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School & Community Drug Talks
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School & Community Drug Talks
Dialogue Assessment Tool
Date:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
02
03
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06
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30
31
Time:
Start:
End:
Facilitators present:
Advisors present:
Discussion initiation methods used:
Number of participants present:
Number of participants who talked during the dialogue:
Number of participants who asked questions:
Number of participants who related the dialogue to personal experiences:
Number of participants who shared new ideas (topics not yet talked about):
As a group, how talkative were they?
(choose one)
Very talkative
Somewhat talkative
Somewhat quiet
Very quiet
As a group, how well did they listen?
(choose one)
Very good
Good
Average
Poor
As a group, how well did they stay on topic?
(choose one)
Most of the time
Some of the time
Once in a while
Almost never
How often did the facilitators talk?
(choose one)
Most of the time
Some of the time
Once in a while
Almost never
How often did the participants talk?
(choose one)
Most of the time
Some of the time
Once in a while
Almost never
Facilitator comments:
Advisor comments:
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