17 question ‘outcome survey’ for adults receiving a wide range of social and community services. You can hide questions that are not relevant to your program. We are planning to add more questions based on user requests, so please feel free to suggest additional measures.
These days, I know that: (Options are Never true, Sometimes true, True half the time, Mostly true, Always true)
- I can cope with whatever challenges come at me
- I know what to do in response to problems that come up
- I know what my next steps are to meet my goal
- When something doesn’t work, I can try something else
- I have a clear sense of my goals for the next few years
- I feel confident in the decisions I make
When I need help with something:
- I have a good idea about what kinds of support I can get from people in my community (friends, family, neighbours, etc.)
- I feel comfortable asking for help.
- I have a good idea about what kinds of support I can get from community programs and services.
- Community programs and services provide the support I need.
How satisfied are you with your housing? (5 point scale from Very satisfied to Very dissatisfied)
How many hours of paid work did you do last week? (Options: More than 25 hours, 5 – 25 hours, Less than 5 hours)
Do you have a regular health care provider? (Yes, No)
How would you describe your sense of belonging to your local community? Would you say it is…? (Very strong, Somewhat strong, Somewhat weak, Very weak)
Using a scale of 0 to 10 where 0 means “Very dissatisfied” and 10 means “Very satisfied”, how do you feel about your life as a whole right now?
How old are you?
What is your gender? (Female, Male, Gender diverse)