Strategies To Respond to Intimate Violence Effectively (STRIVE)

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STRIVE Healthy Marriage Relationship Education (HMRE) Survey
Thank you for taking this survey. As a reminder, you can skip any questions you don’t want to answer, and your name will not be associated with your answers. These questions should take 5 to 10 minutes to complete.
The first few questions of this survey ask what you think about healthy and unhealthy or harmful relationships.
Please indicate how much you agree or disagree.
    1) I have a clear sense of what a healthy and supportive relationship looks like. 
    • Strongly agree 
    • Agree 
    • Neither agree nor disagree  
    • Disagree  
    • Strongly disagree  

    2) Please indicate how much you agree or disagree with each of the following statements.


Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
In a healthy relationship, each partner spends time on their own without the other.





An important part of resolving problems in relationships is deciding who’s at fault.





If one partner spies on the other, there is probably a good reason for it.





It’s normal for one partner to feel scared of the other partner during disagreements.






    3) Please identify whether these hypothetical relationship situations are considered healthy, harmful, or may depend on the details of the situation. 

Healthy
Harmful
Depends on the details of the situation
Don’t know
One partner says embarrassing things about the other to make their friends laugh.




One partner sometimes tells the other partner not to go places.




One partner is in charge of how the other partner can spend their money.




One partner yells or curses at the other partner during an argument but then apologizes.




One partner makes the other partner feel guilty if they don’t want to have sex.




One partner hits the other partner when they get angry.





	
    4) Please mark which of the following health conditions you believe relationship abuse is connected with. [Select all that apply]
[NOTE: This question will only be shown to participants who receive the Oyate version of the safety card.]
    • Stress 
    • Anxiety
    • Depression
    • Trouble sleeping
    • High blood pressure 
    • Drug misuse 
    • Alcohol misuse
    • Unplanned pregnancies 
    • Sexually transmitted infections (STIs) 
    • None of the above
The questions below ask about an intimate relationship. An intimate relationship could refer to a dating partner, girlfriend/boyfriend, hook-ups, spouse, or domestic partner.
Please indicate how much you agree or disagree.
    5) I am comfortable talking with a trusted friend or relative about any challenges I am having in an intimate relationship. 
    • Strongly agree 
    • Agree 
    • Neither agree nor disagree  
    • Disagree  
    • Strongly disagree  

    6) I am comfortable talking with a [program name] staff member about any challenges I am having in an intimate relationship. 
    • Strongly agree 
    • Agree 
    • Neither agree nor disagree  
    • Disagree  
    • Strongly disagree  

    7) There are some things that have happened in my intimate relationships that I don’t feel comfortable talking about with anyone. 
    • Strongly agree 
    • Agree 
    • Neither agree nor disagree  
    • Disagree  
    • Strongly disagree  

For the following questions, think about any friends or relatives who you are close with. 
Please indicate how much you agree or disagree.
    8) I feel comfortable approaching a friend or relative to talk if I’m concerned about their safety or wellbeing in their relationship. 
    • Strongly agree 
    • Agree 
    • Neither agree nor disagree  
    • Disagree  
    • Strongly disagree  

    9) I know what resources to suggest to a friend or relative if I’m concerned about their safety or wellbeing in their relationship. 
    • Strongly agree 
    • Agree 
    • Neither agree nor disagree  
    • Disagree  
    • Strongly disagree  

The last few questions ask about safety. When we use the word safety here, we mean safety from abuse by another person. This could include physical, sexual, emotional, or other forms of abuse. 
    10) I am comfortable asking for help to keep safe from abuse by a current or former intimate partner. 
    • Not at all true
    • A little true
    • Somewhat true
    • Very true
    • I don’t know

    11) Please mark which safety-related programs or services, if any, you know how to access: 
[Note: Response options will be tailored to include the resources included on each version of the safety card]
    • A local organization that offers domestic violence services 
    • A national hotline for adults who are being abused by a dating partner or spouse 
    • A referral system for a range of local services
    • A national textline for anyone who wants to talk to a counselor. 
    • None of the above

    12) How likely are you to share information about these types of programs or services with someone you know? 
    • Not at all likely
    • A little likely
    • Somewhat likely
    • Very likely 
    • I don’t know

PRE ONLY
These last few questions ask about you and your background. We are asking these questions so we can describe some characteristics of the people who participated in this study when we report our findings. 
    13) What race/ethnicity do you identify as? Please select all that apply.
    • Hispanic or Latino
    • American Indian or Alaska Native
    • Asian
    • Black or African American
    • Middle Eastern or North African
    • Native Hawaiian or other Pacific Islander
    • White or Caucasian

    14) Which of the following best describes your sex? 
    • Female (woman) 
    • Male (man)
    • Prefer not to disclose

    15) How old are you? 
[Open-ended]
    16) What is the highest level of education you have completed? 
    • No high school degree or diploma 
    • High school diploma, GED, or High School Equivalency Test (HSE) 
    • Vocational or technical certification
    • Some college but no degree or diploma 
    • Associate or two-year college degree
    • Bachelor’s or four-year college degree or higher 

    17) Which of the following categories best describes your employment status? 
    • Full-time employed (usually work 35 or more hours a week)
    • Part-time employed (usually work 1-34 hours a week)
    • Employed but number of hours changes from week to week
    • Not currently employed, but actively looking for work
    • Not currently employed, and not looking for work

    18) What is your current relationship status? 
    • Married 
    • In a committed relationship but not married
    • In a dating relationship 
    • Not in a romantic relationship

    19) If you are currently in a romantic relationship, do you live with your romantic partner?
    • Yes
    • No

POST ONLY
Recently you had a conversation with a [program name] staff person where you talked about healthy and unhealthy relationships. Please think about that conversation when you answer the following questions. 
    20) During this conversation, did the staff person provide you with two copies of the safety card pictured here? 
[Safety card image]
    • Yes, I received two copies of the safety card
    • Yes, but I only received one copy of the safety card
    • No, I did not receive the safety card
    • I don’t remember

    21) How useful did you find the information on the safety card?
    • Very useful
    • Somewhat useful 
    • Not very useful

    22) Is there anything that would have made the safety card more useful to you?
[Open-ended]
    23) How comfortable were you with the conversation? 
    • Very comfortable
    • Somewhat comfortable
    • Not very comfortable

    24) How openly did you talk with the staff person?
    • Very openly
    • Somewhat openly
    • Not at all openly