Form 1 Baseline DMV Written

633701

YOU AND YOUR FAMILY

INSTRUCTIONS

• This survey asks your opinions about teen driving right after teens get their provisional license and are driving with no adult in the vehicle.

• Read all questions and possible answers.

• Please select the best choice for you by checking the appropriate box or writing in your answer.

1. When teens (in general) drive with no adult in the first month with a provisional license, how does each of the following situations affect their risk of having a crash or getting injured?

	No increase in risk	A little increase in risk	Medium increase in risk	Large increase in risk	Very large increase in risk
a. Under the influence of alcohol or drugs					
b. While not wearing a seat belt					
c. With 2 or more teen passengers					
d. Late at night on the weekend					
e. Outside of local or familiar areas					
f. With 1 teen passenger					
g. After 8 p.m.					
h. Between 9 p.m. and 1 a.m.					
i. In very bad weather (for example, snow, ice, heavy rain)					
j. On unfamiliar roads					
k. With 2 or more teen passengers on a weekend night					
l. Late at night during the week					
m. On freeways or expressways					
n. While passengers use drugs or alcohol in the vehicle					
o. Between 1 a.m. and 6 a.m.					

2. When you will be driving with no adult in the first month after you get your provisional license, how often do you think you will be allowed to drive under the following conditions?

	Never or Almost Never	Rarely	Some- times	Often	Always or Almost always
a. With 1 teen passenger					
b. With 2 or more teen passengers					
c. After 8 p.m.					
d. Between 9 p.m. and 1 a.m.					
e. Between 1 a.m. and 6 a.m.					

3. When you will be driving with no adult in the first month after you get your provisional license, what is the latest you will be allowed to stay out with the car? (Write in the time.)

a) Week nights: ________ b) Week ends: ________

4. When teens drive with no adult in the first month with a provisional license, how many parents do you think allow their teens to drive under the following conditions?

	Not many parents at all	Less than half parents	Half of all parents	More than half parents	Nearly all parents
a. With 1 teen passenger					
b. With 2 or more teen passengers					
c. After 8 p.m.					
d. Between 9 p.m. and 1 a.m.					
e. Between 1 a.m and 6 a.m.					

5. How soon after teens get their licenses do you think they should be able to do the following?

	Right away	Within 1 month of licensure	2 - 3 months of licensure	4 - 6 months of licensure	7 months - 1 year of licensure	After 1 year of licensure
a. Have their own car						
b. Drive wherever they want						
c. Drive anytime they want						
d. Take the car without telling a parent where they are going						
e. Drive as late as they want						
f. Drive a carload of teenagers						
g. Take entire day trips in the car						
h. Take trips longer than a day in the car						

6. When you will be driving with no adult in the first month after you get your provisional license, will your parents know:

	Never or Almost Never	Rarely	Some- times	Often	Always or Almost always
a. Where you drive					
b. How many teen passengers you will take					
c. Who you take as passengers					
d. How late you will stay out with the vehicle					

7. In general do your parents:	Never or Almost Never	Rarely	Some- times	Often	Always or Almost always
a. Know what you do during your free time					
b. Know who you have as friends during your free time					
c. Usually know what type of homework you have					
d. Know what you spend your money on					
e. Usually know when you have an exam or paper due at school					
f. Know how you do in different subjects at school					
g. Know where you go when you are out with friends at night					
h. Normally know where you go and what you do after school					
i. In the last month, have your parents ever had no idea of where you were at night					

8. On how many of the past 30 days did you (expected response from 0 to 30):

1. Smoke cigarettes _____ days

2. Drink beer, wine, or liquor _____ days

3. Use marijuana _____ days

9. What is your gender:  Male  Female

10. What is your date of birth? _______ _______ _______
Month Day Year

11. What grade are you in? (If it’s summertime, what grade were you in last school year?)

 9^th

 10^th

 11^th

 12^th

 Not in school

 Other  Please describe: ____________

12. What was your average grade for all classes last term?

 A average

 B average

 C average

 D average

 Failing

13. What do you consider your ethnicity to be?

  Hispanic or Latino

  Not Hispanic or Latino

14. What do you consider your race to be? [Mark all that apply]

  Black or African American

  White

  Asian

  American Indian or Alaska Native

 Native Hawaiian or Other Pacific Islander

 Other  Please describe: ____________

15. What is your 7-digit Rhode Island Permit Number? (It’s for our records – we’ll never reveal it to anybody. We just need to confirm your driver license exam schedule.) _______________

16. a) Do you have a scheduled on-road exam date for your provisional license?

 Yes (go to ‘b’)

 No (go to ‘c’)

b) What is the date for your exam? Month: _____ Day: _____ Year: _______

c) In what month and year do you expect to get your driver’s license? Month: _____ Year: ______

Thank you again!

633701

YOU AND YOUR FAMILY

INSTRUCTIONS

• This survey asks your opinions about teen driving right after teens get their provisional license and are driving with no adult in the vehicle.

• Read all questions and possible answers.

• Please select the best choice for you by checking the appropriate box or writing in your answer.

1. When teens (in general) drive with no adult in the first month with a provisional license, how does each of the following situations affect their risk of having a crash and/or getting injured?

	No increase in risk	A little increase in risk	Medium increase in risk	Large increase in risk	Very large increase in risk
a. Under the influence of alcohol or drugs					
b. While not wearing a seat belt					
c. With 2 or more teen passengers					
d. Late at night on the weekend					
e. Outside of local or familiar areas					
f. With 1 teen passenger					
g. After 8 p.m.					
h. Between 9 p.m. and 1 a.m.					
i. In very bad weather (for example, snow, ice, heavy rain)					
j. On unfamiliar roads					
k. With 2 or more teen passengers on a weekend night					
l. Late at night during the week					
m. On freeways or expressways					
n. While passengers use drugs or alcohol in the vehicle					
o. Between 1 a.m. and 6 a.m.					

2. When your teen will be driving with no adult in the first month after getting a provisional license, how often do you think your teen will be allowed to drive under the following conditions?

	Never or Almost Never	Rarely	Some- times	Often	Always or Almost always
a. With 1 teen passenger					
b. With 2 or more teen passengers					
c. After 8 p.m.					
d. Between 9 p.m. and 1 a.m.					
e. Between 1 a.m. and 6 a.m.					

3. When your teen will be driving with no adult in the first month with a provisional license, what is the latest your teen will be allowed to stay out with the car?

a) Week nights: ________

b) Week ends: ________

4. When teens drive with no adult in the first month with a provisional license, how many parents do you think allow their teens to drive under the following conditions?

	Not many parents at all	Less than half parents	Half of all parents	More than half parents	Nearly all parents
a. With 1 teen passenger					
b. With 2 or more teen passengers					
c. After 8 p.m.					
d. Between 9 p.m. and 1 a.m.					
e. Between 1 a.m and 6 a.m.					

5. How soon after teens get their licenses do you think they should be able to do the following?

	Right away	Within 1 month of licensure	2 - 3 months of licensure	4 - 6 months of licensure	7 months - 1 year of licensure	After 1 year of licensure
a. Have their own car						
b. Drive wherever they want						
c. Drive anytime they want						
d. Take the car without telling a parent where they are going						
e. Drive as late as they want						
f. Drive a carload of teenagers						
g. Take entire day trips in the car						
h. Take trips longer than a day in the car						

6. When your teen will be driving with no adult in the first month with a provisional license, how confident are you that you could set and enforce successfully the following limits on your teen (if you wanted to):

	Not confident at all	A little confident	Somewhat confident	Very confident	Totally confident
a. Driving with no teen passenger					
b. Driving no later than 8 p.m.					

7. a) When your teen will be driving with no adult in the first month with a provisional license, do you agree that limiting your teen to drive no later than 8 p.m. would have the following effects?

	Strongly Disagree	Disagree	Some-what disagree	Not certain (don’t know)	Some-what agree	Agree	Strongly Agree
a. Reduce your teen’s risky driving behavior							
b. Reduce your teen’s risk of getting a ticket							
c. Reduce your teen’s risk of being involved in a crash							
d. Complicate your teen travel arrangements							
e. Complicate your travel arrangements							
f. Greatly increase conflict with your teen							

7. b) When your teen will be driving with no adult in the first month with a provisional license, would limiting your teen to drive with no teen passenger(s) have the following effects?

	Strongly Disagree	Disagree	Some-what disagree	Not certain (don’t know)	Some-what agree	Agree	Strongly Agree
a. Reduce your teen’s risky driving behavior							
b. Reduce your teen’s risk of getting a ticket							
c. Reduce your teen’s risk of being involved in a crash							
d. Complicate your teen travel arrangements							
e. Complicate your travel arrangements							
f. Greatly increase conflict with your teen							

8. When your teen will be driving with no adult in the first month with a provisional license, your teen’s crash risk will not be as high as those of other teens because s/he…

	Strongly Disagree	Disagree	Some-what disagree	Not certain (don’t know)	Some-what agree	Agree	Strongly Agree
a. … is mature							
b. … is responsible							
c. … is a good student							
d. … is a boy/girl							
e. … will have lots of supervised practice							
f. … is not susceptible to peer pressure							
g. … is not a risk taker							
h. … drives very well							
i. … drives very carefully							

9. Compared to other teens her/his age, how easy is it for your teen to do the following:

	Not easy at all	Not easy	Some-what easy	Not certain (don’t know)	Some-what easy	Easy	Very easy
a. Follow rules at school							
b. Follow rules at home							
c. Make good decisions even when not supervised by an adult							
d. Show maturity							
e. Be reliable and dependable							
f. Remain under control							
g. Associate with responsible, well-behaved friends							

10. What is your gender:  Male  Female

11. What is your approximate age?

 39 years old or younger  40 – 44  45 – 49  50 or older

12. What is your highest level of education?

 Did not complete high school

 High school graduate or G.E.D.

 Some education beyond high school but no degree

 Graduate of a technical school, trade school, or two-year college

 College graduate or higher

13. What do you consider your ethnicity to be?

  Hispanic or Latino   Not Hispanic or Latino

14. What do you consider your race to be? [Mark all that apply]

  Black or African American

  White

  Asian

  American Indian or Alaska Native

 Native Hawaiian or Other Pacific Islander

 Other  Please describe: ____________

15. What is your marital status?

 Married, living together

 Living together, not married

 Separated, not living together

 Divorced, not living together

 Widowed

 Never married

 Other (write in):

16. What is your family’s annual household income (from all sources and before taxes)?

 Under $35,000

 $35,000 to $69,999

 $70,000 $99,999

 $100,000 or over

17. What is your relationship to your teen?

 Mother

 Father

 Stepmother

 Stepfather

 Other  Please describe: ____________________

18. a) How many people live in your teen’s home?

b) How many licensed drivers in your teen’s home?

c) How many vehicles at your teen’s home?

d) Do you have any children that are already licensed?  Yes  No

Thank you again!

Checkpoints Teen DMV Survey – 5 – 2/6/2021