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pdfDEPARTMENT OF STATE
PUBLIC DIPLOMACY AND EVALUATION OFFICE
SURVEY QUESTION: BANK
OMB Control No. 1405-0158
FINAL
November 5, 2007
Public Diplomacy and Evaluation Office (PDEO)
Office of Policy and Evaluation
th
301 4 Street, SW
Room 336 (SA-44)
Washington, DC 20547
Melinda Crowley, Director
T: (202) 203-7136
Steven Gaither, Senior Statistical Research Analyst
T: (202) 453-8816
Michelle Hale, Survey Creation Coordinator
T: (202) 453-8815
TABLE OF CONTENTS
PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS................................... 3
INTRODUCTION ....................................................................................................................... 4
GLOSSARY............................................................................................................................... 5
ECA SET-UP AND INDICATOR QUESTIONS .......................................................................... 6
PROGRAM INFORMATION .....................................................................................................13
PARTICIANT INFORMATION (NON-DEMOGRAPHIC) ...........................................................16
PROGRAM ACTIVITIES...........................................................................................................20
PROGRAM GOALS AND OBJECTIVES..................................................................................22
PARTICIPANT ADJUSTMENT.................................................................................................24
PARTICIPANT SATISFACTION...............................................................................................26
PARTICIPANT ATTITUDES (WORLD) ....................................................................................36
PARTICIPANT ATTITUDES (INDIVIDUAL) .............................................................................40
KNOWLEDGE AND SKILLS (GENERAL) ...............................................................................43
PARTICIPANT BEHAVIOR (GENERAL SKILLS) ....................................................................58
LANGUAGE SKILLS AND BEHAVIOR....................................................................................66
POST PROGRAM EDUCATION AND EMPLOYMENT ............................................................71
ALUMNI PROGRAMS ..............................................................................................................74
RESPONDENT INFORMATION (DEMOGRAPHICS)...............................................................77
ADDITIONAL SUGGESTIONS AND COMMENTS...................................................................83
SURVEY COMPLETION TIME .................................................................................................83
PERFORMANCE MEASUREMENT FOLLOW-UP TEMPLATE SURVEY QUESTIONS..........84
PMDCP INTERVIEW QUESTIONS ..........................................................................................85
INDEPENDENT EVALUATION ................................................................................................99
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PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS
The following privacy act and paperwork reduction act statement will appear on surveys conducted
through PDEO in conjunction with a footer that will include the following information: the OMB control
number, assigned survey form number, clearance expiration date, and estimated burden time.
Privacy Act and Paperwork Reduction Act Statements:
The information solicited on this survey is requested pursuant to the Government Performance and
Results Act of 1993 (P.L. 103-62) and the Mutual Educational and Cultural Exchange Act of 1961, as
amended, also known as the Fulbright-Hays Act (22 U.S.C. 2451, et seq.). In order to ensure that the
U.S. Department of State’s international exchange programs meet statutory program requirements (22
U.S.C. 2460(c)), the Department’s Bureau of Educational and Cultural Affairs (ECA) regularly monitors
the programs, gathers data about program accomplishments, and evaluates selected ones. ECA uses the
information collected to inform program design, management, and funding. All personal information that
is collected through surveys is considered confidential. All responses are coded to ensure the
confidentiality of individual responses. Data collected under this study will not be shared, sold, or used
for fundraising purposes. Survey data and findings will be used only in an aggregate form for the express
purposes of fulfilling the data needs of the outcome assessment. Responses to this survey are voluntary.
Public reporting burden for this collection of information is estimated to average xxx (xx) minutes to
respond to this survey, including time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information.
An Agency may not conduct or sponsor, and respondents are not required to respond to, a collection of
information unless it displays a valid OMB control number. Please send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing the
burden, to: A/ISS/DIR, U.S. Department of State, Washington, D.C. 20520.
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INTRODUCTION
The contents of this question bank include questions that are used in the PDEO project Public Diplomacy
Pilot Performance Measurement Data Collection Project (PMDCP), as well as questions used in ECA’s
Performance Measurement and Evaluation surveys.
The first section of this document contains a complete list of ECA Bureau Indicator Questions. These
Indicator Questions are each linked to one of the Bureau’s nine Performance Outcomes. Both the
Indicator Questions and their Set-up Questions, which enable us to collect baseline data, are the core of
the Bureau’s performance measurement system. The Indicator Questions and the Set-up Questions are
mandatory, and appear on all performance measurement surveys, as appropriate. These Indicator
questions are vital for collecting the data needed for Bureau reporting on performance, as mandated by
GPRA and the OMB. Thus, it is imperative that both the Indicator Questions and Set-up Questions
remain unchanged in the PDEO Question Bank, so as to continue our established, extensive, and vital
performance measurement work.
NOTE: THE ECA INDICATORS ARE HIGHLIGHTED IN YELLOW.
These questions may be presented in written format for a self-administered paper survey, in a written
format for a self-administered web-based survey, or conveyed orally during interviews.
Questions are divided into categories based on their purpose. Where applicable, the questions are
shown in a series (i.e. Question A and Question B) in order to indicate when a follow-up question might
be used. Performance Measurement questions are also grouped together to show the change in wording
based on the survey’s touch point.
Responses for “Name of…” will vary depending on the program and its activities. Four response
categories are illustrative; some survey items may have more than four response choices or some may
have less.
The portions of questions and responses that are included in the brackets “[ ]”, are to: 1) represent
substitution of specific program names, country names, language, etc. that will vary from program to
program; 2) indicate the difference in the verb tense which is dependent on the time frame of the survey
administered (for example: pre, post, and follow-up surveys); 3) indicate alternate word choice which will
depend on the needs of the program office; and 4) represent prompts for when questions are for a survey
done by an interview. It should be noted that even though the items in the brackets are bolded, they
would not be in the actual surveys. The bolding is meant to help them stand out for this question bank
review. Additionally, where the substitution specifies “[Name of Country]” this stands for both the noun
and adjectival form of the country when appropriate (example: Vietnam versus Vietnamese).
Where applicable, notes have also been added to provide clarification.
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GLOSSARY
Below is a listing of glossary items that are used in this question bank:
ECA
Indicators
The ECA Indicators are questions that were specifically designed to gather
data as they relate to the Bureau’s nine Performance Measurement
Outcomes.
ID
Is strictly for our own reference purposes.
TYPE
Refers to either the touch point for a Performance Measurement survey, or a
specific PDEO Project survey that is administered to a participant.
Pre
Is the first data touch point. This survey is administered to participants either
prior to them coming on the program, or directly after they have arrived.
Post
FU
PMDCP
IE
Is the second data touch point. This survey is administered to participants
either right before the end of the program, or shortly after they have returned
home.
rd
Stands for follow-up, and is the final (3 ) data touch point. This survey is
administered to participants typically between 6 months to 1 year after their
exchange program has ended.
Public Diplomacy Pilot Performance Measurement Data Collection Project.
Questions are administered by interview among participants and nonparticipants of public diplomacy activities through the U.S. Embassy’s and
Missions worldwide.
Independent Evaluation. Questions are part of the survey conducted via an
ECA Evaluation.
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ECA SET-UP AND INDICATOR QUESTIONS
Question 1:
Please rate your satisfaction with the following program components. Please check
one box in each row.
NOTE: ECA Indicator Question
This question is used for both U.S. and foreign participants.
Very
Dissatisfied
Dissatisfied
Neutral
Type
Post
ID 354, 870
Satisfied
Very
Satisfied
Administration
Content
Variety of Experiences
Relevance of program to professional or
educational development
Question 2:
How do you view the United States Government and the American people? Please
check one box in each row.
NOTE: ECA Set-up Question
This question is used for foreign participants.
Strongly
Unfavorable
Generally
Unfavorable
Neither
Favorable Nor
Unfavorable
Type
Pre, Post, FU
ID 511, 530
Generally
Favorable
Strongly
Favorable
United States
Government
American people
Question 3:
Type
How did your views of the United States Government and the American people change Post, FU
as a result of your program participation? Please check one box in each row.
NOTE: ECA Indicator
ID 509, 510, 529, 684, 764, 832
This question is used for foreign participants.
Much less
Favorable
Less
Favorable
No Change
More
Favorable
Much More
Favorable
United States Government
American people
Question 4:
How do you view the United States Government and its relationship with your home
country?
NOTE: ECA Indicator
This question is used for foreign participants.
Strongly
Disagree
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Disagree
Neither Agree
Nor Disagree
Type
Pre, Post, FU
ID 476, 709
Agree
Strongly
Agree
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Agree
Strongly
Agree
The United States Government is a
trustworthy partner for my country
Question 5:
To what extent do you agree or disagree with the statements below? Please check one
box in each row.
NOTE: ECA Indicator
This question is used for foreign participants.
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Type
Pre, Post &
FU
ID 119
Agree
Strongly
Agree
Voting is important because real decisions
are made in elections
Free and fair elections are the cornerstone
of democracy
An independent media is important to the
free flow of information
All citizens in a country should have equal
rights and protections under the law
The Rule of Law is fundamental to a
functioning democracy
Individuals and organizations have the
right to free speech and to voice
opposition
Democratic principles enhance the
workplace. Supervisors should
incorporate democratic principles into their
management practices
Question 6:
Please rate your knowledge or understanding of the following topics. Please check
one box in each row.
NOTE: ECA Set-Up Question
This question is used for foreign participants.
No
Knowledge
Less Than
Basic
United States democracy
United States economy
United States values and
culture
Religious and ethnic
diversity in the United States
Freedom of speech and
press in the United States
Voluntary community
service in the United States
Daily life in the United
States
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Basic
Knowledge
Beyond
Basic
Type
Pre, Post, FU
Advanced
Knowledge
Question 7:
How much did participation in the program change your understanding or knowledge of
the following topics? Please check one box in each row.
NOTE: ECA Indicator
This question is used for foreign participants.
No
Change
Minimal
Change
Type
Post
ID 484, 489,
682, 761, 1270
Moderate
Change
Substantial
Change
United States democracy
United States economy
United States values and culture
Religious and ethnic diversity in the United States
Freedom of speech and press in the United States
Voluntary community service in the United States
Daily life in the United States
Question 8:
Do you think you will share your program experience or the knowledge you gained
during your exchange visit in any of the following ways? Please check one box in each
row.
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Type
Post
ID 447
Yes
No
Participate in media interviews (newspaper, television, radio, internet)
Give presentations to community, neighborhood, school or university groups
Write newspapers articles, including editorials and opinion pieces.
Write academic books
Write non-academic books
Write academic articles—for journals or academic publications
Other (Please write in):______________________________________________
Question 9:
Have you shared your program experience or the knowledge you gained during your
exchange visit in any of the following ways? Please check one box in each row.
NOTE: ECA Indicator Question
This question is used for both U.S. and foreign participants.
Type
FU
ID 450
Yes
Participated in media interviews (newspaper, television, radio, internet)
Gave presentations to community, neighborhood, school or university groups
Wrote newspapers articles, including editorials and opinion pieces.
Wrote academic books
Wrote non-academic books
Wrote academic articles—for journals or academic publications
Other (Please write in):______________________________________________
Question 10:
As a direct result of your participation in the exchange program, do you think you will do
or receive any of the following at school or university? Please check one box in each
row.
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Type
Post
No
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Emphasized since usually the multiple Indicators follow each other in the survey,
and want to make sure respondent make the distinction.
Yes
ID 364
No
Higher level of responsibilities or leadership at school/university
Organize or initiate new activities or projects at school/university
Establish a new organization at school/university
Question 11:
As a direct result of your participation in the exchange program, have you done or
received any of the following at school or university? Please check one box in each
row.
NOTE: ECA Indicator
This question is used for both U.S. and foreign participants.
Emphasized since usually the multiple Indicators follow each other in the survey,
and want to make sure respondent make the distinction.
Yes
Type
FU
ID 364
No
Higher level of responsibilities or leadership at school/university
Organized or initiate new activities or projects at school/university
Established a new organization at school/university
Question 12:
As a direct result of your participation in exchange program, do you think you will do or
receive any of the following at work? Please check one box in each row.
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Emphasized since usually the multiple Indicators follow each other in the survey,
and want to make sure respondent make the distinction.
Yes
Type
Post
ID 365
No
Higher level of responsibilities or leadership in the same job
Organize or initiate new activities or projects in the same job
New, more responsible job
Increased salary/wages
Question 13:
As a direct result of your participation in exchange program, have you done or received
any of the following at work? Please check one box in each row.
NOTE: ECA Indicator
This question is used for both U.S. and foreign participants.
Emphasized since usually the multiple Indicators follow each other in the survey,
and want to make sure respondent make the distinction.
Yes
Higher level of responsibilities or leadership in the same job
Organized or initiate new activities or projects in the same job
New, more responsible job
Increased salary/wages
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Type
FU
ID 365
No
Question 14:
As a direct result of your participation in exchange program, do you think you will do or
receive any of the following in your community? Please check one box in each row.
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Emphasized since usually the multiple Indicators follow each other in the survey,
and want to make sure respondent make the distinction.
Yes
Type
Post
ID 366
No
Assume a leadership role or position in your community
Organize or initiate new activities or projects in your community
Establish a new organization in your community
Question 15:
As a direct result of your participation in exchange program, have you done or received
any of the following in your community? Please check one box in each row.
NOTE: ECA Indicator
This question is used for both U.S. and foreign participants.
Emphasized since usually the multiple Indicators follow each other in the survey,
and we want to make sure respondent make the distinction.
Yes
Type
FU
ID 366
No
Assumed a leadership role or position in your community
Organized or initiate new activities or projects in your community
Established a new organization in your community
Question 16:
Do you think you will use the knowledge or experience gained in the program to initiate
any of these formal or informal changes in your organization or work? Please check
one box in each row.
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Type
Post
Yes
Increase volunteer activities/community service
Found an NGO or new organization
Introduce new ideas and knowledge
Introduce initiatives, new ways of doing things
Establish new exchanges
Try to influence public opinion about the United States through the media
Establish joint ventures, organizational partnerships, or linkages
Introduce new policies or procedures
Introduce new curricula, pedagogical methods, or educational standards
Become elected or appointed to a local, regional or national Government position
Propose. write, and/or pass a new law or treaty
Question 17:
Have you used the knowledge or experience gained in the program to initiate any of
these formal or informal changes in your organization or work? Please check one box
in each row.
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Type
FU
No
NOTE: ECA Indicator
This question is used for both U.S. and foreign participants.
Yes
No
Increased volunteer activities/community service
Founded an NGO or new organization
Introduced new ideas and knowledge
Introduced initiatives, new ways of doing things
Established new exchanges
Tried to influence public opinion about the United States through the
media
Established joint ventures, organizational partnerships, or linkages
Introduced new policies or procedures
Introduced new curricula, pedagogical methods, or educational
standards
Became elected or appointed to a local, regional or national
Government position
Proposed, wrote, and/or passed a new law or treaty
Question 18:
Do you think you will remain in contact with people you met during your exchange
program?
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Type
Post:
Question 19:
Have you remained in contact with people you met during your exchange program?
Note: ECA Indicator
This question is used for both U.S. and foreign participants.
Type
FU:
Yes
No
Question 20:
Do you think you will establish and continue professional collaborations that grew out
of your exchange experience?
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Type
Post:
Question 21:
Have you established and continued professional collaborations that grew out of your
exchange program?
NOTE: ECA Indicator
This question is used for both U.S. and foreign participants.
Type
FU
Yes
No
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Question 22:
As a result of your exchange experience, do you think you or your organization will
establish a formal, institutional relationship with another organization?
NOTE: ECA Set-Up Question
This question is used for both U.S. and foreign participants.
Type
Post:
Question 23:
As a result of your exchange experience, have you or your organization established a
formal, institutional relationship with another organization?
NOTE: ECA Indicator
This question is used for both U.S. and foreign participants.
Type
FU
Yes
No
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PROGRAM INFORMATION
Question 24:
Which organization will provide your host/placement upon arrival in the United States?
Please check one box.
NOTE: Underlining is needed in order to help participants differentiate between
the organization hosting them and the organization that prepares them for the
program back in their home country.
Type
Pre
Question 25:
Which organization provided your host/placement in the United States? Please check
one box.
Type
Post, FU
ID 261, 721
ID 725
[Name of Program Grantee 1]
[Name of Program Grantee 2]
[Name of Program Grantee 3]
[Name of Program Grantee 4]
Do Not Know
Question 26:
Which [Name of Institute/Program] will you attend this [summer/winter/ year]?
Response: Drop Down List
NOTE: The list will contain the names of each of the Institute/Programs that the
survey is for.
Type
Pre
Question 27:
Which [Name of Institute/Program] did you attend this [summer/winter/year]?
Response: Drop Down List
NOTE: The list will contain the names of each of the Institute/Programs that the
survey is for.
Type
Post, FU
Question 28:
Which research group [are you participating in/did you participate in]? Please
check one box.
Response: Drop Down List
NOTE: The research groups are dependent on the focus of the program and
must be listed in full when the survey is administered on paper like below.
Type
Pre, Post, FU
ID 384, 710, 868
[Name of Research Group 1]
[Name of Research Group 2]
[Name of Research Group 3]
[Name of Research Group 4]
Question 29:
What year did you [begin/end] your program? Please check one box.
NOTE: Some program have different beginning and end times for different
participants.
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Type
Post, FU
[Program Year 1]
[Program Year 2]
[Program Year 3]
[Program Year 4]
Question 30:
What year did you participate in [the exchange program/Name of Program]?
Response: Drop Down List
NOTE: List contains the Years (for example, 2007, 2008, etc.)
Type
Post, FU
ID 565, 841
Question 31:
In what country did you conduct your research?
Response: Drop Down List
Type
Post, FU
Question 32:
At what institute are you conducting your research?
Response: Open-ended
Type
Post, FU
ID 439
Question 33:
Did you attend an orientation session for [Name of Program] prior to arriving in [Name
of Country/the host country]? Please check one box.
Type
Pre, Post
ID 351, 352
Yes
No
Question 34:
Were you selected as a finalist or an alternate for the [Name of Program]? Please
check one box.
Type
Pre
Finalist
Alternate
Question 35:
Did you receive an extension to your program? Please check one box.
Yes
No
Request Pending
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Type
Post, FU
ID 381
Question 36:
Was the [Name of Provided Material] useful? Please check one box.
Type
Post
ID 412, 690
Yes
No
Did not receive the material
Question 37:
Who [is/was] your advisor?
Response: Drop Down List
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Type
Pre, Post
15
PARTICIANT INFORMATION (NON-DEMOGRAPHIC)
Question 38:
What areas of the world have you traveled to? Please check all boxes that apply.
Type
Pre
ID 474
Africa
Asia
East Asia/Pacific
Europe
Latin America
Middle East/North Africa
North America
Never traveled outside my home country
Other (Please write in):________________
Question 39:
Do you have any connections to [Name of Country/the region of the world/the host
country]? Please check all boxes that apply.
Type
Pre
ID 886, 919, 1023
Family ties
Friends
Religion
Teachers
Academic
Professional
Travel/Personal Experience
No Ties
Question 40:
If you have family ties to [Name of Country/region of the world/the host country],
please identify the family members below. Please check all boxes that apply.
Type
Pre
ID 897, 925, 1024
Mother
Father
Maternal Grandmother
Maternal Grandfather
Paternal Grandmother
Paternal Grandfather
Not applicable
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Question 41 A:
Have you visited [Name of Country] before? Please check one box.
Type
Pre
ID 125, 534, 536
Yes
No
Question 41 B:
If you answered “yes” to question [insert question number], how long did you stay on
your last trip to [Name of Country]? Please check one box.
Type
Pre
ID 272
Less than 6 months
6 to 12 months
More than 12 months
I have never visited the [Name of Country] before
Question 42:
Have you visited [Name of Country/your host country] since your participation in
[Name of Program]? Please check one box.
Type
FU
ID 537, 538
Yes
No
Question 43 A:
In the past [year/two years], have you taught any class directly related to [Name of
Program]?
NOTE: The time frames used above are an example, and may be adjusted to one
that is more applicable to the exchange participants.
Type
Pre, FU
Yes
No
Question 43 B:
If you answered “yes” to question [insert question number], please describe.
Response: Open-ended
Type
Pre, FU
ID 465
Question 44:
Why do you think you won this program scholarship? Please check all boxes that apply.
Type
Pre
ID 393
I am a very good student
I am friendly and open-minded
I am able to live in another country with another family
I will be a good cultural ambassador
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I am involved in school activities
I was selected by my school
I speak English well
I come from an honorable family
My family is well-connected
I am a good person
I am fortunate
Do Not Know
Other (Please write in): _________________________
Question 45:
In addition to your studies, do you work? Please check one box.
Type
Pre, Post, FU
ID 560
Yes
No
Question 46:
How many hours per week do you usually work? Please check one box.
Type
Pre, Post, FU
ID 558
1-5 hours
6-10 hours
11-15 hours
16-20 hours
20+ hours
I do not work
Question 47:
Have you ever worked for an American firm, either in the United States or in another
country? Please check one box.
Type
Pre
ID 561, 562
Yes
No
Question 48:
Are you currently employed? Please check one box.
Type
Pre, FU
ID 563
Yes
No
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Question 49:
How many years have you been teaching? Please check one box.
Type
Pre
ID 568
0-5 years
6 to 10 years
11 to 15 years
More than 15 years
Question 50:
Did any of the people listed below recommend the [Name of Program] to you? Please
check all boxes that apply.
Type
Pre
ID 734
Family member
United States Embassy Official
Professor at university
Teacher at school
Colleague at work
Friend
Community member
Other (Please write in): _____________
No one recommended this program to me
Question 51:
Would you like to return to [Name of Country] to visit, to work, to study or to live?
Please check one box in each row.
Type
Post
ID 751
Yes
Do Not
Know
No
To visit
To work
To study
To live
Question 52 A:
Did anyone encourage or discourage you from participating in [Name of Program]?
Yes
Type
Post
No
Encouraged
Discouraged
Question 52 B:
If you were encouraged and/or discouraged, please explain by whom and why.
Response: Open-ended
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Type
Post
PROGRAM ACTIVITIES
Question 53:
Did you participate in any organized activities or clubs this past year? Please check one
box.
NOTE: This question is used when the program office wants to have base-line
data in order to compare the participant’s activity during and prior to the
program.
Type
Pre
Question 54:
Did you participate in any organized activities or clubs while in the United States?
Please check one box.
Type
Post
ID 737
ID 737
Yes
No—No activities available
No—I was not interested
No—I was not able to
Question 55:
If you participated in community service or volunteer work this past year, please
describe your activities.
Response: Open-ended
Type
Post
Question 56:
Did you have regular, paid employment while in the United States? Please check one
box.
Type
Post
ID 739
ID 740
Yes (Please describe): _______________
No
Question 57:
During your program in the United States, how often did you participate in any of the
following activities? Please check one box in each row.
Type
Post
ID 741
Never
Visiting museums or historical sites, sightseeing
Attending performances, concerts or theater
Attending religious services
Attending sporting events
Attending community events or meetings
Attending school activities and functions (for
example: games, dances)
Celebrating American holidays or festivals
Reading American magazines, literature
Traveling around the United States
Other (Please write in): ___________________
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Less Than
Once A
Month
Once A
Month
More Than
Once A
Month
Question 58:
During your program in the United States, with whom did you participate with most in
the following activities? Please check one box in each row.
Type
Post
ID 742
Host
Family
School and
School
Groups
Local
Representative Friends
On My
Own
Did Not
Participate In
This Activity
Visiting museums or historical sites,
sightseeing
Attending performances, concerts or
theater
Attending religious services
Attending sporting events
Attending community events or meetings
Attending school activities and functions
(for example: games, dances)
Celebrating American holidays or
festivals
Reading American magazines, literature
Traveling around the United States
Other (Please write in): ______________
Question 59:
What were the benefits, if any, of hosting this program in [Name of Country] rather
than in [Name of Country]?
Response: Open-ended
Question 60:
In the past [year/six months], how often were you involved in the following activities?
Please check one box in each row.
Type
Post
ID 557
Type
Post, FU
ID 816, 817, 1180,
Never
Community service (for example: helping others,
environment, health, education)
Civic activism (for example: elections, volunteering)
Political activism
Cultural activities (for example: visiting
museums/historical sites, attending concerts, theater)
Part-time job
Religious activities
Sports teams
School clubs or organizations
Work with NGOs
Other (Please write in): ________________________
FINAL: PDEO QB 11/5/07
21
Seldom
Some
Of The
Time
Most Of
The
Time
All Of
The
Time
PROGRAM GOALS AND OBJECTIVES
Question 61:
There are many different reasons for participating in [the exchange program/Name
of Program]. In the table below, please identify your three most important reasons for
participating.
NOTE: The emphasis (bold & underline) on the number three is used when the
survey is administered on paper to help keep respondents from entering less or
more than needed for data analysis needs. When administered electronically,
the respondent is given an error message if they did not follow the instructions
properly, and asked to go back and adjust their response.
Type
Pre
Question 62:
Exchange programs provide participants with many important opportunities for learning
and engaging people from other countries. In the table below, please identify the three
most important accomplishments of your [exchange program/Name of Program].
NOTE: The emphasis on the number three is used when the survey is
administered on paper to help keep respondents from entering less or more than
needed for data analysis needs. When administered electronically, the
respondent is given an error message if they did not follow the instructions
properly, and asked to go back and adjust their response.
Type
Post
ID 397, 398,
399, 401-405,
407-409, 711,
767, 885, 1231
ID 453, 587,
691, 728, 737,
826, 869, 883,
903, 958, 959,
961, 1913
Question 63:
Type
Exchange programs provide participants with many important opportunities for learning FU
and engaging people from other countries. In the table below, please identify the three
accomplishments that have had the most impact on your life, since your return home.
NOTE: The emphasis on the number three is used when the survey is
ID 453, 587, 691, 728,
administered on paper to help keep respondents from entering less or
737, 826, 869, 883, 903,
more than needed for data analysis needs. When administered
958, 959, 961, 995,
electronically, the respondent is given an error message if they did not
1001, 1027, 1047, 1065,
follow the instructions properly, and asked to go back and adjust their
1913, 2099
response.
NOTE FOR EACH OF THE ABOVE QUESTIONS: Reasons for participation in a program depend
upon the program goals and objectives as well as whether it is U.S. or Foreign participants. Thus,
the list will expand and contract accordingly.
[Promote/Promoted] mutual understanding between both of our countries
[Increase/Increased] my understanding of [Name of Country/host country] and
[Name of Country/host country]society, people, and culture
[Build/Built] relationships with [Name of Country/host country ]students and their
families
[Make/Made] friends with [Name of Country/host country]students and their families
[Make/Made] friends from other countries
[Learn/Learned] and [practice/practiced] [Name of Language/target language]
[Represent/Represented] [my country/the United States] abroad
[Share/Shared] my culture with others
[Learn/Learned] about the culture of [Name of Country/Name of Region/host
country]
[Learn/Learned] more about [Name of Country/host country]history – ancient to
modern
FINAL: PDEO QB 11/5/07
22
[Share/Shared] experience and learning about [name of topic or theme]
[Learn/Learned] more about Islam
[Learn/Learned] more about my field of policy expertise
[Develop/Developed] my professional contacts and network
[Develop/Developed] and [advance /advanced] my professional skills
[Increase/Increased] my understanding of [Name of Country/Name of Region]
political system and political process
[Increase/Increased] my understanding of local and state Government in [Name of
Country/Name of Region]
[Increase/Increased] my understanding of the role of [name of topic or theme]
[Learn/Learned] about key issues and problems facing [Name of Country/Name of
Region]
[Meet/Met] my counterparts in [Name of Country/Name of Town]
[Program Goal 1]
[Program Goal 2]
[Program Goal 3]
[Program Goal 4]
Other (Please write in):__________________________
Question 64:
What is your primary reason for participating in [Name of Program/this exchange
program]?
Response: Open-ended
Type
Pre
Question 65:
During your time in [Name of Country], what goals, if any do you plan to accomplish?
Response: Open-ended
Type
Pre
ID 712
Question 66:
During your time in [Name of Country], what goals did you accomplish?
Response: Open-ended
Type
Post, FU
ID 712
Question 67:
Type
Please elaborate on the most important accomplishment that can be linked to your
Post, FU
exchange experience.
Response: Open-ended
ID 1833, 933, 1444
Question 68:
What does community service mean to you?
Response: Open-ended
FINAL: PDEO QB 11/5/07
Type
Pre, Post
ID 739
23
PARTICIPANT ADJUSTMENT
Question 69 A:
How do you think you will adapt to [life/professional life] in the United States?
Please check one box.
Type
Pre
ID 964
Very
Difficult
Somewhat
Difficult
Neither Easy
Nor Difficult
Somewhat
Easy
Very
Easy
Adapting to life in the United States will
be…
Question 69 B:
If you think adapting to [life/professional life] will be difficult, please explain why.
Response: Open-ended
Type
Pre
ID 25
Question 70 A:
How difficult was it for you to adapt to [life/professional life] in the United States?
Please check one box.
Type
Post
ID 1179
Very
Difficult
Somewhat
Difficult
Neither Easy
Nor Difficult
Somewhat
Easy
Very
Easy
Adapting to life in the United States
was…
Question 70 B:
If adapting to [life/professional life] in the United States was difficult, please explain
why.
Response: Open-ended
Type
Post
Question 71 A:
After completing [Name of Program/your exchange], how was your adjustment to life
back home? Please check one box.
Type
FU
Very
Difficult
Somewhat
Difficult
Neither Easy
Nor Difficult
Somewhat
Easy
ID 25
Very Easy
My return back home was…
Question 71 B:
If your return home was difficult, please explain why.
Response: Open-ended
FINAL: PDEO QB 11/5/07
24
Type
FU
Question 72 A:
[Do/Did] you feel adequately prepared for [Name of Program/your exchange
program]?
Type
Pre, Post
Question 72 B:
If you did not feel adequately prepared for your program, what could have been done to
help you better prepare?
Response: Open-ended
Type
Post
ID 27
Question 73:
What advice would you give future delegates preparing for the [Name of Program]?
Response: Open-ended
Type
Post
Question 74:
What advice would you give future delegates to take advantage of opportunities
outside the [Name of Program]?
Response: Open-ended
Type
Post
FINAL: PDEO QB 11/5/07
25
PARTICIPANT SATISFACTION
Question 75:
Please rate your satisfaction with the specific program components of [Name of
Program] listed below. Please check one box in each row.
NOTE: Program specific components will change depending on the
design of the program, program goals and activities; not all items will be
included as response categories.
Type
Post
ID 588, 659, 729, 784,
855, 904, 1011,
1066,1252, 689
The response scale will include “Not Applicable” as an option, when there
are response categories that do not apply to each individual on the
program.
Very
Dissatisfied
[Name of City/Name of State]: Food
and Lodging
[Name of City/Name of State]: Overall
[Name of City/Name of State]: Travel
and Transportation
[Name of Grantee/ Implementing
Partner] facilities
[Name of Grantee/ Implementing
Partner] staff
[Name of Program/Name of
Language] course instructors/faculty
[Name of Program/Name of
Language] course materials
[Name of Program]: Activities
[Name of Specific sessions/
workshops]
Access to internet connectivity/email and
quality of computing facilities
Access to libraries/information
Accommodations
Administration/logistics (for example:
program events were well planned, and
run efficiently)
Assistance provided by Interpreters or
English Language Officers
Briefings, meetings and interviews
Community service (overall opportunities
to participate in volunteer activities)
Cultural activities
Cultural/Entertainment activities
Discussion sessions
FINAL: PDEO QB 11/5/07
26
Dissatisfied
Neutral
Satisfied
Very
Satisfied
Very
Dissatisfied
End-year Orientation
Geographic and demographic diversity
(for example: regions of United States
visited, urban/rural)
Guest speakers
Home hospitality
Home-stays
Homework load
In-class cultural and other instruction
In-class language instruction
Information received about the program
prior to departure
Length of program
Life with Host Family
Meals
Meeting and consultations with [Name
of Country] professionals in your field
Mid-year Orientation
Opportunities to communicate
information about your country to [Name
of Country]
Opportunities to interact with local
people
Opportunities to use [Name of
Language/target language] outside of
the classroom
Orientation in [Name of City]
Out-of-classroom trips and meetings or
site visits.
Pace of program
Pre-Orientation
Pre-departure briefing provided by the
United States Embassy or Consulate
Quality of language course instruction
Range of views presented
Relationship with your local coordinator
Sensitivity of program to your cultural or
religious needs
FINAL: PDEO QB 11/5/07
27
Dissatisfied
Neutral
Satisfied
Very
Satisfied
Very
Dissatisfied
Dissatisfied
Neutral
Satisfied
Very
Satisfied
Short home-stays (where applicable)
Site visit to [Name of
City/State/Region]
Speaking opportunities (for example:
schools, universities, civic groups)
Stipend
Tutors/Language partners
Weekend trips
[Program Component 1]
[Program Component 2]
[Program Component 3]
[Program Component 4]
Question 76 A:
Please rate your overall satisfaction with the programs in [Name of City]. Please
check one box in each row.
NOTE: The number of cities and the names of cities will change depending on
the exchange program.
Very
Dissatisfied
Dissatisfied
Neutral
Type
Post
ID 786, 790
Satisfied
Very
Satisfied
[Insert City 1]
[Insert City 2]
[Insert City 3]
[Insert City 4]
Question 76 B:
Please identify what you think are the strengths and weaknesses of the program (such
as professional meetings, speakers, arranged events, cultural activities) in [Name of
City].
Response: Open-ended
NOTE: Question will be repeated for each city listed in the above question.
Type
Post
ID 791
Question 77:
What did you like best about [Name of Program/your exchange experience]?
Response: Open-ended
Type
Post
ID 339, 732
Question 78:
What did you like least about [Name of Program/your exchange experience]?
Response: Open-ended
Type
Post
ID 347, 733
FINAL: PDEO QB 11/5/07
28
Question 79:
Did the [Name of Program] meet your expectations? Please check one box.
Type
Post
ID 1013
Did not meet expectations
Was below expectations
Met expectations
Was above expectations
Exceeded expectations
Question 80:
Would you recommend [Name of Program] to others? Please check one box.
Type
Post
ID 753
Yes
No
Not Sure
Question 81:
How would you improve [Name of Program]?
Response: Open-ended
Type
Post
ID 265, 736
Question 82:
What questions about [the country’s/Name of Country] political structure or
government were not addressed during the program? Do you have any suggestions
about how to answer these questions more thoroughly in future programs?
Response: Open-ended
Type
Post
ID 372, 856
Question 83:
What aspect of your [Name of Program] exchange experience best met your
[professional/personal] interest?
Response: Open-ended
Type
Post
Question 84:
How valuable do you think your [Name of Program] experience will be for you in the
future? Please check one box in each row.
Type
Post
ID 383
ID 505
Question 85:
What was the single most inspiring idea, thought or impression you took back to your
home country after the [Name of Program]?
Response: Open-ended
Type
Post
Question 86:
How do you think your participation in this program will impact your
[university/career]?
Response: Open-ended
Type
Pre
FINAL: PDEO QB 11/5/07
29
ID 1248, 539
ID 863, 864
Question 87:
How [will/did] participation in [Name of Program] impact your [university/career]?
Response: Open-ended
Question 88:
How useful were the following program activities or achievements? Please check one
box in each row.
Type
Post, FU
Type
Post
ID 503
Not At All
Useful
Somewhat
Useful
Useful
Improvement of my professional abilities
Learning new skills/techniques for work
Learning to work in a team context
Opportunities to make useful connections
Opportunities to meet [Insert Host Country] citizens
with common interests
Opportunities to meet other women from my region or
home country
Improvement of leadership abilities
Improving my professional abilities
Learning to work in a team
Providing opportunities to make useful connections
Providing opportunities to meet [Name of Country]
citizens with common interests
Providing opportunities to meet other women from my
region or home country
Improving my leadership abilities
Providing opportunities to make useful business
connections
[Program Activity/Achievement 1]
[Program Activity/Achievement 2]
[Program Activity/Achievement 3]
[Program Activity/Achievement 4]
Question 89:
How helpful was your local coordinator in the United States? (For example: Did they
arrange a host family, meet with you at least once a month, or provide you with
support.) Please check one box.
Type
Post
ID 731
Not very helpful
Somewhat helpful
Very helpful
Ignored me completely
We were not in touch
FINAL: PDEO QB 11/5/07
30
Very
Useful
Question 90:
What part of [today’s workshop/session/presentation/event/ Name of
workshop/session/presentation/event] did you like most?
Response: Open-ended
Type
Post
Question 91:
What part of [today’s workshop/session/presentation/event/ Name of
workshop/session/presentation/event] did you like least?
Response: Open-ended
Type
Post
Question 92:
To what extent did you find [today’s workshop/session/presentation/event/ Name
of workshop/session/presentation/event] useful? Please check one box.
NOTE: This question is used when the program office wants to measure the
extent of usefulness.
Type
Post
Not At All Useful
Somewhat Useful
Useful
Very Useful
Question 93 A:
Did you find [today’s workshop/session/presentation/event/ Name of
workshop/session/presentation/event] useful? Please check one box.
Type
Post
Yes
No
NOTE: Of the three options for Question B below, the question used depends on the data needs of
the program office.
Question 93 B1:
What did you find most useful about [today’s workshop/session/presentation/event/
Name of workshop/session/presentation/event]?
Response: Open-ended
NOTE: This version is used when the program office does not want to prompt a
response.
Type
Post
Question 93 B2:
Of the following topics, which one was the most useful to you? Please check one box.
NOTE: This version is used when the program office wants to limit the
responses. Topics will depend on the workshop/presentation/event.
Type
Post
Question 93 B3:
Which of the following topics were most useful to you? Please check all boxes that
apply.
NOTE: This version is used when the program office wants to ask about
particular topics relevant to the workshop/event. Topics will depend on the
workshop/presentation/event.
Type
Post
FINAL: PDEO QB 11/5/07
31
[Topic A]
[Topic B]
[Topic C]
[Topic D]
[Topic E]
None of the topics were useful
Question 93C:
What did you find least useful about [today’s workshop/session/presentation/event/
Name of workshop/session/presentation/event]?
Response: Open-ended
Type
Post
Question 94:
How would you rate the [conference/workshop/session/presentation/event]
overall? Please check one box.
Type
Post
Poor
Fair
Good
Very Good
Excellent
Question 95:
To what extent do you think you can apply the information presented today to your
work? Please check one box.
Type
Post
Not At All
To A Small Extent
To A Good Extent
To A Great Extent
Question 96:
Would you recommend [today’s workshop/session/presentation/event/ Name of
workshop/session/presentation/event] to others? Please check one box.
Type
Post
Definitely Not
Probably Not
Not Sure
Probably Will
Definitely Will
Question 97:
How can [today’s or insert name] [workshop/session/presentation/event] be
improved?
Response: Open-ended
FINAL: PDEO QB 11/5/07
32
Type
Post
Question 98:
Please evaluate [today’s or insert name] [workshop/session/presentation/event].
Please check one box in each row.
Poor
Fair
Good
Very Good
Type
Post
Excellent
Did Not
Attend
General overall
impression
Usefulness of subject
matter for me
professionally
Usefulness of subject
matter for me
personally
Question 99:
Please evaluate the [presentations/sessions] given [today or name day]. Please
check one box in each row.
NOTE: Titles listed depend on the presentation/sessions.
Poor
Fair
Good
Very Good
Type
Post
Excellent
Did Not
Attend
[Title of presentation/
session 1]
[Title of presentation/
session 2]
[Title of presentation/
session 3]
[Title of presentation/
session4]
Question 100:
How did the information presented meet your expectations? Please check one box.
Type
Post
Did not meet expectations
Below expectations
Met expectations
Above expectations
Exceeded expectations
Question 101:
Please rate the following content of the [workshop/seminar]. Please check one box
in each row.
Poor
Fair
Met my needs
Suitable to my level of experience
Interesting
Up-to-date and forward-looking
FINAL: PDEO QB 11/5/07
33
Good
Type
Post
Very Good
Excellent
Poor
Fair
Good
Very Good
Excellent
Consistent with description
Understandable
Logically organized
Included sufficient examples
Overall rating of workshop content
Question 102:
Please indicate your agreement with the following statements about the
[seminar/presentation/event]. Please check one box in each row.
Type
Post
The presenters…
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Strongly
Agree
Agree
Helped me better understand the issue
Provided information relevant to my work
Presented information that is current and
up-to-date
Addressed the topic identified in the title
Were well organized
Were easy to understand
Presented information that will be of
great and immediate use to me
Question 103:
Please rate the quality of materials given to you at [today’s
workshop/session/presentation/event/ Name of workshop/session/
presentation/event]. Please check one box in each row.
Poor
Fair
Good
Type
Post
Very Good
Excellent
[Insert Material 1]
[Insert Material 2]
Question 104 A:
Would you like more information on any topic we covered today? Please check one
box.
Type
Post
Yes
No
Question 104 B:
If you answered “yes” to the question above, please list which topics.
Response: Open-ended
FINAL: PDEO QB 11/5/07
34
Type
Post
Question 105:
What topic would you have liked covered that was not covered [today’s workshop/
session/presentation/event/ Name of workshop/session/ presentation/event]?
Response: Open-ended
Type
Post
Question 106:
What kind of follow-up to [today’s workshop/session/presentation/event/ Name of
workshop/session/ presentation/event] do you think would be helpful?
Response: Open-ended
Type
Post
Question 107:
Please recommend future topics and potential speakers for future [conferences/
workshops/presentations/events].
Response: open-ended
Type
Post
FINAL: PDEO QB 11/5/07
35
PARTICIPANT ATTITUDES (WORLD)
Question 108:
How do you view the [Name of Country/ Host Country] Government and the [Name
of Country/ Host Country] people? Please check one box in each row.
NOTE: This question is used for U.S. participants to mirror the foreign
participants’ indicator question.
Strongly
Unfavorable
Generally
Unfavorable
Neither
Favorable Nor
Unfavorable
Type
Pre, Post, FU
ID 511, 530
Generally
Favorable
Strongly
Favorable
[Name of Country/ Host
Country] Government
[Name of Country/ Host
Country] people
Question 109:
Type
How did your views of [Name of Country/ Host Country] Government and the [Name Post, FU
of Country/ Host Country] people change as a result of your program participation?
Please check one box in each row.
NOTE: This question is used for U.S. participants to mirror the
ID 509, 510, 529, 684, 764, 832
foreign participants’ indicator question.
Much Less
Favorable
Less
Favorable
No Change
More
Favorable
Much More
Favorable
[Name of Country/ Host
Country] Government
[Name of Country/ Host
Country] people
Question 110:
How do you view the [Name of Country/ Host Country] Government and its
relationship with the United States?
NOTE: This question is used for U.S. participants to mirror the foreign
participants’ indicator question.
Strongly
Disagree
Disagree
Type
Pre, Post, FU
ID 775, 475, 1213
Neither Agree
or Disagree
Agree
Strongly
Agree
The [Name of Country/ Host
Country] Government is a
trustworthy partner for my country
Question 111:
What is the first positive thing you think about when you think about [Name of host
country]?
Response: Open-ended
Question 112:
What is the first negative thing you think about when you think about [Name of
host country]?
Response: Open-ended
FINAL: PDEO QB 11/5/07
36
Type
Pre, Post
Type
Pre, Post
ID 634, 766, 777
Question 113:
To what extent do you agree or disagree with the statements below? Please check one
box in each row.
NOTE: Additional responses may vary depending on the program’s objectives.
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Type
Pre, Post &
FU
ID 119
Agree
Strongly
Agree
Teachers should incorporate democratic
principles into their classroom practices
[Statement 1]
[Statement 2]
[Statement 3]
[Statement 4]
Question 114:
Please indicate how strongly you agree or disagree with the following statements about
[Americans and/or the United States]. Please check one box in each row.
Type
Pre
ID 363, 513, 748
Question 115:
Now that you have spent time in the United States, please indicate how strongly you
agree or disagree with the following statements about [Americans and/or the United
States]. Please check one box in each row.
Type
Post
Question 116:
Now that you’ve been home for [6 months/1 year], please indicate how strongly you
agree or disagree with the following statements about [Americans and/or the United
States]. Please check one box in each row.
NOTE: Responses will vary depending on program objectives.
Type
FU
Strongly
Disagree
Americans are family-oriented
Americans are friendly and open
Americans are materialistic
Americans are moral
Americans are interested in the problems of
other people
Americans are religious
Americans are well-informed about the world
Americans believe that they can make a
difference in their society
Americans understand Islam and its cultural
values
Americans enjoy freedom of the press
Americans express their personal opinions,
even if they contradict those of authorities
Americans have friendly attitudes towards
people of my country
FINAL: PDEO QB 11/5/07
37
Disagree
Neither Agree
Nor Disagree
Agree
Strongly
Agree
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Agree
Strongly
Agree
Americans have friends and acquaintances
from different backgrounds
Americans have too much freedom
Americans play an active role in their
communities
Americans rely on a system of laws to protect
the individual
Americans understand Muslim society
Most Americans are wealthy
The policies of the United States government
reflect the desires of the American people
The United States economy provides a good
living for most of its citizens
The United States has even-handed policies
toward Muslim countries
The United States imposes its views on other
countries
The United States is a country that believes in
and wants peace in the world
The United States is a violent country where
people do not feel safe
The United States is a well-functioning
democracy
The United States is concerned with the needs
and welfare of the Islamic world
The United States promotes diversity and
tolerance
The United States provides equal opportunities
for all
The United States has laws and regulations
that protect the individual
The United States foreign policy reflects the
interests and attitudes of the American people
Question 117:
Based on your experience as a [Name of Program] participant, what similarities do you
see between [Name of Country/host country] and the United States?
Response: Open-Ended
Type
Post
Question 118A:
Has your overall perception of the United States changed as a direct result of your
participation in the [Name of Program]?
Response: Open-ended
Type
Post, FU
Yes
No
FINAL: PDEO QB 11/5/07
38
ID 525
Question 118B:
If you answered “yes” to question [insert number], please describe the changes
Response: Open-ended
Type
Post, FU
ID 525
Question 119:
Please describe how participation in [Name of Program] changed your perception of
[Name of Country]?
Response: Open-ended
Type
Post
Question 120:
What do you think was the most valuable thing that you learned from your program?
Response: Open-ended
Type
Post
ID 346
Question 121:
Upon reflection, what was the most valuable lesson from the [name of program] that
you [will apply/have applied] to your [professional and/or personal] life.
Type
FU
ID 1245, 1246
ID 346
Question 122:
To what extent do you agree or disagree with the following statements? Please check
one box in each row.
Type
Pre, Post, FU
ID 526
Strongly
Disagree
Relations between the United States and
[Name of Country] are getting better
The United States supports positive change in
[Name of Country/Name of Region]
FINAL: PDEO QB 11/5/07
39
Disagree
Neither Agree
Nor Disagree
Agree
Strongly
Agree
PARTICIPANT ATTITUDES (INDIVIDUAL)
Question 123:
How much do you agree/disagree with the following statements about you as an
individual? Please check one box in each row.
Type
Pre, Post & FU
ID 860, 918
Strongly
Disagree
Somewhat
Disagree
Neither Agree
Nor Disagree
Somewhat
Agree
Strongly
Agree
I feel I have many choices in my
life
I feel I can make a difference in
my family
I feel I can make a difference in
my community
I feel I can influence people
around me
Question 124:
How has your self-confidence changed as a result of your participation in [Name of
Program]? Please check one box in each row.
Type
Post
Question 125:
How has your self-confidence changed since you left the United States? Please check
one box in each row.
Type
FU
Decreased
Greatly
Decreased
Somewhat
Stayed The
Same
Increased
Somewhat
Increased
Greatly
My self-confidence has…
Question 126:
Do you agree or disagree with the following statements? Please check one box in each
row.
Type
Pre, Post & FU
ID 747
Strongly
Disagree
Men and women should have equal
[opportunities/rights]
Men and women should equally
share family responsibilities
Ethnic minorities should have equal
[opportunities/rights]
People with disabilities (mentally
and/or physically challenged) should
have equal [opportunities/rights]
Religious minorities should have
equal [opportunities/rights]
FINAL: PDEO QB 11/5/07
40
Somewhat
Disagree
Neither Agree
Nor Disagree
Somewhat
Agree
Strongly
Agree
Question 127:
Do you agree or disagree with the following statements? Please check one box in each
row.
Type
Pre, Post & FU
Individuals should have the right to….
ID 747
Strongly
Disagree
Somewhat
Disagree
Neither
Agree Nor
Disagree
Somewhat
Agree
Strongly
Agree
Travel freely to other countries
Have acceptable housing
Be considered equal under law
regardless of age, gender, disability,
ethnicity or religion
Practice any religion
Receive an education
Have a job
Have acceptable health care
Have access to information
Have freedom of speech
Question 128:
How important are the rights and freedoms for an individual to have in society? Please
check one box in each row.
Type
Pre, Post & FU
ID 517,769, 861
Not At All
Important
Not
Important
Neutral
Somewhat
Important
Very
Important
Travel freely to other countries
Have acceptable housing
Be considered equal under law
regardless of age, gender, disability,
ethnicity or religion
Practice any religion
Receive an education
Have a job
Have acceptable health care
Have access to information
Have freedom of speech
Question 129:
Upon reflection, what has [Name of Program] meant to you [personally/
professionally]?
Response: Open-ended
Type
Post & FU
Question 130:
In today’s world, which leader do you admire most and why? Please write in.
Response: Open-ended
Type
Pre
ID 544
FINAL: PDEO QB 11/5/07
41
Question 131:
How is life in the United States different from life in your own country? Please give one
or two examples.
Response: Open-ended
Question 132:
Are the goals listed below as important to you now as they were before you came to
the United States? Please check one box in each row.
Yes
Type
Post
ID 746
Type
Post
No
Going to university
Having a rewarding job
Having a lot of money
Having my own business
Being active in community affairs
Becoming a leader
Having a career in government
Having a family
Having the opportunity to interact with people
in foreign countries
Question 133:
Type
Now that you have participated in this exchange program, please indicate how important
Post, FU
the following goals are for your personal life compared to before the program. Please
check one box in each row.
ID 754, 755, 862
Less
Important
Going to university
Having a rewarding job
Having a lot of money
Having my own business
Being active in community affairs
Becoming a leader
Having a career in government
Having a family
Having the opportunity to interact with people
in foreign countries
FINAL: PDEO QB 11/5/07
42
Equally
Important
More
Important
Not A Goal
KNOWLEDGE AND SKILLS (GENERAL)
Question 134:
Please rate your [knowledge/understanding] of the following topics and themes
highlighted in your [Name of Program]. Please check one box in each row.
NOTE: The responses will vary depending on the topics and themes highlighted
in the exchange program.
No
[Knowledge/
Understanding]
Less Than
Basic
[Knowledge/
Understanding]
Basic
[Knowledge/
Understanding]
Beyond Basic
[Knowledge/
Understanding]
Type
Pre, Post
ID 594, 819,
890, 896, 1278
Advanced
[Knowledge/
Understanding]
[Subject
Matter]
pedagogical
methods
Curriculum
development
Multidisciplinary
approaches
to your
subject area
[Program
Topic 1]
[Program
Topic 2]
[Program
Topic 3]
[Program
Topic 4]
Question 135 A:
Through your participation in [Name of Program], how much do you think you will
[increase/improve] increase your [knowledge/understanding] of the following
themes and topics? Please check one box in each row.
NOTE: The responses will vary depending on the topics and themes highlighted
in the exchange program.
Not At All
Somewhat
A Good
Deal
Type
Pre
ID 772, 853
A Great
Deal
[Program Topic 1]
[Program Topic 2]
[Program Topic 3]
[Program Topic 4]
Question 135 B:
In addition to the list above, what other knowledge do you hope to gain from [Name of
Program]?
Response: Open-ended
FINAL: PDEO QB 11/5/07
43
Type
Pre
Question 136:
Type
While you were [on [Name of Program]/ in the United States], how much did you
Post
improve your [knowledge/understanding] of the following topics and themes? Please
check one box in each row.
ID 590, 663, 686, 694, 704,
866, 998, 1051
Question 137:
How much did you improve your [knowledge/understanding] of the following
[topics/themes] highlighted during the program? Please check one box in each row.
NOTE: The responses will vary depending on the topics or themes highlighted in
the exchange program.
Not At All
Somewhat
A Good
Deal
Type
FU
ID 793, 1247
A Great
Deal
[Program Topic/Theme 1]
[Program Topic/Theme 2]
[Program Topic/Theme 3]
[Program Topic/Theme 4]
Question 138 A:
How useful were the following [topics/themes] for your [studies/ professional
development]? Please check one box in each row.
NOTE: Responses will vary depending on the topics and themes
highlighted in the program.
Not At All
Somewhat
Useful
Type
Post, FU
ID 1084, 933,
1073, 1077
Useful
Very Useful
[Program Topic/Theme 1]
[Program Topic/Theme 2]
[Program Topic/Theme 3]
[Program Topic/Theme 4]
Question 138 B1:
If you found the topics and themes useful or very useful, please explain.
Response: Open-ended
Type
Post, FU
ID 87
Question 138 B2:
How did your participation in the [Name of Program] contribute to your professional
development?
Response: Open-ended
Type
Post, FU
Question 140 A:
Please rate your current skills and abilities in these areas. Please check one box in
each row.
NOTE: Responses will vary depending on the skills being emphasized in the
exchange program.
Type
Pre, Post
Poor
Leadership
Community service
English (reading, writing, speaking)
FINAL: PDEO QB 11/5/07
44
Fair
Good
ID 1238
ID 458, 714
Excellent
Computer (internet, software, programs)
Collaborative policy research
Statistical and analytical skills
Networking
Facilitation of policy discussions in my field
[Program Specific Skill 1]
[Program Specific Skill 2]
[Program Specific Skill 3]
[Program Specific Skill 4]
Question 140 B:
In addition to the list above, what other skills and abilities do you hope to gain from
[Name of Program]?
Response: Open-ended
Type
Pre
Question 141:
Looking back, how much did the [Name of Program] help you improve your skills in
these areas?
NOTE: Responses will vary depending on the skills being emphasized in the
exchange program.
Type
Post, FU
Not At All
Somewhat
A Good
Deal
ID 456, 457, 835,
1078, 1085, 660
A Great
Deal
Leadership
Community service
English (reading, writing, speaking)
Computer (Internet, software programs)
Media skills
Collaborative policy research
Statistical and analytical skills
Networking
Facilitation of policy discussions in my
field
[Program Specific Skill 1]
[Program Specific Skill 2]
Other (Please write in):____________
Question 142 A:
To what extent have you been able to apply these skills since your return home?
Please check all boxes that apply.
NOTE: Response categories will vary depending on the skills being emphasized
in the exchange program.
Not At All
Leadership skills
Problem-solving skills
Team-building skills
Communication skills
Entrepreneurial skills
Community service
English (reading, writing, speaking)
FINAL: PDEO QB 11/5/07
45
To A Small
Extent
To A Good
Extent
Type
FU
ID 661, 664
To A Great
Extent
Not At All
To A Small
Extent
To A Good
Extent
To A Great
Extent
Computer (Internet, software programs)
Other (Please write in): __________________
[Program Specific Skill 1]
[Program Specific Skill 2]
[Program Specific Skill 3]
[Program Specific Skill 4]
Question 142 B:
If you have applied any of the above listed skills, please explain further.
Response: Open-ended
Type
Post, FU
ID 662
Question 143:
Please rate your current [knowledge/understanding] of the following topics and
themes highlighted in your [Name of Program]. Please check one box in each row.
NOTE: Response categories will vary depending on the topics and themes
emphasized in the program.
Type
Pre, Post
No
[Knowledge/
Understanding]
Less Than
Basic
[Knowledge/
Understanding]
Governance in
[Name of
Country/Region]
Civil society in
[Name of
Country/Region]
Parliament and
party politics in
[Name of
Country/Region]
Judicial system
in [Name of
Country/Region]
Local
Governments in
[Name of
Country/Region]
State
Governments in
[Name of
Country/Region]
The relationship
between religion
and Government
in [Name of
Country/Region]
The [Name of
Country/Region]
economy
FINAL: PDEO QB 11/5/07
46
Basic
[Knowledge/
Understanding]
Beyond Basic
[Knowledge/
Understanding]
ID 675, 756,
771
Advanced
[Knowledge/
Understanding]
Relations
between the
United States
and [Name of
Country/Region]
[Name of
Country/Region]
and regional
politics
United States
foreign policy in
[Name of
Country/Region]
Minorities in
[Name of
Country/Region]
[Name of
Country/Region]
culture
[Name of
Country/Region]
people
[Name of
Country/Region]
history
[Name of
Country/Region]
system of
Government
[Topic/Theme 1]
[Topic/Theme 2]
[Topic/Theme 3]
[Topic/Theme 4]
Question 144:
How much did you [improve/increase] your [knowledge/understanding] of the
following topics and themes highlighted in your [Name of Program]? Please check one
box in each row.
NOTE: Which is measured, knowledge or understanding will depend on the
categories, and the data needs of the program. Response categories will vary
depending on the topics and themes emphasized in the program.
Not At
All
Governance in [Name of Country/Region]
Civil society in [Name of Country/Region]
Parliament and party politics in [Name of
Country/Region]
Judicial system in [Name of Country/Region]
Local Governments in [Name of Country/Region]
State Governments in [Name of Country/Region]
The relationship between religion and Government in
[Name of Country/Region]
The [Name of Country/Region] economy
FINAL: PDEO QB 11/5/07
47
Somewhat
Type
Post
ID 758, 1042
A Good
Deal
A Great
Deal
Relations between the United States and [Name of
Country/Region]
[Name of Country/Region] and regional politics
United States foreign policy in [Name of
Country/Region]
Minorities in [Name of Country/Region]
[Name of Country/Region] culture
[Name of Country/Region] people
[Name of Country/Region] history
[Name of Country/Region] system of Government
Methods of citizen involvement in democratic
processes
Representative Government
[Program Specific Topic/Theme 1]
[Program Specific Topic/Theme 2]
[Program Specific Topic/Theme 3]
[Program Specific Topic/Theme 4]
Question 145:
How valuable was your [academic experience/internship/program component] in
giving you practical [knowledge/skills] that you will be able to use in your
[professional/community] life? Please check one box in each row.
Not At All
Valuable
Somewhat
Valuable
Valuable
Type
Post, FU
Extremely
Valuable
[Academic
experience/Internship/Program
component
Question 146:
What do you hope to learn during this exchange that you could not have learned at
home?
Response: Open-ended
Type
Pre
Question 147:
What did you learn during this exchange that you could not have learned at home?
Response: Open-ended
Type
Post
Question 148:
What did you learn about [Name of Country] that you did not expect?
Response: Open-ended
Type
Post
ID 824
Question 149:
Thinking ahead, how do you think you will apply what you learned in your field?
Response: Open-ended
Type
Post
Question 150:
What was the most significant thing that you learned from your participation in [Name of
Program]?
Response: Open-ended
Type
Post
FINAL: PDEO QB 11/5/07
48
Question 151:
Now that you are home, have you applied what you learned from the [Name of
Program] in your [field/organization/professional life/personal life]?
Response: Open-ended
Type
FU
Question 152:
What would you say is the one most important or useful [skill/knowledge] you acquired
from your experience in the United States?
Response: Open-ended
Type
FU
Question 153:
How much did participation in the program change your [knowledge/understanding] of
the following topics? Please check one box in each row.
NOTE: Responses will vary depending on the topics and themes highlighted in
the program.
Type
Post
No Change
[Program Topic 1]
[Program Topic 2]
[Program Topic 3]
[Program Topic 4]
FINAL: PDEO QB 11/5/07
49
Minimal
Change
Moderate
Change
ID 830
Substantial
Change
MUTUAL UNDERSTANDING (KNOWLEDGE AND BEHAVIOR)
Question 154:
Please rate your knowledge or understanding of the following topics. Please check
one box in each row.
NOTE: This question is used for U.S. participants to mirror the foreign
participants’ indicator question.
No
Knowledge
Less Than
Basic
Basic
Knowledge
Beyond
Basic
Type
Pre, Post, FU
Advanced
Knowledge
[Name of Country/host
country] political system
[Name of Country/host
country] economy
[Name of Country/host
country] values and culture
Religious and ethnic
diversity in [Name of
Country/host country]
Freedom of speech and
press in [Name of
Country/host country]
Voluntary community
service in [Name of
Country/host country]
Daily life in [Name of
Country/host country]
Media in [Name of
Country/host country]
[Name of Country/host
country] popular culture
[Name of Country/host
country] history and culture
Question 155:
Type
How much did participation in [Name of Program/the program] change your
Post
understanding or knowledge of the following topics? Please check one box in each row.
NOTE: This question is used for U.S. participants to mirror the
ID 484, 489, 682, 761, 1270
foreign participants’ indicator question.
No Change
[Name of Country/host country] political
system
[Name of Country/host country] economy
[Name of Country/host country] values
and culture
Religious and ethnic diversity in [Name of
Country/host country]
Freedom of speech and press in [Name of
FINAL: PDEO QB 11/5/07
50
Minimal
Change
Moderate
Change
Substantial
Change
Country/host country]
Voluntary community service in [Name of
Country/host country]
Daily life in [Name of Country/host
country]
Media in [Name of Country/host country]
[Name of Country/host country] popular
culture
[Name of Country/host country] history
and culture
Question 156 A1:
Were you able to share information about your country in any of the following ways
during [Name of Program/your exchange]? Please check one box in each row.
Type
Post
Question 156 A2:
Have you shared information about your [Name of Program experience/experience
in Name of Country] in any of the following ways? Please check one box in each row.
Type
FU
Yes
Formal presentation at school
Formal presentation at a community event (for example: recreation center, home
for elderly people, volunteering event)
Formal presentation in a religious setting (for example: mosque, church,
synagogue)
Discussion with your family
Discussion with your host family
Discussion with your friends and community members
Interview with media (for example: newspaper, radio, TV)
Post on a Blog or other internet networking space (for example: My Space,
Facebook, Linked-in)
Other (Please write in):__________________________
Question 156 B1:
How often and in what ways were you able to share information about your country
during [Name of Program/your exchange]? Please check one box in each row.
Type
Post
Question 156 B2:
Since you have returned home, how often have you shared information about your
[Name of Program experience/experience in Name of Country] in any of the
following ways? Please check one box in each row.
NOTE: Response selection will depend on whether exchange participants are
American or Foreign born, in the United States or abroad.
Type
FU
FINAL: PDEO QB 11/5/07
51
No
Never
1-5 times
More
than 10
times
6-10
times
Formal presentation at school
Formal presentation at a community event (for example:
recreation center, home for elderly people, volunteering
event)
Formal presentation in a religious setting (for example:
mosque, church, synagogue)
Discussion with your family
Discussion with your host family
Discussion with your friends and community members
Interview with media (for example: newspaper, radio, TV)
Post on a Blog or other internet networking space (for
example: My Space, Facebook, Linked-in)
Other (Please write in):__________________________
Question 157:
How much better do you think [your family’s’/friend’s/colleague’s] understanding of
[Name of Country/your country/Name of Country people] is because of the
information you shared with them? Please check one box in each row.
Not At All
Somewhat
A Good
Deal
Type
Post, FU
A Great
Deal
[Your family/friends/colleagues] have a
better understanding of [Name of Country/my
home country/Name of Country people]
Question 158:
Do you think [your family/friends/colleagues] have a more positive opinion of [Name
of Country/your country/Name of Country people] because of the information you
shared with them? Please check one box.
Type
Post, FU
Yes
No
I do not know
Question 159:
To what extent did you have opportunities to share information about your home country
or region with professional contacts you met in [Name of Country]?
NOTE: The emphasis is used so that participants note the distinction.
Not At All
Culture, society and values of [Name of Country]
Foreign policy of [Name of Country]
General information about [Name of Country]
[Name of Country] relations with [Name of Home
Country]
View of global issues
Your area of professional interest
FINAL: PDEO QB 11/5/07
52
Type
Post
ID 871
To A Small To A Good To A Great
Extent
Extent
Extent
Question 160:
How often have you had a discussion with your family and friends about your
experience in [Name of Country/Name of Program] in the past [6 months, 1 year]?
Please check one box.
Type
Post, FU
Never
1-5 times
6-10 times
More than 10 times
Question 161:
[Do you plan to continue/Have you continued] to study and learn about [the host
country you visited /Name of Country] while participating in [Name of Program]?
Type
Post, FU
ID 583-585
Yes
No
Question 162:
[Do you plan to seek/Have you sought] other opportunities for study abroad?
Type
Post, FU
ID 584
Yes
No
Question 163:
In the past [6 months/1 year] have you encouraged [family/friends/colleagues] to
travel [to] or study [abroad/in the United States]?
NOTE: The time frames used above are an example, and may be adjusted to one
that is more applicable to the exchange participants.
Yes
No
FINAL: PDEO QB 11/5/07
53
Type
FU
ID 586
KNOWLDEGE AND SKILLS
Question 164:
Please rate your ability to carry out the following activities. Please check one box in
each row.
NOTE: Activities will depend on the program goal, objectives and activities.
Poor
Fair
Type
Pre, Post, FU
ID 871
Good
Excellent
How to plan projects
How to work in a team
Developing new public policy
Identifying public policy problems in your
community
Gathering information on a problem to evaluate
alternative policies
Developing an action plan to get Government to
review your policy
Insert Activity 1
Insert Activity 2
Question 165:
Please rate your current skill level in the following areas. Please check one box in
each row.
NOTE: Skills acquired by participants will depend on the program goal,
objectives and activities.
Poor
Fair
Type
Pre, Post, FU
ID 989
Good
Excellent
Insert Skill 1
Insert Skill 2
Insert Skill 3
Insert Skill 4
Question 166 A:
Looking back, to what extent did the [Name of Program] help you improve your
skills in the following areas? Please check one box in each row.
NOTE: Skills acquired by participants will depend on the program goal,
objectives and activities.
Not At All
To A Small
Extent
Type
FU
ID 1197
To A Good
Extent
Insert Skill 1
Insert Skill 2
Insert Skill 3
Insert Skill 4
Question 166 B:
If any of your skills have improved, please give examples of how you have used
them.
Response: Open-ended
FINAL: PDEO QB 11/5/07
54
Type
FU
ID 871
To A Great
Extent
Question 167:
How do you think this program will enable you to better engage in policy discussions?
Response: Open-ended
Type
Post
ID 715, 716
Question 168:
How has your understanding of the collaborative work process changed?
Response: Open-ended
Type
Post
ID 718
Question 169:
Please rate your current knowledge and understanding of the [topics/areas] listed
below. Please check one box in each row.
NOTE: Response categories will vary depending on the topics and themes
highlighted in the program.
Type
Pre, Post
No
Knowledge
Less Than
Basic
Knowledge
Basic
Knowledge
Beyond
Basic
Knowledge
Advanced
Knowledge
Leadership
Community service
Democratic change and
social action
Media and civil society
Media skills
Media use and abuse
[Topic 1]
[Topic 2]
[Topic 3]
[Topic 4]
Question 170:
To what extent do you expect the program to increase your [knowledge/
understanding] of the following [topics/areas]? Please check one box in each row.
NOTE: Response categories will vary depending on the topics and themes
highlighted in the program.
Not At All
Leadership
Community service
Democratic change and social action
Media and civil society
Media skills
Media use and abuse
[Topic 1]
[Topic 2]
[Topic 3]
[Topic 4]
FINAL: PDEO QB 11/5/07
55
To A Small
Extent
To A Good
Extent
Type
Pre
To A Great
Extent
Not Sure
Question 171:
Please rate yourself on the following abilities. Please check one box in each row.
NOTE: These response categories are only for leadership characteristics, and
will vary depending on the program office.
Poor
Fair
Type
Pre, Post, FU
ID 335, 871
Good
Excellent
Being self-reliant, being independent, relying on yourself
Speaking in public
Listening to other people’s suggestions or concerns
Expressing ideas and feelings
Working closely with people different from yourself
Being tolerant of others different than you
Leading a team and motivating others
Being flexible
Solving problems
Planning for the future
Managing your time
Managing money
Discussing your beliefs/values
Willing to make changes in your community
Critical thinking
[Skill Set 1]
[Skill Set 2]
[Skill Set 3]
[Skill Set 4]
Question 172:
How useful was your [Name of Program experience/stay in the United States] for
achieving the following skills? Please check one box in each row.
NOTE: Response categories will vary depending on the skills highlighted in the
program.
Not At All
Useful
Somewhat
Useful
Useful
Very
Useful
Type
FU
Not Sure
Preparing for a job
Going to university
Learning to work in a team
Volunteering and community work
Making useful connections
Improving leadership skills
Improving language skills
[Program specific Skill 1]
[Program specific Skill 2]
Question 173:
How useful has the knowledge you gained of the following topics been for you at
your home institution? Please check one box in each row.
NOTE: Response categories will vary depending on the topics highlighted in
the program.
FINAL: PDEO QB 11/5/07
56
Type
FU
ID 934
Not At All
Useful
Somewhat
Useful
Useful
Very
Useful
Not Sure
Non-traditional teaching methodologies
[Name of Country] educational system
Ways of linking schools and communities
Religious education in [Name of Country]
[Program specific Topic 1]
[Program specific Topic 2]
Question 174:
What do you expect to learn during this exchange?
Response: Open-ended
FINAL: PDEO QB 11/5/07
57
Type
Pre
ID 545
PARTICIPANT BEHAVIOR (GENERAL SKILLS)
Question 175:
Thinking ahead, how do you think you will apply what you learn at your home
institution?
Response: Open-ended
Type
Pre
Question 176:
What do you see yourself as accomplishing or learning during [this visit/this visit to
Name of Country] that you could not accomplish or learn at home?
Response: Open-ended
Type
Pre
ID 1221
Question 177:
Type
What did you accomplish or learn during [this visit/this visit to Name of Country] that Post, FU
you could not accomplish at home?
Response: Open-ended
ID 552, 759, 829, 1060, 1192, 1221
Question 178:
What did you accomplish during your exchange visit to [Name of Country/Name of
Region]?
Response: Open-ended
Type
Post, FU
Question 179:
What did you learn about your own country as a result of participating on this program?
Response: Open-ended
Type
Post, FU
ID 549
Question 180:
What did you learn about [Name of Country] as a result of participating in this
program?
Response: Open-ended
Type
Post
Question 181:
What did you learn about [Name of Country] that surprised you or that you did not
expect?
Response: Open-ended
ID 551
Type
Post
ID 550, 683, 831
Question 182:
Please describe some of your recent activities (for example: a recent event you
attended or organized, or a project you worked on)
Response: Open-ended
Type
Pre, Post
Question 183:
If you currently participate in any activities, please check the most recent role you have
played in each. Please check one box in each row.
Type
Pre, Post, FU
ID 838
ID 12, 13
FINAL: PDEO QB 11/5/07
58
Led
Events
And
Activities
Planned
Events
And
Activities
Trained
Others
Leadership
Role
Performed
At Events
Founded
New Group
Or
Organization
Did Not
Participate
Civic activism
Civic or political activism
Community service (for
example: helping others
and volunteering)
Culture (for example: arts,
dance, drama, music)
Debate
International activities (for
example: International
Day, Model UN, other
student exchange
programs)
Other (Please write in):
_____________________
Religious activities
Sports
Student clubs or
organizations
Student government
[Activity or club 1]
[Activity or club 2]
[Activity or club 3]
[Activity or club 4]
Question 184:
In the past 12 months, how much of the time were you engaged in any of the following
activities? Please check one box in each row.
NOTE: The time frame used above is an example, and may be adjusted to one that
is more applicable to the exchange participants.
Never
Community service (for example: volunteer or helping
others)
Civic or political activism
Cultural activities (for example: visiting
museums/historical sites, attending concerts, theater)
Part-time job
Religious activities
Sports teams
School clubs or organizations (for example: musicals,
band, debate team, etc.)
Family Activities
Other (Please write in): _______________________
FINAL: PDEO QB 11/5/07
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Seldom
Type
Post, FU
ID 1180
Some Of
The Time
Most Of
The Time
Question 185:
To what extent are you involved in the following activities? Please check one box in
each row.
Type
Pre, FU
Question 186:
To what extent were you involved in the following activities during your exchange visit?
Please check one box in each row.
Type
Post
Not At All
To A Small
Extent
To A Good
Extent
To A Great
Extent
Community service activities (for example:
helping others, environmental, health, education)
Political activities
Cultural activities (for example: arts, dance,
drama, music)
Religious activities
Student clubs or organizations
Student government
Student journalism
Other (Please write in): ________________
Question 187 A:
Did you perform community service or volunteer work in the past [insert time frame,
e.g., 6 months/1 year]? If you mark “yes”, please go to Question B. If you mark “no”,
please go to Question C.
NOTE: The time frame used above is an example, and may be adjusted to one
that is more applicable to the exchange participants.
Type
Post, FU
Yes
No
Question 187 B:
If you performed community service or volunteer work, what exactly did you do?
Response: Open-ended
Type
Post, FU
Question 187 C:
If you did not participate in any community service or volunteer activity, please tell us
why. Please check all boxes that apply.
Type
Post, FU
I was not interested
I did not have any time
I did not have support from my family
I had financial constraints
There was no such opportunity
Question 188:
Describe the type of community service you performed while you were participating in
[Name of Program].
Response: Open-ended
FINAL: PDEO QB 11/5/07
60
Type
Post
Question 189:
If you answered “yes” to question [question number], please elaborate on how you
[intend to use/have used] the knowledge, information or experiences from this
program in your organization or at work.
Response: Open-ended
NOTE: This question can be used as a follow-up to the set-up and indicator
question that asks about how they intend of have shared the knowledge gained.
Type
Post, FU
Question 190 A:
Are you considering adding or changing your field of study or major as a result of your
participation in this program?
Type
Post, FU
Yes
No
Not Sure
Question 190 B:
If you answered “yes” to question [question number] listed above, what field or study
or major/minor will you add or change to?
Response: Open-ended
Type
Post, FU
Question 191:
How do you think your participation in this program will impact your career?
Response: Open-ended
Type
Post
Question 192:
How has participation in [Name of Program] impacted your career?
Response: Open-ended
Type
FU
Question 193:
To what extent have your professional expectations or plans for the future changed as a
result of participating in the program? Please check one box.
Type
Post, FU
Not changed at all
Have changed somewhat
Have changed a great deal
Not sure
Question 194:
How have your professional expectations or plans changed as a result of your
participation in [Name of Program]?
Response: Open-ended
FINAL: PDEO QB 11/5/07
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Type
Post, FU
Question 195:
Where would you like to work in the future? Please check all boxes that apply.
Response: Open-ended
Type
Post, FU
Domestic NGO
International NGO
Government
Self-Employment
Other (Please write in): ______________________
Do Not Know
Question 196:
Have you ever taught “[Name of Course/Subject Matter]”as part of a course or as an
entire course? Please check all boxes that apply.
Type
Pre
Question 197:
Do you intend to teach a course or part of a course on “[Title of Course/Subject
Matter]”? Please check all boxes that apply.
Type
Post
Question 198 A:
In the time since you returned home from your exchange program, did you teach a
course or part of a course on “[Title of Course/Subject Matter]”? Please check all
boxes that apply.
Type
FU
Yes, as part of a course
Yes, as an entire course
No, not at all
Question 198 B:
If “yes”, how valuable was the [Name of Program] in preparing you to teach this course
(or part of a course)? Please check one box in each row.
Not At All
Valuable
Neither
Valuable Nor
Invaluable
Somewhat
Valuable
Type
FU
Extremely
Valuable
As part of a course
As an entire course
Question 199 A1:
As a result of your participation in the [Name of Program], do you think that you will be
a more effective [teacher/instructor] in your field of study? Please check one box.
Type
Post
Question 199 A2:
Are you a more effective teacher as a result of participating in [Name of Program]?
Please check one box.
Type
FU
FINAL: PDEO QB 11/5/07
62
No, I [will be/ am] equally effective
Yes, I [will be/ am] more effective
Yes, I [will be/ am] much more effective
Question 199 B:
If you answered “yes” to any of the responses in questions [insert question #’s],
please provide examples here.
Response: Open-ended
Question 200 A:
Have you been able to apply what you learned at your home institution?
Response: Open-ended
Type
FU
ID 669
Type
FU
ID 1074, 1080, 1115
Yes
No
Question 200 B:
Have you encountered any obstacles or barriers in your attempt to implement what you
have learned while a participant in [Name of Exchange Program] at your home
institution? Please check one box.
Type
FU
Yes
No
Question 200 C:
If so, please detail these obstacles and any strategies you developed to by pass them.
Response: Open-ended
Type
FU
Question 201 A:
Are you considering adding or changing your field of study or major as a result of your
participation in this program?
Type
Post
Yes
No
Not Sure
Question 201 B:
If you answered “yes” to question [number of question] listed above, what field of
study will you add or change to?
Response: Open-ended
Type
Post
Question 202:
How do you think your participation in this program will impact your [career/ field of
study]?
Response: Open-ended
Type
Post
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Question 203 A:
To what extent has your professional [expectations/plans] for the future changed as a
result of participating in the program? Please check one box.
Type
FU
Not Changed at All
Have Changed Somewhat
Have Changed a Great Deal
Not Sure
Question 203 B:
How has your professional [expectations/plans] changed?
Response: Open-ended
Type
FU
Question 204:
What one or two ideas from this [conference/ workshop/seminar/presentation/
event] will you try to implement?
Response: Open-ended
Type
Post
Question 205:
How do you plan to use the information from this [conference/ workshop/seminar/
presentation/event]?
Response: Open-ended
Type
Post
Question 206:
As a result of this [workshop/seminar], do you feel that you have gained new skills in:
Please check one box in each row.
NOTE: The skills listed as response categories will vary depending on the
workshop/seminar.
Type
Post
To A Small
Extent
Not At All
[Skill
[Skill
[Skill
[Skill
[Skill
To A Good
Extent
To A Great
Extent
Area A]
Area B]
Area C]
Area D]
Area E]
Question 207:
How do you plan to use the information from this [conference/ workshop/seminar/
presentation/event]?
Response: Open-ended
Type
Post
Question 208:
As a result of this [conference/workshop/seminar/presentation/event], to what
extent have you learned about the following topics? Please check one box in each
row.
NOTE: The topics listed as response categories will vary depending on the
workshop/seminar.
Type
Post
FINAL: PDEO QB 11/5/07
64
To A Small
Extent
Not At All
[Topic A]
[Topic B]
[Topic C]
[Topic D]
[Topic E]
FINAL: PDEO QB 11/5/07
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To A Good
Extent
To A Great
Extent
LANGUAGE SKILLS AND BEHAVIOR
Question 209:
Please rate your current [target language/Name of Language] skill level. Please
check one box in each row.
NOTE: The specific skill sets associated with language learning varies
depending on the language being taught.
The categories that refer to target language are used when the survey is for the
entire program (i.e. across several languages). The response categories that
specifically name the language are when a survey is conducted for each of the
specific institutes of the program.
None
Beginner
Advanced
Beginner
Type
Pre, Post, FU
Intermediate
Advanced
Speaking target language
Writing target language
Oral comprehension of target
language
Reading target language
Overall language
competency
[Name of Language]:
Speaking
[Name of Language]:
conversational
[Name of Language]:
Reading comprehension
[(pinyin Romanization and
character recognition)]
[Name of Language]:
Grammar and vocabulary
[Name of Language]:
Composition
[Name of Language]:
Writing [(pinyin
Romanization and
character writing)]
[Name of Language]:
Listening comprehension
Question 210:
As a result of your participation in the [Name of Program], did you improve your
[Name of Language/target language] skills level? Please check one box in each row.
Type
Post
Question 211:
Looking back, to what extent did the [Name of Program] help you improve your
[Name of Language] skill levels? Please check one box in each row.
NOTE: The specific skill sets associated with language learning varies
depending on the language being taught.
The categories that refer to target language are used when the survey is for the
entire program (i.e. across several languages). The response categories that
specifically name the language are when a survey is conducted for each of the
specific institutes of the program.
Type
FU
FINAL: PDEO QB 11/5/07
66
ID 1216, 1217
Not At
All
To A Small
Extent
To A Good
Extent
To A Great
Extent
Speaking target language
Writing target language
Oral comprehension of target language
Reading target language
Overall language competency
[Name of Language]: Speaking
[Name of Language]: conversational
[Name of Language]: Reading comprehension
[(pinyin Romanization and character recognition)]
[Name of Language]: Grammar and vocabulary
[Name of Language]: Composition
[Name of Language]: Writing [(pinyin Romanization
and character writing)]
[Name of Language]: Listening comprehension
Question 212:
Please rate your current abilities in [Name of Language]. Please check one box in
each row.
Poor
Fair
Good
Type
Pre, Post, FU
Excellent
Read [Name of Language]
Speak [Name of Language]
Write [Name of Language]
Make presentations in [Name of Language]
Question 213:
Please rate your current abilities using computer technology. Please check one box in
each row.
Type
Pre, Post, FU
ID 1052
Poor
Fair
Good
Excellent
Use the Internet for research
Use E-mail
Use different software programs
Question 214:
What do you think was the most valuable feature, if any of the [Name of Program] for
learning your [Name of Language/target language]?
Response: Open-ended
Type
Post
Question 215:
What do you think was the least valuable feature, if any of the [Name of Program] for
learning your [Name of Language/target language]?
Response: Open-ended
Type
Post
FINAL: PDEO QB 11/5/07
67
Question 216:
To what extent do you think the cultural activities provided through the [Name of
Program] contributed to your learning of the [Name of Language/target language]?
Please check one box.
Type
Post
Not At All
To a Small Extent
To a Good Extent
To a Great Extent
Question 217:
If you have studied the [Name of Language/target language] formally (in school)
prior to participating in [Name of Program], how many years did you study? Please
check one box.
Type
Pre, Post
Less than one year
One year
Two years
Three years
Four or more years
Did not study language formally
Question 218:
Which of the following statements accurately reflects your immediate plans to study
[your target language/Name of Language]? Please check one box in each row.
Type
Post
Yes
I am enrolled in a course for [Name of Language/my target language] at my [high
school/university] or another academic institution
I intend to enroll in a course for [Name of Language/my target language] at my
[high school/university] or another academic institution within the next six months
I intend continue [Name of Language/my target language] studies through private
lessons or a tutor
I intend to continue [Name of Language/my target language] studies on my own
through the use of self-tutoring guides, videos, books
I intend to reinforce my [Name of Language/my target language] studies by
utilizing various media outlets in the target language (for example: radio, television,
movies, music and Internet)
I intend to reinforce my [Name of Language/my target language] studies by
reading newspapers, books and/or magazines in the target language
I intend to seek out conversation with friends, instructors and/or colleagues in
[Name of Language/my target language]
I intend to maintain contact with host-country nationals I met while studying my
[Name of Language/my target language]
I intend to engage in academic or work-related research in [Name of Language/my
target language] within the next six months
I am currently enrolled in a language program, internship or have a job with an
organization in the country or region where [Name of Language/my target
language] is used
I intend to enroll in a language program, internship or have a job with an
organization in the country or region [Name of Language/my target language] is
used
FINAL: PDEO QB 11/5/07
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No
Question 219:
Which of the following statements accurately reflects your actions to study [your target
language/Name of Language]? Please check one box in each row.
Type
FU
Yes
No
I am currently enrolled in a course for [Name of Language/my target
language] at my [high school/university] or another academic institution
In the past year I completed at least one [Name of Language/my target
language] at my [high school/university] or another academic institution
In the past year I continued my [Name of Language/my target language]
studies through private lessons or a tutor
In the past year, I have used self-tutoring guides, videos, books to continue
studying [Name of Language/my target language]
In the past six months, I have used various media outlets (for example: radio,
television, movies, music, internet) to reinforce [Name of Language/my target
language] language skills
In the past six months, I have read newspapers, books and/or magazines in
[Name of Language/my target language]
In the past six months, I have been in contact with people from [Name of
Country/ target country] who I met while participating in [Name of Program]
In the past six months, I had conversations in [Name of Language/my target
language] with friends, instructors and/or colleagues
In the past year, I have engaged in academic or work-related research in
[Name of Language/my target language]
In the past year, I have returned to [Name of Country] and/or have traveled to
another country where [Name of Language/my target language] is spoken to
attend a language program, intern or work
Question 220 A:
Did your plans to continue [Name of Language/your target language] studies
change once you returned home? Please check one box
Type
Pre
Yes
No
Question 220 B:
If you answered “yes” to question [insert #] listed previously, please elaborate on how
your plans to study [the target language/Name of Language] changed.
Response: Open-ended
Type
Pre
Question 221:
[Are you enrolled in a course this summer/Did you enroll in a course this past
summer] to study the same language you studied in the [Name of Program]? Please
check one box.
Type
FU
Yes
No
FINAL: PDEO QB 11/5/07
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Question 222:
Are there any suggestions you could recommend for programming to further promote
students’ studies in [Name of Language/target language] once they return from the
program?
Response: Open-ended
Type
Post
Question 223:
How [will/did] participation in an overseas exchange through the [Name of Program]
complement or strengthen your [Name of Language/target language] studies?
Response: Open-ended
Type
Pre, Post
Question 224:
Looking back, how influential was your participation [Name of Program] to you
pursuing your study of [Name of Language/target language]? Please check one
box.
Type
FU
Not At All Influential
Somewhat Influential
Influential
Very Influential
I am not studying [Name of Language/target
language] at this time
Question 225:
Do you see yourself using [Name of Language/target language] as part of your
future profession? Please check one box.
Type
Post
Yes
No
Not sure yet
Question 226:
Are you using [Name of Language/target language] as part of your future
profession? Please check one box.
Yes
No
FINAL: PDEO QB 11/5/07
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Type
FU
POST PROGRAM EDUCATION AND EMPLOYMENT
Question 227:
Are you considering pursuing a different field of study as a result of your participation in
this program? Please check one box.
Type
Post
Yes
No
Question 228 A:
Do you think your participation in [Name of Program] influenced your decision about
your future career? Please check one box.
Type
FU
Yes
No
Question 228 B:
If you answered “yes” to question [Insert number] listed above, please elaborate on
changes to your future career plans.
Response: Open-ended
Type
FU
Question 229:
When you enter the job market, which of the following institutions or organizations are
you most likely to work for? Please check one box.
Type
Post
Academia
International NGOs
Think-tanks
United States Government, The State Department
United States Government, Other Agency (for example: USAID, DOJ, CIA)
Multi-lateral Institutions (for example: UN, The World Bank)
Private International Development Firms
Private Business
Undecided
Other (Please write in):______________________________________
FINAL: PDEO QB 11/5/07
71
PERSONAL AND INSTITUTIONAL LINKAGES
Question 230:
If you answered “yes” to either question(s) [insert number(s)] listed above, please
comment on any relationships, collaborations, partnerships you intend to develop as a
result of your participation in [Name of Program].
Response: Open-ended
NOTE: This question can be used depending on which combination of the ECA
set-up question were also asked.
Type
Post
Question 231:
If you answered “yes” to question(s) [insert number(s)] listed above, please elaborate
on any relationships, professional collaborations or partnerships established as a result
of your participation in [Name of Program].
Response: Open-ended
NOTE: This question can be used depending on which combination of the above
ECA indicators were also asked.
Type
FU
Question 232:
Of the following people you met during your visit to [Name of Country], whom do you
think you will keep in contact with once you return home? Please check one box in
each row.
NOTE: Categories of contacts listed as responses will vary and depend on the
program.
Type
Post
Question 233:
Of the following people you met during your visit to [Name of Country], whom have
you remained in contact with since your return home? Please check one box in each
row.
NOTE: Categories of contacts listed as responses will vary and depend on the
program.
Type
FU
Yes
[Name of Country] students in the program
[Name of Country] teachers/faculty in the program
Host family
[Name of Country people] classmates and friends
[Name of Country people] colleagues and/or professional counterparts I
met while in [Name of Country]
[Name of Program] participants I met while in [Name of Country]
[Name of Program] staff in [Name of Country]
Other [U.S./Foreign] students I met while participating in [Name of
Program].
Other [Name of Country people] I met while on [Name of Program].
United States Department of State staff in Washington, D.C.
United States Embassy/Consulate staff
[Name of Program] alumni and/or alumni of other United States
exchange programs in my country
[Name of Program] alumni
Other (Please write in):________________________________________
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ID 800
ID 800
No
Do Not
Know
Question 234:
Since your return home, how often have you been in contact with the following people
you met [in Name of Country/while participating in Name of Program]? Please
check one box in each row.
NOTE: Categories of contacts listed as responses will depend on the program.
Never
[Name of Country] students in the program
[Name of Country] teachers/faculty in the program
Host family
[Name of Country people] classmates and friends
[Name of Country people] colleagues and/or
professional counterparts I met while in [Name of
Country]
[Name of Program] participants I met while in [Name of
Country]
[Name of Program] staff in [Name of Country]
Other [U.S./Foreign] students I met while participating in
[Name of Program].
Other [Name of Country people] I met while on [Name
of Program].
United States Department of State staff in Washington,
D.C.
United States Embassy/Consulate staff
[Name of Program] alumni and/or alumni of other United
States exchange programs in my country
[Name of Program] alumni
Other (Please write in): __________________________
FINAL: PDEO QB 11/5/07
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Occasionally
Type
FU
Weekly
Monthly
ALUMNI PROGRAMS
Question 235:
In what ways would you like to continue your involvement with [Name of Program]?
Please check all boxes that apply.
Type
Post
ID 859
Host incoming delegations
Brief new, outgoing [Name of Program] delegates
Host meals for incoming delegations
Join annual [Name of Program] Alumni Council
Join [Name of Program] Alumni Council as a Lifetime Member
Meet with incoming delegations
Assist [Name of Program] Development Office with
fundraising opportunities in home state
Other (Please write in): __________________________
Question 236:
Who in your delegation would be a good, future [Name of Program] escort and why?
Response: Open-ended
Type
Post
Question 237:
Have you participated in any [Name of Program] activities? Please check one box.
Type
FU
Yes
No, I do not know of any [Name of Program] activities
No, I am unable to participate in any [Name of Program] activities
No, I do not participate in any [Name of Program] activities, but I am
planning to do so in the future
I am not interested in participating in any [Name of Program] activities
Question 238:
Have you participated in any activities or projects conducted by [Name of
Program/State Department Exchange Program] alumni in your home country?
Please check one box.
Type
Pre, FU
ID 35
Yes
No
Question 239:
If you have participated in [Name of Program] alumni activities in the past [6
months/1 year], what type of events have you attended and how often? Please check
one box in each row.
NOTE: The time frames used above are an example, and may be adjusted to one
that is more applicable to the exchange participants.
FINAL: PDEO QB 11/5/07
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Type
Pre, FU
Never
1-3
Times
4-6
Times
More
Than 6
Times
Social gatherings or events hosted by an exchange
organization
Social gatherings or events hosted by the U.S. Embassy or
Consulate
Workshops or lectures
Community service events
Recruitment for future [Name of Program] participants
Other (Please write in): ___________________________
Question 240:
Have you ever participated before in an alumni association or any alumni activities
related to [other State Department exchange programs/ Name of Program]? Please
check one box.
Type
Pre
ID 35, 20
Yes
No
Question 241:
Since your return home, have you participated in an alumni association or any alumni
activities related to other State Department or United States Government exchange
programs? Please check one box.
Type
FU
ID 35, 20
Yes
No
Question 242:
Have you mentored other U.S. Department of State alumni since participating in the
exchange? Please check one box.
Type
FU
ID 36
Yes
No
Not Sure
Question 243:
Do you know about the State Department Alumni website, https://alumni.state.gov?
Please check one box.
Type
Post, FU
ID 38
Yes
No
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Question 244:
Have you registered for the State Department Alumni website, https://alumni.state.gov?
Please check one box.
Type
Post, FU
ID 38
I have registered
I have not yet registered
I do not plan to register
I do not know about it
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RESPONDENT INFORMATION (DEMOGRAPHICS)
Question 245:
What year of school have you most recently completed? Please check one box.
NOTE: The response categories are dependent on the program and the students.
These response categories are for students still in secondary school.
Type
Pre, Post
th
8 year
th
9 year
th
10 year
th
11 year
th
12 year
Question 246:
What year of college/university have you most recently completed? Please check one
box.
NOTE: The response categories are dependent on the program and the students.
st
1 Year undergraduate
nd
2 Year undergraduate
rd
3 Year undergraduate
th
4 Year undergraduate
th
5 Year undergraduate
None /Not Applicable
Type
Pre, Post
st
1 Year graduate
nd
2 Year graduate
rd
3 Year graduate
th
4 Year graduate
th
5 Year graduate
Question 247:
How would you describe your school? Please check one box.
Type
Pre, Post
Public
Private
Do Not Know
Question 248:
Please check your most recently completed level of education. Please check one
box.
NOTE: Response categories used depend upon the students on the program.
Type
Pre, Post
Primary education (complete or incomplete)
Secondary (complete or incomplete)
Technical
University – first degree
University – postgraduate degree (for example: Masters or Ph.D.)
Do Not Know
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Question 249 A1:
Which of these fields are you considering studying or working in when you graduate?
[Please check one box. or Please check all boxes that apply.]
NOTE: This question is used for high school students. Which directions are used
depend on the data needs of the program office.
Type
Pre, Post
Question 249 A2:
What is your major field of study? Please check all boxes that apply.
NOTE: This question is used for undergraduate and graduate students
Type
Pre, Post
Agriculture
Arts and Humanities (history, languages, literature, art, theater)
Athletics
Business Administration, Finance
Computer Science, Information Technology
Education
Engineering
Environment
Government
Humanitarian Affairs, Development Assistance, Conflict Resolution
International Relations
Labor, Trade Unions
Law, Judicial Law, Law Enforcement
Library and Information Science
Media, Mass Communications, Journalism, Communication Technology,
Advertising, Graphics
Medicine
Military Service
Public Administration
Public Health
Religion
Science (physics, math, chemistry, biology, astronomy, geography, agronomy)
Social Sciences (sociology, economics, psychology, political science)
Social Work
Teaching English, English language instructions
Teaching (General)
Not Sure
Other (Please write in):_____________________________________________
Question 250:
What is your field of work? Please check one box.
NOTE: This question is used for professionals
Type
Pre, Post
Agriculture
Arts and humanities (history, languages, literature, art, theater)
Athletics
Business Administration, Finance
Computer Science, Information Technology
Education
Engineering
Environment
FINAL: PDEO QB 11/5/07
78
Government
Humanitarian Affairs, Development Assistance, Conflict Resolution
International Relations
Labor, Trade Unions
Law, Judicial Law, Law Enforcement
Library and Information Science
Media, Mass Communications, Journalism, Communication Technology, Advertising,
Graphics
Medicine
Military Service
Public Administration
Public Health
Religion
Science (physics, math, chemistry, biology, astronomy, geography, agronomy)
Social Sciences (sociology, economics, psychology, political science)
Social Work
Teaching English, English language instructions
Teaching (General)
Not Sure
Other (Please write in):_________________________________________________
Question 251:
What is your job title?
Response: Open-ended
Type
Pre, Post, FU
ID 1249
Question 252:
What field will you study in the United States? Please check one box.
NOTE: Response categories listed will change and are very specific to the fields
the program is focusing on.
Business Administration
Economics
Education
Environmental Management and Policy
International Affairs
Liberal Arts
Sciences
Engineering
Journalism/Mass Communications
Law and Law Pedagogy
Library and Information Science
Public Administration/Government
Public Health/Medicine
Public Policy
Religion
Other (Please write in): _______________
[Field 1]
[Field 2]
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Type
Pre
Question 253:
Which type of organization or company do you work for? Please check one box.
NOTE: Response categories will change depending on the program.
Type
Pre
Local political office
Regional political office
National political office
Non-profit organization
Private organization
University
Research Institution
Government
Domestic NGO
International NGO
Multilateral or Bilateral Donor Organization (for
example: World Bank, USAID, DFID)
Self-Employment
Question 254:
Which business sector do you work in? Please check one box.
NOTE: Response categories will change depending on the program.
Type
Pre
Public/Private sector: manufacturing
Public/Private sector: Service
Public/Private sector: Technology
Public/Private sector: Retail
Public/Private sector: Wholesale
Public/Private sector: Other
Other (Please write in): ___________________
Question 255:
How long have you held your current position?
Response: Open-ended
Type
Pre, FU
ID 471
Question 256:
Home country: _____________
Response: Drop Down List – Electronic, Open-Ended – Paper
NOTE: Question only used for foreign participants.
Type
Pre, Post, FU
Question 257:
Home state: _____________
Response: Drop Down List – Electronic, Open-Ended – Paper
NOTE: Question only used for U.S. participants.
Question 258:
Which best describes the geographic location where you live. Please check one
box.
NOTE: These response categories apply only to surveys with foreign
participants.
FINAL: PDEO QB 11/5/07
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ID 256
Type
Pre, Post, FU
ID 1025
Type
Pre, Post, FU
ID 244
My country’s capital city
Another major city in my country other than the capital
A small city, town or rural location in my country
Question 259:
Which best describes the geographic location where you live. Please check one
box.
NOTE: These response categories apply only to surveys with U.S.
participants.
Type
Pre, Post, FU
ID 1190
A major city
A suburb of a major city
A small city or town
A rural area
Question 260:
Age: ________
Response: Drop Down List – Electronic, Open-Ended – Paper
NOTE: The Drop Down List used for this question sometimes lists ages, and
sometimes lists age ranges; which depends on the data needs of the program
office.
Type
Pre, Post, FU
Question 261:
Gender: Please check one box.
Type
Pre, Post, FU
ID 446
ID 32, 33, 1366
Female
Male
Question 262:
Which religion do you most closely identify with? Please check one box.
Type
Pre
Baha’ism
Buddhism
Christianity (for example: Orthodox, Catholic,
Protestant)
Confucianism
Hinduism
Islam
Jainism
FINAL: PDEO QB 11/5/07
Judaism
Shintoism
Sikhism
Taoism
Zoroastrianism
None
Other (Please write in):___________
81
Question 263:
What is your [father's/mother’s] current level of education? Please check the
appropriate level of schooling whether complete or incomplete.
Type
Pre
ID 842
No formal education
Primary education (complete or incomplete)
Secondary (complete or incomplete)
Technical
University – first degree
University – postgraduate degree (for example: Masters or Ph.D.)
Do Not Know
Question 264:
Which of the following do you have in your home? Please check all boxes that apply.
Television
Radio
Telephone
Mobile/cellular telephone
Computer
Internet access
Do not have any of the above
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Type
Pre
ADDITIONAL SUGGESTIONS AND COMMENTS
Question 265:
Thank you for completing this survey! If you have additional comments you would
like to make, about any of the things above, or something we have not touched
upon, please do so here. We value your thoughts very much.
Response: Open-ended
Type
Pre, Post, FU
Question 266:
Thank you for completing this survey! If you have additional comments you would
like to make, please do so here. We value your thoughts and feedback.
Response: Open-ended
Type
Pre, Post, FU
Question 267:
Thank you for completing this survey! If you have additional comments you would
like to make, please do so here.
Response: Open-ended
Type
Pre, Post, FU
SURVEY COMPLETION TIME
Question 268:
How long did it take you to complete this survey? ________ Minutes
Response: Drop Down List – Electronic, Open-Ended – Paper
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Type
Pre, Post, FU
PERFORMANCE MEASUREMENT FOLLOW-UP TEMPLATE SURVEY QUESTIONS
Question 269 A:
Would you say that the program helped you in honing skills, articulated below,
necessary for [this/your] profession? Please check one box in each row.
NOTE: Additional skills will vary depending on the program.
Type
FU
Yes
No
Insert Skill 1
Insert Skill 2
Building professional relationships and networking
Integrating important [Insert Skill] into your work
Explaining and articulating
Other (Please write in): ____________________________
Question 269B:
If so, please explain in more detail.
Response: Open-Ended
Type
FU
Question 270:
Has the knowledge you gained during the [Name of Program] been useful for your
professional development? Please check one box in each row.
Type
FU
Not At All
Useful
Somewhat
Useful
Very
Useful
Useful
The particular subject area of your program
United States practices in this subject area
Current scholarly thinking on this subject
Best professional practices in this subject area
Question 271 A:
Have you used the skills or experience gained during the program to do any of the
following? Please check one box in each row.
NOTE: Response categories will vary depending on the program.
Type
FU
ID 578, 836, 1152
Yes
Participated in community service, if you had not done so before you left
Shared leadership skills, if you had not done so before you left
Took part in community organizing, if you had not done so before you left
Relied on individual initiative in various activities, if you had not done so before
Used leadership skills in various activities, if you had not done so before you left
Strengthened youth involvement in the community, if you had not done so before
Question 271 B:
If so, please explain in more detail.
Response: Open-ended
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Type
FU
ID 582
84
No
PMDCP INTERVIEW QUESTIONS
Question 272:
Have you ever been to the United States?
Type
PMDCP
Yes
No Skip to Question [Insert #]
Question 273:
How much time have you spent in the United States in the last ten years?
Type
PMDCP
Less than two weeks
Two weeks to one month
One month to six months
Six months to one year
More than one year
Question 274:
Using the responses on this card, how well do you [fill from items below]?
NOTE: Participants will be handed a hand card.
Not At
All
A Little
Somewhat
Type
PMDCP
Very
Well
Well
Speak English
Understand spoken English
Write in English
Understand written English
Question 275:
Using the responses on this next card, how often have you [fill from items below] in
the past 12 months?
NOTE: Participants will be handed a hand card.
Never
Read books, newspapers or magazines
published in the United States
Watched American movies
Watched American television programs
(comedies, dramas, news channels)
Listened to American music
Visited American websites
Attended American cultural events
(concerts, exhibits)
Bought American products (food,
clothing, other)
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Once Per
Month Or
Less
2-3 Times
Per Month
Type
PMDCP
Once Per
Week
More Than
Once Per
Week
Question 276:
If you were to rate yourself, how much do you think you know about the United States
in general—would you say you have no knowledge, a little knowledge, some
knowledge, a good deal of knowledge or a great deal of knowledge?
Type
PMDCP
No knowledge
A little knowledge
Some knowledge
A good deal of knowledge
A great deal of knowledge
Question 277:
I am going to ask you to rate how well you understand different aspects of the United
States. Using the response choices on this card, how well do you understand [fill
from items below]?
NOTE: Participants will be handed a hand card.
Not Well At
All
Not That
Well
Somewhat
Well
Type
PMDCP
Well
Very Well
Daily life of the people who live in the
United States
Ethnic diversity in the United States
Religious diversity in the United States
Educational processes and opportunities
in the United States
The arts in the United States (music,
film, literatures, etc.)
Voluntary community service in the
United States
Freedom of speech and press in the
United States
Human rights and legal protections for
all in the United States
Free elections in the United States
Equal opportunities in the United States
The role of the market and economic
competition in the United States
The U.S. overall
Question 278:
Do you consider the United States a positive model for other countries or a negative
model for other countries? Would you say very positive model, somewhat positive
model, somewhat negative model, or very negative model?
Very negative
Somewhat negative
Somewhat positive
Very positive
Do Not Know
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Type
PMDCP
Question 279:
What about the influence of the United States in the world—would you say the United
States has a very positive influence, somewhat positive influence, somewhat negative
influence, or very negative influence?
Type
PMDCP
Very negative
Somewhat negative
Somewhat positive
Very positive
Do Not Know
Question 280:
In thinking more about the role the United States takes in the world, and using the
response options on this card, to what extent do you agree or disagree with the
following statement: [fill from items below]?
NOTE: Participants will be handed a hand card.
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Type
PMDCP
Agree
Strongly
Agree
The United States is a trustworthy partner
for my country.
The United States treats my country with
respect.
The United States is a good trading
partner for my country.
The United States tries to impose its
culture on other countries.
The United States provides assistance to
other countries to help do things like
improve roads, healthcare, agriculture
The United States aids in disaster relief
around the world
The United States supports human rights
for all in the world
Question 281:
Using the response choices on this card, please tell me how favorable or unfavorable
you feel about [fill from items below]?
NOTE: Participants will be handed a hand card.
Strongly
Unfavorable
Unfavorable
Daily life of the people who
live in the United States
Ethnic diversity in the United
States
Religious diversity in the
United States
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Neither
Favorable Nor
Unfavorable
Favorable
Type
PMDCP
Strongly
Favorable
Do Not
Know
Educational processes and
opportunities in the United
States
The arts in the United States
(music, film, literature, etc.)
Voluntary community service
in the United States
Freedom of speech and press
in the United States
Human rights and legal
protections for all in the United
States
Free elections in the United
States
Equal opportunities in the
United States
The role of the market and
economic competition in the
United States
The U.S. Overall
Question 282:
Using the response choices on this card, to what extent do you agree or disagree that
most Americans are [fill from items below]?
NOTE: Participants will be handed a hand card.
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Agree
Type
PMDCP
Strongly
Agree
Do Not
Know
Friendly
Hard-working
Selfish
Trustworthy
Open-minded
Arrogant
Religious or spiritual
Concerned about people from other
countries
Aggressive
Cooperative
Materialistic
Question 283:
I’m going to read you a series of statements about countries or governments and the
ways that they operate. Using the response choice on this card, how important is it for
your country or government to [fill from items below]?
NOTE: Participants will be handed a hand card.
Not
Important
At All
Have all citizens vote
Hold free and fair elections
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Not
Important
Neither
Important Nor
Unimportant
Type
PMDCP
Important
Very
Important
Have a free media
Provide all citizens with equal rights
and protections under the law
Respect The Rule of Law
Allow individuals and organizations the
right to free speech
Have a free market economy
Question 284:
Where do you get most of your information about the United States?
Response: Open-Ended
Type
PMDCP
Question 285:
Using the response choices on this card, how much do you trust information from [fill
from items below]?
NOTE: Participants will be handed a hand card.
Type
PMDCP
Not at all
Not Very
Much
A Fair
Amount
A Great
Deal
Not
Applicable
United States television news
channels [PROMPT: CNN, CNBC]
United States television programming
United States government radio
stations [PROMPT: Voice of America,
Radio Free Europe, Radio Liberty]
[U.S. Embassy/ U.S.
Consulate/American Center] website
Other United States websites. (Yahoo,
New York Times, Wall Street Journal,
etc.)
[U.S. Embassy/U.S. Consulate
General/American Center] in your
country
Local television stations
Local radio stations
Internet websites in your language
Other regional media [Prompt:
regional satellite channel?]
Your government
Views of Friends and family
Print media, e.g., newspapers, news
magazines
Question 286:
I’d like to ask you about [U.S. Embassy/U.S. Consulate General/American Center]sponsored activities you’ve participated in. Have you ever [fill from items below]?
Type
PMDCP
No
Attended lectures or interviews in [country/location] with American professionals,
celebrities or government officials [PROMPT: authors, academics, journalists, scientists
Participated in international journalist/media tours sponsored by the United States
FINAL: PDEO QB 11/5/07
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Yes
Attended multi-speaker events such as conferences, panel discussions, seminars,
symposia, or workshops
Participated in long-distance communication events, such as dialogues via live satellite
television bridges or digital video conferences
Attended social events, such as art exhibits, receptions, meals, concerts, or movie nights
Participated in an exchange program [PROMPT: Such as a Fulbright program; an
International Visitor Leadership Program]
Visited the [Add Specific Name] American Corner?
Participated in any other activity sponsored by [U.S. Embassy/ U.S. Consulate
General/American Center]? (IF YES: Please describe___________________________)
Question 287:
IF YES: Using the response choices on this card, how satisfied or unsatisfied were you
with the activity?
NOTE: Participants will be handed a hand card.
This prompt will be used for each category above when the participant says yes.
Very
Dissatisfied
Dissatisfied
Neither
Satisfied Nor
Dissatisfied
Type
PMDCP
Satisfied
Attended lectures or interviews in
[country/location] with American
professionals, celebrities or government
officials [PROMPT: authors, academics,
journalists, scientists
Participated in international
journalist/media tours sponsored by the
United States
Attended multi-speaker events such as
conferences, panel discussions,
seminars, symposia, or workshops
Participated in long-distance
communication events, such as dialogues
via live satellite television bridges or
digital video conferences
Attended social events, such as art
exhibits, receptions, meals, concerts, or
movie nights
Participated in an exchange program
[PROMPT: Such as a Fulbright program;
an International Visitor Leadership
Program]
Visited the [Add Specific Name]
American Corner?
Participated in any other activity
sponsored by [U.S. Embassy/ U.S.
Consulate General/American Center]?
(IF YES: Please describe____________)
Question 288:
Have you ever received any [fill from items below] sponsored by the [U.S.
Embassy/ U.S. Consulate General/American Center]?
FINAL: PDEO QB 11/5/07
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Type
PMDCP
Very
Satisfied
No
Yes
Brochures, booklets, posters, or books
Transcripts of interviews, seminars, or presentations
Articles or reports
Video materials
Audio materials
Online resources
CDs or other electronic media
Any other materials or publications (IF YES: please describe ____________________)
Question 289:
IF YES: Using the same response choices as before how satisfied or dissatisfied were
you with [fill from items below]?
NOTE: Participants will be handed a hand card.
This prompt will be used for each category above when the participant says yes.
Very
Dissatisfied
Dissatisfied
Neither
Satisfied Nor
Dissatisfied
Type
PMDCP
Satisfied
Very
Satisfied
Brochures, booklets, posters, or books
Transcripts of interviews, seminars, or
presentations
Articles or reports
Video materials
Audio materials
Online resources
CDs or other electronic media
Any other materials or publications (IF
YES: please describe ______________)
Question 290:
Have you ever visited an American Library, American Corner [Add specific name of
American Corner] or a U.S. Information Resource Center?
Type
PMDCP
Yes
No Skip to Question [Insert #]
Question 291:
Have you ever reviewed or used any [fill from items below] while visiting an
American Library, American Corner or a U.S. Information Resource Center?
Type
PMDCP
No
Brochures, booklets, posters, or books
Transcripts of interviews, seminars, or presentations
Articles or reports
Video materials
Audio materials
Online resources
CDs or other electronic media
Any other materials or publications (IF YES: please describe ____________________)
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Yes
Question 292:
IF YES: How satisfied or dissatisfied were you with the [fill item]?
NOTE: Participants will be handed a hand card.
This prompt will be used for each category above when the participant says yes.
Very
Dissatisfied
Dissatisfied
Neither
Satisfied Nor
Dissatisfied
Type
PMDCP
Satisfied
Very
Satisfied
Brochures, booklets, posters, or books
Transcripts of interviews, seminars, or
presentations
Articles or reports
Video materials
Audio materials
Online resources
CDs or other electronic media
Any other materials or publications (IF
YES: please describe ______________)
Question 293:
Now I’d like you to think about all the [U.S. Embassy/U.S. Consulate
General/American Center]-sponsored activities you’ve participated in during the past
12 months, and all the materials provided by the [U.S. Embassy/U.S. Consulate
General/American Center] you’ve received or used in the past 12 months. Using the
same response choices, how satisfied or dissatisfied are you with [fill from items
below]?
Very
Dissatisfied
Dissatisfied
Neither
Satisfied Nor
Dissatisfied
Type
PMDCP
Satisfied
The content of the activities and materials
(topic, ideas)
The accuracy of the information
How current the information was
How easy it was to understand
The usefulness of the information
(relevant to your needs or interests)
How balanced it was (range of views)
The convenience (easy to access, in a
good location)
The activities and materials overall
Question 294:
Now I want you to think about all the information you received from participating in
[U.S. Embassy/U.S. Consulate General/American Center]-sponsored activities and
using materials provided by the [U.S. Embassy/U.S. Consulate General/American
Center]. I would like to learn how this information increased your understanding of the
U.S. Using the choices on this card, how much has your understanding of [fill with
items below] increased?
NOTE: Participants will be handed a hand card.
FINAL: PDEO QB 11/5/07
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Type
PMDCP
Very
Satisfied
Not at
All
A Little
Some
A Good
Deal
A Great
Deal
Not
Applicable
Daily life of the people who live in the United
States
Ethnic diversity in the United States
Religious diversity in the United States
Educational processes and opportunities in the
United States
The arts in the United States (music, film,
literature, etc.)
Voluntary community service in the United
States
Freedom of speech and press in the United
States
Human rights and legal protections for all in the
United States
Free elections in the United States
Equal opportunities in the United States
The role of the market and economic
competition in the United States
The United States overall
Question 295:
Looking at this response card, to what extent do you agree or disagree that your
participation in [U.S. Embassy/U.S. Consulate General/American Center] activities
and programs has [fill with items below]?
NOTE: Participants will be handed a hand card.
Strongly
Disagree
Disagree
Neither Agree
Nor Disagree
Type
PMDCP
Agree
Strongly
Agree
Increased your appreciation for U.S.
culture and values
Increased your appreciation for U.S. policy
Question 296:
Have you ever shared information you had learned about the United States by [fill
from items below]?
Type
PMDCP
No
Referring others to United States media (newspapers, magazines, television, radio, and
internet)
Giving talks, or presentations lectures in your community, neighborhood, local schools,
or religious facility
Talking with others in small groups
Sharing materials received from [U.S. Embassy/U.S. Consulate General/American Center]
Writing opinion pieces, articles or books
Giving interviews to the media
Using the Internet to communicate information about the United States
Some other method (IF YES: please describe____________)
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Yes
Question 297:
Has your participation in [U.S. Embassy/U.S. Consulate General/American Center]
sponsored activities or programs helped you to [fill from items below]?
NOTE: Participants will be handed a hand card.
Type
PMDCP
No
Perform volunteer activities or community service?
Establish a Non-Government Organization (NGO) network, association, or group?
Become involved with new groups, organizations, or networks?
Start a new business?
Introduce new ideas and knowledge to a local organization, community, or group?
Introduce new policies, procedures, or ways of doing things at your work?
Become elected or appointed to a local, regional or national government position?
Propose, write or pass a new law and/or treaty?
Write or publish a book, articles, editorials, plays/ screen plays, music?
Any other things? (IF YES: Please specify __________________________________)
Question 298:
IF YES: Please tell me briefly what you did specifically?
Response: Open-Ended
NOTE: This prompt will be used for each category above when the participant
says yes.
Type
PMDCP
Question 299:
What is your age?
Response: Open-Ended
Type
PMDCP
Question 300:
Including yourself, how many people reside in your household?
Response: Open-Ended
Type
PMDCP
Question 301:
Please look at the response choices on this card and tell me which category best
describes your current marital status.
NOTE: Participants will be handed a hand card.
Type
PMDCP
Never married
Married
Widowed
Divorced
Separated
Question 302:
What is your religious affiliation?
Response: Open-Ended
FINAL: PDEO QB 11/5/07
Type
PMDCP
94
Yes
Question 303:
Please look at this card and tell me which category best describes your religious
orientation/practice/participation.
NOTE: Participants will be handed a hand card.
Type
PMDCP
Nonreligious/secular
Identify with religious faith, but do not practice
Participate in religious activities only on major
religious holidays
Participate in religious activities weekly
Participate in religious activities daily
Question 304:
What do you consider to be your race, ethnicity, tribal affiliation or indigenous group?
Response: Open-Ended
Type
PMDCP
Question 305:
Now please look at this card, and tell me which category best describes your highest
level of formal education.
NOTE: Participants will be handed a hand card.
Type
PMDCP
Primary school
Secondary school/high school
Trade or technical school
Post-secondary up to Bachelor’s degree
Graduate up to Master’s or Doctorate
Professional certification (MSW, MD)
Other (specify__________________________)
Question 306:
Which one of these categories best describes your current employment status?
NOTE: Participants will be handed a hand card.
Participant is prompted for only one response.
Type
PMDCP
Employed full or part time outside the home
Not working but looking for a job
In school
Homemaking or caring for children or other family members
Retired from employment
Question 307:
What is your occupation?
Response: Open-Ended
Type
PMDCP
Question 308:
What is your usual occupation?
Response: Open-Ended
Type
PMDCP
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Question 309:
What occupation do you expect to do when you finish your studies?
Response: Open-Ended
Type
PMDCP
Question 310:
Are you employed at a [fill item from below]?
Note: Asked only if participant is currently employed
Type
PMDCP
No
Yes
Education institution
Government agency or public sector organization
Private not-for-profit organization (not college or university)
Private for-profit organization
Self-employed
Other (IF YES: Please specify________________________)
Question 311:
Currently, do you have regular access to the Internet?
NOTE: Interviewer will check all that apply
Type
PMDCP
Work
Home
School
Public library
Other (IF YES: Please specify__________)
Question 312:
In the past year, how often did you [fill from items below]—would you say never,
once per month, 2 to 3 times per month, once per week, several times per week or
daily?
Never
Once
Per
Month
2-3 Time Per
Month
Once
Per
Week
Type
PMDCP
Several
Times
Per
Week
Use the Internet
Send or receive emails
Send or receive text messages (SMS,
MMS)
Write a blog (web log)
Write comments on someone else’s
blog
Question 313:
That’s all the questions I have. Is there anything else you would like to share
regarding activities, programs or products sponsored by the [U.S. Embassy/U.S.
Consulate General/American Center]?
Response: Open-Ended
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Type
PMDCP
Daily
Question 314:
The [U.S. Embassy/U.S. Consulate General/American Center] sometimes sponsors
activities/programs in [survey country] like lectures, concerts, and workshops. Have
you ever participated in an activity/program sponsored by the [U.S. Embassy/U.S.
Consulate General/American Center]?
Type
PMDCP
No
Yes
Question 315:
IF YES: What kind of activity was it?
Response: Open-Ended
Type
PMDCP
Question 316:
How often do you attend lectures, symposiums or other kinds of events? Would you
say never, once per month or less, two to three times per month, once per week, or
more than once per week?
Type
PMDCP
Never
Once per month or less
Two to three times per month
Once per week
Yes More than once per week
Question 317:
What is the main reason why you attend these events?
Response: Open-Ended
Type
PMDCP
Question 318:
On a scale of 1 to 5, where 1 is least likely and 5 is most likely, how likely would you
be to attend, at least once, a lecture, symposium, or other kind of event providing
information about the United States culture, society and values?
Type
PMDCP
1
2
3
4
5
Question 319:
What is the likelihood of your opinion changing if the event/program was created or
sponsored by the [U.S. Embassy/U.S. Consulate General/American Center]—
would you be more likely or less likely to attend?
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Type
PMDCP
Not likely at all
Less likely
More likely
Question 320:
Have you ever received any booklets, brochures, or other kinds of information from the
[U.S. Embassy/U.S. Consulate General/American Center]?
Type
PMDCP
No
Yes
Question 321:
IF YES: What information did you get?
Response: Open-Ended
Type
PMDCP
Question 322:
What type of publications do you read monthly?
Response: Open-Ended
Type
PMDCP
Question 323:
What do you like most about the publications you read regularly?
Response: Open-Ended
Type
PMDCP
Question 324:
On a scale of 1 to 5, where 1 is least likely and 5 is most likely, how likely would you
be to read, at least once, a magazine or a website providing information about the
United States culture, society and values?
Type
PMDCP
1
2
3
4
5
Question 325:
How likely would your opinion change if the publication or website was created or
sponsored by the [U.S. Embassy/U.S. Consulate General/American Center]—
would you be more likely or less likely to read it?
Not likely at all
Less likely
More likely
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Type
PMDCP
INDEPENDENT EVALUATION
Question 326:
What ID number were you assigned in the letter you received from the U.S.
Department of State?
Response: Open-Ended
Type
IE
Question 327:
How many [Name of Program] exchange students have you hosted in your home?
Response: Drop-Down List– Electronic, Open-Ended – Paper
Type
IE
Question 328:
In what academic year(s) did you host a [Name of Program] exchange student(s)?
Please check all that apply.
NOTE: Years listed will vary depending on the evaluation.
Type
IE
1993 – 1994
1994 – 1995
1995 – 1996
1996 – 1997
1997 – 1998
1998 – 1999
1999 – 2000
2000 – 2001
2001 – 2002
2002 – 2003
2003 – 2004
2004 – 2005
2005 – 2006
2006 – 2007
Question 329:
What was the home country or countries of the [Name of Program] exchange
student(s) you hosted? Please check all that apply.
NOTE: Countries listed will vary depending on the evaluation.
Armenia
Azerbaijan
Belarus
Georgia
Kazakhstan
Kyrgyzstan
Type
IE
Moldova
Russia
Tajikistan
Turkmenistan
Ukraine
Uzbekistan
Question 330:
How did you learn about the [Name of Program] Program? Please check all that apply.
Business Colleague
Community Member
Direct Contact with
Exchange Agency
Exchange Agency
Website
Family Member
Friend
Local Community Center
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Local FLEX Coordinator
Local High School
Newspaper
Article/Advertisement
U.S. Department of State
Website
Other, Please Specify:
______________
Do Not Know
99
Type
IE
Question 331:
In what capacity have you been involved with the [Name of Program]? Please check
all that apply.
NOTE: Response categories listed will vary depending on the evaluation.
Type
IE
Host Family
Local [Name of Program] Coordinator
Exchange Agency Representative
Other [Name of Program] Volunteer
Other, Please Specify: ______________
Question 332:
Have you been involved as a host family with any non-[Name of Program] high
school student exchange program(s)?
Type
IE
Yes
No
Question 333:
Of the following non-[Name of Program] high school student exchange programs, for
which have you been a host family? Please check all that apply.
NOTE: Response categories listed will vary depending on the evaluation.
Type
IE
People to People
Sister Cities Exchange
Youth for Understanding
Rotary International Exchange
Youth Exchange and Study (YES) Program
Congress-Bundestag Youth Exchange (CBYX)
Other, Please Specify:
Not Sure
Question 334:
How many non-[Name of Program]exchange students have you hosted in your
home?
Response: Drop-Down List – Electronic, Open-Ended – Paper
Type
IE
Question 335:
The following are possible reasons for volunteering with the [Name of Program]
program. Please indicate how important each of these reasons is to you for hosting
[Name of Program] exchange students. Please check one box in each row. Check
N/A, if the statement is not applicable.
Type
IE
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Very
Important
Moderately
Important
Slightly
Important
Not At All
Important
N/A
I feel hosting foreign exchange students
contributes to my children’s education
I feel an obligation to share hospitality
received in other countries
I want to meet people from around the world
I want to share my community with foreign
exchange students
I want to learn more about foreign countries
and cultures
I feel it is important for foreign exchange
students to meet “real Americans”
I feel that hosting foreign exchange students
broadens my family’s perspective
I want to help improve the overall image of
the United States
I want to continue the legacy of hosting
foreign exchange students instilled by my
parents or other family member(s)
Other, Please Specify:________________
Question 336:
Please describe some of the benefits to you and your family in hosting [Name of
Program] exchange students.
Response: Open-Ended
Type
IE
Question 337:
Please describe some of the challenges to you and your family in hosting [Name of
Program] exchange students.
Response: Open-Ended
Type
IE
Question 338:
How often did you discuss the following topics with your most recent [Name of
Program] exchange student concerning the student’s home country? Please check
one box in each row.
Type
IE
Very
Often
Regularly
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
Religious Diversity
Values and Culture
Voluntary Community Service
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Sometimes
Rarely
Never
Do Not
Know
Question 339:
How often did you discuss the following topics with the most recent [Name of
Program] exchange student concerning the United States? Please check one box in
each row.
Very
Often
Regularly
Sometimes
Once or
Twice
Type
IE
Never
Do Not
Know
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
Religious Diversity
Values and Culture
Voluntary Community Service
Question 340:
Thinking about your most memorable [Name of Program] exchange student, what
was your level of knowledge about the following aspects of the student’s home country
BEFORE learning that you would be hosting the student? Please check one box in
each row.
No Knowledge
At All
Limited
Knowledge
Moderate
Knowledge
Type
IE
Extensive
Knowledge
Do Not
Know
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
Religious Diversity
Values and Culture
Voluntary Community Service
Question 341:
Thinking about your most memorable [Name of Program] exchange student, what
was your level of knowledge about the following aspects of the student’s home country
AFTER hosting the student? Please check one box in each row.
No Knowledge
At All
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
Religious Diversity
Values and Culture
Voluntary Community Service
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Limited
Knowledge
Moderate
Knowledge
Type
IE
Extensive
Knowledge
Do Not
Know
Question 342:
What makes this particular [Name of Program] student the most memorable?
Response: Open-Ended
Type
IE
Question 343:
Please indicate the extent to which you agree or disagree with whether hosting [Name
of Program] exchange students…
Type
IE
Strongly
Agree
Promotes mutual understanding among
Americans and people from other
countries
Promotes peaceful relations between the
United States and other countries
Promotes United States national
interests
Helps my family and me develop
friendships with people from other
countries
Helps my family and me better
appreciate people from other countries
Helps my family and me improve our
foreign language skills
Increases my family’s and my interest in
international events and news
Increases my family’s and my interest in
visiting foreign countries
Helps my family and me learn more
about the perspectives of people from
other countries
Helps me educate my children about
other countries and cultures
Gives my family and me the opportunity
“to make a difference”
Allows my family and me to share United
States values and beliefs with people
from other countries
Allows my family and me to share my
local community with people from other
countries
Allows foreign exchange students to
share their values and beliefs with my
family and me
Allows my family and me to volunteer our
time and resources in our community
Offers my family and me an opportunity
to return hospitality that we received in
other countries
Increases my family’s and my
appreciation of our local community
Increases my family’s and my
appreciation of the United States
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Agree
Neither Agree
Nor Disagree
Disagree
Strongly
Disagree
N/A
Question 344:
Have you ever spoken with family, friends and/or colleagues about your experience(s)
hosting [Name of Program] exchange student(s)?
Type
IE
Yes
No
Question 345:
Whom do you speak with about your hosting experience? Please check all that apply.
Type
IE
Business Colleague(s)
Community Member(s)
Family Member(s)
Friend(s)
Neighbor(s)
Other(s)
Question 346:
In general, how often do the following people directly participate in the hosting
experience? Please check one box in each row.
Always
Regularly
Sometimes
Rarely
Type
IE
Never
N/A
Family
Friends
Colleagues
Question 347:
After the experience of hosting a [Name of Program] student(s), has your child (or
children) done any of the following? Please check all that apply.
Type
IE
Traveled to a foreign country to study (e.g., study abroad,
Semester-At-Sea, U.S. exchange student, etc.)
Studied a foreign language spoken by a former FLEX exchange
student(s) (e.g., Russian, Ukrainian, Uzbek, Azerbaijani, Kazakh,
Armenian, etc.)
Pursued a college degree in international relations or
international studies (e.g., Bachelors or Masters)
Pursued a career in international relations or foreign affairs. (e.g.,
Peace Corps volunteer, Foreign Service Officer, career with
United Nations, etc.)
Pursued a career in international law (e.g., international trade
law, human rights law, etc.)
None
Not Applicable
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Question 348:
As a result of your hosting a [Name of Program] exchange student, have any of your
extended family, friends, neighbors and/or colleagues hosted a [Name of Program]
exchange student? Please check all that apply.
Type
IE
Business Colleague(s)
Community Member(s)
Family Member(s)
Friend(s)
Neighbor(s)
Other(s), Please Specify: ____________
None
Question 349:
Now, we would like to ask a series of questions about how hosting a [Name of
Program] student(s) may have impacted the life of you and your family. Please
indicate the extent to which you agree or disagree with each of the following
statements.
Type
IE
After the experience of hosting a [Name of Program] student(s), my family and I are
more likely to:
Strongly
Agree
Agree
Neither
Agree Nor
Disagree
Disagree
Strongly
Disagree
Read or listen to world news
Read or listen to news about the
[Name of Program] student’s home
country
Learn about the culture/traditions of
other countries
Learn more about the culture/traditions
of the student’s home country
Attend cultural events from the
student’s home country
Volunteer my time with other student
exchange programs
Meet people from other countries
Travel to other countries
Learn another language
Question 350:
What motivated you and your family to begin hosting [Name of Program] exchange
students?
Response: Open-Ended
Type
IE
Question 351:
What motivates you and your family to continue hosting [Name of Program] exchange
students?
Response: Open-Ended
Type
IE
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N/A
Question 352:
Of the [Name of Program] exchange student(s) you have hosted, have you visited
any of them in their home country?
Type
IE
Yes
No
Question 353:
If yes, please check the country or countries you have traveled to, in order to visit a
[Name of Program] exchange student(s). Please check all that apply.
NOTE: Countries listed will vary depending on the evaluation.
Armenia
Azerbaijan
Belarus
Georgia
Kazakhstan
Kyrgyzstan
Type
IE
Moldova
Russia
Tajikistan
Turkmenistan
Ukraine
Uzbekistan
Question 354:
If yes, please describe the situation that prompted you to visit your [Name of
Program] exchange student(s) in their country.
Response: Open-Ended
Type
IE
Question 355:
How many [Name of Program] exchange students have you maintained contact with
after hosting them in your home?
Response: Drop-Down List –Electronic, Tabled List –Paper
Type
IE
None
1 [Name of Program] Student
2 [Name of Program] Students
3 [Name of Program] Students
4 [Name of Program] Students
5+ [Name of Program] Students
Question 356:
In general, how frequently do you and your [Name of Program] exchange student(s)
contact one another?
Once a Year
2 to 3 Times a Year
More than 3 Times a Year
Never
Not Sure
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Type
IE
Question 357:
How do you and your [Name of Program] exchange student(s) stay in contact with
one another? Please check all that apply.
Type
IE
Letters
Telephone Calls
E-mails
Faxes
Personal Visits
Other
Question 358:
What topics do you and the [Name of Program] exchange student discuss during
your contact(s)?
Please check all that apply.
Type
IE
Possible/Upcoming Visits
Personal/Family News
New Contact Information
International News/Events
U.S. News/Events
Other
Question 359:
Have any [Name of Program] exchange alumni visited you in your home after their
exchange program?
Type
IE
Yes
No
Question 360:
If yes, please describe the situation that prompted the [Name of Program] alumni to
visit you and your family after their exchange program.
Response: Open-Ended
Type
IE
Question 361:
Which category best describes the location of your home?
Type
IE
Rural/Farm Area
Suburban Area
Small Town or City
Large or Major City, Not Capital
State’s Capital City
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Question 362:
Including yourself, how many people resided in your household when you (first)
hosted?
Response: Drop-Down List –Electronic, Open-Ended –Paper
Type
IE
Question 363:
How many children under the age of 18 years resided in your household when you
(first) hosted?
Response: Drop-Down List –Electronic, Open-Ended –Paper
Type
IE
Question 364:
Which category best described your marital status when you (first) hosted?
Type
IE
Single, Never Married
Living Together, Not Married
Married
Widowed
Divorced
Separated
Question 365:
What is your age?
Response: Drop-Down List –Electronic, Tabled List –Paper
Type
IE
18 - 24 Years
25 - 34 Years
35 - 44 Years
45 - 54 Years
55 - 64 Years
65 - 74 Years
75 Years or Older
Question 366:
What is your gender?
Type
IE
Female
Male
Question 367:
What is your field of work or profession? Please check all that apply.
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Type
IE
Agriculture
Arts & Culture
Business/Finance
Education
Government
Homemaker
International Affairs
Legal/Law Enforcement
Media/Communications
Medicine
Military Service
Non-Profit
Public Administration
Retired
Science & Technology
Trade
Other
Question 368:
Which category best describes your highest level of formal education?
Type
IE
Less than High School Diploma
High School Diploma/GED
Vocational/Technical Diploma or Certificate
Some College, No Degree
Associate’s Degree (AA, AS)
Bachelor’s Degree (BA, BS)
Master’s Degree (MA, MS)
Doctorate Degree (PhD, EdD)
Professional Degree (MD, MBA, DDS, JD,
LLB)
Question 369:
Thank you for your participation! Do you have any suggestions or feedback for the
U.S. Department of State and the exchange agencies on how to attract new host
families to become involved with the [Name of Program]?
Type
IE
Question 370:
How many minutes did it take you to complete this survey?
Response: Drop-Down List –Electronic, Open-Ended –Paper
Type
IE
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| File Type | application/pdf |
| File Title | FINAL PDEO Question Bank |
| Subject | PDEO Question Bank for OMB Generic Collection |
| Author | halemj2 |
| File Modified | 2007-11-05 |
| File Created | 2007-11-05 |