
5 minute read
Attachment
[All participants will need consent prior to completing the survey]
Questionnaire for the Good Neighbor Cohort Participants (Post-Test)
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Please mark the appropriate answer on each question. If you feel uncomfortable answering a question, simply mark “Prefer not to answer”.
1. In order for us to match your responses before and after the program, we will create an identification number for each of the questionnaires. This number will be the combination of your birthday date. Please write here in numbers only in the following format: MMDDYYYY (ex. 03071987) ___________
2. What best describes your gender identity: a. Female b. Male c. Specify if not listed: _____________ d. Prefer not to answer
3. What best describes your race (select all that apply): a. African American/Black b. Native American/Alaskan Native c. Pacific Islander d. Asian e. Native Hawaiian f. Caucasian/White g. Middle Eastern h. Specify if not listed: ____________________ i. Prefer not to answer
4. What best describes your ethnicity (select all that apply): a. Hispanic/Latinx b. Non-Hispanic/Latinx c. Specify if not listed: ____________________ d. Prefer not to answer
5. Please check the highest level of education you have completed: a. Did not complete High School b. GED/High School Diploma
c. Some College d. Undergraduate Degree e. Graduate Degree f. Doctoral/Advanced Medical g. Other: __________________ h. Prefer not to answer
6. What best describes your current marital/relationship status: a. Single (Never Married) b. Committed Relationship/Partnership/Polyamorous c. Married d. Separated e. Divorced f. Widowed g. Specify if not listed: _____________ h. Prefer not to answer
7. Are you employed? a. Full Time b. Part Time c. Unemployed, Seeking employment d. Not Seeking Employment (ie. retired, stay at home parent) e. Specify if not listed: _________________ f. Prefer not to answer
8. What is your religious affiliation? a. Methodist b. Baptist c. Presbyterian d. Catholic e. Evangelical f. Lutheran g. Mennonite h. Specify if not listed:___________________ i. Prefer not to answer
9. What is your zipcode? ______________________
10. Let’s talk about what you know about the following as of now. It is ok to not know something. This is probably why you are part of this program. How much do you agree or disagree with the following statements? Simply mark the box that best reflects your response.
Completely disagree Disagree Neither agree or disagree Agree Completely Agree
I can articulate why neighboring is important for my community
I know my own gifts (strengths, skills, talents, hobbies) as a neighbor
I know specific ways I can grow into being a good neighbor.
I know what it looks like to have meaningful relationships with my neighbors
I know ways to create meaningful relationships with neighbors
I can list the assets of my community
I know how to find the strengths (abundance) of my neighborhood
I know how to create joy with my neighbors
I understand how God models good neighboring I don’t know Prefer not to answer
I am aware of design elements of my house that facilitate or hinder neighboring
I know what actions I could take in my neighborhood
I am ready to make change in my neighborhood
I believe I have the capability to be a good neighbor
I feel a lot of hope for the future of our congregation
I feel that our congregation has a high energy level (eg. members take initiative, shared leadership among members, connected to the community).
I feel my congregation has relationships with neighbors near our church building
Now let’s talk about what you are doing in your neighborhood as of now. Give us your best guess for how many hours per week you spend on the following activities.
11. How many hours per week do you spend on building relationships with your neighbors? a.___________ b. Prefer not to answer
12. How many hours a week do you spend outside of your house in your neighborhood? (ex. Gardening, reading outside, working on the car) a. _______ b. Prefer not to answer
13. Of the neighbors who live in close proximity to you, how many do you know by name? a. ________ b. Prefer not to answer
14. Of the neighbors who live in close proximity to you, how many are acquaintances (i.e. you know some of their interests and skills)? a. ____________ b. Prefer not to answer
15. Of the neighbors who live in close proximity to you, how many do you have a relationship with (i.e. you might send them a card, or ask them to borrow something)? a. ___________ b. Prefer not to answer
16. How many neighborhood events did you participate in last year (ex. clean up day, block party)? a. ___________ b. I was not aware of any neighborhood events c. Prefer not to answer
17. How much do you agree or disagree with the following statements? Simply mark the box with the response that best reflects your answer.
Completely disagree Disagree Neither agree or disagree Agree Completely Agree
I understand how to recruit a small group for the Good Neighbor Experiment
I know how to connect neighboring with the Bible
I am confident in conducting Idea activities and experiment reflections
I can handle the situation when things are not going I don’t know Prefer not to answer
as planned during the sessions
I have ideas on how I can make the Good Neighbor Experiment to fit my context
I live according to the program values of abundance, relationship, and joy
18. Are you planning to take part in additional training for the trainers? It means you might have agreed to train others who will facilitate the Great Neighboring Experiment in their communities. If you are unsure, feel free to contact the workshop organizers. a. Yes, I will train other people on how to train facilitators b. No c. Not sure
19. If you are planning to train facilitators, please respond to the following: How much do you agree or disagree with the following statements? Simply mark the box that best reflects your answer.
Completely disagree Disagree Neither agree or disagree Agree Completely Agree
I can articulate the model of AssetBased Community Development
I can articulate the advantages of an assetbased approach over a needsbased approach
I can describe how neighboring improves community health I don’t know Prefer not to answer
I can articulate a theological framework for neighboring
I seek to live according to the program values of abundance, relationship and joy
I see neighboring as a spiritual practice that is transforma-tive for me, rather than as a church growth model or an evangelism tool
I am comfortable teaching church leaders a group discern- ment model for a changing society
Thank you for taking the time to complete this survey!