Communications Campaign Tracking Form

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

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 (0920-0941).

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:

Comm. Tracking #:

Survey Date:

Communications Tracking Form

1. Number of students that apply to be i2i Ambassadors____

2. Number of students selected to be i2i Ambassadors____

3. Number of i2i Ambassadors that complete training_____

4. Number of i2i Ambassadors that remain with program for full year____

5. Total Number of Facebook likes to the community Facebook page ___

6. Average number of Facebook comments posted online in response to i2i Ambassador posts___

7. Number of events/activities hosted ___

8. Approximate number of students participating in each activity___

9. Number and type of materials distributed ___

10. Number of new partnerships developed to support the Youth Communications Program ___

11. Each month, we ask that the Ambassador Managers export a Facebook Insights report in order to gather

and report the following data:

a. Monthly New Likes: The number of new people who have liked the Page (Unique Users)___

b. Monthly People Talking About This: The number of people sharing stories about the page ___
(; this includes liking the Page; posting to the Page’s wall; liking, commenting on or sharing one of the

Page posts; answering a posted question; RSVPing to one of the events; mentioning the Page; photo-

tagging the Page; or checking in at the events)

c. Monthly Page Engaged Users: The number of people who engaged with the Page, including any click or

story created __

d. Monthly Total Reach: The number of people who have seen any content associated with the Page___

e. Monthly Total Consumers: The number of people who clicked on any of the content ___

Cost

12. What is the total value of stipends or participation incentives distributed to i2i Ambassadors for their participation as a i2i Ambassador over the past 12 months? ______________

13. How much time (excluding travel time) did you spend on i2i Ambassador or other Dating Matters communications activities over the past 3 months? ________________

14. How much travel time and mileage did you spend on i2i Ambassador or other Dating Matters communications activities over the past 3 months? ________________

15. What is your annual salary? (select one of the following choices)

1. $0 to $9,999

2. $10,000 to $19,999

3. $20,000 to $29,999

4. $30,000 to $39,999

5. $40,000 to $49,999

6. $50,000 to $59,999

7. $60,000 to $69,999

8. $70,000 to $79,999

9. $80,000 to $89,999

10. $90,000 to $99,999

11. $100,000 or above