Community Assessment of Youth Sexuality Education
Kandiyohi County
The Coalition for Healthy Adolescent Sexuality (CHAS) and St. Cloud State University Nursing students has partnered to collect a community assessment of Kandiyohi County regarding Youth Sexuality Education. The survey was developed to help CHAS assess and implement programs that are available to youth and parents. With your help, the community needs assessment can be achieved. Please have this form completed by a staff member that knows about youth programs that are offered at your organization. Please answer the following questions and email them back by Friday, November 16, 2007.
1. What is the name of your organization?
2. What type of organization are you?
q Non-profit
q Faith based
q Boys/ Girls club/scouts
q Youth group
q Other
3. What is your mission or purpose?
q Provide direction/guidance to youth
q Teach/share the word of God
q Provide counseling to those in need
q Provide appropriate extracurricular activities to youth
q Other
4. How frequently in the past year have you provided direct education about healthy child/adolescent sexuality to youth/families?
q Never
q 1 every 12 months
q 1 every 6 months
q 1 every 3 moths
q 1 month
q more frequently
5. Who is this information provided to?
q Youth
q Parents/guardians
q Youth and Parents
q Other
6. If you do not offer direct education regarding healthy child/adolescent sexuality to your members, what prevents you from doing this?
q Not appropriate to this organization
q No interest/concern
q Nobody to teach it
q No youth are members
q Against faith/beliefs
q Parents/guardians do not want this information offered
q Other
7. Who provides this education?
q Teachers
q Pastor/Priest
q Community member
q Health Care provider
q Other
8. How often in the past 5 years have they received training/education for teaching healthy child/adolescent sexuality to youth/families?
q 0
q 1-2
q 3-4
q 5-6
q 7 or more
9. Where did they receive their training?
10. How is the education you offer presented to the youth/families?
q Presentation/speakers
q Videos
q Books/pamphlets
q Individual counseling
q Other
11. How many youth participate?
q 0
q 1-10
q 11-20
q 21-30
q 31-40
q 41-50
q more than 50
12. How many parents/guardians participate?
q 0
q 1-10
q 11-20
q 21-30
q 31-40
q 41-50
q more than 50
13. In the past year, has attendance increased, decreased or remained the same?
q Increased
q Decreased
q Remained same
14. Do you require permission from parents/guardians for youth to participate in direct education?
q Yes
q No
15. At what age do you feel youth should begin receiving information about healthy sexuality?
q Under 10
q 10-12
q 13-14
q 15-16
q 16+
Please mark the response that best represents your opinion about the following statements.
SA- strongly agree
A-agree
N- neutral, neither agree or disagree
D- disagree
SD- strongly disagree
16. I feel that parents in our community are/would be supportive of their child/ren receiving information about healthy child/adolescent sexuality.
q SA
q A
q N
q D
q SD
17. I feel that information about anatomy and puberty should be included in our program.
q SA
q A
q N
q D
q SD
18. I feel that information about abstinence should be included in our program.
q SA
q A
q N
q D
q SD
19. I feel that information about birth control (contraceptive methods) should be included in our program.
q SA
q A
q N
q D
q SD
20. I feel that information on STDs should be included in our program.
q SA
q A
q N
q D
q SD
21. I feel that information on STD prevention should be included in our program.
q SA
q A
q N
q D
q SD
22. I feel that information on community resources (Planned Parenthood, Hope Pregnancy Center, etc.) should be included in our program.
q SA
q A
q N
q D
q SD
23. Any other comments?