1. Stages of Change & TTM Models: A Comparison Pre-Cont  Cont  Prep  Act  Maint

2. Stages of Change & TTM Pre-Cont  Cont  Prep  Act  Maint Knowledge

3. Stages of Change & TTM Pre-Cont  Cont  Prep  Act  Maint Knowledge Attitudes & Beliefs

4. Stages of Change & TTM Pre-Cont  Cont  Prep  Act  Maint Knowledge Attitudes Intent & & Beliefs Efficacy

5. Stages of Change & TTM Pre-Cont  Cont  Prep  Act  Maint Knowledge Attitudes Intent & Behavior & Beliefs Efficacy

6. Stages of Change & TTM Pre-Cont  Cont  Prep  Act  Maint Knowledge Attitudes Intent & Behavior Sustained & Beliefs Efficacy

7. If Not for the SoC (TTM) Then… 1. Which of the following statements best describes your exercise habits? (Filler Item) A. I exercise at least 3 times per week & have done so for more than 6 months B. I recently started exercise at least 3 times per week C. I do not exercise at least 3 times per week but I plan to start in the next month. D. I do not exercise at least 3 times per week but I plan to start in the next 6 months. E. I do not exercise at least 3 times per week & I don’t plan on starting in the next 6 months. 2. Which of the following statements describes your volunteering activities? (Filler Item) a. I volunteer regularly & have done so for more than 6 months b. I recently started volunteering regularly c. I do not volunteer regularly but I plan to start in the next month. d. I do not volunteer regularly but I plan to start in the next 6 months e. I do not volunteer regularly & I don’t plan on starting in the next 6 months. 3. Which of the following statements best describes you when it comes to agreeing to become an organ donation after you pass away? (SoC Item) a. I am currently a registered organ donor and have been so for more than 6 months. b. I recently became a registered organ donor. c. I haven’t agreed to be an organ donor but I plan to agree to do so in the next month. d. I haven’t agreed to be an organ donor but I plan to agree to do so in the next 6 months. e. I haven’t agreed to be an organ donor & I don’t plan to agree to do so in the next 6 months.

8. And This 1. Were you an organ donor prior to today?Yes No Unsure 2. Was your family aware of your wishes concerning organ donation?Yes No Unsure 3. Do you plan to join a donor registry today?Yes No Unsure 4. Will you notify you family as to your wishes about organ donation?YesNoUnsure On the scale below, please indicate your feelings about “Organ Donation.” Good 7 6 5 4 3 2 1 Bad Wrong 1 2 3 4 5 6 7 Right Harmful 1 2 3 4 5 6 7 Beneficial Wise 7 6 5 4 3 2 1 Foolish Negative 1 2 3 4 5 6 7 Positive

9. And This As Well… How many of your friends do you think would tell you not to sign an organ donor card? None Few Some Most All How many of your friends do you think would be willing to sign an organ donor card? None Few Some Most All I intend to add my name to a donor registry today? Strongly Disagree Disagree Unsure Agree Strongly Agree For me to decide to become an organ today would be Easy1234567Difficult I believe that I have the ability to give consent to donation today False1234567True

10. And Don’t Forget… Please answer the following items by circling True, False or Don’t Know. 1. A person must carry an organ donor card to be an organ donor YesNoDon’t know 2. A person’s next of kin must give permission to organ donation. YesNoDon’t know 3. Most people who need a transplant receive one. YesNoDon’t know 4. Racial discrimination prevents minority patients from receiving an organ transplant. YesNoDon’t know 5. It is possible for a brain-dead person to recover from their injuries. YesNoDon’t know

11. And Finally,… 6. People who choose to donate a family member’s organs incur additional expenses YesNoDon’t know 7. Given equal need, a poor person has as good a chance to receive an organ as a rich person YesNoDon’t know 8. Organs for transplant can be bought and sold on the black market in the US. YesNoDon’t know 9. It is possible to have a regular funeral (including open casket) following organ donation YesNoDon’t know

12. Why we Love The SoC (TTM) Which of the following best describes your Source Water Protection (SWP) planning activities? a. We currently have a SWP plan & have had one for more than 6 months b. We just recently implemented a SWP plan c. We do not have a SWP plan but are trying to put one together in the next month d. We do not have a SWP plan but are trying to put one together in the next 6 months e. We do not have a SWP plan and have no plans on putting one together in the next 6 months

13. Remember Evaluation is About the Program

14. Remember Evaluation is About the Program Data is not the answer but…. It provides us with a guide

15. Remember Evaluation is About the Program Data is not the answer but…. It provides us with a guide Garbage In … Garbage Out