Social Studies Sample Questionnaire

INSTRUMENT USED TO COLLECT DATA

SURVEY ON THE CAUSES OF TEENAGE PREGNANCY IN THE GREAT DIAMOND COMMUNITY

Dear respondent,
This is a survey being taken to figure out the causes of teenage pregnancy in the Great Diamond community. This inquiry is for the purpose of a Social Studies SBA (School Based Assessment) that I am currently engaging in at school.
The questionnaire does not require for you to write your name anywhere. Please answer all questions truthfully and remember, your answers will be reviewed anonymously. Most questions can be answered by placing a check in the box next to the answer you’ve selected. Please answer this questionnaire comfortably since there are no right or wrong answers.
Thank you for your time and consideration.
Yours sincerely,
……………………………………
Saif Khan

VILLAGER’S QUESTIONNAIRE

1) Gender: Male Female

2) Age: 18-20 21-29 30-39 40-49 50 or over

3) To what ethnic group do you belong to?

African
East Indian
Chinese
Amerindian
European
Portuguese
Mixed

4) What is your marital status?
Married
Single
Separated or Divorce
Widowed

5) How would you, in your personal opinion, define teenage pregnancy?
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

6) Who do you think is most likely responsible for the causes of teen sex which can result in teenage pregnancy?
Parents- Due to lack of supervision and affection
Friends- Peer pressure
Teenagers Themselves- Due to carelessness and desire for sexual activity
Other, kindly state…………………………………………………………………………..

7) Do you believe that weak family relationships between teenagers and their parents can lead to teens seeking love from other people which causes them to have sex?
Yes
No
Kindly give a reason for your answer:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

8) Do you know anyone, whether it is a friend or relative, who has been a victim of teenage pregnancy?
Yes
No

9) Do you think that the roles of some drugs such as alcohol may cause unintended sexual activity between teenagers which may later result in pregnancy?
Yes
No
Kindly give a reason for your answer:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

10) Do you think that too many restrictions set by parents may cause teenagers to give rise to a feeling of frustration which may lead teens to get involve in sexual activities?
Yes
No

11) How would you rate the level of sex education received by young people today?
Good
Bad
Sufficient

12) What factor experienced by girls in their childhood do you think will most likely cause them to get pregnant when they are teenagers?
Abuse- sexual, emotional and physical
Domestic violence
Family conflict
Low educational expectations

13) Do you believe that sexual media influences teenagers to have sex?
Yes
No

14) If yes, what type of media do you agree is the most influential?
Television
Internet
Books- magazines, etc

15) In your opinion, are teenagers who suffer low self esteem likely to engage in sexual activities?
Yes
No

16) Who do you think is faced with the most consequences of teenage pregnancy?
The pregnant teenager
The parent of the pregnant teenager
The father of the child of the pregnant teenager
The child of the teenager

17) What advice would you give to a teenager being pressured by peers into having sex?
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

18) What solution would you recommend to a pregnant teenager?
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

19) Do you think that a pregnant teenager who is still in school can be able to maintain both her baby and school work?
Yes
No
Kindly give a reason for your answer:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

20) What suggestions would you recommend to help the government prevent teenage pregnancy?
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………