Summit Evaluation

Moving Delaware Forward: From Equity Awareness to Action

Thank you for your participation at the Moving Delaware Forward: From Equity Awareness to Action Summit. The purpose of this feedback form is to understand to what extent we met the goals of the event and to inform next steps for collective action for equity. The form is anonymous. This feedback form will take approximately 5 minutes to complete.

If you have any questions regarding this feedback form, please contact us at: [info@healthycommunitiesde.org].

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* 1. Which of the following best describes your role as a participant in the equity action summit? (check all that apply)

Co-host

Speaker

Non-profit or community-based organization

Public sector/State or local agency

Private sector/business

Policymaker or elected official

Community champion resident

Investor

Student

Vendor

Other; please specify: ____________________

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* 2. Rate your overall Summit experience from 1-5 (one being poor experience, 5 - excellent experience.

1

5

Clear

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

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* 3. Please indicate the degree to which you agree or disagree with the following statements: (1 = strongly disagree, 5 = strongly agree)

The Summit content will be helpful in my work to advance equity.

1

5

Clear

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

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* 4. I identified new opportunities for collaboration at the Summit.

1

5

Clear

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

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* 5. The Summit informed me about opportunities to take action that I was not aware of.

1

5

Clear

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

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* 6. The Summit gave me appropriate opportunities for self-care.

1

5

Clear

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

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* 7. The Summit helped me to feel excitement and hope for the future.

1

5

Clear

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

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* 8. Have or will you take any actions to advance equity as a result of this event? (Check all that apply). [Some examples include: signing up for an e-newsletter, signing up to attend an advocacy day, emailing legislators/policymakers, community organizing, etc.)

I took action in one way while at the Summit.

I took action in more than one way while at the Summit.

I intend to take action in one or more ways as a result of opportunities/information shared at the Summit.

I do not plan to take action as a result of learnings/information/opportunities at the Summit.

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* 9. What did you enjoy the most about the Summit?

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* 10. What would have made it better?

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* 11. How did the Summit contribute to the equity movement in Delaware? (check all that apply)

Improved awareness/knowledge

Created space to connect with others

Increased energy around the movement

The Summit did not advance the equity movement in Delaware

The Summit reversed progress of the equity movement in Delaware.

There is not an equity movement in Delaware.

Other (open text space)

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* 12. What should happen next to advance the equity movement in Delaware?

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* 13. Is there anything else that you would like to share?

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* 14. What is your age?

14-18

19-24

25-34

35-44

45-54

55-64

65 and over

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* 15. Are you of Hispanic, Latino, or Spanish origin?

Yes

No

Prefer not to answer

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* 16. How would you describe yourself? Select all that apply.

American Indian or Alaska Native

Asian or Asian American

Black or African American

Native Hawaiian or Pacific Islander

White

Prefer not to answer

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* 17. What is your gender?

Male

Female

Self-Identify: ________________________

Prefer not to answer