Assessment Instrument title: HELP US HELP YOU: Follow-Up
Evaluation
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
(303)491-5889
***********************************
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
b. 19-30
c. 31-40
d. 41-50
e. 51-60
f. 61-70
g. Over 70
9. What is your race or ethnic background? (Circle one - optional.)
a. White, not Hispanic
b. Hispanic
c. Black
d. American Indian/Alaska Native
e. Asian or Pacific Islander
f. Other_______________
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