Thank you for participating in this survey. The survey asks your opinion about a number of things in your life, including your friends and your family. 
This is not a test. There are no right or wrong answers.  We want to know how you feel about parts of our program and how we can improve. Your responses will be used to improve the PEER Ambassador program.

Your email address is collected here and will be seen only by the Evaluation Coordinator to let you know when it is time to take this survey again, and will remain confidential. Your others responses will be anonymized before sharing with the team. 

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* 1. What is your email address?

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* 2. Have you completed the Peer Ambassador training modules?

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* 3. How long have you been a PEER Ambassador?

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* 4. In all of the questions with SQUARE checkbox answers, you should select ALL the answers that are true for you.

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* 5. How confident do you feel helping a friend, family member, or a community member…

Please check all that apply:

  Not confident Could listen empathetically Could provide contact info for services Could tell them about services
…access resources related to food pantries, fuel assistance, and/or housing/rent assistance?
...access substance use treatment services?
…access mental health services?
…that is experiencing domestic violence?
…access parenting resources?

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* 6. About how many community-based organizations are you familiar with?

Examples: Community Action Family Center, Recover Project, The Brick House, Tapestry Health, Salasin, WIC, Headstart, etc.

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* 7. How many days per week does your family usually share a meal together?

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* 8. In the past month, how often have you had a conversation with your children about...

  Not at this time Once per week Twice per week More than twice per week Prefer not to say
...helping them label their emotions and understand the causes and consequences?
...the benefits of limiting their screen time, including social media?
...the risks and harms of youth alcohol and drug use?

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* 9. In the past month, how often have you had a conversation with a friend, family member, or community member about…

  Not at all Once per week Twice per week More than twice per week Prefer not to say
…helping children label their emotions and understand the causes and consequences.
…the benefits of limiting their screen time, including social media.
…the risks and harms of youth alcohol and drug use.
...how to talk to their kids about drugs and alcohol use.

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* 10. In the past month, how often has your family...

  Not at all Once per week Twice per week More than twice per week Prefer not to say
...(including children) been assigned roles and responsibilities in your household (washing dishes, helping with laundry, etc.)?
...engaged in physical activity together (walking, hiking, bike riding, etc.)?

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* 11. Please rate your agreement with the following statements:

  Strongly disagree Disagree Neutral Agree Strongly agree
"Even though I may not always manage it, I know what I need to do with my child."
"I am able to do the things that will improve my child’s behavior."
"I can make an important difference to my child."
"In most situations I know what I should do to ensure my child behaves."
"The things I do make a difference to my child’s behavior."

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* 12. Please rate your agreement with the following statements:

  Strongly disagree Disagree Neutral Agree Strongly agree
"I feel comfortable talking to people from all different family structures."
"My career connections have increased as a result of the PEER Ambassador Program."
"My confidence has improved as a result of the PEER Ambassador Program."

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* 13. I'm more likely to use the term:

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* 14. I’m more likely to use the term:

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* 15. Have you ever participated in a parenting program like the Nurturing Families program or Parenting Journey or Strengthening Families (NOT including this PEER Ambassador program)?

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