Black Identity Study Form

Black Identity & Acculturation Study

Danielle Leach, founder of UBAWA, is currently working on her dissertation for her PhD and has developed a Mental Health and Wellness pilot program catered towards self-published authors that identifies various psychological and sociocultural factors that influence an author's likelihood for success. To measure the effectiveness of the program, she is seeking authors to participate in a 16 week long study where all program materials will be provided to participants free of charge. Your responses will be kept confidential. There are 3 sections total, including a demographic section, the CRIS, and the AAAS scales. The CRIS scale contains 40 questions and the AAAS scale contains 47. Please answer each question honestly. By completing this form, you consent to participate in this study.

Approximate time to complete: 15-20 minutes

SECTION I (Demographic Info)

* Indicates required field

Name *

First

Last

Email *

Birthplace *

Age *

Race/Ethnicity *

Black African-American Caribbean Other

Sex: (What is your sex assigned at birth?) *

Female Male Intersex

Highest Level of Education Completed (Please indicate your highest level of education) *

Annual Income (What is your estimated annual income?) *

Martital Status (Please indicate your maritial status) *

Single Married Divorced Widowed

Do you have a child between the ages of 4-5 *

Age of child *

Name of child's school *

Neighborhood where you live *

What is your religious preference? *

How many ethnic organizations do you belong to? *

SECTION TWO (CRIS)

Instructions: Read each item and indicate to what degree it reflects your own thoughts and
feelings, using the 7-point scale below. There are no right or wrong answers. Base your responses on your opinion at the present time. To ensure that your answers can be used, please respond to the statements as written, and place your numerical response on the line provided to the left of each question.

1. As an African American, life in America is good for me. *

2. I think of myself primarily as an American, and seldom as a member of a racial group *

3. Too many Blacks “glamorize” the drug trade and fail to see opportunities that don’t involve crime. *

4. I go through periods when I am down on myself because I am Black. *

5. As a multiculturalist, I am connected to many groups (Hispanics, Asian-Americans, Whites, Jews, gays & lesbians, etc.). *

6. I have a strong feeling of hatred and disdain for all White people *

7. I see and think about things from an Afrocentric perspective. *

8. When I walk into a room, I always take note of the racial make-up of the people around me. *

9. I am not so much a member of a racial group, as I am an American. *

10. I sometimes struggle with negative feelings about being Black. *

11. My relationship with God plays an important role in my life. *

12. Blacks place more emphasis on having a good time than on hard work. *

For numbers 13-40, please indicate the extent to which you agree or disagree with the following statements. Refer to the scale provided and list your numerical response for each statement below.

1 = Strongly Disagree
2= Somewhat Disagree
3 = Disagree
4 = Neutral
5 = Agree
6 = Somewhat Agree
7 = Strongly Agree

13. I believe that only those Black people who accept an Afrocentric perspective can truly solve the race problem in America. *

14. I hate the White community and all that it represents. *

15. When I have a chance to make a new friend, issues of race and ethnicity seldom play a role in who that person might be. *

16. I believe it is important to have both a Black identity and a multicultural perspective, which is inclusive of everyone (e.g., Asians, Latinos, gays & lesbians, Jews, Whites, etc.). *

17. When I look in the mirror at my Black image, sometimes I do not feel good about what I see *

18. If I had to put a label on my identity, it would be “American,” and not African American. *

19. When I read the newspaper or a magazine, I always look for articles and stories that deal with race and ethnic issues. *

20. Many African Americans are too lazy to see opportunities that are right in front of them. *

21. As far as I am concerned, affirmative action will be needed for a long time. *

22. Black people cannot truly be free until our daily lives are guided by Afrocentric values and principles. *

23. White people should be destroyed. *

24. I embrace my own Black identity, but I also respect and celebrate the cultural identities of other groups (e.g., Native Americans, Whites, Latinos, Jews, Asian Americans, gays & lesbians, etc.). *

25. Privately, I sometimes have negative feelings about being Black. *

26. If I had to put myself into categories, first I would say I am an American, and second I am a member of a racial group. *

27. My feelings and thoughts about God are very important to me. *

28. African Americans are too quick to turn to crime to solve their problems. *

29. When I have a chance to decorate a room, I tend to select pictures, posters, or works of art that express strong racial-cultural themes. *

30. I hate White people. *

31. I respect the ideas that other Black people hold, but I believe that the best way to solve our problems is to think Afrocentrically. *

32. When I vote in an election, the first thing I think about is the candidate’s record on racial and cultural issues. *

33. I believe it is important to have both a Black identity and a multicultural perspective, because this connects me to other groups (Hispanics, Asian-Americans, Whites, Jews, gays & lesbians, etc.). *

34. I have developed an identity that stresses my experiences as an American more than my experiences as a member of a racial group. *

35. During a typical week in my life, I think about racial and cultural issues many, many times. *

36. Blacks place too much importance on racial protest and not enough on hard work and education. *

37. Black people will never be free until we embrace an Afrocentric perspective. *

38. My negative feelings toward White people are very intense. *

39. I sometimes have negative feelings about being Black. *

40. As a multiculturalist, it is important for me to be connected with individuals from all cultural backgrounds (Latinos, gays & lesbians, Jews, Native Americans, Asian-americans, etc *

SECTION THREE (AAAS)

Below are some beliefs and attitudes about religion, families, racism, Black people, White people, and health. Please tell us how much you personally agree or disagree with these beliefs and attitudes by circling a number. There are no right or wrong
answers, we simply want to know your views and your beliefs. Please indicate the extent to which you agree or disagree with the following statements. Refer to the scale provided and list your numerical response for each statement below.

1 = Strongly Disagree
2= Somewhat Disagree
3 = Disagree
4 = Neutral
5 = Agree
6 = Somewhat Agree
7 = Strongly Agree

1. I believe in the Holy Ghost *

2. I like gospel music. *

3. I believe in heaven and hell. *

4. The church is the heart of the Black community. *

5. I have seen people “get the spirit” or speak in tongues. *

6. I am currently a member of a Black church. *

7. When I was young, I was a member of a Black church. *

8. Prayer can cure disease. *

9. What goes around, comes around. *

10. I used to sing in the church choir. *

11. Most of the music I listen to is by Black artists. *

12. I like Black music more than White music. *

13. I listen to Black radio stations. *

14. I try to watch all the Black shows on TV. *

15. The person I admire the most is Black. *

16. I feel more comfortable around Blacks than around Whites. *

17. When I pass a Black person (a stranger) on the street, I always say hello or nod at them. *

18. Most of my friends are Black. *

19. I read (or used to read) Essence or Ebony magazine. *

20. I don’t trust most White people *

21. IQ tests were set up purposefully to discriminate against Black people. *

22. Most Whites are afraid of Blacks. *

23. Deep in their hearts, most White people are racists. *

24. Whites don’t understand Blacks. *

25. Most tests (like the SATs and tests to get a job) are set up to make sure that Blacks don’t get high scores on them. *

26. Some members of my family hate or distrust White people. *

27. When I was young, I shared a bed at night with my sister, brother, or some other relative. *

28. When I was young, my parent(s) sent me to stay with a relative (aunt, uncle, grandmother) for a few days or weeks, and then I went back home again. *

29. When I was young, my cousin, aunt, grandmother, or other relative lived with me and my family for awhile. *

30. When I was young, I took a bath with my sister, brother, or some other relative. *

31. Some people in my family use Epsom salts. *

32. Illnesses can be classified as natural types and unnatural types. *

33. Some old Black women/ladies know how to cure diseases *

34. Some older Black women know a lot about pregnancy and childbirth. *

35. I was taught that you shouldn’t take a bath and then go outside. *

36. I avoid splitting a pole. *

37. When the palm of your hand itches, you’ll receive some money. *

38. There’s some truth to many old superstitions. *

39. I eat black-eyed peas on New Year’s Eve. *

40. I grew up in a mostly Black neighborhood. *

41. I went to (or go to) a mostly Black high school. *

42. I went to a mostly Black elementary school. *

43. I currently live in a mostly Black neighborhood. *

44. It’s better to try to move your whole family ahead in this world than it is to be out for only yourself. *

45. Old people are wise. *

46. I often lend money or give other types of support to members of my family. *

47. A child should not be allowed to call a grown woman by her first name, “Alice.” The child should be taught to call her “Miss Alice.” *

Submit

Black Identity & Acculturation Study

SECTION I (Demographic Info)

SECTION TWO (CRIS)

SECTION THREE (AAAS)

Come Back Soon!

Mailing Address

Website

Email