Form No number No number Coalition-Leader-Interview

ATTACHMENT F

Form Approved

OMB No. __0920-XXX__

Exp. Date _xx/xx/20xx_

COALITION LEADER INTERVIEW

Public Reporting burden of this collection of information is estimated at 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency many not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-XXXX).

COALITION LEADER INTERVIEW

About the coalition:

The questions in this first section will help us learn a little more about your coalition.

1. What is the mission of your coalition? Has it changed over the past 6-months? If so, how?

2. Approximately how many people currently make up your coalition?

3. Approximately how many organizations, agencies, or community groups are currently represented at the coalition?

4. What partners are involved in the coalition?

(Note to interviewer: Please read all rows out loud in the table below) I am going to read a list of possible coalition members. Please state whether these people are active members, non-active members, or not members of your coalition

	Not a member	Member, but not active	Active member
Mayor
County/City Commissioner or Executive
Law enforcement/police
Faith communities
Media
Educations/schools
Housing services
Business community
Youth serving organizations
Victim services agencies
Culturally specific organizations
Neighborhood service organizations
Health Department
Health care providers
Funders
Other _________

5. How do coalition members communicate (Note to interviewer: Please read all response options out loud; Check all that apply)

• In person (one-on-one)

• In person (coalition meetings)

• E-mail

• Telephone

• Listservs

• Online Workspace @ Safeyouth.org

• Other ____________________________

6. How often do meetings occur for the full membership? (Note to interviewer: Please read all response options out loud; Check only one response)

• more than monthly

• monthly

• every other month

• quarterly

• semi-annually

• annually

• other

7. Do you have a dedicated budget for conducting coalition activities? If so, what is the amount of the budget? What is the funding source?

8. Do you have dedicated staff assigned to support coalition activities? If so, how many? At what level of effort? (Note to interviewer: Level of effort = Number of hours per week)

9. How would you complete the following sentence? The majority of active agencies and organizations in the coalition (Note to interviewer: Please read all response options individually; Check all that apply):

• Are committed to and supportive of the coalition’s activities

• Commit personnel to the coalition

• Commit financial resources to the coalition

• Are knowledgeable about the coalition

• Are experienced in collaboration related to youth violence prevention

• Clearly understand their roles and responsibilities

• Share the workload

• Regularly participate in meetings

Coalition activities

10. Tell us a little about the activities your coalition has engaged in over the past 6 months.

Probes: Organizing the process?

Identifying partners?

Training members?

Identifying funding/ resources?

Conducting assessments?

Determining mission and vision?

Developing a strategic plan?

Implementing a strategic plan (if applicable)?

11. What activities do you have planned for the next 6 months?

Probes: Organizing the process?

Identifying partners?

Training members?

Identifying funding/ resources?

Conducting assessments?

Determining mission and vision?

Developing a strategic plan?

Implementing a strategic plan (if applicable)?

SafeYouth.org

(If needed, the interviewer will ask participants to access the website for reference)

12. Have you been to the safeyouth.org website? If so, what is your overall opinion of the website?

13. What information have you searched for on the website? Were you able to find the resources you needed? What information/resources could be added to the website to help you prevent youth violence in your community?

14. Did you take any of the trainings available on the website? What did you like about the trainings? What didn’t you like about the trainings? Any recommendations you would make for the trainings?

15. Has your coalition created a space on the safeyouth.org website?

Probes: To what extent are you utilizing the website to form your coalition? Organize your coalition? Develop your strategic plan? Support and document other activities?

If not using the website, why? How can we make the website a better tool for your coalition?

Did you find the online workspace useful for sharing information with members of your coalition? Why or why not?

Did you find the find the online workspace useful for sharing information with members of other coalitions? Why or why not?

16. Finally, how has this project impacted your community’s ability to address youth violence?

Thank you for your time. We appreciate your input!

Public Reporting burden of this collection of information is estimated at 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency many not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-XXXX).

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