Standard Set of Survey Questions
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Standard Set of Survey Questions


Table of Contents • Introduction • What Do I Need to Get Started? •  Falls Free© Logic Model  • Standard Set of Survey Questions • Next Steps • Appendix  

State and local coalitions are encouraged to adopt four surveys developed in the Standard Set of Survey Questions (Appendix B). The surveys measure progress of key stakeholders (older adults, children of older adults, primary care providers, and state legislators) from: salience (or awareness) of the issue, to belief that falls are preventable, to taking action to reduce fall risk.

Coalitions are encouraged to adopt one or all of Standard Set of Survey Questions, in the exact form that they are presented. In other words, please use the questions as designed. Evaluators can add questions but do not make changes to the questions developed here. The standard set of questions must be the same to allow comparisons across states and to demonstrate national impact. NOTE: If your state or local coalition uses one or more of the surveys, please contact  



The questions have been taken from validated surveys or research where possible. The development of the Standard Set of Survey Questions was informed by a matrix that includes key stakeholders and a continuum of measurable outcomes related to health behaviors (i.e., salience, beliefs, and behaviors). That matrix is presented in Appendix F.

Use of Surveys for Program Evaluation

Survey methodology is an important component of the overall evaluation strategy recommended by the Evaluation Committee. Surveys can be used to track stakeholder group beliefs regarding falls among older adult falls and related preventive actions. Conducting a well-designed survey to obtain valid and unbiased data is not easy. For those not schooled in sampling methods or questionnaire design we recommend that you partner with experts at a local university or college. For more information about conducting surveys or focus groups, a brief outline of considerations and discussions you may wish to have with evaluation experts helping to assess coalition impact are provided in Methodology Considerations (Appendix C).

Why use Focus Groups to Supplement Stakeholder Surveys?

Focus groups can be used to gain additional insights into survey information for program evaluation. A focus group is a group interview of approximately six to twelve people who share similar characteristics or common interests.  A facilitator guides the group based on a predetermined set of topics and encourages participants to share their perceptions and points of view.  Focus groups are a qualitative data collection method, meaning that the data is descriptive and cannot be measured numerically. (CDC 2008) The format allows for more in-depth assessment of stakeholder perceptions or experiences.  Coalitions may find additional feedback on programs, policies or activities would be helpful in understanding survey findings from different stakeholders. More detail about the use of focus groups is available in Methodology Considerations (Appendix C).




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