3. VULNERABLE GROUPS Who do you think are the people most vulnerable to family violence? Please rank the following in order of vulnerability (1 is most vulnerable): □ Girls younger than 6 □ Elderly women (65 and □ Teen boys ages 13 to 18 □ Girls ages 7 to 12 older) □ Men 19 to 64 □ Teen girls ages 13 to 18 □ Young fa’afafine □ Elderly men (65 and □ Women 19 to 64 □ Adult fa’afafine older) □ People with disabilities □ Boys younger than 6 □ Other □ Boys ages 7 to 12 _________________ 4. EXPEREINCE Have you experienced any of the following in the past 6 months by a family member? (Please mark all that apply.) □ Kicking, slapping or hitting with a body □ Unwanted sexual attention or part or hard object harassment □ Pushing, grabbing, shoving or hair □ Rape or sexual assault by a family pulling member (not including a spouse) □ Choking □ Rape or sexual assault by a spouse □ Yelling or verbal aggression □ Rape or sexual assault by a stranger □ Namecalling/humiliation/insults □ Being followed or repeatedly contacted □ Threats of physical violence against your will □ Being forbidden from spending time □ Being prevented from accessing your with friends or family or from leaving finances by a family member or spouse the house □ □ □ □ □ □ □ □ Kicking, slapping or hitting with a body part or hard object Pushing, grabbing, shoving or hair pulling Choking Yelling or verbal aggression Namecalling/humiliation/insults Threats of physical violence Being forbidden from spending time with friends or family or from leaving the house Unwanted sexual attention or □ □ □ □ □ Rape or sexual assault by a family member (not including a spouse) Rape or sexual assault by a spouse Rape or sexual assault by a stranger Being followed or repeatedly contacted against your will Being prevented from accessing your finances by a family member or spouse