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Table 1 – Questionnaire details

From: After the Fort McMurray wildfire there are significant increases in mental health symptoms in grade 7–12 students compared to controls

 

Questions

Answer choices

Ft McMurray Demographics Questionnaire

 1

Are you at school right now, while you are taking the survey?

Yes, no

 2

Are you a student?

Yes, no

 3

What gender do you identify with?

Female, male, other, prefer not to say

 4

What is your age in years?

10 years or less, 11 years, 12 years, 13 years, 14 years, 15 years, 16 years, 17 years, 18 years, 19 years, 20 years or more

 5

What is your school?

7, 8, 9, 10, 11, 12, other

 6

What grade are you in?

Select from a list of all Ft McMurray schools with any classes in grades 7–12

 7

What school were you in for grade 6?

Select from a list of all Ft McMurray schools with grade 6

Red Deer EMPATHY Demographics Questionnaire

 1

What gender do you identify with?

Female, male

 2

What is today’s date?

Date selection

 3

What is your date of birth?

Date selection

 4

What grade are you in?

6, 7, 8, 9, 10, 11, 12

Ft McMurray Patient Health Questionnaire (PHQ-A, Depression Symptoms)

 

Over the past 2 weeks, how often have you been bothered by any of the following problems?

 

 1

Feeling down, depressed, irritable or hopeless

Not at all, Several days, More than half the days, Nearly every day

 2

Little interest or pleasure in doing things?

Same as above

 3

Trouble falling or staying asleep, or sleeping too much

Same as above

 4

Poor appetite, weight loss, or overeating?

Same as above

 5

Feeling tired, or having little energy?

Same as above

 6

Feeling bad about yourself-or that you are a failure or that you have let yourself or your family down

Same as above

 7

Trouble concentrating on things, such as school work, reading or watching television

Same as above

 8

Moving or speaking so slowly that other people could have noticed. Or the opposite-being so figety or restless that you have been moving around a lot more than usual

Same as above

 9

Thoughts that you would be better off dead, or of hurting yourself in some way

Same as above

 

Questions 10 and 11 asked only if answer to question 9 is not “Not at all”

 

 10

Has there been a time in the past month when you have had serious thoughts about ending your life?

Yes, no

 11

Have you ever, in your WHOLE LIFE, tried to kill yourself or made a suicide attempt?

Yes, no

Red Deer EMPATHY Patient Health Questionnaire (PHQ-A, Depression Symptoms)

 

Over the past 2 weeks, how often have you been bothered by any of the following problems?

 

 1

Feeling down, depressed, irritable or hopeless

Not at all, Several days, More than half the days, Nearly every day

 2

Little interest or pleasure in doing things?

Not at all, Several days, More than half the days, Nearly every day

 3

Trouble falling or staying asleep, or sleeping too much

Not at all, Several days, More than half the days, Nearly every day

 4

Poor appetite, weight loss, or overeating?

Not at all, Several days, More than half the days, Nearly every day

 5

Feeling tired, or having little energy?

Not at all, Several days, More than half the days, Nearly every day

 6

Feeling bad about yourself-or that you are a failure or that you have let yourself or your family down

Not at all, Several days, More than half the days, Nearly every day

 7

Trouble concentrating on things, such as school work, reading or watching television

Not at all, Several days, More than half the days, Nearly every day

 8

Moving or speaking so slowly that other people could have noticed. Or the opposite-being so figety or restless that you have been moving around a lot more than usual

Not at all, Several days, More than half the days, Nearly every day

 9

Thought of hurting yourself in some way

Not at all, Several days, More than half the days, Nearly every day

 10

Thoughts that you would be better off dead

Not at all, Several days, More than half the days, Nearly every day

 11

If you checked off “any problems”, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

Not difficult at all; Somewhat difficult; Very difficult; Extremely difficult

 

Questions 12 and 13 asked only if answer to question 10 is not “Not at all”

Yes, no

 12

Has there been a time in the past month when you have had serious thoughts about ending your life?

Yes, no

 13

Have you ever, in your WHOLE LIFE, tried to kill yourself or made a suicide attempt?

Yes, no

Hospital Anxiety and Depression Scale (HADS, Anxiety Symptoms)

 

Tick the box beside the reply that is closest to how you have been feeling in the past week. Don’t take too long over you replies: your immediate is best.

 

 1

I feel tense or wound up:

Most of the time; A lot of the time; From time to time, occasionally; Not at all

 2

I get a sort of frightened feeling as if something bad is about to happen:

Very definitely and quite badly; Yes, but not too badly; A little, but it doesn’t worry me; Not at all

 3

Worrying thoughts go through my mind:

A great deal of the time; A lot of the time; From time to time, but not too often; Only occasionally

 4

I can sit at ease and feel relaxed:

Definitely; Usually; Not often; Not at all

 5

I get a sort of frightened feeling like ‘butterflies’ in the stomach:

Not at all; Occasionally; Quite often; Very often

 6

I feel restless and have to be on the move:

Very much indeed; Quite a lot; Not very much; Not at all

 7

I get sudden feelings of panic:

Very often indeed; Quite often; Not very often; Not at all

CRAFFT Questionnaire (Drugs/Alcohol/Tabacco)

 

During the past 12 months, did you:

 

 1

Drink any alcohol (more than a few sips)?

Yes, no

 2

Smoke any marijuana or hashish?

Yes, no

 3

Use anything else to get high?

Yes, no

 4

Have you ever ridden in a CAR driven by someone (including yourself) who was “high” or had been using alcohol or drugs?

Yes, no

 

Questions 5–9 asked only if “yes” to one or more of questions 1–3.

 

 5

Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?

Yes, no

 6

Do you ever use alcohol or drugs while you are by yourself, or ALONE?

Yes, no

 7

Do you every FORGET things you did while using alcohol or drugs?

Yes, no

 8

Do your FAMILY or FRIENDS ever tell you that you should cut down on your drinking or drug use?

Yes, no

 9

Have you ever gotten into TROUBLE while you were using alcohol or drugs?

Yes, no

Tobacco Use Questionnaire

 

During the past month:

 

 1

Do you smoke tobacco products?

Yes, no

 2

Do you use smokeless tobacco products?

Yes, no

Rosenberg Self-Esteem Scale

 1

On the whole, I am satisfied with myself.

Strongly agree, Agree, Disagree, Strongly disagree

 2

At times, I think I am no good at all.

Strongly agree, Agree, Disagree, Strongly disagree

 3

I feel that I have a number of good qualities.

Strongly agree, Agree, Disagree, Strongly disagree

 4

I am able to do things as well as most other people

Strongly agree, Agree, Disagree, Strongly disagree

 5

I feel I do not have much to be proud of.

Strongly agree, Agree, Disagree, Strongly disagree

 6

I certainly feel useless at times.

Strongly agree, Agree, Disagree, Strongly disagree

 7

I feel that I’m a person of worth, at least on an equal plane with others.

Strongly agree, Agree, Disagree, Strongly disagree

 8

I wish I could have more respect for myself.

Strongly agree, Agree, Disagree, Strongly disagree

 9

All in all, I am inclined to feel that I am a failure.

Strongly agree, Agree, Disagree, Strongly disagree

 10

I take a positive attitude toward myself.

Strongly agree, Agree, Disagree, Strongly disagree

Kidscreen Questionnaire (Quality of Life)

 

Thinking about the last week:

 

 1

Have you physically felt fit and well

Not at all, slightly, moderately, very,

 2

Have you felt full of energy?

Never, seldom, quite often, very often,

 3

Have you felt sad?

Never, seldom, quite often, very often,

 4

Have you felt lonely?

Never, seldom, quite often, very often,

 5

Have you had enough time for yourself?

Never, seldom, quite often, very often,

 6

Have you been able to do the things that you want to do in your free time?

Never, seldom, quite often, very often, always

 7

Have your parent(s) treated you fairly?

Never, seldom, quite often, very often,

 8

Have you had fun with your friends?

Never, seldom, quite often, very often,

 9

Have you got on well at school?

Not at all, slightly, moderately, very,

 10

Have you been able to pay attention?

Never, seldom, quite often, very often,

 11

In general, how would you say your health is?

Excellent, very good, good, fair, poor