Senior Thesis Project by Clara Gruen & Karen Hooker Doug Davis, Faculty Advisor
Weekly Logging Questionnaire for 1/17-1/23
ID Number: ** ** This is the ID Number that you received in an email from Merleen MacDonald.
Please answer all of the following for each day of the week from last Monday through Sunday. Please be as honest and accurate in your responses as possible. **If you always abstain from drinking alcohol (meaning you have not drunk for at least this entire academic year) click here.
How many drinks did you consume on each day of the week?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
0 1 2 3-4 5-6 7-8 9+
On each night that you drank, what type of alcohol did you drink? Check all that apply. **For the days that you didn't drink, you do not need to check any boxes.
Beer
Wine or Wine Coolers
Hard Alcohol/Shots
Mixed Drinks
Which of the following were significant factors in choosing to drink on each day that you drank? Check all that apply. **For the days that you didn't drink, you do not need to check any boxes.
Because I wanted to relax
Because I wanted to change my personality
Because I wanted to have fun
Because I wanted to increase chances for sexual opportunities
Because the people I was with were drinking
Because I was in a drinking game
Because I was pressured to drink
Because I wanted to be more sociable
Because I was celebrating an event (i.e. birthday or accomplishment)
Because I finished my schoolwork
Because I wanted the physical effects
Because I was stressed about schoolwork
Because I was stressed about my personal life
Because I felt shy or uncomfortable
Because I was angry
Because I was sad or lonely
Because I was bored
Because I wanted to escape or forget
Because I wanted to get drunk
Other
Which of the following were significant factors in choosing not to drink on each day that you did not drink? Check all that apply. **For the days that you did drink, you do not need to check any boxes.
Because I was not in a social situation where alcohol was present
Because I had to study
Because I had to get up early for class the next day
Because I wasn't in the mood
Because I wasn't feeling well
Because I was on medication that shouldn't be mixed with alcohol
Because none of the people I was with were drinking
Because I was having fun without drinking
Because I drank the night before
Because I didn't like the drink options (i.e. only beer)
Because I was tired
On each day, which of the following situations were you in where alcohol was present or part of the social activity, whether or not you drank? Check all that apply.
Restaurant
Bar or Club
My room alone
My room with friends
Small party (3-11 people)
Pre-party before large party or event
Campus party
With my athletic team
With my social organization (club/activity)
With my family
Drinking game
For each day that you drank, in which situation did you consume the most alcohol?
Monday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other Tuesday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other Wednesday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other Thursday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other Friday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other Saturday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other Sunday Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other
Did not drink Restaurant Bar or Club My room alone My room with friends Small party (3-10 people) Pre-party Campus party With my athletic team With my social organization (clubs/activities) With my family In a drinking game Other
On each day, which of the following situations were you in where alcohol was not present or part of the social activity? Check all that apply?
On-campus movie
Campus dance
Hanging out with friends
Doing homework
Getting off campus (i.e. going to Philadelphia, movies, restaurants, plays, museums, etc.)
Please rate your personal stress level for this past week, where 5 is your average personal stress level, 1 is your least stressed ever, and 10 is the most stressed you ever are.
1 2 3 4 5 6 7 8 9 10
**BE SURE YOU ENTERED YOUR ID# AT THE TOP OF THE FORM BEFORE CLICKING THE SUBMIT BUTTON**
Please click the submit button below ONCE to send your responses.