5800-027 ECCR Facilitated Dialogue Participant Questionnaire

OMB Control Number: 2030-0051

Approval Expiry Date: MM/DD/YYYY

ECCR Facilitated Dialogue Participant Questionnaire

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2030-0051). Responses to this collection of information are voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to be 32 minutes per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to Director, Information Engagement Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

The U.S. Environmental Protection Agency, Conflict Prevention and Resolution Center (CPRC) requests your assistance in evaluating this facilitated process. As a part of this evaluation, we ask the various participants who have been involved in this project or case to provide us with information about their experience. The data compiled will be used to improve future facilitation services provided by the CPRC.

The CPRC will not report information from this evaluation in a way that respondents or their organizations can be identified.

Section 1: Reactions

We would first like to hear more from you about the outcomes of the facilitated process.

1. Were the goals of this process communicated to you? Please select one.

   • Yes

   • No [Skip to Q4]

   • Not sure. [Skip to Q4]

2. To what extent did the process meet its goals? Please select one.

   • The process fully met its goals.

   • The process partially met its goals.

   • The process did not meet its goals.

   • I am not sure if the process met its goals.

3. Please use the space below to elaborate on your response to the previous question.

{Open-ended box}

4. To what extent did this facilitated process contribute to participants’ decisions? Please select one.

• The matter has been resolved.

• The matter will be resolved.

• There is a good possibility that the matter can be resolved.

• This process provided information and suggestions that will inform future decision-making.

• The process will not make much of a difference in resolving the matter. [Skip to Q6]

• This was not a decision-making process. [Skip to Q7]

• Not sure. [Skip to Q7]

5. Please use the space below to elaborate on how this facilitated process has helped or will help address the matter. [Move to Q7]

{Open-ended box}

6. Please use the space below to elaborate on why this process may not be able to make a difference in addressing the matter.

{Open-ended box}

7. To what extent do you agree with the following statements about the ability of participants to work together following participation in this process?

	Strongly agree	Agree	Somewhat agree	Neither agree nor disagree	Somewhat disagree	Disagree	Strongly Disagree	NA
Participating in this process improved our ability to work together cooperatively.
Participating in this process increased our trust in each other.
Participating in this process increased our mutual understanding of each other’s perspectives.

8. Please use this space if you wish to elaborate on changes in participants’ levels of cooperation, trust, and understanding.

{Open-ended box}

Section 2: Process Effectiveness

In this set of questions, we would like you to reflect on the effectiveness of the facilitated process you participated in.

9. Please rate your level of agreement with the following about the early phases of the facilitated dialogue process.

	Strongly agree	Agree	Somewhat agree	Neither agree nor disagree	Somewhat disagree	Disagree	Strongly Disagree	NA
I had a good understanding of the process from the outset.
I was able to assess the risks, costs, and benefits associated with participating in the facilitated process from the outset.
Early discussions with the facilitator were critical in helping me understand how a facilitated process might serve my interests.
I had a good understanding of how to contribute to the facilitated process.
Participants were encouraged to engage in considering the key issues in the dialogue.
The facilitate dialogue process was structured to consider the key issues in an appropriate sequence.

10. Please use this space if you wish to elaborate on your answers to any of these questions.

{Open-ended box}

11. Please rate your level of agreement with the following about the participants involved in the facilitated dialogue process:

	Strongly agree	Agree	Somewhat agree	Neither agree nor disagree	Somewhat disagree	Disagree	Strongly Disagree	NA
The participants, as a group, represented all affected concerns.
The participants had sufficient authority to make commitments on behalf of their organizations.
I had the resources (e.g., time, money) needed to participate effectively in the process.

12. Please use this space if you wish to elaborate on your answers to any of these questions.

{Open-ended box}

13. We’d like to learn more about your experiences with the process. Using the scale provided, please rate your level of agreement with the following statements:

	Strongly agree	Agree	Somewhat agree	Neither agree nor disagree	Somewhat disagree	Disagree	Strongly Disagree	NA
The process enabled me to gain a good understanding of the issues important to the other participants.
The process enabled me to understand why issues addressed in the process were important to other participants.
The process enabled participants to be civil to each other.
This was an appropriate process to address the matter.
The process helped us identify key issues that needed to be addressed.
The other participants listened to me/us.
The other participants respected the views I/we expressed.
I would recommend this type of facilitated process to colleagues in a similar situation.

14. Please use this space if you wish to elaborate on your answers to any of these questions.

{Open-ended box}

15. We’d like to hear your thoughts about the facilitator for this process. Using the scale provided, please rate your level of agreement with the following about the facilitator:

	Strongly agree	Agree	Somewhat agree	Neither agree nor disagree	Somewhat disagree	Disagree	Strongly Disagree	NA
When needed, the facilitator helped us find ways to move forward constructively.
The facilitator dealt with all participants fairly.
I trusted the facilitator.
The facilitator ensured my views and perspectives were considered in the process.
The facilitator helped participants test the practicality of the options under discussion.
I would recommend this facilitator to colleagues in a similar situation.

16. Use this space if you wish to elaborate on your answers to any of these questions.

{Open-ended box}

17. Did the facilitated dialogue help address the goals of the process in ways that would not have happened if the facilitated dialogue did not occur? Please check one.

• Yes

• No [Move to Q19]

• Don't know [Move to Q19]

• Too soon to tell [Move to Q19]

18. Please describe how the goals of this process were furthered by using a facilitated dialogue.

{Open-ended box}

19. Based on your experience, what was the greatest advantage of the facilitated dialogue process?

{Open-ended box}

20. Based on your experience, what was the greatest disadvantage of the facilitated dialogue process?

{Open-ended box}

21. What is your top suggestion on how this facilitated process could have been improved? Please indicate “none” if you feel this process could not have been improved.

{Open-ended box}

22. Please use the space below for any additional comments you would like to make.

{Open-ended box}

Thank you for taking the time to complete this questionnaire!

PERSONS WITH DISABILITIES WHO REQUIRE ALTERNATIVE MEANS FOR COMMUNICATION OF PROGRAM EVALUATION INFORMATION SHOULD CONTACT THE CPRC OFFICE.

Burden Statement: Public reporting burden for this collection of information is estimated to average 32 minutes per response, including the time for reviewing instructions, gathering information, and completing and reviewing the collection of information. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates, and any suggestions for reducing the burden, including the use of automated collection techniques to:

CONFLICT PREVENTION AND RESOLUTION CENTER

U.S. Environmental Protection Agency (MC: 2388A)

1200 Pennsylvania Avenue, NW, Washington, DC 20460

Telephone: 202.564.0214, Fax: 202.501.1715

Website: www.epa.gov/adr

Email: adr@epa.gov

EPA Form: 5800-027 6