0704-0627_WIT Implementer Fidelity Assessment Feedback Form

OMB CONTROL NUMBER: 0704-0627

OMB EXPIRATION DATE: XX/XX/XXXX

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60-Minute Training: WIT Implementer Fidelity Assessment

Your participation in this anonymous session feedback form is completely voluntary, your data will be held securely and only used for research purposes.

As a Violence Prevention Integrator (VPI) or third-party observer, please complete this form while the implementer is either delivering the WIT session or shortly after the completion of the WIT session.

1. Please identify the MAJCOM or component you are based out of.

• Air Combat Command (ACC)

• Air Education and Training Command (AETC)

• Air Force District of Washington (AFDW)

• Air Force Global Strike Command (AFGSC)

• Air Force Materiel Command (AFMC)

• Air Force Reserve Command (AFRC)

• Air Force Special Operations Command (AFSOC)

• Air Mobility Command (AMC)

• Pacific Air Force Command (PACAF)

• United States Air Forces in Europe-Air Forces Africa (USAFE-AFAFRICA)

• United States Space Force (USSF)

2. Please indicate the installation you are based out of.

• [Open-ended question] (Please do not include personally identifiable information (PII) in your response.)  Needs hard check

Please indicate your level of agreement on how the implementer delivered the following components.

Introduction:	Strongly Disagree	(2)	(3)	(4)	Strongly Agree
The implementer clearly stated that the goals of the training are to describe how sexual assault may be a common problem within the U.S. Department of the Air Force (DAF), and to reduce the number of Airmen who experience violence.					
The implementer emphasized the importance of shifting the culture to bystanders intervening and provided examples of how negative culture and violence (red dots) can spread by sharing, liking, or commenting on social media posts.					

Introducing the Red Dots & Green Dots	Strongly Disagree	(2)	(3)	(4)	Strongly Agree
The implementer provided a clear definition of red and green dots.					
The implementer provided useful examples of red dots, and both reactive and proactive green dots.					
The implementer asked Airmen to vividly imagine the impact a single green dot can have on preventing sexual assault within the U.S. Department of the Air Force.					

Barriers to Reactive Green Dots & the Three Ds	Strongly Disagree	(2)	(3)	(4)	Strongly Agree
The implementer gave useful examples of the types of barriers (personal, relationship, organizational) that can hinder or promote intervention.					
The implementer provided a clear definition and examples of the 3Ds (Direct, Delegate, and Distract).					

Proactive Green Dots	Strongly Disagree	(2)	(3)	(4)	Strongly Agree
The implementer clearly defined two social norms: Violence will not be tolerated. Everyone needs to do their part to help.					

“The Commitment” and Closing	Strongly Disagree	(2)	(3)	(4)	Strongly Agree
The implementer clearly reminded Airmen they have many options for reducing sexual assault and domestic violence.					
The implementer definitively asked Airmen to commit to intervene when they notice situations that cause them concern or discomfort.					
The implementer adjusted their delivery style and tone to ensure Airmen stayed engaged.					