Uploaded by Charles Kelly

Data Collection Tool

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Please answer the following questions
1. How old are you?
2. Do you identify as:
a. Man
b. Woman
c. Other
3. Do you identify as Hispanic or Non-Hispanic?
4. If you do no identify as Hispanic, please choose one of the following
a. White (Caucasian)
b. African-American (Black)
c. Asian
d. Native American
e. Pacific Islander
f. More than one
g. Prefer not to say
5. How often are you able to walk in your neighborhood (number of days).
6. How many times have you seen someone get shot at least once?
7. How many guns do you own?
8. How many days has it been since you fired a gun?
Answer the following questions with on the scale
1. Would you say that your neighborhood is safe?
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
2. Would you say that shootings happen a lot in your neighborhood?
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
3. Would you feel safer if an intervention is in place?
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
4. Do you believe that the police are using their resources to stop gun violence in your
neighborhood?
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
5. Does your local government place emphasis on fighting gun violence?
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
Please answer the following questions with a Yes or No
1. Are there intervention methods established in your community?
a. Yes
b. No
2. Have you been a victim of gun violence?
a. Yes
b. No
3. Does someone in your immediate family own a gun?
a. Yes
b. No
4. Do you feel like you need to own a gun to live in your neighborhood?
a. Yes
b. No
5. Do you feel like race plays an issue with your community and gun violence?
a. Yes
b. No
6. Do you think an intervention program can change the violence in your neighborhood?
a. Yes
b. No
7. Do you believe that interventions are made specifically for your community?
a. Yes
b. No
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