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First Name
1
Grade the idea
2
How did this idea
make you feel?
Group
(Mark ONLY one)
(Check all that apply)
q
Surprised
q
Curious
q
First Name
1
Grade the idea
2
How did this idea
make you feel?
Group
(Mark ONLY one)
q
Surprised
q
Curious
Worried
q
Worried
q
Angry
q
Angry
q
Disgusted
q
Disgusted
q
Skeptical
q
Skeptical
(Check all that apply)
Other
3
Other
How much do you agree or disagree
with the following statements:
3
(Check ONly one response for each item)
How much do you agree or disagree
with the following statements:
(Check ONly one response for each item)
Strongly
Disagree
Disagree
NEITHER
AGREE NOR
DISAGREE
AGREE
sTRONGLY
AGREE
Strongly
Disagree
Disagree
NEITHER
AGREE NOR
DISAGREE
AGREE
sTRONGLY
AGREE
This idea is worth remembering
q q
q
q
q
This idea is worth remembering
q q
q
q
q
This idea grabbed my attention
q q
q
q
q
This idea grabbed my attention
q q
q
q
q
This idea is ridiculous
q q
q
q
q
This idea is ridiculous
q q
q
q
q
This idea is meaningful to me
q q
q
q
q
This idea is meaningful to me
q q
q
q
q
This idea will convince young
people to think twice about
using smokeless tobacco
q q
q
q
q
This idea will convince young
people to think twice about
using smokeless tobacco
q q
q
q
q
This idea is offensive
q q
q
q
q
This idea is offensive
q q
q
q
q
This idea told me something
I did not already know
about smokeless tobacco
q q
q
q
q
This idea told me something
I did not already know
about smokeless tobacco
q q
q
q
q
This idea made me
think differently about
smokeless tobacco
q q
q
q
q
This idea made me
think differently about
smokeless tobacco
q q
q
q
q
This idea made me want to
learn more about the effects
of smokeless tobacco
q q
q
q
q
This idea made me want to
learn more about the effects
of smokeless tobacco
q q
q
q
q
| File Type | application/pdf |
| File Modified | 2014-02-04 |
| File Created | 2013-10-24 |