Media Literacy Process Evaluation

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* 1. Name of Implementation Site

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* 2. Name of Facilitator/Presenter

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* 3. Name of Observer

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* 4. Type of Observer

Coalition Member

Volunteer

AmeriCorps

Staff Advocate

Site Teacher

Other

Other (please specify)

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* 5. Dates of Session

First Session

Date

Last Session

Date

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* 6. Duration/length of sessions

average 30 minutes each

average 45 minutes

average 60 minutes

average 90 minutes

average 120 minutes

varied each time - specify range in other

Other (please specify)

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* 7. Total number of sessions

Other (please specify)

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* 8. Name of Sexual Violence Program

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* 9. County

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* 10. Has evaluator been trained in any media literacy program?

Yes

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* 11. Special circumstances - describe any circumstances that impacted on program delivery or process evaluation

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* 12. Activity Used

	1	2	3	4	5	6	7	8	9	10	Not Done
Agree/Disagree	Agree/Disagree 1	Agree/Disagree 2	Agree/Disagree 3	Agree/Disagree 4	Agree/Disagree 5	Agree/Disagree 6	Agree/Disagree 7	Agree/Disagree 8	Agree/Disagree 9	Agree/Disagree 10	Agree/Disagree Not Done
People Search	People Search 1	People Search 2	People Search 3	People Search 4	People Search 5	People Search 6	People Search 7	People Search 8	People Search 9	People Search 10	People Search Not Done
Gender Boxes	Gender Boxes 1	Gender Boxes 2	Gender Boxes 3	Gender Boxes 4	Gender Boxes 5	Gender Boxes 6	Gender Boxes 7	Gender Boxes 8	Gender Boxes 9	Gender Boxes 10	Gender Boxes Not Done
Deconstructing Ads	Deconstructing Ads 1	Deconstructing Ads 2	Deconstructing Ads 3	Deconstructing Ads 4	Deconstructing Ads 5	Deconstructing Ads 6	Deconstructing Ads 7	Deconstructing Ads 8	Deconstructing Ads 9	Deconstructing Ads 10	Deconstructing Ads Not Done
Reconstructing/Making A Counter Ad	Reconstructing/Making A Counter Ad 1	Reconstructing/Making A Counter Ad 2	Reconstructing/Making A Counter Ad 3	Reconstructing/Making A Counter Ad 4	Reconstructing/Making A Counter Ad 5	Reconstructing/Making A Counter Ad 6	Reconstructing/Making A Counter Ad 7	Reconstructing/Making A Counter Ad 8	Reconstructing/Making A Counter Ad 9	Reconstructing/Making A Counter Ad 10	Reconstructing/Making A Counter Ad Not Done

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* 13. Media Literacy Concepts

	1	2	3	4	5	6	7	8	9	10	Not Done
Media Shapes Our Culture	Media Shapes Our Culture 1	Media Shapes Our Culture 2	Media Shapes Our Culture 3	Media Shapes Our Culture 4	Media Shapes Our Culture 5	Media Shapes Our Culture 6	Media Shapes Our Culture 7	Media Shapes Our Culture 8	Media Shapes Our Culture 9	Media Shapes Our Culture 10	Media Shapes Our Culture Not Done
Media messages affect thoughts...	Media messages affect thoughts... 1	Media messages affect thoughts... 2	Media messages affect thoughts... 3	Media messages affect thoughts... 4	Media messages affect thoughts... 5	Media messages affect thoughts... 6	Media messages affect thoughts... 7	Media messages affect thoughts... 8	Media messages affect thoughts... 9	Media messages affect thoughts... 10	Media messages affect thoughts... Not Done
Language of persuasion	Language of persuasion 1	Language of persuasion 2	Language of persuasion 3	Language of persuasion 4	Language of persuasion 5	Language of persuasion 6	Language of persuasion 7	Language of persuasion 8	Language of persuasion 9	Language of persuasion 10	Language of persuasion Not Done
Active versus passive consumers	Active versus passive consumers 1	Active versus passive consumers 2	Active versus passive consumers 3	Active versus passive consumers 4	Active versus passive consumers 5	Active versus passive consumers 6	Active versus passive consumers 7	Active versus passive consumers 8	Active versus passive consumers 9	Active versus passive consumers 10	Active versus passive consumers Not Done
No one tells whole story	No one tells whole story 1	No one tells whole story 2	No one tells whole story 3	No one tells whole story 4	No one tells whole story 5	No one tells whole story 6	No one tells whole story 7	No one tells whole story 8	No one tells whole story 9	No one tells whole story 10	No one tells whole story Not Done
Texts & subtexts	Texts & subtexts 1	Texts & subtexts 2	Texts & subtexts 3	Texts & subtexts 4	Texts & subtexts 5	Texts & subtexts 6	Texts & subtexts 7	Texts & subtexts 8	Texts & subtexts 9	Texts & subtexts 10	Texts & subtexts Not Done
Values & viewpoints	Values & viewpoints 1	Values & viewpoints 2	Values & viewpoints 3	Values & viewpoints 4	Values & viewpoints 5	Values & viewpoints 6	Values & viewpoints 7	Values & viewpoints 8	Values & viewpoints 9	Values & viewpoints 10	Values & viewpoints Not Done
Processing of images/words - emotional impact	Processing of images/words - emotional impact 1	Processing of images/words - emotional impact 2	Processing of images/words - emotional impact 3	Processing of images/words - emotional impact 4	Processing of images/words - emotional impact 5	Processing of images/words - emotional impact 6	Processing of images/words - emotional impact 7	Processing of images/words - emotional impact 8	Processing of images/words - emotional impact 9	Processing of images/words - emotional impact 10	Processing of images/words - emotional impact Not Done
We all create media	We all create media 1	We all create media 2	We all create media 3	We all create media 4	We all create media 5	We all create media 6	We all create media 7	We all create media 8	We all create media 9	We all create media 10	We all create media Not Done
Power dynamics and inequality	Power dynamics and inequality 1	Power dynamics and inequality 2	Power dynamics and inequality 3	Power dynamics and inequality 4	Power dynamics and inequality 5	Power dynamics and inequality 6	Power dynamics and inequality 7	Power dynamics and inequality 8	Power dynamics and inequality 9	Power dynamics and inequality 10	Power dynamics and inequality Not Done
Media Activists	Media Activists 1	Media Activists 2	Media Activists 3	Media Activists 4	Media Activists 5	Media Activists 6	Media Activists 7	Media Activists 8	Media Activists 9	Media Activists 10	Media Activists Not Done
Other1	Other1 1	Other1 2	Other1 3	Other1 4	Other1 5	Other1 6	Other1 7	Other1 8	Other1 9	Other1 10	Other1 Not Done
Other2	Other2 1	Other2 2	Other2 3	Other2 4	Other2 5	Other2 6	Other2 7	Other2 8	Other2 9	Other2 10	Other2 Not Done

Other (please specify)

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* 14. Persuasion Techniques

	1	2	3	4	5	6	7	8	9	10	Not Done
Association - Beautiful people	Association - Beautiful people 1	Association - Beautiful people 2	Association - Beautiful people 3	Association - Beautiful people 4	Association - Beautiful people 5	Association - Beautiful people 6	Association - Beautiful people 7	Association - Beautiful people 8	Association - Beautiful people 9	Association - Beautiful people 10	Association - Beautiful people Not Done
Association - Symbols	Association - Symbols 1	Association - Symbols 2	Association - Symbols 3	Association - Symbols 4	Association - Symbols 5	Association - Symbols 6	Association - Symbols 7	Association - Symbols 8	Association - Symbols 9	Association - Symbols 10	Association - Symbols Not Done
Bandwagon - group dynamics	Bandwagon - group dynamics 1	Bandwagon - group dynamics 2	Bandwagon - group dynamics 3	Bandwagon - group dynamics 4	Bandwagon - group dynamics 5	Bandwagon - group dynamics 6	Bandwagon - group dynamics 7	Bandwagon - group dynamics 8	Bandwagon - group dynamics 9	Bandwagon - group dynamics 10	Bandwagon - group dynamics Not Done
Bandwagon - Majority belief	Bandwagon - Majority belief 1	Bandwagon - Majority belief 2	Bandwagon - Majority belief 3	Bandwagon - Majority belief 4	Bandwagon - Majority belief 5	Bandwagon - Majority belief 6	Bandwagon - Majority belief 7	Bandwagon - Majority belief 8	Bandwagon - Majority belief 9	Bandwagon - Majority belief 10	Bandwagon - Majority belief Not Done
Testimonials - Celebrities	Testimonials - Celebrities 1	Testimonials - Celebrities 2	Testimonials - Celebrities 3	Testimonials - Celebrities 4	Testimonials - Celebrities 5	Testimonials - Celebrities 6	Testimonials - Celebrities 7	Testimonials - Celebrities 8	Testimonials - Celebrities 9	Testimonials - Celebrities 10	Testimonials - Celebrities Not Done
Testimonials - Plain Folk	Testimonials - Plain Folk 1	Testimonials - Plain Folk 2	Testimonials - Plain Folk 3	Testimonials - Plain Folk 4	Testimonials - Plain Folk 5	Testimonials - Plain Folk 6	Testimonials - Plain Folk 7	Testimonials - Plain Folk 8	Testimonials - Plain Folk 9	Testimonials - Plain Folk 10	Testimonials - Plain Folk Not Done
Fear - solutions	Fear - solutions 1	Fear - solutions 2	Fear - solutions 3	Fear - solutions 4	Fear - solutions 5	Fear - solutions 6	Fear - solutions 7	Fear - solutions 8	Fear - solutions 9	Fear - solutions 10	Fear - solutions Not Done
Fear - name calling	Fear - name calling 1	Fear - name calling 2	Fear - name calling 3	Fear - name calling 4	Fear - name calling 5	Fear - name calling 6	Fear - name calling 7	Fear - name calling 8	Fear - name calling 9	Fear - name calling 10	Fear - name calling Not Done
Humor	Humor 1	Humor 2	Humor 3	Humor 4	Humor 5	Humor 6	Humor 7	Humor 8	Humor 9	Humor 10	Humor Not Done
Repetition	Repetition 1	Repetition 2	Repetition 3	Repetition 4	Repetition 5	Repetition 6	Repetition 7	Repetition 8	Repetition 9	Repetition 10	Repetition Not Done
Rhetorical Question	Rhetorical Question 1	Rhetorical Question 2	Rhetorical Question 3	Rhetorical Question 4	Rhetorical Question 5	Rhetorical Question 6	Rhetorical Question 7	Rhetorical Question 8	Rhetorical Question 9	Rhetorical Question 10	Rhetorical Question Not Done
Simple solutions/instant gratification	Simple solutions/instant gratification 1	Simple solutions/instant gratification 2	Simple solutions/instant gratification 3	Simple solutions/instant gratification 4	Simple solutions/instant gratification 5	Simple solutions/instant gratification 6	Simple solutions/instant gratification 7	Simple solutions/instant gratification 8	Simple solutions/instant gratification 9	Simple solutions/instant gratification 10	Simple solutions/instant gratification Not Done
Cause vs. Correlation	Cause vs. Correlation 1	Cause vs. Correlation 2	Cause vs. Correlation 3	Cause vs. Correlation 4	Cause vs. Correlation 5	Cause vs. Correlation 6	Cause vs. Correlation 7	Cause vs. Correlation 8	Cause vs. Correlation 9	Cause vs. Correlation 10	Cause vs. Correlation Not Done
Scapegoating	Scapegoating 1	Scapegoating 2	Scapegoating 3	Scapegoating 4	Scapegoating 5	Scapegoating 6	Scapegoating 7	Scapegoating 8	Scapegoating 9	Scapegoating 10	Scapegoating Not Done
Timing	Timing 1	Timing 2	Timing 3	Timing 4	Timing 5	Timing 6	Timing 7	Timing 8	Timing 9	Timing 10	Timing Not Done
Scientific Evidence	Scientific Evidence 1	Scientific Evidence 2	Scientific Evidence 3	Scientific Evidence 4	Scientific Evidence 5	Scientific Evidence 6	Scientific Evidence 7	Scientific Evidence 8	Scientific Evidence 9	Scientific Evidence 10	Scientific Evidence Not Done
Other1	Other1 1	Other1 2	Other1 3	Other1 4	Other1 5	Other1 6	Other1 7	Other1 8	Other1 9	Other1 10	Other1 Not Done
Other2	Other2 1	Other2 2	Other2 3	Other2 4	Other2 5	Other2 6	Other2 7	Other2 8	Other2 9	Other2 10	Other2 Not Done

Other (please specify)

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* 15. Deconstructing Media

	1	2	3	4	5	6	7	8	9	10	Not Done
Clip #39	Clip #39 1	Clip #39 2	Clip #39 3	Clip #39 4	Clip #39 5	Clip #39 6	Clip #39 7	Clip #39 8	Clip #39 9	Clip #39 10	Clip #39 Not Done
Source of message	Source of message 1	Source of message 2	Source of message 3	Source of message 4	Source of message 5	Source of message 6	Source of message 7	Source of message 8	Source of message 9	Source of message 10	Source of message Not Done
Audience	Audience 1	Audience 2	Audience 3	Audience 4	Audience 5	Audience 6	Audience 7	Audience 8	Audience 9	Audience 10	Audience Not Done
Text	Text 1	Text 2	Text 3	Text 4	Text 5	Text 6	Text 7	Text 8	Text 9	Text 10	Text Not Done
Subtext	Subtext 1	Subtext 2	Subtext 3	Subtext 4	Subtext 5	Subtext 6	Subtext 7	Subtext 8	Subtext 9	Subtext 10	Subtext Not Done
Tools of persuasion	Tools of persuasion 1	Tools of persuasion 2	Tools of persuasion 3	Tools of persuasion 4	Tools of persuasion 5	Tools of persuasion 6	Tools of persuasion 7	Tools of persuasion 8	Tools of persuasion 9	Tools of persuasion 10	Tools of persuasion Not Done
Story not told	Story not told 1	Story not told 2	Story not told 3	Story not told 4	Story not told 5	Story not told 6	Story not told 7	Story not told 8	Story not told 9	Story not told 10	Story not told Not Done
Positive/negative gender messages	Positive/negative gender messages 1	Positive/negative gender messages 2	Positive/negative gender messages 3	Positive/negative gender messages 4	Positive/negative gender messages 5	Positive/negative gender messages 6	Positive/negative gender messages 7	Positive/negative gender messages 8	Positive/negative gender messages 9	Positive/negative gender messages 10	Positive/negative gender messages Not Done
Lifestyle	Lifestyle 1	Lifestyle 2	Lifestyle 3	Lifestyle 4	Lifestyle 5	Lifestyle 6	Lifestyle 7	Lifestyle 8	Lifestyle 9	Lifestyle 10	Lifestyle Not Done
Empowered	Empowered 1	Empowered 2	Empowered 3	Empowered 4	Empowered 5	Empowered 6	Empowered 7	Empowered 8	Empowered 9	Empowered 10	Empowered Not Done
Disempowered	Disempowered 1	Disempowered 2	Disempowered 3	Disempowered 4	Disempowered 5	Disempowered 6	Disempowered 7	Disempowered 8	Disempowered 9	Disempowered 10	Disempowered Not Done
Media maker's interest	Media maker's interest 1	Media maker's interest 2	Media maker's interest 3	Media maker's interest 4	Media maker's interest 5	Media maker's interest 6	Media maker's interest 7	Media maker's interest 8	Media maker's interest 9	Media maker's interest 10	Media maker's interest Not Done
Getting more information	Getting more information 1	Getting more information 2	Getting more information 3	Getting more information 4	Getting more information 5	Getting more information 6	Getting more information 7	Getting more information 8	Getting more information 9	Getting more information 10	Getting more information Not Done

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* 16. Reconstructing Media

	1	2	3	4	5	6	7	8	9	10	Not Done
Also deconstructed	Also deconstructed 1	Also deconstructed 2	Also deconstructed 3	Also deconstructed 4	Also deconstructed 5	Also deconstructed 6	Also deconstructed 7	Also deconstructed 8	Also deconstructed 9	Also deconstructed 10	Also deconstructed Not Done
Clips #40 & 41	Clips #40 & 41 1	Clips #40 & 41 2	Clips #40 & 41 3	Clips #40 & 41 4	Clips #40 & 41 5	Clips #40 & 41 6	Clips #40 & 41 7	Clips #40 & 41 8	Clips #40 & 41 9	Clips #40 & 41 10	Clips #40 & 41 Not Done
What works	What works 1	What works 2	What works 3	What works 4	What works 5	What works 6	What works 7	What works 8	What works 9	What works 10	What works Not Done
Proactive consumers	Proactive consumers 1	Proactive consumers 2	Proactive consumers 3	Proactive consumers 4	Proactive consumers 5	Proactive consumers 6	Proactive consumers 7	Proactive consumers 8	Proactive consumers 9	Proactive consumers 10	Proactive consumers Not Done
Conversations in sphere of influence	Conversations in sphere of influence 1	Conversations in sphere of influence 2	Conversations in sphere of influence 3	Conversations in sphere of influence 4	Conversations in sphere of influence 5	Conversations in sphere of influence 6	Conversations in sphere of influence 7	Conversations in sphere of influence 8	Conversations in sphere of influence 9	Conversations in sphere of influence 10	Conversations in sphere of influence Not Done
Push back against producers	Push back against producers 1	Push back against producers 2	Push back against producers 3	Push back against producers 4	Push back against producers 5	Push back against producers 6	Push back against producers 7	Push back against producers 8	Push back against producers 9	Push back against producers 10	Push back against producers Not Done

Other (please specify)

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* 17. Linkage to Sexual Violence

	1	2	3	4	5	6	7	8	9	10	Not Done
Gender roles/gender equity	Gender roles/gender equity 1	Gender roles/gender equity 2	Gender roles/gender equity 3	Gender roles/gender equity 4	Gender roles/gender equity 5	Gender roles/gender equity 6	Gender roles/gender equity 7	Gender roles/gender equity 8	Gender roles/gender equity 9	Gender roles/gender equity 10	Gender roles/gender equity Not Done
Age appropriate healthy sexuality/relationships	Age appropriate healthy sexuality/relationships 1	Age appropriate healthy sexuality/relationships 2	Age appropriate healthy sexuality/relationships 3	Age appropriate healthy sexuality/relationships 4	Age appropriate healthy sexuality/relationships 5	Age appropriate healthy sexuality/relationships 6	Age appropriate healthy sexuality/relationships 7	Age appropriate healthy sexuality/relationships 8	Age appropriate healthy sexuality/relationships 9	Age appropriate healthy sexuality/relationships 10	Age appropriate healthy sexuality/relationships Not Done
Linkage between media and sv	Linkage between media and sv 1	Linkage between media and sv 2	Linkage between media and sv 3	Linkage between media and sv 4	Linkage between media and sv 5	Linkage between media and sv 6	Linkage between media and sv 7	Linkage between media and sv 8	Linkage between media and sv 9	Linkage between media and sv 10	Linkage between media and sv Not Done