Choose Respect Community Survey

Choose Respect Speakers Panel Survey

Thank you for watching the Choose Respect Speakers Panel brought to you through the collaboration of Cordova Family Resource Center, Native Village of Eyak, Sound Alternatives, and funded by the Council on Domestic Violence and Sexual Assault. Please take a moment to answer a few questions about your experience and knowledge of Interpersonal Violence.

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* 1. Please tell us your age.

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 2. What is your gender?

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* 3. Do you live in Cordova, Alaska?

Yes

Other (please specify)

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* 4. What was your knowledge about Interpersonal Violence prior to watching the Choose Respect Panel?

I know very little

I know some

I know a moderate amount

I know a lot

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* 5. Which segment did you watch? Choose all that apply.

Segment One

Segment Two

Segment Three

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* 6. How much do you know about each of the following topics?

	I know very little	I know some	I know a moderate amount	I know a lot
Recognizing when someone is experiencing interpersonal violence	Recognizing when someone is experiencing interpersonal violence I know very little	Recognizing when someone is experiencing interpersonal violence I know some	Recognizing when someone is experiencing interpersonal violence I know a moderate amount	Recognizing when someone is experiencing interpersonal violence I know a lot
What I can do to help end interpersonal violence in the community	What I can do to help end interpersonal violence in the community I know very little	What I can do to help end interpersonal violence in the community I know some	What I can do to help end interpersonal violence in the community I know a moderate amount	What I can do to help end interpersonal violence in the community I know a lot
Agencies or services in Cordova that can assist people who experience interpersonal violence	Agencies or services in Cordova that can assist people who experience interpersonal violence I know very little	Agencies or services in Cordova that can assist people who experience interpersonal violence I know some	Agencies or services in Cordova that can assist people who experience interpersonal violence I know a moderate amount	Agencies or services in Cordova that can assist people who experience interpersonal violence I know a lot
Causes of interpersonal violence	Causes of interpersonal violence I know very little	Causes of interpersonal violence I know some	Causes of interpersonal violence I know a moderate amount	Causes of interpersonal violence I know a lot
Short-term impacts of interpersonal violence	Short-term impacts of interpersonal violence I know very little	Short-term impacts of interpersonal violence I know some	Short-term impacts of interpersonal violence I know a moderate amount	Short-term impacts of interpersonal violence I know a lot
Long-term impacts of interpersonal violence	Long-term impacts of interpersonal violence I know very little	Long-term impacts of interpersonal violence I know some	Long-term impacts of interpersonal violence I know a moderate amount	Long-term impacts of interpersonal violence I know a lot

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* 7. Think about what you learned from the segment or segments that you watched to answer the following question.

	I know very little	I know some	I know a moderate amount	I know a lot
What level of knowledge about interpersonal violence do you have after watching the Choose Respect segment or segments?	What level of knowledge about interpersonal violence do you have after watching the Choose Respect segment or segments? I know very little	What level of knowledge about interpersonal violence do you have after watching the Choose Respect segment or segments? I know some	What level of knowledge about interpersonal violence do you have after watching the Choose Respect segment or segments? I know a moderate amount	What level of knowledge about interpersonal violence do you have after watching the Choose Respect segment or segments? I know a lot

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* 8. Please select the level of improvement in your awareness of community resources.

I am confused and feel that I know less

Knowledge of resources remained the same

Knowledge of resources improved a lot

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 9. Do you feel that you have an increased knowledge base after watching the Choose Respect segment or segments and can be an active bystander in preventing interpersonal violence in Cordova.

Yes

Unsure

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* 10. Have you shared anything you learned from the segment or segments with with peers, colleagues, family/friends after watching the Choose Respect Panel?

Yes

Choose Respect Community Survey

Choose Respect Speakers Panel Survey

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* 1. Please tell us your age.

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* 2. What is your gender?

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* 3. Do you live in Cordova, Alaska?

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* 4. What was your knowledge about Interpersonal Violence prior to watching the Choose Respect Panel?

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* 5. Which segment did you watch? Choose all that apply.

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* 6. How much do you know about each of the following topics?

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* 7. Think about what you learned from the segment or segments that you watched to answer the following question.

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* 8. Please select the level of improvement in your awareness of community resources.

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* 9. Do you feel that you have an increased knowledge base after watching the Choose Respect segment or segments and can be an active bystander in preventing interpersonal violence in Cordova.

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* 10. Have you shared anything you learned from the segment or segments with with peers, colleagues, family/friends after watching the Choose Respect Panel?

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* 11. Please write any additional thoughts or comments.