Social Network Survey

Attachment 11_Social Network Survey.doc

Drug Free Communities Support Program National Evaluation

Social Network Survey

OMB: 3201-0012

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Attachment 11


Case Study Social Network Survey


Survey Instructions


Thank you for filling out the DFC Social Network Survey. By taking the time to fill out this survey, you will provide valuable information for informing the work of DFC coalitions across the nation. As you know, coalitions can be powerful organizations for improving a community’s response to youth drug use, but sometimes they can also struggle to accomplish their long-term goals. This survey is designed to help us better understand how DFC coalition sectors work together and how they can be more effective in collaborating with one another.


Please respond to this survey regarding your perceptions and experiences with your coalition as a whole rather than only within one subcommittee/workgroup. These questions ask about the nature of the relationships your organization/agency has with the other sectors of your coalition. If you are answering these questions as a representative of the parent or youth sectors, please think of the broader sector of parents/youth as “your organization/agency.”


1. Below is a list of the different stakeholder sectors represented on DFC coalitions. Please check which stakeholder sector you represent. While you may work in an agency (e.g., law enforcement), you may be serving on this coalition in the role of parent and therefore you would check parent sector here. If you feel you participate in additional roles beyond the primary sector, please indicate that under “Other Sector(s) Represented.” If your agency or group does not fit within the broad sector categories, please check other and describe your agency or group.


Sector

Primary Sector Represented

( )

Other Sector(s) Represented

( )

  1. Parents



  1. Youth



  1. Business Community



  1. Civic/Volunteer Groups



  1. Healthcare Professionals



  1. Law Enforcement Agency



  1. Media



  1. Religious/Fraternal Organizations



  1. Schools



  1. State, Local and/or Tribal Government Agencies



  1. Youth-Serving Organizations



  1. Other Sector Not Represented Above:


______________________________________





2. For each of the stakeholder sectors, please circle the number that indicates the extent to which your organization/agency has worked with each stakeholder sector on prior coalitions or joint projects on any issue. By prior experience, we mean prior to participation on the DFC coalition.



Extent to Which Your Organization/Agency Has Worked with Each Sector on Prior Coalitions/Projects


Never

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

  1. Parents

1

2

3

4

  1. Youth

1

2

3

4

  1. Business Community

1

2

3

4

  1. Civic/Volunteer Groups

1

2

3

4

  1. Healthcare Professionals

1

2

3

4

  1. Law Enforcement Agency

1

2

3

4

  1. Media

1

2

3

4

  1. Religious/Fraternal Organizations

1

2

3

4

  1. Schools

1

2

3

4

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

  1. Youth-Serving Organizations

1

2

3

4

  1. Other Sector Not Represented Above:

______________________________


1

2

3

4


3. For each of the stakeholder sectors, please circle the number that indicates how often over the past year your organization/agency has communicated on issues related to youth substance use with any of the coalition members belonging to that sector outside of coalition meetings.



In the Past Year, How Often Has Your Organization/Agency Communicated with This Sector Outside of Coalition Meetings?


Never/Not Familiar

Once or Twice

Once Every 3 Months

Once a Month

Two or Three Times a Month

Every Week

  1. Parents

1

2

3

4

5

6

  1. Youth

1

2

3

4

5

6

  1. Business Community

1

2

3

4

5

6

  1. Civic/Volunteer Groups

1

2

3

4

5

6

  1. Healthcare Professionals

1

2

3

4

5

6

  1. Law Enforcement Agency

1

2

3

4

5

6

  1. Media

1

2

3

4

5

6

  1. Religious/Fraternal Organizations

1

2

3

4

5

6

  1. Schools

1

2

3

4

5

6

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

6

  1. Youth-Serving Organizations

1

2

3

4

5

6

  1. Other Sector Not Represented

Above:

______________________________

1

2

3

4

5

6


4. For each of the stakeholder sectors, please circle the number that indicates the extent to which you feel the members on your coalition representing that sector share a common philosophy with your organization/agency regarding issues related to youth substance use.



Extent to Which You Feel Members Share a Common Philosophy with Your Organization/Agency Regarding Issues Related to Youth Substance Use


Not at All

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

Unknown/ Not Familiar with Sector

  1. Parents

1

2

3

4

5

  1. Youth

1

2

3

4

5

  1. Business Community

1

2

3

4

5

  1. Civic/Volunteer Groups

1

2

3

4

5

  1. Healthcare Professionals

1

2

3

4

5

  1. Law Enforcement Agency

1

2

3

4

5

  1. Media

1

2

3

4

5

  1. Religious/Fraternal Organizations

1

2

3

4

5

  1. Schools

1

2

3

4

5

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

  1. Youth-Serving Organizations

1

2

3

4

5

  1. Other Sector Not Represented

Above:

______________________________

1

2

3

4

5


5. For each of the stakeholder sectors, please circle the number that indicates the extent to which you feel the members on your coalition representing that sector would be responsive if your organization/agency brought a concern or issue related to youth substance use to their attention.



Extent to Which You Feel Members Would Be Responsive if Your Organization/Agency Brought a Concern or Issue Related to Youth Substance Use to Their Attention


Not at All

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

Unknown/ Not Familiar with Sector

  1. Parents

1

2

3

4

5

  1. Youth

1

2

3

4

5

  1. Business Community

1

2

3

4

5

  1. Civic/Volunteer Groups

1

2

3

4

5

  1. Healthcare Professionals

1

2

3

4

5

  1. Law Enforcement Agency

1

2

3

4

5

  1. Media

1

2

3

4

5

  1. Religious/Fraternal Organizations

1

2

3

4

5

  1. Schools

1

2

3

4

5

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

  1. Youth-Serving Organizations

1

2

3

4

5

  1. Other Sector Not Represented

Above:

______________________________

1

2

3

4

5



6. For each of the stakeholder sectors, please circle the number that indicates the extent to which the members on your coalition representing that sector offer a unique perspective or form of expertise that has been valuable in addressing issues related to youth substance use.



Extent to Which Members Offer a Unique Perspective or Form of Expertise in Addressing/Understanding Issues Related to Youth Substance Use


Not at All

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

Unknown/ Not Familiar with Sector

  1. Parents

1

2

3

4

5

  1. Youth

1

2

3

4

5

  1. Business Community

1

2

3

4

5

  1. Civic/Volunteer Groups

1

2

3

4

5

  1. Healthcare Professionals

1

2

3

4

5

  1. Law Enforcement Agency

1

2

3

4

5

  1. Media

1

2

3

4

5

  1. Religious/Fraternal Organizations

1

2

3

4

5

  1. Schools

1

2

3

4

5

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

  1. Youth-Serving Organizations

1

2

3

4

5

  1. Other Sector Not Represented

Above:

______________________________

1

2

3

4

5



7. For each of the stakeholder sectors, please circle the number that indicates the extent to which the members on your coalition representing that sector can be trusted to follow through on what they say they will do regarding completing coalition tasks.



Extent to Which Members Can Be Trusted to Follow Through on What They Say They Will Do


Not at All

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

Unknown/ Not Familiar with Sector

  1. Parents

1

2

3

4

5

  1. Youth

1

2

3

4

5

  1. Business Community

1

2

3

4

5

  1. Civic/Volunteer Groups

1

2

3

4

5

  1. Healthcare Professionals

1

2

3

4

5

  1. Law Enforcement Agency

1

2

3

4

5

  1. Media

1

2

3

4

5

  1. Religious/Fraternal Organizations

1

2

3

4

5

  1. Schools

1

2

3

4

5

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

  1. Youth-Serving Organizations

1

2

3

4

5

  1. Other Sector Not Represented

Above:

______________________________

1

2

3

4

5



8. For each of the stakeholder sectors, please circle the number that indicates the extent to which the members on your coalition representing that sector assisted in achieving improved collaboration within your coalition.



Extent to Which Members Assisted in Achieving Improved Collaboration in Your Coalition


Not at All

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

Unknown/ Not Familiar with Sector

  1. Parents

1

2

3

4

5

  1. Youth

1

2

3

4

5

  1. Business Community

1

2

3

4

5

  1. Civic/Volunteer Groups

1

2

3

4

5

  1. Healthcare Professionals

1

2

3

4

5

  1. Law Enforcement Agency

1

2

3

4

5

  1. Media

1

2

3

4

5

  1. Religious/Fraternal Organizations

1

2

3

4

5

  1. Schools

1

2

3

4

5

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

  1. Youth-Serving Organizations

1

2

3

4

5

  1. Other Sector Not Represented Above:

______________________________

1

2

3

4

5




9. For each of the stakeholder sectors, please circle the number that indicates the extent to which the members on your coalition representing that sector assisted the coalition on issues related to youth substance use in your community.



Extent to Which Members Assisted the Coalition on Issues Related to Youth Substance Use in Your Community


Not at All

To a Slight

Extent

To a Moderate

Extent

To a Great Extent

Unknown/ Not Familiar with Sector

  1. Parents

1

2

3

4

5

  1. Youth

1

2

3

4

5

  1. Business Community

1

2

3

4

5

  1. Civic/Volunteer Groups

1

2

3

4

5

  1. Healthcare Professionals

1

2

3

4

5

  1. Law Enforcement Agency

1

2

3

4

5

  1. Media

1

2

3

4

5

  1. Religious/Fraternal Organizations

1

2

3

4

5

  1. Schools

1

2

3

4

5

  1. State, Local and/or Tribal Government Agencies

1

2

3

4

5

  1. Youth-Serving Organizations

1

2

3

4

5

  1. Other Sector Not Represented

Above:

______________________________

1

2

3

4

5



General Background


Please answer the following questions regarding your participation on the DFC coalition and your work experience.


10. When (year/month) did you begin participating on the DFC coalition?


Year_____ Month _____


11. Your Role in DFC coalition


______ Chair/Co-Chair (leader) overall coalition

______ Chair/Co-Chair (leader) of subcommittee, workgroup, etc.

______ Contributing coalition member

______ Other (Please briefly describe your role):


______________________________________________________________________________


______________________________________________________________________________


12. If you represent an organization/agency, approximately how long have you been employed at that organization/agency?


Years _____ Months _______


13. If you represent an organization/agency, please select ONE of the following that BEST describes your position within your organization/agency:

A. Agency Director

B. Administrative

C. Supervisor/Manager

D. Direct Services (primarily work directly with clients)

E. Not applicable (do not represent an agency/organization)

F. Other:_____________________________________________



Closing


What, if any, challenges has your coalition faced regarding collaboration across sectors? What has your coalition done to try to overcome these challenges?



















Is there any additional information you would like to provide the National Evaluation regarding the relationships and activities of your DFC coalition? This can include relevant information regarding the local community, political, and/or economic context. Any addition information regarding what has facilitated or impeded the attainment of successful outcomes of your coalition efforts on issues related to your substance abuse.
























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