MILK Screening/Workshop- Participant Follow up Survey

Question Title

* 1. I attended the following screening/workshop of MILK

Screening/Workshop Date:

Host Organization:

Question Title

* 2. Please enter your name (**Optional. You can respond to this survey anonymously.)*

First Name

Last Name

Question Title

* 3. Country:

Question Title

* 4. Email address:

Question Title

* 5. I attended the event in my capacity as (choose one that applies the most):

A parent

A peer supporter/advocate

A student

A teacher

A health practitioner/professional

A paid staff member

A volunteer

General interest

Question Title

* 6. Age:

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Question Title

* 7. After the screening/workshop of MILK my awareness and understanding of birth and infant feeding issues was:

Greatly deepened

Deepened a little bit

I didn’t learn anything knew

Question Title

* 8. The scene/theme I appreciated the most in the film was:

Question Title

* 9. The one thing that impacted me the most in the film was:

Question Title

* 10. Did you attend the post-screening workshop?

Yes

Only some of it

Question Title

* 11. The workshop gave me more confidence to prepare my family for emergencies.

True

Not True

Clear

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

Question Title

* 12. The workshop gave me more confidence to work as a health care provider in emergency situations.

True

Not True

Clear

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

Question Title

* 13. Tell us about the most important or interesting thing you learned about emergencies.

Question Title

* 14. The screening/workshop gave me more confidence in the decisions I make about feeding my family.

Yes

Please elaborate

Question Title

* 15. Tell us how the workshop increased your knowledge or confidence about feeding your family.

Question Title

* 16. Is there anything you were expecting to learn that you didn’t?

Yes

Please elaborate

Question Title

* 17. What did you learn from the post-screening/workshop discussion and activities? Can you elaborate?

Question Title

* 18. The screening/workshop event has inspired me to become an advocate for maternal-child health or play a new role in supporting and improving maternal-child health in my community.

Yes

Please elaborate

Question Title

* 19. If you could implement one specific change in the way maternal-child health is addressed in your community what would that be? Please elaborate.

Question Title

* 20. Would you recommend the film to someone you know?

Yes

MILK Screening/Workshop- Participant Follow up Survey

Question Title

* 1. I attended the following screening/workshop of MILK

Question Title

* 2. Please enter your name (*Optional. You can respond to this survey anonymously.)

Question Title

* 3. Country:

Question Title

* 4. Email address:

Question Title

* 5. I attended the event in my capacity as (choose one that applies the most):

Question Title

* 6. Age:

Question Title

* 7. After the screening/workshop of MILK my awareness and understanding of birth and infant feeding issues was:

Question Title

* 8. The scene/theme I appreciated the most in the film was:

Question Title

* 9. The one thing that impacted me the most in the film was:

Question Title

* 10. Did you attend the post-screening workshop?

Question Title

* 11. The workshop gave me more confidence to prepare my family for emergencies.

Question Title

* 12. The workshop gave me more confidence to work as a health care provider in emergency situations.

Question Title

* 13. Tell us about the most important or interesting thing you learned about emergencies.

Question Title

* 14. The screening/workshop gave me more confidence in the decisions I make about feeding my family.

Question Title

* 15. Tell us how the workshop increased your knowledge or confidence about feeding your family.

Question Title

* 16. Is there anything you were expecting to learn that you didn’t?

Question Title

* 17. What did you learn from the post-screening/workshop discussion and activities? Can you elaborate?

Question Title

* 18. The screening/workshop event has inspired me to become an advocate for maternal-child health or play a new role in supporting and improving maternal-child health in my community.

Question Title

* 19. If you could implement one specific change in the way maternal-child health is addressed in your community what would that be? Please elaborate.

Question Title

* 20. Would you recommend the film to someone you know?

Question Title

* 21. Any other comments about the film or the event you would like to share with us? Please elaborate.

Question Title

* 22. Can we share your written responses?

* 2. Please enter your name (**Optional. You can respond to this survey anonymously.)*