Assessment Instrument title: HELP US HELP YOU: Follow-Up
Target Audience: Workshop participants in family living Cooperative Extension Programs
Comments about the tool: This two-part, simple evaluation tool is based on Claude Bennett's theory of how and when people change their knowledge, attitudes, and behaviors as a result of taking in research-based information.
Contact who has experience using this assessment instrument:
Robert J. Fetsch
Colorado State University
Title or program _____________________________________________________________________
Date of program________________________________ County_________________________
1. The most important thing I learned from participating in the program was:
2. As a direct result of this program, I now have a different attitude or outlook on the subject that is likely to improve my life. ______Yes ______No (Please explain briefly.)
3. As a direct result of this program, I have done something differently that I consider an improvement. _____Yes _____No (Please explain briefly.)
4. What did you gain from this program? (Circle one or more.)
a. As a parent, I now use more effective parenting practices.
b. We've improved our parent-youth relationship.
c. We've increased our use of effective family coping strategies.
d. My knowledge increased about this subject.
e. My self-confidence increased.
f. My decision-making skills increased.
g. I put the information to good use.
h. My health/finances/relationships improved at home/work.
i. There were no benefits to me.
j. Other (Please specify.) __________________________________________
5. To what extent have you used the ideas or skills you learned regarding this subject?
None at all --- Somewhat --- Greatly
1 2 3 4 5 6 7 8 9
6. Your tax dollars supported this program either totally or in part. Do you want your tax dollars to continue supporting this type of program? _____Yes ____No
7. What is your gender?
8. What is your age? (Circle one.)
a. Under 19
g. Over 70
9. What is your race or ethnic background? (Circle one - optional.)
a. White, not Hispanic
d. American Indian/Alaska Native
e. Asian or Pacific Islander
10. How many years of education have you completed? (Circle one.)
a. Less than high school
b. High school graduate (GED)
c. Some college or technical school
d. College graduate or more
THANK YOU for helping us help you put research-based knowledge to work.
Revised by Robert J. Fetsch and Pat Johnson (HUHY2 10.012).
Evaluation Tools Page
ENTRY DATE:: May 1998