NAHIC :: Evaluation

Materials Response Form

INSTRUCTIONS: Please complete the following information if you have received hard copies or downloaded the 2010 Guide Improving the Health of Adolescents and Young Adults: A Guide for States and Communities and/or other National Initiative materials. Once you've submitted the form you will get a successful message.

Contact Information

If someone referred you to the National Initiative materials, please fill out his/her information in the National Initiative Partner area. If not, please leave that area blank and move on to the Recipient Organization area to provide your information.

National Initiative Partner

Partner Organization:		Contact Name:
Phone:		Email:

Recipient Organization

Organization		Contact Name:
State:
Phone:		Email:

Recipient's Organization Type
Funder Healthcare Provider Education Health Educator Youth Services Org Public Health Group Contractor Community Coalition Coordinator Grantee Other

Materials Recieved

Please indicate which National Initiative Materials you have used.

Materials	Number
Full Document
Executive Summary
Powerpoint
News Article
Other:

Feedback on Materials

Please answer the following questions about the NIIAH Adolescent Health Materials you've used.

Usefulness

How likely is your organization to utilize the National Initiative materials? (choose one)

Extremely likely

Likely

Somewhat likely

Not at all likely

How would you rate the overall usefulness of the National Initiative materials?

Extremely useful

Very useful

Somewhat useful

Not at all useful

Relevance

How would you evaluate the relevance of the National Initiative materials to the work of your organization?

Extremely relevant

Very relevant

Somewhat relevant

Not at all relevant

Were you able to adapt the National Initiative materials to the work of your organization?

Yes, with great ease

Yes, easily

Yes, with difficulty

Length

How would you evaluate the length of the National Initiative materials?

Too long

About right

Too short

Additional Resources

What other adolescent health materials would be useful to your organization now and in the future?

Do you have any further comments?

NAHIC is honored to be the 2006 recipient of the Society for Adolescent Medicine's Millar Award for Innovative Approaches to Adolescent Health Care. Please click on the picture below to download the Award presentation.

Please be sure to visit our Sister Site, the Policy Center. Resources on the site include papers on Young Adult health, Middle Childhood documents, a Brief listing organizations that track state and federal policies in adolescent health, and many more publications.

We are pleased to announce our partnership with Child Trends. Together we conduct research, create resources and offer assistance to improve the health of young people and their families.

For technical information, permission to use text or images, or permission to link to the NAHIC site, please contact our webmistress at nahic@ucsf.edu.

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