Evaluation Template for the Caregiver Policy Lens

Please take a moment to fill out this evaluation form as your comments are very valuable to us. Your feedback will help us strengthen the usability and update of this resource.



Organizational Affiliation:

Public Health Care

Private Health Care
University/Academic Setting
Non-Profit Advocacy

City:

Province:


Profession:

Nurse
Social Worker
Administrator
Educator
Govenment Employee

Caregiver
Student
Other


Rate the overall ease of applying the CGPL:
Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult 


Rate the clarity of instructions for applying the CGPL:

Very Clear

Somewhat Clear

Somewhat Unclear

Not Clear at All 


Rate the relevancy of the background materials for applying the CGPL:

Very Relevant

Somewhat Relevant

Somewhat Irrelevant

Not Relevant at All 


What would make the CGPL easier to use?

 


What would make the background material more relevant?

 


Rate the usefulness of the CGPL application to identify potential negative effects of a policy or program:

Very Useful

Somewhat UsefulSomewhat Useless

Completely Useless

Not Applicable 


Rate the usefulness of the CGPL application in creating supportive policy or programs for caregivers of older adults:

Very Useful

Somewhat UsefulSomewhat Useless

Completely Useless

Not Applicable 


Rate the usefulness of the CGPL application to identify strengths of a policy or program:

Very Useful

Somewhat UsefulSomewhat Useless

Completely Useless

Not Applicable 


Rate the usefulness of the CGPL application to promote caregivers of older adults in your organization/setting:

Very Useful

Somewhat UsefulSomewhat Useless

Completely Useless

Not Applicable 


Rate the ability of the CGPL application to promote caregivers of older adults in other organizations/settings:

Very Useful

Somewhat UsefulSomewhat Useless

Completely Useless

Not Applicable 


What would improve the relevance of the Policy Lens to your organization/setting?

 


Rate your knowledge increase regarding caregivers of older adults after applying the CGPL:

Significant Increase

Moderate Increase

Small Increase

No Increase 


Please describe the main value you received from applying the CGPL:

 


Please describe any changes you and/or your organization will undertake as a result of applying the CGPL:

 


Will you use the Policy Lens again? Why or why not?

 


*** Of the following questions, select the one set of questions most applicable to you (i.e., A, B or C) and answer only that set. ***

 


A1. If the CGPL was applied by a group, how many people were involved?

 


A2. How many times did the group use the CGPL?

More Than 4

3-4 Times

1-2 Times

Not at All 


A3. Prior to using the CGPL, what was the level of knowledge of the group about caregivers of older adults?

Very High Level of Knowledge

Moderately High Level of Knowledge

Minimal Knowledge

No Knowledge at All 


B1. If the CGPL was applied by an individual on behalf of an organization, rate the level of pre-existing knowledge organization members had regarding caregivers of older adults.

Very High Level of Knowledge

Moderately High Level of Knowledge

Minimal Knowledge

No Knowledge at All 


C1. If the CGPL was applied by an individual, how much experience did this person have with applying the CGPL?

More Than 4

3-4 Times

1-2 Times

Not at All 


C2. Prior to completing the CGPL, how much knowledge did this person have about caregivers of older adults?

Very High Level of Knowledge

Moderately High Level of Knowledge

Minimal Knowledge

No Knowledge at All


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