OMB No. 0930-0316
Expiration Date: XX/XX/XXXX
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Introduction
Thank you for participating in the Policy Academy. We are interested in hearing about what your organization has been working on since the academy, and what progress you have made since the academy.
Personal Information
Q1. Participant name:
Q2. Participant email:
Q3. Participant organization:
Content
Q4. Please rate your level of knowledge related to supporting the adoption of policy since the end of the Policy Academy.
Not knowledgeable (1)
Slightly knowledgeable (2)
Somewhat knowledgeable (3)
Very knowledgeable (4)
Extremely knowledgeable (5)
Q5. Please rate your confidence level related to supporting the adoption of policy since the end of the Policy Academy.
Not confident (1)
Slightly confident (2)
Somewhat confident (3)
Very confident (4)
Extremely confident (5)
Q6. Please rate your skill level related to supporting the adoption of policy since the end of the Policy Academy.
Not skilled (1)
Slightly skilled (2)
Somewhat skilled (3)
Very skilled (4)
Extremely skilled (5)
Q6.1. Which of the skills presented in the Policy Academy are you still using?
Q7. For the policy that you selected in the Policy Academy, which step are you currently on?
Step 1 – Draft Policy Action Statement
Step 2 – Engage Compliance Organizations
Step 3 – Collect Data
Step 4 – Develop Issue Brief
Step 5 – Draft Policy Language
Step 6 – Increase Public Awareness
Step 7 – Organize and Mobilize Support
Step 8 – Prepare & Present Policy for Adoption
Step 9 – Support Implementation & Enforcement
Step 10 – Evaluate
Q7.1. Please elaborate on the progress you have made.
Q8. What steps in policy process were you successful with? (Select all that apply.)
Step 1 – Draft Policy Action Statement
Step 2 – Engage Compliance Organizations
Step 3 – Collect Data
Step 4 – Develop Issue Brief
Step 5 – Draft Policy Language
Step 6 – Increase Public Awareness
Step 7 – Organize and Mobilize Support
Step 8 – Prepare & Present Policy for Adoption
Step 9 – Support Implementation & Enforcement
Step 10 – Evaluate
Q8.1. Please elaborate.
Q9. What steps in the policy process did you have challenges with? (Select all that apply.)
Step 1 – Draft Policy Action Statement
Step 2 – Engage Compliance Organizations
Step 3 – Collect Data
Step 4 – Develop Issue Brief
Step 5 – Draft Policy Language
Step 6 – Increase Public Awareness
Step 7 – Organize and Mobilize Support
Step 8 – Prepare & Present Policy for Adoption
Step 9 – Support Implementation & Enforcement
Step 10 – Evaluate
Q9.1. Please elaborate.
Q10.
At the start of the Policy Academy, you were asked: " What are
you looking to get out of the Policy Academy?"
You
responded with: "inserted
text from participant’s baseline survey."
What
progress have you made on these goals since completing the Policy
Academy?
Sustainability
Q11. Has your coalition started the policy process with any additional policies?
Yes (1)
No (2)
Q11.1. If yes, please describe those additional policies.
Q12. How have you continued to use the knowledge and skills gained from the Policy Academy?
Q13. Have you trained any additional staff members on the information you received during the Policy Academy?
Yes
No
Q13.1. If yes, how many additional staff have you trained?
Q13.2. If yes, what information have you centered this training around?
Q14. What resources have you utilized in the last 6 months to help you with the policy process?
Q15. Is there additional training that would be helpful to you as you continue to work through the policy steps?
Q16. Please describe the impact the Policy Academy continues to have on your coalition work.
Community and Partnerships
Q17. Have you developed any new partnerships since the Policy Academy?
Yes
No
Q17.1. If yes, who are your new partners?
Q18. To what extent has alcohol policy support from members of your community changed since you completed the Policy Academy?
Q19. What barriers to the policy process have you faced in your community?
Q20. What barriers to the policy process have you faced from local and state decision makers?
Thank You Page
We thank you for your time spent taking this survey. Your response has been recorded.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Broadus, Alicia (SAMHSA/CBHSQ) |
File Modified | 0000-00-00 |
File Created | 2024-09-09 |