Health II Curriculum Map

Lifelines Prevention Pre-test: Students

Participant: __________________________________________________ Date: _____________________

1. What grade are you in? ___________________

2. What is your gender? _____ Female

_____ Male

3. What is your race/ethnicity?

_____ African American/Black _____ White/not of Hispanic origin

_____ Asian American/Pacific Islander

_____ Native American _____ Other or multiracial

_____ Hispanic/Latino

Circle the number that most closely represents what you think about these statements: 1 = Strongly disagree 2 = Disagree 3 = Neither disagree nor agree 4 = Agree 5 = Strongly agree

4. Young people can’t do very much to prevent youth suicide.

1 2 3 4 5

5. It is important to have at least one adult you can talk to if something is bothering you.

1 2 3 4 5

6. A friend’s confidence about suicidal feelings should never be broken.

1 2 3 4 5

7. Young people are at a point in their lives when they should not rely on adults for help with problems.

1 2 3 4 5

8. It is not a good idea to ask someone if they are thinking about suicide, because you may give them the idea to try it.

1 2 3 4 5

9. My school is prepared to help a student who might be thinking about killing himself or herself.

1 2 3 4 5

10. If a friend came to school in a bad mood and casually mentioned, “My family would be better off without me,” I would encourage that person to get help from a responsible adult.

1 2 3 4 5

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LIFELINES PREVENTION GRADES 11–12 CURRICULUM

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CANYONS SCHOOL DISTRICT - SANDY, UT