SHAPES-PEI

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- SHAPES-PEI School Health Action Planning & Evaluation System- Prince Edward Island HE Dear student, Thousands of students across PEI, just

This important survey will help the Government of PEI and the Comprehensive School Health Research Group at UPEI to better understand health

This information will help us learn how to encourage students to be healthier. Your help today is very important. This is NOT a test.

So, please be honest when you answer the questions. Mark only one option per question unless the instructions tell you to do something else.

Please, use a pencil to complete this questionnaire Proper Mark Improper Marks The PEI Department of Education and Early Childhood

1 - SHAPES-PEI School Health Action Planning & Evaluation System- Prince Edward Island HE Dear student, Thousands of students across PEI, just like you, have been asked to take part in this survey. This important survey will help the Government of PEI and the Comprehensive School Health Research Group at UPEI to better understand health behaviours (i.e., healthy eating, physical activity, mental fitness, and tobacco use) of young people in PEI. This information will help us learn how to encourage students to be healthier. Your help today is very important. This is NOT a test. All of your answers will be kept private. one, not even your parents or teachers, will ever know what you answered. So, please be honest when you answer the questions. Mark only one option per question unless the instructions tell you to do something else. Choose the option that is the closest to what you think/feel is true for you. Thank you! Please, use a pencil to complete this questionnaire Proper Mark Improper Marks The PEI Department of Education and Early Childhood Development and the PEI Department of Health and Wellness funded this survey. This project is a partnership between the Comprehensive School Health Research Group (University of PEI), the Propel Centre for Population Health Impact (University of Waterloo), and the Health and Education Research Group (University of New Brunswick). For Office Use Only SERIAL

2 About You. What grade are you in? Grade Grade Grade Grade Grade Grade Grade Grade. How old are you today? years or younger years years years years years years years or older. Are you...? Female Male. How would you describe yourself? (Mark all that apply) White Black Asian Aboriginal (First Nations, Métis, Inuit) Latin American/Hispanic Other. Does your family own a car, van, or truck? Yes, one Yes, two or more. Do you have your own bedroom for yourself? Yes. During the past months, how many did you travel away on holiday with your family? t at all Once Twice More than twice. How many computers does your family own? ne One Two More than two

3 Your Experience with Smoking. Are you a smoker? Yes. Have you ever tried cigarette smoking, even just a few puffs? Yes. Do you think in the future you might try smoking cigarettes? Definitely yes Probably yes Probably not Definitely not. If one of your best friends was to offer you a cigarette would you smoke it? Definitely yes Probably yes Probably not Definitely not. At any time during the next year do you think you will smoke a cigarette? Definitely yes Probably yes Probably not Definitely not. Have you ever smoked a whole cigarette? Yes. Have you ever smoked or more whole cigarettes in your life? Yes. Have you ever smoked every day for at least days in a row? Yes. On how many of the last days did you smoke one or more whole cigarettes? ne day to days to days to days to days to days days (every day) SERIAL

4 Physical Activity. How tall are you without your shoes on? (Please write your height in feet and inches OR in centimetres, and then fill in the appropriate numbers for your height.) I do not know how tall I am "My height is feet inches" OR "My height is centimetres" Height Feet Inches OR Height Centimetres Example: My height is ft in Height Feet Inches. How much do you weigh without your shoes on? (Please write your weight in pounds OR in kilograms, and then fill in the appropriate numbers for your weight.) I do not know how much I weigh "My weight is pounds" OR "My weight is kilograms" Weight Pounds OR Weight Kilograms Example: My weight is lbs Weight Pounds. How do you describe your weight? Very underweight Slightly underweight About the right weight Slightly overweight Very overweight. Which of the following are you trying to do about your weight? Lose weight Gain weight Stay the same weight I am not trying to do anything about my weight

5 HARD physical activities include jogging, team sports, fast dancing, jump-rope and any other physical activities that increase your heart rate and make you breathe hard and sweat. MODERATE physical activities include lower intensity activities such as walking, biking to school, and recreational swimming.. Mark how many minutes of HARD physical activity you did on each of the last days. This includes physical activity during physical education class, lunch, after school, evenings, and spare time. Monday Tuesday Wednesday Thursday Hours Minutes For example: If you did minutes of hard physical activity on Monday, you will need to fill in the hour circle and the minute circle, as shown below: Monday Hours Minutes Friday Saturday Sunday. Mark how many minutes of MODERATE physical activity you did on each of the last days. This includes physical activity during physical education class, lunch, after school, evenings, and spare time. Do not include time spent doing hard physical activities. Monday Tuesday Wednesday Thursday Hours Minutes For example: If you did hour and minutes of moderate physical activity on Monday, you will need to fill in the hour circle and the minute circle, as shown below: Hours Minutes Monday Friday Saturday Sunday SERIAL

6 . In the last days, how much total time did you spend doing homework? ne Less than hour From to hours From to hours or more hours. On average, about how many hours a day do you do the following? ne Less than hour a day More than to hours a but less than day hours a day or more hours a day a) Watching/streaming TV shows or movies b) Playing video/computer games c) Talking on the phone d) Surfing the internet e) Reading for fun. What is the highest level of education that your parents/ guardians have completed? Less than high school High school College University I don't know a) Mother (or other adult female in the home) b) Father (or other adult male in the home). In the last days, how many days did you do exercises to strengthen or tone your muscles, such as push-ups, wall climbing, bowling, or weight lifting? days day days days days days days days. In the last days, how many days did you do exercises for flexibility, such as stretching or yoga? days day days days days days days days

7 Healthy Eating. YESTERDAY, from the time you woke up until the time you went to bed, how many did you eat the following foods? Number of ne + a) salty snacks (for example, chips, cheesies, nachos, buttered popcorn) b) nuts or seeds (for example, peanuts, peanut butter, sunflower seeds) c) lentils, chickpeas (for example, hummus), kidney beans, or other dried beans d) fish or shellfish (for example, canned tuna, salmon, trout, shrimp) e) breaded/fried chicken or breaded/fried fish (for example, chicken nuggets or fingers, fish sticks) f) one slice of pizza or a pizza snack (for example, a Pizza Pop ) g) one hot dog or sausage on a bun h) one hamburger or cheeseburger i) one sub or deli sandwich j) whole grains (for example, whole grain bread or pasta, brown rice, whole grain cereal; like oatmeal, shredded wheat, or Mini-Wheats ) k) fruit, not including juice (for example, fresh, dried, canned, or frozen fruit) l) dark green vegetables (for example, lettuce, broccoli, green beans) m)dark orange vegetables (for example, carrots, squash, sweet potatoes/yams) n) other vegetables (for example, other raw or cooked vegetables, like corn) o) French fries or other fried potatoes (for example, wedges, hash browns, poutine) p) one package of candy or one chocolate bar q) one slice of cake or pie, two cookies, one doughnut, one brownie, or other baked sweets r) ice cream, an ice cream bar, frozen yogurt, a Popsicle, etc.

8 . YESTERDAY, from the time you woke up until the time you went to bed, how many servings of the following did you drink? Number of servings ne + a) white or chocolate milk, or soy beverage (for example, one cup or small carton of milk) b) % fruit juice or vegetable juice (for example, one cup or drinking box-size serving of % orange, apple, or tomato juice) c) fruit-flavoured drinks (for example, one cup or drinking box-size serving of Kool-aid, Sunny D, or lemonade) d) regular (non-diet) pop or soft drinks (for example, one cup or can of pop) e) diet pop or soft drinks (for example, one cup or can of diet pop) f) sports drinks (for example, one cup or a small bottle of Gatorade ) g) high energy drinks (for example, one cup or can of Red Bull ) h) hot chocolate, cappuccino, or frappaccino (for example, one mug of hot chocolate) i) tea, iced tea, or coffee (for example, one mug or small coffee) j) slurpees, slushies, or snow cones (for example, one small slurpee) k) shakes (for example, one small milkshake) l) water (for example, one cup or small bottle of water). In a usual school week (Monday to Friday), how many do you do the following? ne Less than once a week time + a) eat breakfast b) eat lunch c) eat as a part of a breakfast and/or snack program at school, where food is supplied to you d) eat foods purchased at a fast food place or restaurant e) eat snacks purchased from a vending machine, corner store, snack bar, or canteen f) eat meals while watching television g) eat meals with at least one adult family member SERIAL

9 . On a usual weekend (Saturday and Sunday), how many do you do the following? ne time + a) eat breakfast b) eat lunch c) eat foods purchased at a fast food place or restaurant d) eat snacks purchased from a vending machine, corner store, snack bar, or canteen e) eat meals while watching television f) eat meals with at least one adult family member. If you do not eat breakfast every day, why do you skip breakfast? (Mark all that apply) I eat breakfast every day I don't have time for breakfast The bus comes too early I sleep in I'm not hungry in the morning I feel sick when I eat breakfast I'm trying to lose weight There is nothing to eat at home Other: Your Feelings. We are interested in how you feel about yourself and how you think other people see you. For each item, fill in the circle that best describes your feelings and ideas in the past week. Really false for me Sort of false for me Sort of true for me Really true for me a) I feel I do things well at school. b) My teachers like me and care about me. c) I feel free to express myself at home. d) I feel my teachers think I am good at things. e) I like to spend time with my parents. f) I feel free to express myself with my friends. g) I feel I do things well at home. h) My parents like me and care about me. i) I feel I have a choice about when and how to do my schoolwork. j) I feel my parents think that I am good at things. k) I like to be with my teachers. l) I feel I have a choice about which activities to do with my friends. m)i feel I do things well when I am with my friends. n) My friends like me and care about me. o) I feel free to express myself at school. p) I feel my friends think I am good at things. q) I like to spend time with my friends. r) I feel like I have a choice about when and how to do my household chores.

10 . This scale consists of a number of words that describe different feelings and emotions. Read each item and fill in the appropriate circle next to that word. Indicate to what extent you have felt this way during the past week. Very Slightly or t at All A Little Moderately Quite a Bit Extremely a) Sad b) Frightened c) Upset d) Happy e) Energetic f) Scared g) Miserable h) Cheerful i) Active j) Afraid k) Joyful l) Lively. How strongly do you agree or disagree with each of the following? Strongly agree Agree Disagree Strongly disagree a) I feel close to people at my school. b) I feel I am part of my school. c) I am happy to be at my school. d) I feel the teachers at my school treat me fairly. e) I feel safe in my school. f) Getting good grades is important to me. SERIAL

11 . For each item, fill in the circle that best describes what you are like as a person. Definitely t Like Me Definitely Like Me a) I cut classes or skip school. b) I make other people do what I want. c) I disobey my parents. d) I talk back to my teachers. e) I get into fights. f) I often say mean things to people to get what I want. g) I take things that are not mine from home, school, or elsewhere. h) I often do favours for people without being asked. i) I often lend things to people without being asked. j) I often help people without being asked. k) I often compliment people without being asked. l) I often share things with people without being asked.. In your family, you are... (Mark only one) The only daughter The oldest daughter A middle daughter The youngest daughter The only son The oldest son A middle son The youngest son. In the last days, in what ways were you bullied by other students? (Mark all that apply) I have not been bullied in the last days Physical attacks (e.g., getting beaten up, pushed, or kicked) Verbal attacks (e.g., getting teased, threatened, or having rumours spread about you) Cyber-attacks (e.g., being sent mean text messages or having rumours spread about you on the internet) Had someone steal from you or damage your things. In the last days, in what ways did you bully other students? (Mark all that apply) I did not bully other students in the last days Physical attacks (e.g., beat up, pushed, or kicked them) Verbal attacks (e.g., teased, threatened, or spread rumours about them) Cyber-attacks (e.g., sent mean text messages or spread rumours about them on the internet) Stole from them or damaged their things

12 Some teenagers have problems or feel upset about things. When this happens, they may do different things to solve the problem or to make themselves feel better. For each item below, choose the answer that BEST describes how often you usually did this to solve your problems or to make yourself feel better during the past month.. When you have had problems Never Some Often Most of the time a) You asked your mother/father for help in figuring out what to do. b) You told your mother/father how you felt about the problem. c) You thought about why it happened. d) You thought about what would happen before you decided what to do. e) You played sports. f) You told your mother/father how you would like to solve the problem. g) You told yourself that it would be OK. h) You tried to put it out of your mind. i) You told your friends about what made you feel the way you did. j) You talked with friends about what you would like to happen. k) You told yourself you could handle whatever happens. l) You wished that bad things wouldn t happen. m)you told your mother/father how you felt. n) You did something to solve the problem. o) You did some exercise. p) You reminded yourself that overall things are pretty good for you. q) You watched TV. r) You avoided the people who made you feel bad. s) You did something like video games or a hobby. t) You wished that things were better. u) You figured out what you could do by talking with one of your friends. v) You talked with your friends about your feelings.. When you have a school-related problem (e.g. too much homework, trouble learning a subject, a poor grade), how often do you seek assistance from the people below? Never Some Often Most of the time a) Parent or guardian b) Sister or brother c) Friend d) Teacher or resource teacher e) Other school professionals (e.g. school/guidance counsellor, psychologist, social worker) f) Another professional (e.g., doctor, mental health counsellor) g) Solve without the help of others SERIAL

1. The crossed-out phrases have mistakes. Find the mistakes. Write the correct form.

Grammar Expressions of quantity (1) 1. The crossed-out phrases have mistakes. Find the mistakes. Write the correct form. A: Do you have everything you need for the party? B: Yeah. We have a lot of foods