0990-0407Appendix D - TCH Follow-Up Survey (Community Health Workers)(12.2.15)

Appendix D
Think Cultural Health (TCH) Follow-Up Survey (Community Health Workers)

Form Approved
OMB No. 0990-0407
Exp. Date XX/XX/20XX

Appendix F
3 Month and 6 Month Follow-up Surveys for Users Who Complete One Unit
Strongly
Agree

Agree

Neither
Agree
Nor
Disagree

Disagree

Strongly
Disagree

1. In the past three/six months, I have
applied the information in Unit _ to the
work that I do.
2. My attitude about {Unit topic*} has
improved because I completed Unit _.
3. Completing Unit _ has helped me {Unit
skill**}.
4. In the past three/six months, I have
looked at the information in Unit _ again
to help me in my daily work.
5. Unit _ was relevant to my culture.
6. Taking a training in {Unit topic} was easy
to do online.
7. I would take another training related to
my work online.
8. I think other promotores de salud would
benefit from Unit _.
9. Do you have more comments about Unit _? If so, please explain them here.
*Unit Topics:
Unit A: “understanding healthy choices”
Unit B: “helping people make healthy choices”
Unit C: “understanding community change”
Unit D: “helping people make community changes”
**Unit Skills:
Unit A: “talk with someone about healthy choices”
Unit B: “teach people in your community to take action toward health”
Unit C: “make community changes”
Unit D: “empower people to make community changes”

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