4 Collaborative Behavior Survey

COLLABORATIVE BEHAVIOR SURVEY

We'd like to ask you to reflect on the collaborations emerging through the Project and your perspectives on this collaboration, including your leadership teams. We’ll ask you to complete this survey again sometime next year, to assess the development of the leadership teams. While completion of the surveys is certainly voluntary, what we learn from your and others' responses is critically important for guiding and strengthening our work together. Please take a few minutes of your time to share your perspectives with us. As the information will be aggregated, please note just the location you represent in the box provided below, no names please. We will share the results with you to help guide your collaboration. Thank you!

Organization name (please write in):

Statement	Strongly Disagree	Disagree	Neutral, No Opinion	Agree	Strongly Agree
Our agencies have a productive history of working together.	1	2	3	4	5
Others (in this community) who are not a part of this collaboration would generally agree that the organizations involved in this collaborative project are the “right” organizations to make this work.	1	2	3	4	5
The political and social climate seems to be “right” for starting a collaborative project like this one.	1	2	3	4	5
People involved in our collaboration trust one another.	1	2	3	4	5
I have a lot of respect for the other people involved in this collaboration.	1	2	3	4	5
The people involved in our collaboration represent a cross section of those who have a stake in what we are trying to accomplish.	1	2	3	4	5
The people involved in our collaboration represent a cross-section of the diversity in the community.	1	2	3	4	5
The people involved in our collaboration have the expertise necessary to work with underserved communities.	1	2	3	4	5
All the organizations that we need to be members of this collaborative group are members of the group.	1	2	3	4	5
My organization benefits from being involved in this collaboration.	1	2	3	4	5
The organizations that belong to our collaborative group invest the right amount of time in our collaborative.	1	2	3	4	5
Everyone who is a member of our collaborative group wants this project to succeed.	1	2	3	4	5
Each of the people who participate in decisions in this collaborative group can speak for the entire organization they represent, not just a part.	1	2	3	4	5

Public Burden Statement: 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. The OMB control number for this project is 0915-0212. Public reporting burden for this collection of information is estimated to average .25 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N-39, Rockville, Maryland, 20857.

People in this collaborative group are open to different approaches to how we can do our work. They are willing to consider different ways of working.	1	2	3	4	5
People in this collaborative group have a clear sense of their roles and responsibilities.	1	2	3	4	5
There is a clear process for making decisions among the partners in this collaboration.	1	2	3	4	5
This collaboration is able to adapt to changing conditions, such as fewer funds than expected, changing political climate, or change in leadership.	1	2	3	4	5
The people who lead this collaborative group communicate well with the members.	1	2	3	4	5
Communication among the people in this collaborative group happens both at formal meetings and in informal ways.	1	2	3	4	5
I have a clear understanding of what our collaboration is trying to accomplish.	1	2	3	4	5
People in our collaborative group know and understand our goals.	1	2	3	4	5
People in our collaborative group have established reasonable goals.	1	2	3	4	5
The people in this collaborative group are dedicated to the idea that we can make this project work.	1	2	3	4	5
My ideas about what we want to accomplish with this collaboration seem to be the same as the ideas of others.	1	2	3	4	5
What we are trying to accomplish with our collaborative project would be difficult for any single organization to accomplish by itself.	1	2	3	4	5
Our collaborative group has adequate funds to do what it wants to accomplish.	1	2	3	4	5
Our collaborative group has adequate “people power” to do what it wants to accomplish.	1	2	3	4	5
The people in leadership positions for this collaboration have good skills for working with other people and organizations.	1	2	3	4	5

Modified from Collaboration: What Makes it Work 2nd Ed. by Mattessich et al. Copyright 2001, Fieldstone Alliance. www.FieldstoneAlliance.org

Any additional comments? ____________________________________________________________

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