Evaluation Form
Evaluation of Video Vignettes:
Teamwork
1. Please describe yourself:
__
__
__
__
__
__
__
Mother or mother figure(active duty)
Father or father figure (active duty)
Mother (not active duty)
Father (not active duty)
Female teen
Male teen
Facilitator and/or professional working with
military families
__
Educational meeting concerning parent teen
relationships
Installation Newspaper
Internet
Paper copy provided by military support
network (Family Support, ACS, Life-lines,
etc,)
other_________________________
2. Parents & Teens:
Where did you see/hear about the activity:
__
__
__
__
4. How clear is the message or main point portrayed in the video? (Please circle your answer)
Very
Very
Unclear
Clear
1
2
3
4
5
6
5. How important do you think these topics are concerning parent-teen relationships? (Please circle your answer)
Very
Very
Unimportant
Important
1
2
3
4
5
6
6. Did the video message grab your attention? (Please circle your answer)
Very
Ineffective
1
2
3
4
5
Very
Effective
6
7. After watching the video message, did you and your teen (or parent) talk about the topics discussed, and how
they relate to your relationship? (Please circle your answer)
Not
At All
1
A Lot
2
3
4
5
6
8. After watching this video, were you able to talk about and identify your family’s support network?
Not
At All
1
A Lot
2
3
4
5
6
9. Do you have any other comments regarding this video message? Please, use the space below.
Professionals working with families:
10. Did you find the video message useful to make or strengthen your point? (Please circle your answer)
Not
Useful
1
2
3
4
5
Very
Useful
6
11. Did it help to encourage discussions between parents/teens, or parents/facilitators, or facilitators/parents/teens,
etc. (Please circle your answer)
Not
At All
1
A Lot
2
3
4
5
6