Pre-Program Survey (girls only) - Robinson
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Age
1) How many times, that you can remember, have you felt you made the right decision, even though your friends tried to pressure you to make the wrong decision (such as spreading a rumor you are not sure is true)?
2) How many times, that you can remember, have you talked openly with your mom/caregiver about your body image? (Have you talked about the way you think you look in the mirror or about the way you think others see you?)
3) How many times, that you can remember, have you and your mom/caregiver talked together your eating habits?
4) How many times, that you can remember, have you and your mom/caregiver talked about the dangers of eating disorders such as bulimia and anorexia?
5) How many times in the last six months have you shared a picture of yourself or shared personal information on Facebook, Twitter, Instagram or another social website?
6) How many times, that you can remember, did you go to a "trusted adult" about an issue because you were uncomfortable talking to parents/caregivers? (A "trusted adult" is an adult other than your parent(s), who you feel comfortable approaching in a time of need.)
7) How many times, that you can remember, have you and your mom/caregiver talked about puberty?
8) How many times, that you can remember, , have you and your mom/caregiver talked about human reproduction?
9) I know I communicate well with mom/caregiver
Strongly Agree
Strongly Disagree
10) It is important to focus on the internal characteristics (the way someone acts from the inside; some examples are: generous, friendly, loving) rather than the external characteristics (the way someone looks on the outside; some examples are: pretty, ugly, skinny, fat) of myself and others.
Strongly Agree
Strongly Disagree
11) I know what it means to be a good friend.
Strongly Agree
Strongly Disagree
12) When making food choices, I know which portion sizes are appropriate for me.
Strongly Agree
Strongly Disagree
13) (Mobile Phones) Texting someone I don't know is dangerous.
Strongly Agree
Strongly Disagree
14) I know what changes take place in my body during puberty.
Strongly Agree
Strongly Disagree
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