Girls in the Know Post-Program Survey for Trusted Adults
Dear Girls in the Know Trusted Adult: We’d like you to think back over your program experiences and give us feedback on the following: 1) What you knew, or how you felt about the different topic areas we covered BEFORE you began participating in Girls in the Know, and 2) What you knew, or how you felt about the different topic areas AFTER you participated in the program.
Date: *
MM
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DD
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Session Location/School Name *
Your answer
Please rate your KNOWLEDGE of the different topics covered in sessions BEFORE you participated in Girls in the Know?
(1) Only a Little
(2)
(3) Some
(4)
(5) A Lot
Self-esteem, friendship and empowerment
Healthy body image, good food choices and exercise
Internet, mobile phone and other types of personal safety
Puberty and human reproduction
Please rate your knowledge about these topics NOW?
(1) Only a little
(2)
(3) Some
(4)
(5) A lot
Self-esteem, friendship and empowerment
Healthy body image, good food choices and exercise
Internet, mobile phone and other types of personal safety
Puberty and human reproduction
How much COMFORT/CONFIDENCE did you have when communicating and supporting your pre-teen in these areas BEFORE you participated in Girls in the Know?
(1) Only a Little
(2)
(3) Some
(4)
(5) A Lot
Self-esteem, friendships and empowerment
Healthy body image, good food choices and exercise
Internet, mobile phone and other types of personal safety
Puberty and human reproduction
How about your COMFORT/CONFIDENCE levels NOW?
(1) Only a little
(2)
(3) Some
(4)
(5) A lot
Self-esteem, friendship and empowerment
Healthy body image, good food choices and exercise
Internet, mobile phone and other types of personal safety
Puberty and human reproduction
Did the FREQUENCY of conversations you have had with your pre-teen, (i.e. communication level) or the time you spent communicating about sensitive topics, increase AFTER you participated in the various Girls in the Know sessions?
(1) No change
(2)
(3) Increased Somewhat
(4)
(5) Increased A lot
Self-esteem, friendship and empowerment
Healthy body image, good food choices and exercise
Internet, mobile phone and other types of personal safety
Puberty and human reproduction
All, or a combination of the topics above
Please share your perspectives on what you believe your pre-teen girl gained from her participation with Girls in the Know by completing the next set of survey items. Did you observe/anticipate changes in the knowledge, comfort, and/or self-confidence levels of your pre-teen AFTER her participation in GITK in any of the topic areas we addressed?
(1) No Change
(2)
(3) Increased Somewhat
(4)
(5) Increased A Lot
Self-esteem, friendship and empowerment
Healthy body image, good food choices and exercise
Internet, mobile phone and other types of personal safety
Puberty and human reproduction
Looking back, what did you think about the following:
Could Have Used More
Could Have Used Less
Just RIght
The number of total sessions
The number of guest speakers
The number of topics
The length of individual sessions
The number of participants
If you were going to use THREE words to describe this session, what would they be?
Your answer
Please add any other comments you’d like to make about things you and your pre-teen gained from Girls in the Know.
Your answer
Please share up to three recommendations for improving the program in the future.
Your answer
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