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You Know Different Pilot Evaluation Form

The You Know Different National Youth HIV Testing Campaign is in the pilot stage of development. Please answer the following questions, as they relate to your experience and the organization you represent.  The campaign involves three stages; community mobilization, training and social marketing. Below are questions that relate the areas of community mobilization (coalition building meeting, planning meeting, etc) and the pilot social marketing campaign.

For all questions, use the following Likert scale and choose the category that best describes/most closely reflects your response.

Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
(SA)
(A)
(NS)
(D)
(SD)
This project encourages relationship building among participating organizations.
SA    A    NS    D    SD 
 
I planned a collaborative event during the pilot campaign with at least 1 other organization.
SA    A    NS    D    SD 
 
As a result of my participation, I intend to collaborate with other participating organizations in the future.
SA    A    NS    D    SD 
 
This project strengthened my relationship(s) with anther participating organization(s).
SA    A    NS    D    SD 
 
This project increased my organization’s capacity to provide HIV counseling and testing to youth.
SA    A    NS    D    SD 
 
This project increased my interest in using social marketing to promote HIV testing.
SA    A    NS    D    SD 
 
This project increased my intent to collaborate on testing issues in the future.
SA    A    NS    D    SD 
 
Overall, my agency benefited from participating in NYAC’s You Know Different campaign.
SA    A    NS    D    SD 
 
I intend to participate in the You Know Different campaign next year.
SA    A    NS    D    SD 
 
The message on the printed materials was effective in reaching young people.
SA    A    NS    D    SD 
 
The image on the printed materials was identifiable by young people.
SA    A    NS    D    SD 
 
The posters were an effective tool.
SA    A    NS    D    SD 
 
The stickers were an effective outreach tool.
SA    A    NS    D    SD 
 
The palm cards were an effective outreach tool.
SA    A    NS    D    SD 
 
The web page was an effective tool.
SA    A    NS    D    SD 
 
The viral buttons were an effective tool.
SA    A    NS    D    SD 
   
If you indicated a weakness with the image on the print materials in reaching/identifying young African Americans in your community, please explain and provide feedback received from youth about the image.
   
What events did your organization conduct in conjunction with the pilot campaign (i.e., testing events, outreach events, health fairs, etc)?
   
What happened at those events?
   
What materials or other resources were provided to participants by your agency?
   
What was your perception of the receptiveness of the participants?
   
Did your organization use peer educators/outreach workers during this campaign?   Yes  No
If yes, please describe their involvement.
   
What unexpected outcomes did you observe that are a direct result of the campaign?
   
Your Name
   
Organization Name
   
 

 
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