Stay Teen: Survey - MTV's "16 and Pregnant"

MTV's "16 and Pregnant" - Viewer Survey

Tell us what you think about MTV's ''16 and Pregnant'' and you can enter to win a $300 iTunes gift card by including your email address in Question 3 below. Only those aged 13-19 are eligible to participate in this survey and the prize drawing.

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Question - Required - What is your age?

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Question - Required - What is your gender?

Question - Not Required - What is your email address? (optional but required to enter drawing to win $300 iTunes gift certificate. We'll only use your email address to contact you if you are the winner.)

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Question - Required - What is your zip code? (optional)

Question - Not Required - What is your race/ethnicity? (optional)

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Question - Required - 1. Which episode(s) of MTV's ''16 and Pregnant'' did you watch?

	Maci
	Farrah
	Amber
	Whitney
	Ebony
	Catelynn

Please check “agree” or “disagree” for each of the following statements.

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Question - Required - 2. This show made me think about how a pregnancy would affect my life. Agree
Disagree

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Question - Required - 3. This show made me more likely to talk about protection with my partner. Agree
Disagree

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Question - Required - 4. Because of this show, I will insist on using protection every time I have sex. Agree
Disagree

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Question - Required - 5. This show made me want to learn more about my birth control options. Agree
Disagree

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Question - Required - 6. This show makes me think that being a teen parent would: (check only one) prevent me from reaching my future goals
delay me from reaching my future goals
not affect me from reaching my future goals
help me reach my future goals

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Question - Required - 7. Watching this show makes me want to: (check all that apply)

	talk to a friend about her/his risk of getting pregnant/causing a pregnancy
	talk to my parents about sex
	have a baby
	do whatever it takes not to get myself or someone else pregnant
	use contraception every time I have sex
	wait until I'm older to have sex

Question - Not Required - 8. What did you learn about relationships from watching "16 and Pregnant?"

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Question - Required - If you'd be willing to talk more with us about what you thought of the show, check here: YES, I'd like to talk more about the show (If so, you might be one of a few people we email to set up an interview).
NO, I don't want to talk more.