Form RR Communications Campaign Tracking

Form Approved

OMB No. 0920-XXXX

Exp. Date:

Public Reporting burden of this collection of information is estimated at 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NW, MS D-24, Atlanta, GA 30333; Attn: PRA (0920-XXXX).

Attachment RR:

Communications Campaign Tracking

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Site number:

Program Year:

Survey Date:

Survey Iteration:

Communications Campaign Tracking Form

Since core components of the communication campaign are yet to be determined, below are some preliminary suggestions on process measures that will likely be relevant.

1. Number of students that apply to be brand ambassadors

2. Number of students selected to be brand ambassadors

3. Number of brand ambassadors that complete training

4. Number of brand ambassadors that remain with program for full year

5. Number of Facebook friends/fans

6. Average number of Facebook comments posted online in response to brand ambassador messages

7. Number of activities hosted

8. Number of students participating in each activity

9. Number and type of gear distributed

10. Number of advertisements placed

Cost

11. What is the total value of stipends or participation incentives distributed to Brand Ambassadors for their participation as a Brand Ambassador over the past 12 months?

12. How much time (excluding travel time) did you spend on Brand Ambassador or other Dating Matters communications activities over the past 3 months?

13. How much travel time and mileage did you spend on Brand Ambassador or other Dating Matters communications activities over the past 3 months?

14. What is your annual salary?

$0 to $9,999

$10,000 to $19,999

$20,000 to $29,999

$30,000 to $39,999

$40,000 to $49,999

$50,000 to $59,999

$60,000 to $69,999

$70,000 to $79,999

$80,000 to $89,999

$90,000 to $99,999

$100,000 or above