Sense of Community Questionnaire
PART I : Block Questions
In this section, you will be asked questions about your block (describe geographic boundaries).
1. _____ How long have you lived on this block? [years & months]
I will be giving you a list of statements. Let me know how well each one describes the people on this block, using the following categories:
(5). Strongly agree or definitely true
(4). Agree or true
(3). Neutral
(2). Disagree or not true
(1). Strongly disagree or definitely not true
(9). Not sure, don't know
2. _____ People on this block know each other. [C]
3. _____ People on this block participate in social activities (e.g., pot lucks, group garage sales) [P]
4. _____ People on this block socialize with each other. [C]
5. _____ It is fairly safe to walk on this block at night. [Sa]
6. _____ On this block people talk to each other about community problems. [C]
7. _____ People on this block take care of each others' plants, kids, pets. [S]
8. _____ People on this block never do things together to improve the block. [-P]
9. _____ People on this block feel connected to each other. [C]
10._____ People who live on this block think of themselves as a community. [B]
11._____ When someone on this block has a problem, it's hard to get help from neighbors. [-S]
12._____ People on this block don't trust each other. [C]
13._____ People on this block would give rides to each other if needed. [S]
14._____ People on this block feel isolated from each other. [-C]
15._____ A feeling of community spirit exists among the residents on this block. [B]
16. _____ If faced with a problem on this block, residents would be unable to create a solution. [-E]
17._____ People on this block watch out for each other. [S]
18._____ Residents don't care about the block's future. [-B]
19._____ People on this block participate in community improvement activities (e.g., community clean-ups, flower plantings, etc.). [P]
20._____ People on this block have a voice regarding important community issues. [E]
21._____ The people on this block make it a safer place to live. [Sa]
22._____ People on this block participate in the curbside recycling program. [P]
23._____ Together, people on this block can persuade the city to respond to their needs and concerns. [E]
24._____ People on this block feel they belong here. [B]
25_____ Overall, what is your feeling about the sense
of community on this block?
(3). Too much --Ø What should be changed?
(2). Just about right
(1). Too little --Ø How could it be
increased?
26. What is it that you feel contributes most to your sense of community on your block?
27. What is the best thing about living on this block?
28. What is the major problem facing this block?
29._____ Do you participate in a neighborhood organization? (Y/N)
30._____ Do you participate in a neighborhood watch group? (Y/N)
31._____ Is there a neighborhood or community newsletter? (Y/N/DK)
32._____ Is there a clear leader on your block whom you can go to with questions, concerns, or suggestions? (Y/N/DK)
33._____ Do you have a community police officer assigned to your block? (Y/N/DK)
34._____ People on this block believe that their City Council representatives do their jobs well. (Y/N/DK)
35._____ Do people from this block get together to hold
meetings? (Y/N/DK)
Ø If so, where?
________________________
36._____ Do people from this block get together to socialize?
(Y/N/DK)
Ø If so, where?
________________________
37._____ In the last year, what social activities have occurred on this block [not including private events]? (e.g., pot lucks, group garage sales, etc.) [list them]
38._____ In the last year, what community improvement activities have occurred on this block? (e.g., community clean-ups, flower plantings, etc.)? [list them]
39._____ What is the racial/ethnic group of most of the
people on this block?
(1). White (2). Black (3). Hispanic (4). Asian
(5). Native American (6). Other
40._____ How racially/ethnically diverse is this block?
(3). very diverse
(2). somewhat diverse
(1). not at all diverse
41._____ What is your feeling about the level of racial/ethnic
diversity on this block?
(3). Too much
(2). Just about right
(1). Too little
42._____ How are race relations on this block? (write
any comments)
(3). (Positive response, generally good)
(2). (Neutral response)
(1). (Negative response, generally poor)
43._____ Do race relations affect the sense of community
on this block? (Y/N/DK)
Ø _____ If yes, code as 3). positively,
2). neutrally, 1). negatively
44._____ How would increasing the racial/ethnic diversity
impact the sense of community on this block?
(3). Sense of community would increase
(2). Sense of community would stay the same
(1). Sense of community would decrease
45._____ Which of the following categories best describes
the financial condition of the people on this block?
(5). well-off
(4). middle income, on the higher side
(3). middle income
(2). middle income, on the lower side
(1). poor/low income
46._____ What is your feeling about the amount of criminal
activity on this block?
(3). There is more criminal activity
on this block than on other blocks in this neighborhood/city
(2). There is about the same amount
of criminal activity on this block as on other blocks
(1). This block has less criminal
activity than other blocks in the neighborhood/city
47._____ How interested would you be in assuming a leadership
role on the block?
(3). Very interested
(2). Somewhat interested
(1). Not interested
48._____ How interested would you be in working with your
neighbors to improve conditions on this block?
(3). Very interested
(2). Somewhat interested
(1). Not interested
PART II: Individual Questions
In this section, you will be asked some questions about you or your household.
49. Where do you get information about your community? Please indicate whether or not you get information about your community from the following potential sources of information.
NO
YES
a. Community/neighborhood newsletter
_____
_____
b. Neighbors (word-of-mouth)
_____
_____
c. Neighborhood leader
_____
_____
Ø Please rate the
following statements from 1-5 based on the following scale:
(5). All (100%)
(4). Most (75%)
(3). Some (50%)
(2). Few (25%)
(1). None (0%)
50._____ How many families/households on this block do
you know by sight?
51._____ How many families/households on this block do
you know by name?
52._____ How many families/households on this block do
you socialize with?
53._____ How many families/households on this block do
you consider friends?
54._____ How often do you talk to your neighbors?
Ø
[Code as 5). just about daily, 4). several times per week, 3). weekly,
2). monthly,
1). never or hardly ever]
55._____ Is there anyone on this block that you particularly
dislike? (Y/N)
Ø If yes, why?
56._____ Do you: 1). own your home, 2). rent your home
(1). If own:
_____ (a). Why did you buy on this block?
_____ (b). How is/was your home financed? [Code as 1).
mortgage, 2). land contract, 3). cash, 4). other]
(2). If rent:
_____ (c). Would you buy a home on this block? (Y/N/DK)
_____ (d). Why/why not?
57._____ Does anyone in your household have a car? (Y/N)
58._____ Does your household have a telephone? (Y/N)
59._____ Within the past month, have you provided a service
to someone (helped someone out) without getting compensated (paid, helped
out yourself)? [do not include routine tasks for an immediate family/household
member] (Y/N)
ØIf
yes, what did you do? (Describe specifically)
60._____ Within the past month, have you provided a service
to someone on your block without getting compensated? (Y/N)
ØIf
yes, what did you do? (Describe specifically)
61._____ Have you donated blood within the past year? (Y/N)
62._____ Do you have a current library card for a local library (a library located in Lansing)? (Y/N)
63._____ Have you voted in any political elections within the past year? (Y/N)
64._____ How frequently does your household recycle? [Code as 3). weekly or more, 2). every other week, 1). monthly, 0). less than monthly]
65._____ In the past month, have you taken materials to a recycling center? (Y/N)
66.
How many people [list numbers] in your household are
_____ Under 5 years of age?
_____ 5 - 12?
_____ 13 - 17?
_____ 18 - 64, including yourself?
_____ 65 or older, including yourself?
67._____ What is your age?
68._____ What is your gender?
69_____ What race/ethnicity are you? (Ask to confirm)
(1). White (2). Black (3). Hispanic
(4). Asian (5). Native American (6). Other
70._____ Are any other racial/ethnic groups represented
in your household? (check all that apply)
(0). No (1). White (2). Black (3). Hispanic
(4). Asian (5). Native American (6). Other
71._____What is the highest level of education (how far
in school) that each adult in your household has reached? [list the number
of adults for each category]
_____ (1). Junior high/middle school
_____ (2). Some high school
_____ (3). Graduated from high school/earned GED
_____ (4). 1-2 years of college or other training
_____ (5). 3-4 years of college
_____ (6). Finished 4-year college (Bachelor's degree)
_____ (7). Some post-college education
_____ (8). Finished graduate/professional degree (MA, PhD, MD, DDS, etc.)
72._____ Do you or any of the adults in your household
regularly attend a church or other place of worship? (Y/N)
Ø (If
yes, where?)
73._____ How would you rate the quality of life on this
block?
(3). High
(2). Moderate
(1). Low
74._____ How happy are you with your life overall?
(5). Very happy
(4). Somewhat happy
(3). Neither happy nor unhappy
(2). Somewhat unhappy
(1). Very unhappy
75._____ How much do you like living on this block?
(5). Love living here
(4). Like living here
(3). Do not mind living here
(2). Do not like living here
(1). Hate living here
Ø
Why?
76._____ Estimate the number of years you plan to stay on this block.
77._____ Estimate the number of years you would like to stay on this block.
ØIs there anything else about this block that we should know?