Monitoring Data for ECA (MODE) Framework

ECA Program Alumni Survey

Instructions for survey administrators: Alumni should receive the survey at the following intervals: one year, three years and five years after program participation

Introduction and Privacy Act Statement:

The Evaluation Division of the U.S. State Department’s Bureau of Educational and Cultural Affairs (ECA) would like to ask you a few questions about your knowledge, attitudes, and future plans following your program experience. [SPECIFIC PROGRAM LANGUAGE TO BE TAILORED AS NEEDED]

Privacy Act Statement

AUTHORITY: The information on this form is requested under the authority of 22 U.S.C. 2451 et seq (Mutual Educational and Cultural Exchange Act of 1961), P.L. 103-62 (Government Performance and Results Act of 1993), and P.L. 111-352 (Government Performance and Results Modernization Act of 2010).

PURPOSE: The purpose of gathering this information is to track program performance and the direction, pace, and magnitude of change for ECA programs.

ROUTINE USES: The information on this form may be shared with members of Congress, and the Office of Management and Budget (OMB). De-identified data files may be shared (without Personally Identifiable Information such as names or contact information) with ECA implementing partners and external researchers who are assisting ECA in measuring its impact. More information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program Records.

DISCLOSURE: Responding to this survey is voluntary. The answers you provide on the survey will have no bearing on your participation in alumni activities or any future applications you may submit for U.S. State Department programs.

By clicking “Consent and Enter Survey” button below, you are consenting to the above terms.

You can read ECA’s full data sharing and storage policy here: [LINK TO DATA POLICY]

Please complete this survey by [DEADLINE]. The survey has [NUMBER OF QUESTIONS] questions and will take approximately [TIME ESTIMATE] minutes to complete.

Thank you in advance for your time and participation!

[CONSENT AND ENTER SURVEY BUTTON]

Program Questions

1. Please select any ECA programs from the list below that you have participated in: [Drop-down ECA programs, including “Other” option]

2. Please provide the following information for each program:

**A reciprocal exchange is if you went abroad after having an individual from another country visit your home, school, or workplace as part of a Department of State ECA program**

	Year of participation	Reciprocal Exchange
Selected program 1	[year drop down]	[y/n]
Selected program 2	[year drop down]	[y/n]
Selected program 3	[year drop down]	[y/n]

Unique Identifier Questions

The responses to the following four questions will be used to create a Respondent Unique UD, which will be unique to you. We will use this unique ID to match your responses across different surveys while maintaining your anonymity.

3. What is the first initial of your middle name? (If you do not have a middle name, enter “X”) (drop down)

4. What are the first two letters of your mother’s first name? (drop down)

5. What are the first two letters of your father’s name? (drop down)

6. What are the digits of the day of the month on which you were born as a 2-digit number (e.g. 06, 12, 25) (drop down)

7. What are the last two digits of your birth year (drop down)

Demographic Questions

8. Please check the option that best describes your gender:

   1. Male

   2. Female

   3. Non-Binary

   4. I do not wish to respond

9. Please select the country of your citizenship at the time of your most recent exchange: [Drop-down countries]

If country other than “United States”, skip to Q12.

10. Please select the State you were living in when you participated in your most recent ECA program: [Drop-down State]

11. What is your race or ethnicity? Mark one or more.

1. White

2. Hispanic or Latino

3. Black or African American

4. Asian

5. American Indian or Alaskan Native

6. Native Hawaiian or Other Pacific Islander

Cross-Cultural Competency

12. FBS 1.1.1a/ E1.1.4 (Foreign)- How have your views of the United States Government and the American people evolved since your program participation?

	Less favorable	No change- my has remained unfavorable	No change- my view has remained favorable	More favorable
E1.1.4- United States Government
FBS1.1.1a- American People

13. FBS 1.1.1b (Foreign)- How much did participation in the program change your understanding or knowledge of the following topics?

	No change	Minimal change	Moderate change	Substantial change
United States democracy	1	2	3	4
United States economy	1	2	3	4
Foreign affairs in the United States	1	2	3	4
Domestic affairs in the United States	1	2	3	4
United States values and culture	1	2	3	4
Daily life in the United States	1	2	3	4
Religious and ethnic diversity in the United States	1	2	3	4
Freedom of speech and press in the United States	1	2	3	4
Voluntary community service in the United States	1	2	3	4

14. E1.1.11 (American)- How much did participation in the program change your understanding or knowledge of the following topics?

	No change	Minimal change	Moderate change	Substantial change
Host country political system	1	2	3	4
Host country economy	1	2	3	4
Foreign affairs of my host country	1	2	3	4
Domestic affairs of my host country	1	2	3	4
Host country values and culture	1	2	3	4
Daily life in my host country	1	2	3	4
Religious and ethnic diversity in my host country	1	2	3	4
Freedom of speech and press in my host country	1	2	3	4
Voluntary community service in my host country	1	2	3	4

15. E1.1.12 (American and Foreign)- Thinking about the exchange participants you met that were from other countries (not your home country or your host country), how much did participation in the program change your understanding or knowledge of the following topics related to those countries?

	No change	Minimal change	Moderate change	Substantial change
Political system	1	2	3	4
Economy	1	2	3	4
Foreign affairs	1	2	3	4
Domestic affairs	1	2	3	4
Values and culture	1	2	3	4
Daily life	1	2	3	4
Religious and ethnic diversity	1	2	3	4
Freedom of speech and press	1	2	3	4
Voluntary community service	1	2	3	4

16. FBS 4.2.1 (American and Foreign)- To what extent do you agree or disagree with the statements below?

	Strongly disagree	Disagree	Agree	Strongly agree
Voting is important because real decisions are made in elections	1	2	3	4
Free and fair elections are the cornerstone of democracy	1	2	3	4
An independent media is important to the free flow of information	1	2	3	4
All citizens in a country should have equal rights and protections under the law, regardless of circumstances	1	2	3	4
The Rule of Law is fundamental to a functioning democracy	1	2	3	4
Individuals and organizations have the right to free speech and to voice 0position	1	2	3	4
Democratic principles enhance the workplace. Supervisors should incorporate democratic principles into their management practices	1	2	3	4

17. E1.1.2 (American and Foreign)- Have you shared about your exchange experience in any of the following ways in the past year?

	Yes	No
Media interviews (newspaper, television, radio, podcast)
Presentations to community, neighborhood, school or university groups
Informal discussions with colleagues and other professionals
Informal discussions with family, friends, or community members
Postings on electronic or social media (website, Facebook, Twitter, blog, etc)
Newspapers or magazine articles, including editorials and opinion pieces

If from the United States, skip to Q19.

18. E1.1.5 (Foreign)- By sharing about my exchange experience, I have helped those in my community better understand the United States.

1. Yes

2. No

Skip to Q20.

19. E1.1.7 (American)- By sharing about my exchange experience, I have helped those in my community better understand my host country.

1. Yes

2. No

For the following questions, please consider the following statement: “My responsibility to people of other countries is as great as my responsibility to people of my own country.”

20. E1.0.2 (American and Foreign)- Immediately following your program experience, what was your perspective on the above statement?

1. Strongly agree

2. Agree

3. Neutral

4. Disagree

5. Strongly disagree

6. Don’t know/ Can’t Ascertain

21. E1.0.2 (American and Foreign)- Today, as an ECA alum, has your perspective on the above statement changed?

1. Agree more

2. Remained the same

3. Agree less

4. Don’t Know/ Can’t Ascertain

Civic Engagement

22. E2.02 (American and Foreign)- In the past 6 months, I have:

	Often	Several times	Once or twice	Never
Raised awareness on issues that affect my community or country.
Volunteered in my local community

23. E2.1.2 (American and Foreign)- As a direct result of your participation in the exchange program, have you done any of the following:

	Yes	No
Organized or initiated new activities or projects in your organization
Introduced new policies or procedures in the workplace
Advocated for new initiatives in the workplace to support women
Advocated for new initiatives in the workplace to support under-represented populations
Established joint ventures, organizational partnerships, or linkages
Introduced new curricula, teaching methods, or educational standards
Other

24. E2.1.3 (American and Foreign)- In the past 6 months, I have:

	Often	Several times	Once or twice	Never
Contacted media to express my concerns about an international problem
Contacted media to express my concerns about a domestic problem
Expressed my views about international politics on a website, blog, or chat room
Expressed my views about domestic politics on a website, blog, or chat room
Contacted or visited someone in government to seek public action on international issues and concerns
Contacted or visited someone in government to seek public action on domestic actions or concerns
Participated in an event where people express their views about international problems
Participated in an event where people express their views about domestic problems

25. E2.0.5 (American and Foreign)- As a result of your program participation, have you designed and implemented any projects to help your community or country?

1. Yes

2. No

If “No”, skip to Q29.

26. E2.0.5 (American and Foreign)- Did you access any of the following resources through the U.S. Embassy for your project(s):

1. AEIF

2. Small Grants

3. American Spaces

4. Supplies or equipment

5. Embassy network of experts and leaders

6. Other

7. None

27. E2.0.5 (American and Foreign)- Which category below best describes your project(s):

1. Youth engagement

2. Environment (Example: sustainability, ecotourism, agriculture, etc)

3. Social entrepreneurship

4. Economic development

5. Leadership training

6. Education

7. Civic engagement

8. Promoting equality (Example: interfaith dialogue, disability rights, women’s empowerment)

9. Disinformation (Example: information campaign, media literacy training)

28. E2.0.5 (American and Foreign)- Please select the main activities of your project:

1. Trainings or workshops

2. Established an NGO or other organization

3. Mentorship program

4. Advocacy/awareness campaign

5. Events or speeches

6. Fundraising

7. Research

8. Other

Skip to Q30.

29. E2.0.5 (American and Foreign)- What has prevented you from implementing a project:

1. I am not sure what to do

2. I have not had the time

3. I have not had the funding

4. I cannot get support from the appropriate stakeholders

5. My interests have shifted

6. Other

If from the United States, skip to Q36.

30. E2.1.5 (Foreign)- Do you ever post or submit your own news content, such as articles, videos, or photos, to a news outlet, listserv or social media group? (News content includes articles, videos, photos, blogs and social media posts that are intended to inform the public about current events either locally, nationally, or globally)

1. Yes

2. No

If “No”, skip to Q32.

31. E2.1.5 (Foreign)- Please indicate approximately how many articles, videos, photos or posts you have produced across the following platforms in the past 3 months:

	Number
Local news outlet (TV, Radio, Print)
National news outlet (TV, Radio, Print)
International news outlet (TV, Radio, Print)
Blog
Social Media (Twitter, Instagram, Facebook, SnapChat, WhatsApp)
Listserv

32. E2.1.1 (Foreign) - Understanding that false information is all around us, did you do either of the following prior to your program participation?

	Yes	No
Shared news or information that you LATER FOUND OUT was made up?
Shared news and information that you KNEW AT THE TIME was made up?

If “no” to second item, skip to Q34.

33. E2.1.1 (Foreign) What is the main reason you shared news and information that you knew at the time was made-up?

1. I thought it was surprising or entertaining

2. I liked what it said

3. I wanted to create a discussion about it

4. I wanted to tell others it was inaccurate

34. E2.1.1 (Foreign) - Have you done either of the following since your program participation?

	Yes	No
Shared news or information that you LATER FOUND OUT was made up?
Shared news and information that you KNEW AT THE TIME was made up?

If “no” to second item, skip to Q36.

35. E2.1.1 (Foreign) - What is the main reason you shared news and information that you knew at the time was made-up?

1. I thought it was surprising or entertaining

2. I liked what it said

3. I wanted to create a discussion about it

4. I wanted to tell others it was inaccurate

36. E4a.0.16 (American and Foreign)- Please indicate the level to which you agree or disagree with the following statements compared to the end of your program:

	Agree more	My views have not changed, I agree	My views have not changed, I disagree	Disagree more
If I am misinformed by the news media, it is my own behavior that determines how soon I will learn credible information
I am in control of the information I get from the news media
The main thing that affects my knowledge about the world is what I myself do
If I pay attention to different sources of news, I can avoid being misinformed
If I take the right actions I can stay informed

37. E4a.0.17 (American and Foreign)- Did what you learned during your program on the issue of made-up news and information lead you to do any of the following?

	Yes	No	N/A
Stop getting news from a non-credible outlet
Check the facts of news stories yourself
Report or flag a story that you think is made-up
Change the way you use social media
Consume multiple news sources

38. E4a.0.17 (American and Foreign)- Please briefly expand on the ways you have changed your media consumption. [Open-Ended]

If from the United States, skip to Q43.

39. E4a.0.21 (Foreign)- Please select how frequently you got your information from the following news sources in the past month:

	A lot	Some	Not too much	Not at all
International news organizations
National news organizations
Local news organizations
Friends, family, and acquaintances
Political figures or leaders
Social media sites, such as Facebook, Twitter or Snapchat
Local newsletters or listservs

40. E4a.0.21 (Foreign)- Please select which languages you primarily used to consume media in the past month: [Drop down list of languages]

41. E4a.0.21 (Foreign)- Please select how frequently you got your information from the following news sources in the prior to program participation:

	A lot	Some	Not too much	Not at all
International news organizations
National news organizations
Local news organizations
Friends, family, and acquaintances
Political figures or leaders
Social media sites, such as Facebook, Twitter or Snapchat
Local newsletters or listservs

42. E4a.0.21 (Foreign)- Please select which languages you primarily use to consume media in the prior to program participation: [Drop down list of languages]

Capacity Building

43. E4.0.4/E4.0.2 (American/Foreign) As a result of your program participation, have you done any of the following

	Yes	No
E4.0.4 (American/ Foreign)- Become an elected leader or been appointed to a regional or national government position
E4.0.4/4.0.2 (American/ Foreign)- Started an organization, NGO or business
E4.0.4 (American/ Foreign)- Become a leader within a student or civil society organization
E4.0.4 (American/ Foreign)- Officially recognized or received an award for any achievement
E4.0.2 (American/ Foreign)- Began planning to start a new NGO or new organization
E4.0.2 (American/ Foreign)- Introduced new ways of doing things at your workplace, academic institution, or organization

If “No” to fourth item, skip to Q45.

44. E4.0.4 (American Foreign)-Please explain why you were officially recognized or received the award. [Open Ended]

45. E4.0.15 (American and Foreign)- Did your program participation help you do any of the following?

	Yes	No
Get a new job
Gain more responsibilities in your current position
Receive a promotion
Receive a salary increase
Expand your current business
Become a recognized subject matter expert in my field
Become a leader in my organization/community
Become involved in a professional organization

46. E4.0.6 (American and Foreign)- Has participating in this program given you leadership skills that are applicable to your professional, academic, or civil pursuits

1. Yes

2. No

47. During your program participation did you learn another language (either formally or informally)? [yes/no]

If “None”, skip to Q51

48. E4.0.10 (American and Foreign) Which of the following best describes your current ability to speak in the following languages:

	No ability at all	Able to communicate only in a very limited capacity	Able to satisfy basic survival needs and minimum courtesy requirements	Able to satisfy routine social demands and limited work requirements	Able to speak with sufficient grammatical accuracy and vocabulary to discuss relevant professional areas	Able to speak fluently and accurately in all situations	Proficiency equivalent to that of an educated native speaker
Selected Language 1
Selected Language 2

49. E4.0.8 (American and Foreign)- Have you used the language skills gained through ECA program participation to advance your career, studies, or work in civil society?

1. Yes

2. No

If “No”, skip to Q51.

50. E4.0.8 (American and Foreign)- In which of the following areas have you experienced advancement as a result of the language skills gained through ECA program participation? Select all that apply.

1. Career

2. Education

3. Community work [volunteerism]

4. Civil society work

5. Other area [free entry]

51. E4.0.05 (American and Foreign)- Did you increase any of the following skills as a result of participating in this program? Please select all that apply.

1. project management skills

2. entrepreneurship skills

3. journalism skills

4. teaching instruction skills

5. science skills

6. technology skills

7. engineering skills

8. mathematics skills

9. other technical skill

10. no skills improvement

52. E4.0.7 (American and Foreign)- Have you used any of the following skills gained as a result of participating in an ECA program to advance your career, studies, or work in civil society? Please select all that apply. *will only populate the options selected in Q51**

1. project management skills

2. entrepreneurship skills

3. journalism skills

4. teaching instruction skills

5. science skills

6. technology skills

7. engineering skills

8. mathematics skills

9. other technical skill

10. I have not used any skills gained as a result of participating in an ECA program

Networking

If from the United States, skip to Q55.

53. E3.1.1 (Foreign)- Are you still in contact with the following?

	Yes, personally in contact	Yes, professionally in contact	Yes, both personally and professionally in contact	Not in contact at all	N/A – I did not make contact at all
American friends
American academic colleagues
American professional colleagues
Other program participants from my country
Other program participants from my region
Other program participants from outside my region
Program host family
U.S. Embassy

54. E3.0.7 (Foreign) - Have you pursued any of the following collaboration activities as a direct result of your program experience?

	Yes	No
Professionally collaborated with alumni from my country that I met during the program
Professionally collaborated with alumni from another country that I met during the program
Professionally collaborated with Americans that I met during the program
Professionally collaborated with alumni from other programs or cohorts that I met through alumni activities
Received advice or mentorship from alumni from my country that I met during the program
Received advice or mentorship from alumni from another country that I met during the program
Received advice or mentorship from Americans that I met during the program

Skip to Q57.

55. E3.1.1 (American)- Are you still in contact with the following?

	Yes, personally in contact	Yes, professionally in contact	Yes, both personally and professionally in contact	Not in contact at all	N/A – I did not make contact at all
Host country friends
Host country academic colleagues
Host country professional colleagues
Other program participants from the United States
Program host family
U.S. Embassy

56. E3.0.7 (American) - Have you pursued any of the following collaboration activities as a direct result of your program experience?

	Yes	No
Professionally collaborated with alumni from the United States that I met during the program
Professionally collaborated with contacts from my host country that I met during the program
Professionally collaborated with alumni from other programs or cohorts that I met through alumni activities
Received advice or mentorship from alumni from the United States that I met during the program
Received advice or mentorship from contacts from my host country that I met during the program

57. E3.1.4 (American and Foreign)- Are you registered on the following websites:

	Yes	No	Do Not Know
International Exchange Alumni Network
Program Facebook page
Program WhatsApp group
Other: ___________ [write-in]

58. E8.1.3 (American and Foreign)- Have you received the International Exchange Newsletter?

1. Yes

2. No

3. I don’t know

59. E3.1.5 (American and Foreign)- Have you used any of the following resources?

	Yes	No
Small grants applications for the U.S. Government
AEIF applications
Contact information for other alumni
Project Development toolkits
Information on workshops/events hosted by the Embassy

60. E3.0.2 (American and Foreign) - Do you consider yourself an alumni of a U.S. Department of State program?

1. Yes

2. No

If from the United States, End Survey.

61. E3.1.2 (Foreign)- Have you participated in an event or activity after your program that the U.S. Embassy hosted or organized?

1. Yes

2. No

62. E4.1.15/ E5.3.04 (Foreign)- Since your exchange experience have you returned to the United States for any of the following reasons?

	Yes	No
Make money/work
Continue education
Participate in another ECA exchange program
Tourism/visit friends/family
Other

OMB Control Number: 1405-XXXX Burden Estimate:  30 minutes Expiration Date: XX-XX-XXXX

PRA Statement Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection.  You do not have to supply this information unless this collection displays a currently valid OMB control number.  If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: [email protected].