Coalition Functioning Instrument

This survey asks questions about your coalition or group. It gives you a chance to privately state what you think about how the coalition or groups works together. It will take about 5 minutes to fill out. Your name is not attached to it in any way and other people in the group will not see your answers.

Please answer honestly; there are no right or wrong answers. The information you provide will be combined with other members' responses and will be used to measure and improve coalition capacity and effectiveness. Thank you for your participation.

Did you already complete the coalition survey on paper? If you did--there is no need to do the survey again.

Question Title

* 1. Participant Satisfaction

How satisfied are you with:

	Completely satisfied	Mostly satisfied	Somewhat satisfied	A little satisfied	Not at all satisified
A. The way the people and organizations in the coalition work together?	A. The way the people and organizations in the coalition work together? Completely satisfied	A. The way the people and organizations in the coalition work together? Mostly satisfied	A. The way the people and organizations in the coalition work together? Somewhat satisfied	A. The way the people and organizations in the coalition work together? A little satisfied	A. The way the people and organizations in the coalition work together? Not at all satisified
B. Your ability to make change as a coalition participant?	B. Your ability to make change as a coalition participant? Completely satisfied	B. Your ability to make change as a coalition participant? Mostly satisfied	B. Your ability to make change as a coalition participant? Somewhat satisfied	B. Your ability to make change as a coalition participant? A little satisfied	B. Your ability to make change as a coalition participant? Not at all satisified
C. The coalition's plans for achieving its goals?	C. The coalition's plans for achieving its goals? Completely satisfied	C. The coalition's plans for achieving its goals? Mostly satisfied	C. The coalition's plans for achieving its goals? Somewhat satisfied	C. The coalition's plans for achieving its goals? A little satisfied	C. The coalition's plans for achieving its goals? Not at all satisified
D. The way the coalition is implementing its plans?	D. The way the coalition is implementing its plans? Completely satisfied	D. The way the coalition is implementing its plans? Mostly satisfied	D. The way the coalition is implementing its plans? Somewhat satisfied	D. The way the coalition is implementing its plans? A little satisfied	D. The way the coalition is implementing its plans? Not at all satisified
E. Communication between coalition leadership and members?	E. Communication between coalition leadership and members? Completely satisfied	E. Communication between coalition leadership and members? Mostly satisfied	E. Communication between coalition leadership and members? Somewhat satisfied	E. Communication between coalition leadership and members? A little satisfied	E. Communication between coalition leadership and members? Not at all satisified

Question Title

* 2. Coalition Leadership

Please rate the total effectiveness of your coalition's leadership in each of the following areas:

	Excellent	Very good	Good	Fair	Poor	Don't know
A. Inspiring or motivating people involved in the coalition	A. Inspiring or motivating people involved in the coalition Excellent	A. Inspiring or motivating people involved in the coalition Very good	A. Inspiring or motivating people involved in the coalition Good	A. Inspiring or motivating people involved in the coalition Fair	A. Inspiring or motivating people involved in the coalition Poor	A. Inspiring or motivating people involved in the coalition Don't know
B. Assigning roles or duties to the people involved in the coalition	B. Assigning roles or duties to the people involved in the coalition Excellent	B. Assigning roles or duties to the people involved in the coalition Very good	B. Assigning roles or duties to the people involved in the coalition Good	B. Assigning roles or duties to the people involved in the coalition Fair	B. Assigning roles or duties to the people involved in the coalition Poor	B. Assigning roles or duties to the people involved in the coalition Don't know
C. Fostering respect, trust, inclusiveness and openness in the coalition	C. Fostering respect, trust, inclusiveness and openness in the coalition Excellent	C. Fostering respect, trust, inclusiveness and openness in the coalition Very good	C. Fostering respect, trust, inclusiveness and openness in the coalition Good	C. Fostering respect, trust, inclusiveness and openness in the coalition Fair	C. Fostering respect, trust, inclusiveness and openness in the coalition Poor	C. Fostering respect, trust, inclusiveness and openness in the coalition Don't know
D. Creating an environment where differences of opinion can be voiced	D. Creating an environment where differences of opinion can be voiced Excellent	D. Creating an environment where differences of opinion can be voiced Very good	D. Creating an environment where differences of opinion can be voiced Good	D. Creating an environment where differences of opinion can be voiced Fair	D. Creating an environment where differences of opinion can be voiced Poor	D. Creating an environment where differences of opinion can be voiced Don't know
E. Resolving conflict among partners	E. Resolving conflict among partners Excellent	E. Resolving conflict among partners Very good	E. Resolving conflict among partners Good	E. Resolving conflict among partners Fair	E. Resolving conflict among partners Poor	E. Resolving conflict among partners Don't know
F. Using the perspectives, resources and skills of partners to accomplish coalition goals	F. Using the perspectives, resources and skills of partners to accomplish coalition goals Excellent	F. Using the perspectives, resources and skills of partners to accomplish coalition goals Very good	F. Using the perspectives, resources and skills of partners to accomplish coalition goals Good	F. Using the perspectives, resources and skills of partners to accomplish coalition goals Fair	F. Using the perspectives, resources and skills of partners to accomplish coalition goals Poor	F. Using the perspectives, resources and skills of partners to accomplish coalition goals Don't know
G. Helping the coalition identify new ways to solve problems	G. Helping the coalition identify new ways to solve problems Excellent	G. Helping the coalition identify new ways to solve problems Very good	G. Helping the coalition identify new ways to solve problems Good	G. Helping the coalition identify new ways to solve problems Fair	G. Helping the coalition identify new ways to solve problems Poor	G. Helping the coalition identify new ways to solve problems Don't know
H. Recruiting diverse people and organizations into the coaltion	H. Recruiting diverse people and organizations into the coaltion Excellent	H. Recruiting diverse people and organizations into the coaltion Very good	H. Recruiting diverse people and organizations into the coaltion Good	H. Recruiting diverse people and organizations into the coaltion Fair	H. Recruiting diverse people and organizations into the coaltion Poor	H. Recruiting diverse people and organizations into the coaltion Don't know

Question Title

* 3. Coalition Characteristics

By working together, how well are coalition partners able to:

	Extremely well	Very well	Somewhat well	Not so well	Not well at all	N/A
A. Use data to identify community needs and guide coalition decisions?	A. Use data to identify community needs and guide coalition decisions? Extremely well	A. Use data to identify community needs and guide coalition decisions? Very well	A. Use data to identify community needs and guide coalition decisions? Somewhat well	A. Use data to identify community needs and guide coalition decisions? Not so well	A. Use data to identify community needs and guide coalition decisions? Not well at all	A. Use data to identify community needs and guide coalition decisions? N/A
B. Include the views and priorities of the people affected by the coalition's work?	B. Include the views and priorities of the people affected by the coalition's work? Extremely well	B. Include the views and priorities of the people affected by the coalition's work? Very well	B. Include the views and priorities of the people affected by the coalition's work? Somewhat well	B. Include the views and priorities of the people affected by the coalition's work? Not so well	B. Include the views and priorities of the people affected by the coalition's work? Not well at all	B. Include the views and priorities of the people affected by the coalition's work? N/A
C. Develop goals and objectives that are widely understood and supported among partners?	C. Develop goals and objectives that are widely understood and supported among partners? Extremely well	C. Develop goals and objectives that are widely understood and supported among partners? Very well	C. Develop goals and objectives that are widely understood and supported among partners? Somewhat well	C. Develop goals and objectives that are widely understood and supported among partners? Not so well	C. Develop goals and objectives that are widely understood and supported among partners? Not well at all	C. Develop goals and objectives that are widely understood and supported among partners? N/A
D. Respond to the needs and problems of the community?	D. Respond to the needs and problems of the community? Extremely well	D. Respond to the needs and problems of the community? Very well	D. Respond to the needs and problems of the community? Somewhat well	D. Respond to the needs and problems of the community? Not so well	D. Respond to the needs and problems of the community? Not well at all	D. Respond to the needs and problems of the community? N/A
E. Select and implement strategies that are most likely to work in the community?	E. Select and implement strategies that are most likely to work in the community? Extremely well	E. Select and implement strategies that are most likely to work in the community? Very well	E. Select and implement strategies that are most likely to work in the community? Somewhat well	E. Select and implement strategies that are most likely to work in the community? Not so well	E. Select and implement strategies that are most likely to work in the community? Not well at all	E. Select and implement strategies that are most likely to work in the community? N/A
F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward?	F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward? Extremely well	F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward? Very well	F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward? Somewhat well	F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward? Not so well	F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward? Not well at all	F. Build relationships with policymakers and key stakeholder in the community who can help move the coalition's plans forward? N/A
G. Collaborate with other coalitions/organizations in the community to address common issues and concerns?	G. Collaborate with other coalitions/organizations in the community to address common issues and concerns? Extremely well	G. Collaborate with other coalitions/organizations in the community to address common issues and concerns? Very well	G. Collaborate with other coalitions/organizations in the community to address common issues and concerns? Somewhat well	G. Collaborate with other coalitions/organizations in the community to address common issues and concerns? Not so well	G. Collaborate with other coalitions/organizations in the community to address common issues and concerns? Not well at all	G. Collaborate with other coalitions/organizations in the community to address common issues and concerns? N/A
H. Keep the community updated and informed on past, present and upcoming activities?	H. Keep the community updated and informed on past, present and upcoming activities? Extremely well	H. Keep the community updated and informed on past, present and upcoming activities? Very well	H. Keep the community updated and informed on past, present and upcoming activities? Somewhat well	H. Keep the community updated and informed on past, present and upcoming activities? Not so well	H. Keep the community updated and informed on past, present and upcoming activities? Not well at all	H. Keep the community updated and informed on past, present and upcoming activities? N/A
I. Clearly communicate to people in the community why the coalition's actions are important to them?	I. Clearly communicate to people in the community why the coalition's actions are important to them? Extremely well	I. Clearly communicate to people in the community why the coalition's actions are important to them? Very well	I. Clearly communicate to people in the community why the coalition's actions are important to them? Somewhat well	I. Clearly communicate to people in the community why the coalition's actions are important to them? Not so well	I. Clearly communicate to people in the community why the coalition's actions are important to them? Not well at all	I. Clearly communicate to people in the community why the coalition's actions are important to them? N/A
J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods?	J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods? Extremely well	J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods? Very well	J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods? Somewhat well	J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods? Not so well	J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods? Not well at all	J. Use partners' in-kind resources (e.g. skills, expertise, Information, data, connections, influence, space, equipment, goods? N/A

Question Title

* 4. Coalition Impact

By working together, how well are coalition partners able to:

	Extremely well	Very well	Somewhat well	Not so well	Not well at all	N/A
A. Empower the community to address identified problems?	A. Empower the community to address identified problems? Extremely well	A. Empower the community to address identified problems? Very well	A. Empower the community to address identified problems? Somewhat well	A. Empower the community to address identified problems? Not so well	A. Empower the community to address identified problems? Not well at all	A. Empower the community to address identified problems? N/A
B. Have an impact on the community?	B. Have an impact on the community? Extremely well	B. Have an impact on the community? Very well	B. Have an impact on the community? Somewhat well	B. Have an impact on the community? Not so well	B. Have an impact on the community? Not well at all	B. Have an impact on the community? N/A

Question Title

* 5. Participation

Participating in the coalition has:

	Yes	No
A. Enhanced my ability to address an important issue	A. Enhanced my ability to address an important issue Yes	A. Enhanced my ability to address an important issue No
B. Enhanced my ability to have a greater impact than I could have on my own	B. Enhanced my ability to have a greater impact than I could have on my own Yes	B. Enhanced my ability to have a greater impact than I could have on my own No
C. Given me frustration or aggravation	C. Given me frustration or aggravation Yes	C. Given me frustration or aggravation No
D. Diverted time and resources away from other priorities and obligations	D. Diverted time and resources away from other priorities and obligations Yes	D. Diverted time and resources away from other priorities and obligations No

Demographics

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* 6. Please select your age category

Under 18

18-24

25-44

45-64

65+

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* 7. What is your gender?

Male

Female

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* 8. What is your race/ethnicity?

American Indian or Alaska Native

Asian

Black or African American

Hawaiian or other Pacific Islander

Multi-racial

White

Other (please specify)

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* 9. Are you Hispanic or Latino?

Yes

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* 10. Which of the following best describes the sector of the community you represent in this coalition?

Government or law enforcement

Behavioral health, prevention, or recovery

Community resident, family member

Business

Youth

Advocacy group

Youth center

Religious community

Schools and education

Other (please specify)

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* 11. What is your role in the coalition?

Board member

Committee leader

Agency representative

Community member

Not sure/Prefer not to answer

Other (please specify)

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* 12. Please check all that apply

I attend 75-100% of coalition meetings

I attend at least 50% of coalition meetings

I attend at least one coalition meeting per year

I attend subcommittee meetings

I am a coalition member but am unable to attend meetings

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* 13. How long has the coalition been functioning?

More than 3 years

2-3 years

1-2 years

6 months-1 year

less than 6 months

Not sure/Prefer not to answer

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* 14. How long have you been a member of the coalition?

More than 3 years

2-3 years

1-2 years

6 months- 1 year

less than 6 months

Not sure/Prefer not to answer

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* 1. Participant SatisfactionHow satisfied are you with:

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* 2. Coalition LeadershipPlease rate the total effectiveness of your coalition's leadership in each of the following areas:

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* 3. Coalition CharacteristicsBy working together, how well are coalition partners able to:

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* 4. Coalition ImpactBy working together, how well are coalition partners able to:

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* 5. ParticipationParticipating in the coalition has:

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* 6. Please select your age category

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* 7. What is your gender?

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* 8. What is your race/ethnicity?

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* 9. Are you Hispanic or Latino?

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* 10. Which of the following best describes the sector of the community you represent in this coalition?

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* 11. What is your role in the coalition?

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* 12. Please check all that apply

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* 13. How long has the coalition been functioning?

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* 14. How long have you been a member of the coalition?

* 1. Participant Satisfaction

How satisfied are you with:

* 2. Coalition Leadership

Please rate the total effectiveness of your coalition's leadership in each of the following areas:

* 3. Coalition Characteristics

By working together, how well are coalition partners able to:

* 4. Coalition Impact

By working together, how well are coalition partners able to:

* 5. Participation

Participating in the coalition has: