Tobacco Free Coalition of Weld County Evaluation 2009

1. Please rate the following according to your interest.

	Topic of Least Interest	Topic of Little Interest	Topic Of Medium Interest	Topic of Some Interest	Topic of Most Interest
Disparate Population Issues including spit tobacco	Please rate the following according to your interest. Disparate Population Issues including spit tobacco Topic of Least Interest	Topic of Little Interest	Topic Of Medium Interest	Topic of Some Interest	Topic of Most Interest
Youth Prevention (empowerment, Own Your C, schools)	Youth Prevention (empowerment, Own Your C, schools) Topic of Least Interest	Topic of Little Interest	Topic Of Medium Interest	Topic of Some Interest	Topic of Most Interest
Secondhand Smoke (Smokefree Colorado, housing, children)	Secondhand Smoke (Smokefree Colorado, housing, children) Topic of Least Interest	Topic of Little Interest	Topic Of Medium Interest	Topic of Some Interest	Topic of Most Interest
Adult and Youth Cessation (You Can Quit, N-O-T, Quitline)	Adult and Youth Cessation (You Can Quit, N-O-T, Quitline) Topic of Least Interest	Topic of Little Interest	Topic Of Medium Interest	Topic of Some Interest	Topic of Most Interest
Policy Development	Policy Development Topic of Least Interest	Topic of Little Interest	Topic Of Medium Interest	Topic of Some Interest	Topic of Most Interest

Other topics that the Coalition should address

2. What types of policies are needed to address these issues? What specific actions or policies would make the biggest impact? What type of research? Please explain for each of the four areas:

What types of policies are needed to address these issues? What specific actions or policies would make the biggest impact? What type of research? Please explain for each of the four areas: Secondhand Smoke
Adult and Youth Cessation
Youth Prevention
Disparate Populations

3. How well does the current place, date and time for our coalition meetings (Cache Bank, second Tuesday of each month 12-1:30pm) work for you compared with other times and places?

	Not at all well	Not well	No opinion/Doesn't Matter	Well	Very Well
Cache Bank, in Greeley second Tuesday of month 12-1:30pm	How well does the current place, date and time for our coalition meetings (Cache Bank, second Tuesday of each month 12-1:30pm) work for you compared with other times and places? Cache Bank, in Greeley second Tuesday of month 12-1:30pm Not at all well	Not well	No opinion/Doesn't Matter	Well	Very Well
Evenings	Evenings Not at all well	Not well	No opinion/Doesn't Matter	Well	Very Well
Weekends	Weekends Not at all well	Not well	No opinion/Doesn't Matter	Well	Very Well
North Weld County	North Weld County Not at all well	Not well	No opinion/Doesn't Matter	Well	Very Well
South Weld County	South Weld County Not at all well	Not well	No opinion/Doesn't Matter	Well	Very Well

Any other suggestions for time and place?

4. At what level would you like to participate in the Tobacco Coalition? Please mark the following items you are willing to do:

At what level would you like to participate in the Tobacco Coalition? Please mark the following items you are willing to do: Attend monthly meetings

Receive email updates

Perform in an advisory capacity

Help to develop organizational policies (tobacco free campuses at colleges, medical clinics, worksites, etc)

Help with research, surveys and focus groups as needed

Make phone calls or stuff envelopes for various projects

Recruit new members

Develop stronger and/or new policies and ordinances at municipal level for Greeley and other Weld cities

Work with state and national organizations on higher level polices

Attend health fairs, parades or other community events

Give presentations to groups

Give input to decision makers regarding policies

Act as spokesperson for coalition

Become a board member (chair, secretary, treasurer) of coalition

Write guest editorials or articles

Write posts (articles) for web log (blog)

Other (please specify)

5. What do you feel are the best attributes of the coalition?

What do you feel are the best attributes of the coalition?

6. How can our coalition be improved?

How can our coalition be improved?

7. Do you have anyone you would like to recruit to the coalition? If so, please list known contact information such as name, mailing address, email, phone number.

Do you have anyone you would like to recruit to the coalition? If so, please list known contact information such as name, mailing address, email, phone number.

8. How can we better reach and recruit members from outside of Greeley to help our coalition maintain a Weld County focus?

How can we better reach and recruit members from outside of Greeley to help our coalition maintain a Weld County focus?

9. How can we better reach and recruit members of disparate populations (to include ethnic diversity, people with disabilities, people representing mental illness/substance abuse community, gay/lesbian community, rural community, etc)? Please name and give contact information for any key community members from these populations we should reach.

How can we better reach and recruit members of disparate populations (to include ethnic diversity, people with disabilities, people representing mental illness/substance abuse community, gay/lesbian community, rural community, etc)? Please name and give contact information for any key community members from these populations we should reach.

10. This survey is anonymous but if you wish to leave your name and/or any other comments, please do so here.

If you indicated an interest in specific activities, please contact the Weld County Tobacco Education Program so that they can let you know about these opportunities or link you with the appropriate person or committee.

Thank you for filling out this survey! Your responses are valuable.

This survey is anonymous but if you wish to leave your name and/or any other comments, please do so here. If you indicated an interest in specific activities, please contact the Weld County Tobacco Education Program so that they can let you know about these opportunities or link you with the appropriate person or committee. Thank you for filling out this survey! Your responses are valuable.

1. Default Section