 minutes. Comments on the burden or content of the instrument should be sent to the Millennium Cohort Study of Adolescent Resilience (SOAR) team, PO Box 503310, San Diego, CA 92150. Under 5 CFR 1320.5(b), an Agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid control number.

Start of Block: Landing Page and Pre-screener

[IF A1 DID COMPLETE A BASELINE SURVEY] Thank you for completing your survey on [insert date].

Now that you’re older, we are going to ask you some questions that we asked your parent(s) last time.

[IF A1 DID NOT COMPLETE A BASELINE SURVEY] We’re so happy that you decided to take the SOAR survey! Your parent completed their survey on [insert date], but now we want to hear just from you!

Throughout the survey, we will ask you questions about your parents and will refer to them by a name code. As a reminder, name codes were generated by taking your parent’s second and third letters of their given first name and their birth month and day. For example, if your parent’s name is Jordan and their birthday is August 15^th, their name code would be OR0815. Please think of this parent when you see their name code.

1. AGE: Youth Risk Behavior Survey (YRBS) 2021

What is your month and year of birth? __/____

2. RACE: YRBS 2021

What is your race and/or ethnicity?

Select all that apply and enter additional details in the spaces below.

American Indian or Alaska Native – Enter, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.

Asian – Provide details below.

Chinese

Vietnamese

Asian Indian

Korean

Filipino

Japanese

Enter, for example, Pakistani, Hmong, Afghan, etc.

Black or African American – Provide details below.

African American

Nigerian

Jamaican

Ethiopian

Haitian

Somali

Enter, for example, Trinidadian and Tobagonian, Ghanaian, Congolese, etc.

Hispanic or Latino – Provide details below.

Mexican

Cuban

Puerto Rican

Dominican

Salvadoran

Guatemalan

Enter, for example, Colombian, Honduran, Spaniard, etc.

Middle Eastern or North African – Provide details below.

Lebanese

Syrian

Iranian

Iraqi

Egyptian

Israeli

Enter, for example, Moroccan, Yemeni, Kurdish, etc.

Native Hawaiian or Pacific Islander – Provide details below.

Native Hawaiian

Tongan

Samoan

Fijian

Chamorro

Marshallese

Enter, for example, Chuukese, Palauan, Tahitian, etc.

White – Provide details below.

English

Italian

German

Polish

Irish

Scottish

Enter, for example, French, Swedish, Norwegian, etc.

End of Block: LANDING PAGE AND PRE-SCREENER

Start of Block: LIVING SITUATION

Thank you for participating in this study. Survey participation is voluntary. You can skip any questions you choose not to answer, and you can stop participating at any time.

Throughout the survey, we have used a 6-digit name code to identify your parent(s). This name code uses the second and third letters of this person's given first name and their month and day of birth. Please think about this person when responding to items using their name code.

1. Do you live with [MilCo Parent Name Code]?

   • No

   • Yes

2. IF ‘YES’ TO OTHER PARENT FROM P1 BASELINE: Do you live with your other parent, [Other Parent Name Code]?

   • No

   • Yes

1. IF ‘NO’ TO LIVING WITH P1 AND P2: Who do you live with?

• I live alone.

• Roommate(s)

• Relative(s)

• Other (Please do not include any names): [free-text]

3. Is [MilCo Parent Name Code] currently in the military?

   • No [GO TO 3A]

   • Yes, Active Duty (Navy, Army, Marines, Coast Guard, Air Force, Space Force) [GO TO 3B]

   • Yes, Reserve or National Guard [GO TO 3B]

   • I don’t know [GO TO 3B]

[IF MISSING, GO TO 3B]

1. Did [MilCo Parent Name Code] get out of the military (retired or discharged) recently, that is, since you completed your last survey [insert date]?

• No [GO TO 8B]

• Yes [GO TO 3B]

2. In the last 2 years, have you experienced any of the following because of your parent's job in the U.S. military?

	No	Yes
You moved to a new home.
You changed schools.
[MilCo Parent name code] was away from home for more than 30 consecutive days.

4. IF ‘YES’ TO CHANGED SCHOOLS: After you changed schools, how easy was it for you to...

	Not easy	Somewhat easy	Very easy
Fit in at your new school?
Make friends at your new school?
Keep up with the school work at your new school?

1. IF ‘YES’ TO CHANGED SCHOOLS: After you changed schools, did you connect with a school military liaison (i.e., someone that helps with school transitions for military kids, Military Family Life Counselor)?

• Yes, someone contacted me.

• Yes, I reached out or my family reached out for help.

• No, I didn’t want help.

• I didn’t know about this person.

• I don’t think there was this resource available.

4. IF ‘YES’ TO MILCO PARENT AWAY FROM HOME: Overall, how stressful was it to have [MilCo parent name code] away from home? 

• Not at all stressful

• Slightly stressful

• Moderately stressful

• Very stressful

6. IF ‘YES’ TO MILCO PARENT AWAY FROM HOME: How stressful was your reunion with [MilCo parent name code] when they came back from being away for military duties?

• Not at all stressful

• Slightly stressful

• Moderately stressful

• Very stressful

6. IF ‘YES’ TO PARENT SEPARATED FROM MILITARY SINCE LAST SURVEY: How stressful was it for you when your parent got out of the military?

• Not at all stressful

• Slightly stressful

• Moderately stressful

• Very stressful

6. MILITARY FEELINGS AND SUPPORT: Family Study Survey 
   
   

   1. IF ‘YES’ TO #3 PARENT STILL IN THE MILITARY: Do you think [MilCo Parent Name Code] should stay or leave the U.S. military?

• I favor staying.

• I favor leaving.

• I have no opinion one way or the other.

2. IF ‘NO’ to #3: Think about how you felt when [MilCo Parent Name Code] was in the U.S. military. Did you think they should stay or leave the U.S. military?

• I favored staying.

• I favored leaving.

• I had no opinion one way or the other.

• I don’t remember my parent serving in the U.S. military.

3. IF ‘I FAVOR STAYING’ OR ‘I FAVOR LEAVING’ TO 8a OR 8b: If you’d like to comment, we’d love to know more about why you favor staying or favor leaving the military. Please do not include any identifying information, such as people’s names, in your response.

6. PARENT RELATIONSHIP STATUS

In the last 2 years, did your parents separate or divorce?

• No

• Yes

6. In the last 2 years, did either parent remarry?

• No

• Yes

6. In the last 2 years, were any new children added to your family because of adoption, new birth, or new blended family?

• No

• Yes

6. If there have been any changes to your living situation that we haven’t addressed in this section, please feel free to comment here. Do not include any identifying information, such as people’s names, in your response.

End of Block: LIVING SITUATION

Start of Block: DEMOGRAPHICS

6. GENDER IDENTITY: Adapted from Child Trends
   How do you currently describe yourself (mark all that apply)?

• Female

• Male

• Transgender

• I use a different term [free text]

6. EMPLOYMENT STATUS: JAMRS Youth Poll 2020

IF AGES 16+: Are you currently working for pay outside the home, either full-time or part-time?

• No

• Yes

1. IF ‘YES’ TO WORKING: On average, how many total hours per week do you work for pay outside the home?

• Less than 1 hour

• 1-4 hours

• 5-9 hours

• 10-14 hours

• 15-19 hours

• 20-24 hours

• 25-29 hours

• 30 or more hours

End of Block: DEMOGRAPHICS

Start of Block: PHYSICAL AND PSYCHOLOGICAL HEALTH

The next section of questions is about your health and how you feel about yourself. Please answer as honestly as you can. There are no right or wrong answers. Your answers are confidential and will not be shared with anyone outside of the research team.

6. OVERALL HEALTH: Adapted from the National Survey on Drug Use and Health 2020 (NSDUH 2020)

In general, would you say your health is:

• Poor or Fair

• Good

• Very good or Excellent

6. Are you taking any prescription medication for ADD or ADHD?

• No

• Yes

6. Are you taking any prescription medication for anxiety or depression?

• No

• Yes

6. BODY ESTEEM: Body-Esteem Scale for Adolescents and Adults (BESAA)
   Below is a list of sentences that describe how people feel. Read each phrase and decide if it is "Not true or Hardly ever true" or "Somewhat true or Sometimes true" or "Very true or Often true" for you. 

	Not true or Hardly ever true	Somewhat true or Sometimes true	Very true or Often true
There are lots of things I'd change about my looks if I could.
I like what I see when I look in the mirror.
I like what I look like in pictures.

6. EMOTIONAL SYMPTOMS, CONDUCT PROBLEMS, HYPERACTIVITY, PEER PROBLEMS, AND PROSOCIAL BEHAVIORS: Strengths and Difficulties Questionnaire (SDQ) S^11-17

IF AGES 11-17:

Please give your answers on the basis of how things have been for you over the last 30 days... 

	Not true	Somewhat true	Certainly true
I try to be nice to other people. I care about their feelings.
I am restless, I cannot stay still for long.
I get a lot of headaches, stomach-aches, or sickness.
I usually share with others, for example, clothes, food.
I get very angry and often lose my temper.
I would rather be alone than with people of my age.
I usually do as I am told.
I worry a lot.
I am helpful if someone is hurt, upset, or feeling ill.
I am constantly fidgeting or squirming.
I have one good friend or more.
I fight a lot. I can make other people do what I want.
I am often unhappy, depressed, or tearful.
Other people my age generally like me.
I am easily distracted; I find it difficult to concentrate.
I am nervous in new situations. I easily lose confidence.
I am kind to younger children.
I am often accused of lying or cheating.
Other children or young people pick on me or bully me.
I often offer to help others (parents, teachers, children).
I think before I do things.
I take things that are not mine from home, school or elsewhere.
I get along better with adults than with people my own age.
I have many fears, I am easily scared.
I finish the work I was doing. My attention is good.

6. ANXIETY: Generalized Anxiety Disorder Screen (GAD-2)
   Over the last 2 weeks, how often have you been bothered by the following problems?

	Not at all	Several days	More than half the days	Nearly every day
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying

6. DEPRESSION: Patient Health Questionnaire (PHQ-2)

Over the last 2 weeks, how often have you been bothered by the following problems?

	Not at all	Several days	More than half the days	Nearly every day
Little interest or pleasure in doing things
Feeling down, depressed irritable or hopeless

6. SUICIDE: YRBS 2021

Sometimes people feel so depressed about the future that they may consider attempting suicide, that is, taking some action to end their own life.

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

• No

• Yes [INCLUDE POP UP FOR SUICIDE HOTLINE]

6. CHILDHOOD TRAUMA/STRESS: Family Study Survey; Adapted from the Felitti Adverse Childhood Experiences (ACE) Questionnaire

In the last 2 years….

	No	Yes
Did you live with a parent or guardian who got divorced or separated?
Did you live with a parent or guardian who died?
Did you live with a parent or guardian who served time in jail or prison?
Did you see or hear your parents, guardians, or any other adults in your home slap, hit, kick, punch, or beat each other up?
Were you the victim of violence or witnessed any violence in your neighborhood?
Did you live with anyone who was mentally ill or suicidal, or was severely depressed for more than a couple of weeks?
Did you live with anyone who had a problem with alcohol or drugs?

6. CAREGIVING: National Alliance for Caregiving Youth Study
   During the last 12 months, have you helped care for any of the following people in your household who are sick, elderly, frail, disabled, or mentally ill? This may include help with personal needs, meals, household chores, shopping, paperwork, medication, getting around, or providing emotional support. 

	No	Yes
Your father
Your mother
Your brother(s)/sister(s)
Your grandparent(s)
Other (please specify e.g., aunt, uncle, cousin, friend; do not include any names in your response): _____________________

1. IF ‘YES’ TO CAREGIVING FOR ANYONE: Overall, how stressful is it to help care for this person/people in your household?

• Not stressful

• Somewhat stressful

• Very stressful

6. BARRIERS TO ADOLESCENTS SEEKING HELP: Adapted from Barriers to Adolescents Seeking Help Scale (BASH), Barriers to Adolescents Seeking Help Scale — Brief Version (BASH-B), and the Family Study

The statements below reflect feelings you may have about seeking care for an emotional or psychological problem from a mental health professional (e.g., a therapist, psychologist, or counselor). Please rate how much you agree or disagree with each statement.

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
If I had a problem, I would solve it myself.
Even if I wanted to, I wouldn’t have time to see a therapist.
If I had a problem and told a therapist, they would not keep it secret.
My parents don’t approve of me seeing a therapist.
My friends would judge me if I saw a therapist.
Even If I had a problem, I’d be too embarrassed to talk to a therapist about it.
No matter what I do, it will not change the problems I have.
If I had a problem, my friends could help me more than a therapist.
It would make me feel inferior to ask a therapist for help.

6. When was the last time you had counseling, therapy, or any mental health services?

• Never

• During the last 12 months

• Between 12 and 24 months ago

• More than 24 months ago

• Not sure

End of Block: PHYSICAL AND PSYCHOLOGICAL HEALTH

Start of Block: ACADEMICS AND CAREER ASPIRATIONS

The next few questions are about your experiences in school. Please include home schooling, if applicable.

6. GRADE LEVEL
   What is your current grade or education level?

• 5^th grade or below

• 6^th grade

• 7^th grade

• 8^th grade

• 9^th grade

• 10^th grade

• 11^th grade

• 12^th grade

• Classes for General Equivalency Exam (GED)

• Technical or vocational school (e.g., carpentry, automotive technology, cosmetology)

• 2-year community college (Associate's degree)

• 4-year college or university (Bachelor’s degree)

• Master’s, doctoral, or professional degree (e.g., PhD, MD, JD)

• I am not currently in school or college [SKIP TO EDUCATIONAL AND CAREER ATTAINMENT]

6. SCHOOL TYPE: Survey of Active Duty Spouses (ADSS) 2017
   IF 5^TH GRADE THRU 12^TH GRADE: In which type of school are you enrolled? Public school (no tuition, traditional teaching methods)

• Public school – charter/magnet (no tuition, unique teaching methods)

• Department of Defense School (no tuition, usually on a military base when living overseas)

• Home school (primarily taught at home by a parent or tutor)

• Private school (pay tuition to attend)

• Other (please specify): __________________

6. SCHOLARSHIPS

IF CURRENTLY ATTENDING POST-SECONDARY SCHOOL: Did you use any of the following scholarship programs for school (select all that apply)?

• GI Bill

• Yellow Ribbon

• Other military scholarship

• Other non-military scholarship

• I did not use any military scholarship

6. SCHOOL ENGAGEMENT: Adapted from NSDUH 2020  IF 5^TH GRADE THRU 12^TH GRADE: How interesting do you think most of your courses at school have been during the last 12 months?

• Very interesting

• Somewhat interesting

• Not interesting

6. SCHOOL ENGAGEMENT: Adapted from NSDUH 2020 

IF 5^TH GRADE THRU 12^TH GRADE: How important do you think the things you have learned in school during the last 12 months are going to be to you later in life? 

• Very important

• Somewhat important

• Not important

6. GRADES: YRBS 2021

In general, how would you describe your current grades in school?

• Mostly A’s

• Mostly B’s

• Mostly C’s

• Mostly D’s

• Mostly F’s

• My school does not give these grades.

6. EXTRACURRICULAR ACTIVITIES: Family Study Survey
   IF 5^TH GRADE THRU 12^TH GRADE: During the last 12 months, in how many of the following kinds of activities have you participated?  

	None	One	Two	Three or more
Leadership and community service (e.g., Youth of the Year, Congressional Awards, youth councils, 4-H, Scout programs)
Education, STEM, and career development (e.g., homework assistance, tutoring, mentor programs, internships, college fairs)
Health and wellness (e.g., financial readiness, cooking)
Art programs (e.g., art classes, music lessons, band, dance classes, theater)
Sports or recreation programs (e.g., individual or team sports, fishing, swimming lessons, geo-hunt)

1. IF GREATER THAN ‘NONE’ FOR EACH ACTIVITY: Was the program(s) military-sponsored or on a military installation?

• No

• Yes

6. IF 9TH GRADE THRU 12TH GRADE: Are you currently enrolled in the Junior Reserve Officers' Training Corps (JROTC) program?

• No

• Yes

6. IF CURRENTLY ATTENDING POST-SECONDARY SCHOOL: Are you currently enrolled in the Reserve Officers' Training Corps (ROTC) program or military college?

• No

• Yes

6. IF AGES 16+: How likely is it that you will be serving in the U.S. military in the next few years?

• Definitely

• Probably

• Probably not

• Definitely not

6. SCHOOL ENVIRONMENT: Adapted from NAEP 2016
   During the last 12 months (OR “SINCE YOU CHANGED SCHOOLS”, IF APPLICABLE), how often have you felt any of the following ways about your school? 

	Never or Hardly ever	About half of the time	All or Almost all of the time
I felt like I belong at school.
I looked forward to going to school in the morning.
I felt safe at school.

6. MILITARY PEERS: RAND Deployment Life Study

Are you friends with other kids/teens from military families?

• No

• Yes

6. EDUCATIONAL/CAREER ASPIRATIONS
   Do you plan to...

	No	Yes	Not sure
IF 5TH GRADE THRU 12TH GRADE Graduate from high school?
Join the military?
IF AGES 13-15: Graduate from college?
IF AGES 16+: Graduate from a 2-year community college (e.g., Associate's degree)?
IF AGES 16+: Graduate from a 4-year college or university (e.g., Bachelor's degree)?
IF AGES 16+: Obtain a master's, doctoral, or professional degree (e.g., PhD, MD, JD)?
Start a small business or take over a family business?
Become an entrepreneur (e.g., start a new company on your own)?
Pursue a career in the performing arts (e.g., dance, music, entertainment) or in professional sports?

6. IF ‘NO’ TO SCHOOL/COLLEGE ENROLLMENT: EDUCATIONAL/CAREER ATTAINMENT

	No	Yes
Did you graduate from high school?
Did you graduate from a 2-year community college (earn an Associate's degree)?
Did you graduate from a 4-year college or university (earn a Bachelor's degree)?
Did you obtain a master's, doctoral, or professional degree (PhD, MD, or JD)?
Have you taken over a family business?
Have you become an entrepreneur (e.g., started a new company on your own)?
Are you pursuing a career in the performing arts (e.g., dance, music, entertainment) or in professional sports?
Are you employed in your chosen field?

6. IF ‘NO’ TO CURRENTLY IN SCHOOL: Are you currently serving in the U.S. military?

• No

• Yes, regular active duty (not a member of the national guard or reserve)

• Yes, activated national guard or reserve (full-time active duty program: AGR/FTS/AR)

• Yes, traditional national guard or reserve (e.g., drilling unit, IMA, IPR)

1. ATTITUDES TOWARD MILITARY from Chaudhuri & Holbrook 2009 adapted by Cistulli et al 2012

IF ‘YES’ TO CURRENTLY SERVING IN THE MILITARY: What is your overall feeling about your military service?

	Strongly disagree	Somewhat disagree	Neither disagree nor agree	Somewhat agree	Strongly agree
I trust the United States Armed Forces.
The United States Armed Forces keep me safe.
I am happy with the United States Armed Forces.

2. ENLISTMENT REFERRAL DECISION

IF ‘YES’ TO CURRENTLY SERVING IN THE MILITARY: How likely are you to recommend joining the armed forces to…

	Not at all likely	Unlikely	Neither unlikely nor likely	Likely	Extremely likely
A friend
A family member

End of Block: ACADEMICS AND CAREER ASPIRATIONS

Start of Block: HEALTH BEHAVIORS

This section contains questions about your health behaviors. There are no right or wrong answers. Your responses are confidential and will not be shared with anyone outside of the study team. 

6. CAFFEINE DRINKS

During the past 7 days, how many times did you drink a cup, can, or bottle of caffeinated coffee or tea?

• I did not drink coffee or tea during the past 7 days

• 1 to 3 times during the past 7 days

• 4 to 6 times during the past 7 days

• 1 time per day

• 2 times per day

• 3 times per day

• 4 or more times per day

6. During the past 7 days, how many times did you drink a can, bottle, or glass of an energy drink, such as Red Bull, Monster, or Jolt?

• I did not drink energy drinks during the past 7 days

• 1 to 3 times during the past 7 days

• 4 to 6 times during the past 7 days

• 1 time per day

• 2 times per day

• 3 times per day

• 4 or more times per day

6. ALCOHOL USE: YRBS 2021

The next questions ask about drinking alcohol, which includes 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. 

Have you ever had a drink of alcohol other than a few sips?

• No [SKIP TO CIGARETTE USE SECTION]

• Yes

• ALCOHOL USE AGE: YRBS 2021 
  IF ‘YES’ TO ALCOHOL USE: How old were you when you had your first drink of alcohol other than a few sips? 8 years old or younger

• 9 years old

• 10 years old

• 11 years old

• 12 years old

• 13 years old

• 14 years old

• 15 years old

• 16 years old

• 17 years old or older

1. ALCOHOL USE FREQUENCY: YRBS 2021

IF ‘YES’ TO ALCOHOL USE: During the last 30 days, on how many days did you have at least one drink of alcohol? 

• I did not drink alcohol during the last 30 days. [SKIP TO CIGARETTE USE SECTION]

• 1 or 2 days

• 3 to 5 days

• 6 to 9 days

• 10 to 19 days

• 20 to 29 days

• All 30 days

3. BINGE DRINKING: YRBS 2021 
   IF ‘YES’ TO ALCOHOL USE: During the last 30 days, on how many days did you have 4 or more drinks of alcohol in a row, within a couple of hours (if you are female), or 5 or more drinks of alcohol in a row, within a couple of hours (if you are male)?

• 0 days

• 1 day

• 2 days

• 3 to 5 days

• 6 to 9 days

• 10 to 19 days

• 20 or more days

6. CIGARETTE USE: YRBS 2021 
   Have you ever tried cigarette smoking, even one or two puffs? 

• No [SKIP TO ELECTRONIC VAPOR USE SECTION]

• Yes

1. CIGARETTE USE AGE: YRBS 2021

IF ‘YES’ TO CIGARETTE USE: How old were you when you first tried cigarette smoking, even one or two puffs? 

• 8 years old or younger

• 9 years old

• 10 years old

• 11 years old

• 12 years old

• 13 years old

• 14 years old

• 15 years old

• 16 years old

• 17 years old or older

2. CIGARETTE USE FREQUENCY: YRBS 2021

IF ‘YES’ TO CIGARETTE USE: During the last 30 days, on how many days did you smoke cigarettes? 

• I did not smoke cigarettes during the last 30 days. [SKIP TO ELECTRONIC VAPOR USE SECTION]

• 1 or 2 days

• 3 to 5 days

• 6 to 9 days

• 10 to 19 days

• 20 to 29 days

• All 30 days

3. CIGARETTE USE INTENSITY: YRBS 2021

IF ‘YES’ TO CIGARETTE USE: During the last 30 days, on the days you smoked, about how many cigarettes did you smoke per day? 

• Less than 1 cigarette per day

• 1 cigarette per day

• 2 to 5 cigarettes per day

• 6 to 10 cigarettes per day

• 11 to 20 cigarettes per day

• More than 20 cigarettes per day

6. ELECTRONIC VAPOR USE FREQUENCY: YRBS 2021

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

• I did not use an electronic vapor product during the last 30 days.

• 1 or 2 days

• 3 to 5 days

• 6 to 9 days

• 10 to 19 days

• 20 to 29 days

• All 30 days

6. OTHER TOBACCO USE FREQUENCY: YRBS 2021

• During the last 30 days, on how many days did you use smokeless tobacco (chewing tobacco, snuff, dip, snus, or dissolvable tobacco products), cigars (including little cigars or cigarillos), shisha or hookah tobacco, or pipe tobacco? (Do not count any electronic vapor products.) I did not use smokeless tobacco, cigars, shisha or hookah tobacco, or pipe tobacco during the last 30 days.

• 1 or 2 days

• 3 to 5 days

• 6 to 9 days

• 10 to 19 days

• 20 to 29 days

• All 30 days

6. MARIJUANA USE AGE: YRBS 2021 

The next questions ask about marijuana use, which is also 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. 

Have you ever tried marijuana?

• No [SKIP TO PRESCRIPTION DRUG MISUSE SECTION]

• Yes

1. MARIJUANA USE AGE: YRBS 2021 

IF 'YES' TO MARIJUANA: How old were you when you tried marijuana for the first time?

• 8 years old or younger

• 9 years old

• 10 years old

• 11 years old

• 12 years old

• 13 years old

• 14 years old

• 15 years old

• 16 years old

• 17 years old or older

2. MARIJUANA USE FREQUENCY: YRBS 2021

IF 'YES' TO MARIJUANA: During the last 30 days, how many times did you use marijuana?

• I did not use marijuana during the last 30 days.

• 1 or 2 times

• 3 to 9 times

• 10 to 19 times

• 20 to 39 times

• 40 or more times

6. PRESCRIPTION DRUG MISUSE FREQUENCY: YRBS 2021 

During the last 30 days, how many times did you take prescription pain medicine, such as codeine, Vicodin, OxyContin, Hydrocodone, and Percocet, without a doctor's prescription or differently than how a doctor told you to use it.

• I did not take prescription pain medication not prescribed during the last 30 days.

• 1 or 2 times

• 3 to 9 times

• 10 to 19 times

• 20 to 39 times

• 40 or more times

6. SEXUAL ASSAULT: Adapted from YRBS 2021

Has anyone ever forced you to do sexual things that you did not want them to do? (Count such things as kissing, touching, or being physically forced to have sexual intercourse.)

• No

• Yes

6. SEXUAL INTERCOURSE: YRBS 2021
   Have you ever had sexual intercourse?

• No 

• Yes

1. SEXUAL INTERCOURSE AGE: YRBS 2021  

IF 'YES' TO SEXUAL INTERCOURSE: How old were you when you had sexual intercourse for the first time?

• 11 years old or younger

• 12 years old

• 13 years old

• 14 years old

• 15 years old

• 16 years old

• 17 years old or older

2. SEXUAL INTERCOURSE PARTNERS: YRBS 2021

IF 'YES' TO SEXUAL INTERCOURSE: During the last year or so, with how many people have you had sexual intercourse? 

NOTE: IF AGES 11-12, ONLY ASK “1 PERSON” “2 PEOPLE” OR “3 OR MORE PEOPLE”

• 1 person

• 2 people

• 3 people

• 4 people

• 5 people

• 6 or more people

49. SEXUAL IDENTITY: Adapted from YRBS 2021
    Which of the following best describes you?

• Gay or lesbian

• Straight, that is not gay or lesbian

• Bisexual

• I use a different term [free-text]

• I don’t know

50. SLEEP: YRBS 2021
    On an average night, how many hours of sleep do you get? 

• 4 hours or less

• 5 hours

• 6 hours

• 7 hours

• 8 hours

• 9 hours

• 10 or more hours

50. PHYSICAL ACTIVITY: YRBS 2021
    During the last 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.)

• 0 days

• 1 day

• 2 days

• 3 days

• 4 days

• 5 days

• 6 days

• 7 days

• I cannot physically exercise.

50. TRAUMATIC BRAIN INJURY: YRBS 2017

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.

How many times have you had a concussion?

• 0 times

• 1 time

• 2 times

• 3 times

• 4 or more times

50. SEDENTARY BEHAVIORS: YRBS 2021

On an average day, about 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.) 

• Less than 1 hour per day

• 1 hour per day

• 2 hours per day

• 3 hours per day

• 4 hours per day

• 5 or more hours per day

50. SOCIAL MEDIA USE: MC&FP

On an average day, how many hours do you spend on social media (e.g., Instagram, Snapchat, TikTok)?

• I do not use social media.

• Less than 1 hour per day

• 1 hour per day

• 2 hours per day

• 3 hours per day

• 4 hours per day

• 5 or more hours per day
  
  
  

50. Could you get a firearm and shoot it right now if you wanted to?

• No

• Yes

1. IF ‘YES’ TO FIREARM: Where would you obtain that firearm?

• From my home

• From elsewhere/outside my home

• Both my home and elsewhere/outside my home

End of Block: HEALTH BEHAVIORS

Start of Block: YOUTH RISK & RESILIENCE FACTORS

The next set of questions is about how you feel about yourself. Please answer these items as honestly as you can. There are no right or wrong answers. Your responses will be kept confidential and will not be shared with anyone outside of the study team. 

50. IF AGES 13+: MASCULINE EXPRESSION: Maryland Adolescent Development in Context Study (MADICS) 
    Please rate your opinion of the following statements about yourself. 

	Not at all masculine	Somewhat masculine	Very masculine
I feel as though I am...
I look as though I am...
Other people see me as...

50. IF AGES 13+: FEMININE EXPRESSION: MADICS 
    Please rate your opinion of the following statements about yourself. 

	Not at all feminine	Somewhat feminine	Very feminine
I feel as though I am...
I look as though I am...
Other people see me as...

50. SELF-ESTEEM: Rosenberg Self-Esteem Scale
    How true is each of the following statements?

	Not true or Hardly ever true	Somewhat true or Sometimes true	Very true or Often true
On the whole, I am satisfied with myself.
I feel that I have a number of good qualities.
I take a positive attitude toward myself.

50. CHARACTER: Positive Youth Development (PYD) Questionnaire
    How important is each of the following to you?

	Not important or A little important	Moderately or Somewhat important	Important or Very important
Getting to know people who are of a different race than I am.
Helping to make the world a better place to live in.
Helping to make sure all people are treated fairly.
Speaking up for equality (everyone should have the same rights and opportunities).
Standing up for what I believe, even when it’s unpopular to do.
Telling the truth, even when it’s not easy.
Accepting responsibility for my actions when I make a mistake or get in trouble.

50. FAMILY SOCIOPOLITICAL DISCUSSIONS: Youth Civic and Character Measures Toolkit
    How often does your family do the following?

	Never or Hardly Ever	Sometimes	Often or Very often
In my family, we talk about politics and current events.
In my family, we talk about times when people are treated unfairly.
In my family, we talk about problems facing our community.

50. RELIGIOSITY: Adapted from NSDUH 2020 
    During the last 12 months, how many times did you participate in religious services? Please do not include special occasions such as weddings, funerals, or other special events in your answer.

• 0 times

• 1 to 2 times

• 3 to 5 times

• 6 to 24 times

• 25 to 52 times

• More than 52 times

End of Block: YOUTH RESILIENCE FACTORS

Start of Block: PARENT-ADOLESCENT RELATIONSHIP

50. Accountable Health Communities – Health-Related Social Needs (ACH–HRSN) Screening tool

1. IF ‘YES’ TO LIVING WITH P1 AND/OR P2: How hard is it for your family to pay for the very basics like food, housing, medical care, and heating/air conditioning? Would you say it is…

• Very hard

• Somewhat hard

• Not hard at all

2. IF ‘NO’ TO LIVING WITH P1 AND P2: How hard is it for you to pay for the very basics like food, housing, medical care, and heating/air conditioning? Would you say it is…

• Very hard

• Somewhat hard

• Not hard at all

50. FINANCIAL MANAGEMENT

• IF 'YES’ TO LIVING WITH P1 AND/OR P2: I feel secure about our family's financial future. Strongly disagree

• Somewhat disagree

• Neither disagree nor agree

• Somewhat agree

• Strongly agree

1. IF ‘NO’ TO LIVING WITH P1 AND P2: What is your living situation today?

• I have a steady place to live

• I have a place to live today, but I am worried about losing it in the future

• I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park)

The next set of questions is about your relationship with your parent(s).

50. MONITORING/SUPERVISION: Adapted from Monitoring the Future 2018
    IF ‘YES’ TO LIVING WITH P1 AND/OR P2: During the course of a typical day, how often do your parent(s)...

	Never or Rarely	Sometimes	Most of the time or Always
Know where you are when you are away from home?
Know whom you are with when you are away from home?
Know what you are doing when you are away from home?

50. PARENTAL RELATIONSHIP QUALITY: Adapted from NIH Toolbox
    [NOTE: IF MORE THAN ONE PARENT IS ENROLLED IN THE STUDY, THE ADOLESCENT WILL BE ASKED TO THINK ABOUT EACH PARENT SEPARATELY USING THE MILCO PARENT / OTHER PARENT’S NAME CODE.]

During the last year or so…

	Not true or Hardly ever true	Somewhat true or Sometimes true	Very true or Often true
I enjoyed doing things with [MilCo/Other parent name code].
I shared ideas and talk about things that really matter with [MilCo/Other parent name code].
I felt close to [MilCo/Other parent name code].

50. COMMUNICATION: Adapted from PROMIS Family Relationships
    [NOTE: IF MORE THAN ONE PARENT IS ENROLLED IN THE STUDY, THE ADOLESCENT WILL BE ASKED TO THINK ABOUT EACH PARENT SEPARATELY USING THE MILCO PARENT / OTHER PARENT’S NAME CODE.]

During the last year or so…

	Not true or Hardly ever true	Somewhat true or Sometimes true	Very true or Often true
I could tell [MilCo/Other parent name code] how I feel about things.
[MilCo/Other parent name code] listened to me.
I could talk to [MilCo/Other parent name code] about my problems.

50. CONFLICT: Adapted from NSDUH 2020
    During the last 12 months, how many times have you argued or had a fight with [MilCo/Other parent name code]?

[NOTE: IF MORE THAN ONE PARENT IS ENROLLED IN THE STUDY, THE ADOLESCENT WILL BE ASKED TO THINK ABOUT EACH PARENT SEPARATELY USING THE MILCO PARENT / OTHER PARENT’S NAME CODE.]

• 0 times

• 1 or 2 times

• 3 to 5 times

• 6 to 9 times

• 10 or more times

End of Block: PARENT-ADOLESCENT RELATIONSHIP

Start of Block: PEER, DATING PARTNER, AND SIBLING RELATIONSHIPS

This section is about your relationships with your friends, dating partners, and sibling(s). Please answer each question as honestly as you can. There are no right or wrong answers. Your responses are confidential and will not be shared with anyone outside of the research team. 

50. BULLYING VICTIMIZATION AND PERPETRATION: Olweus Bullying Questionnaire
    The next questions are about bullying, which could include calling other kids/teens mean names, making fun of them, or teasing them in a hurtful way; hitting, kicking, punching, or shoving other kids/teens; telling lies or spreading false rumors about other kids/teens; trying to get other kids/teens to fight or dislike someone; and ignoring or excluding other kids/teens from activities on purpose.

Bullying can happen in person or electronically through texting or social media (cyberbullying). 

During the last 30 days...

	Never	1 or 2 times	3 or 4 times	5 or more times
How often have you been bullied by other kids/teens your age?
How often have you bullied other kids/teens your age?

PEER RELATIONSHIPS: Network of Relationships Inventory (NRI-RQV)
Please think about the person whom you consider to be your best or closest friend when answering the next set of questions. Do not choose a sibling. 

50. PEER SEX
    Is your best or closest friend...?

• Male

• Female

• Person self-identifies as something other than male or female.

• I don't have a best or closest friend. [SKIP TO DATING PARTNER RELATIONSHIP SECTION]

• PEER RELATIONSHIP LENGTH
  IF 'YES' TO PEER RELATIONSHIP: How long have you been friends with this person?  Less than 1 year

• 1-5 years

• 6-10 years

• More than 10 years

1. PEER RELATIONSHIP QUALITY: NRI-RQV
   IF 'YES' TO PEER RELATIONSHIP: During the last 30 days, how often did you...

	Never or Hardly ever	Sometimes	Often or Very often
Go places and do things with your best or closest friend?
Share secrets and private feelings with your best or closest friend?
Depend on your best or closest friend for help with a personal problem?
Argue with your best or closest friend?

50. DATING RELATIONSHIPS
    In the last year or so, have you been in a dating relationship (i.e., had a boyfriend or girlfriend)?

• No [SKIP TO SIBLING RELATIONSHIP SECTION]

• Yes

1. CURRENT DATING RELATIONSHIP
   IF 'YES' TO DATING RELATIONSHIP: Are you currently in a dating relationship (i.e., have a boyfriend or girlfriend)?

• No [SKIP TO SIBLING RELATIONSHIP SECTION]

• Yes

• DATING PARTNER SEX
  IF 'YES' TO DATING RELATIONSHIP: Is this person...? Male

• Female

• Person self-identifies as something other than male or female.

• CURRENT DATING RELATIONSHIP LENGTH
  IF 'YES' TO DATING RELATIONSHIP: How long have you been in a relationship with this person? Less than 1 month

• 1-3 months

• 4-6 months

• 7-9 months

• 10-12 months

• More than 12 months

4. DATING PARTNER RELATIONSHIP QUALITY: NRI-RQV

IF 'YES' TO DATING RELATIONSHIP: When answering the next questions, please think about the person with whom you are currently in a dating relationship.

How often do you...

	Never or Hardly ever	Sometimes	Often or Very often
Go places and do things with this person?
Share secrets and private feelings with this person?
Depend on this person for help with a personal problem?
Argue with this person?

5. IF 'YES' TO DATING RELATIONSHIP AND IF AGES 13+: Has your partner pushed you, hit you, or thrown something at you that could hurt?

• Often (INCLUDE POP UP FOR DV HOTLINE)

• Sometimes (INCLUDE POP UP FOR DV HOTLINE)

• Never

6. IF 'YES' TO DATING RELATIONSHIP AND IF AGES 13+: Have you pushed, hit, or thrown something at your partner that could hurt?

• Often

• Sometimes

• Never

50. SIBLING RELATIONSHIPS
    Do you have any siblings (i.e., brothers or sisters)?

• No [SKIP TO FINAL COMMENTS]

• Yes

• NUMBER OF SIBLINGS
  IF 'YES' TO SIBLINGS: How many siblings (i.e., brothers or sisters) do you have?  1

• 2

• 3

• 4

• 5 or more

1. SIBLING AGE

IF 'YES' TO SIBLINGS AND IF MORE THAN ONE SIBLING: Please think of the sibling who is closest in age to you when responding to the following questions. 

• 
  How old is your sibling? 5 years old or younger

• 6-10 years old

• 11-12 years old

• 13-14 years old

• 15-17 years old

• 18 years old or older

• SIBLING SEX
  IF 'YES' TO SIBLINGS: Is your sibling...? Male

• Female

• Person self-identifies as something other than male or female.

• SIBLING SCHOOL
  IF 'YES' TO SIBLINGS: Are you and your sibling currently enrolled in the same school? If you are not currently enrolled in school, think about the last school year that you completed.  No

• Yes

5. SIBLING RELATIONSHIP QUALITY: NRI-RQV
   IF 'YES' TO SIBLINGS: During the last 30 days, how often did you...

	Never or Hardly ever	Sometimes	Often or Very often
Spend time with your sibling alone or with the same group of friends?
Share secrets and private feelings with your sibling?
Depend on your sibling for help with a personal problem?
Argue with your sibling?

End of Block: PEER, DATING PARTNER, AND SIBLING RELATIONSHIPS

Start of Block: COMMENTS

50. Do you have any comments that you would like to share? Please do not include any identifying information, such as people’s names, in your response.

Thank you for taking the time to complete this survey.