Form Instrument 1 Instrument 1 Participant Survey

Instrument 1 – Participant Survey
INTRODUCTION TO PARTICIPANT SURVEY
Slight modifications may be made for each of the administration modes.
Thank you for participating in this survey for the Creative Forces®: NEA Military Healing Arts Network
Community Arts Engagement Grant Program Evaluation. This study is funded by the National
Endowment for the Arts. We are interested in learning more about the experiences and needs of the
people who participate in Creative Forces community arts programs. The survey takes about 10 minutes
to complete. We ask participants to take the survey two times: at the beginning of the program and
again at the end. You will receive a $30 eGift card in appreciation for your time after each survey in a
follow-up email.
For digital surveys: Your survey access code is unique to this survey. When you use this link, your
responses are entered into a database that does not include your name, but links the responses you
make on the survey at the beginning and end of the program. Your responses on this survey are
confidential and only the program researchers (Shawn Bachtler and Candace Gratama) have access to
the responses. The connection between you and the unique link is kept in a separate, password
protected file that only the researchers can access. Details about identifiers (e.g., unique access code,
use of email address) will be included here.
For paper surveys: Your survey code links the responses you make on the survey at the beginning and
end of the program. Your responses on this survey are confidential and only the program researchers
(Shawn Bachtler and Candace Gratama) have access to the responses. The connection between you and
the unique code is kept in a separate, password protected file that only the researchers can access.
No one associated with this program or Creative Forces will be able to see your survey or know whether
you completed the survey. Your answers will be kept confidential and combined with the answers from
other participants in Creative Forces programs. While the researchers will keep your information
confidential, there are some risks of data breeches when sending information over the internet that are
beyond the control of the researchers.
You should also know that:
● You must be 18 or older to take this survey.
● The survey is completely voluntary. You may skip any questions or quit at any time. If you decide
to withdraw, simply close the survey window.
● All information collected through this study will be kept in locked offices and on password
protected computers.
● Your participation in the Creative Forces program will not be impacted by whether or not you
choose to complete the survey.
● There are no benefits to you for taking this survey. There are no risks expected with
participation in this survey, although it is possible that some people may experience discomfort
when answering questions about making art, how connected they feel to others, and how they
handle challenges.
● The database with access codes will be permanently deleted at the end of the project on DATE.

If you have any questions about this survey, information can be obtained from Shawn Bachtler, Ph.D., of
ProgramWorks (shawnbachtler@gmail.com or 206-595-5878) or the National Endowment for the Arts at
research@arts.gov if you have any questions regarding the estimated time burden or any other aspect
of this data collection. If you have any questions about your rights as a participant in the study, you may
contact IRB Service (the body that oversees our protection of study participants) at (855) 226-4472
or participants@solutionsirb.com.
By completing this survey, you are consenting to participate in this study.
*Please feel free to print or save a copy of this form for your records.*

This version of the survey shows analyses related to the specific participant outcomes outlined in the logic models. The
form presented to grantees will show only the survey items.

PARTICIPANT SURVEY
POST-SURVEY ONLY: Self-report of current attendance and prior participation
1.

Self-report attendance and engagement questions will be tailored to each program according to their model.
A. Please estimate how often you participated in this program. [3 examples]
EX 1: How many sessions did you attend out of the eight sessions offered? _____
EX 2: This program offered two drop-in sessions each week. How many sessions have you attended over the past two months? ____
EX 3: In the past 30 days, approximately how many total hours have you been involved in the program?
o Less than 1 hour total
o 1 to 3 hours total
o 4 to 5 hours total
o 6 to 9 hours total
o 10 or more hours total
B. When I attended the sessions over the past 30 days, I took part in the activities:

o
o
o
o
2.

Very often
Often
Occasionally
Rarely

Have you previously attended this program or a similar program?
o Yes
o No

Please select the answer that fits best. For this survey:
● Art refers to all forms of art, such as visual art, music, theatre, dance, and so on.
● Engaging with art refers to observing art, such as watching a performance, viewing an exhibition, etc.

#

Item [source scale]

Analyses

Outcome

Items 3 – 32 use a 5-point Likert response scale: Strongly Disagree, Disagree, Mixed or Neither Agree nor Disagree, Agree, Strongly Agree
Through arts engagement art, I:

3.

4.
5.

a.a.
b.b.
c.c.
d.d.
e.e.
f.f.
g.g.
h.h.

Understand myself better. [CFCE 1]
Understand the things that matter most to me. [CFCE 1]
Feel understood by others. [CFCE 2]
Understand others better. [CFCE 3]
Feel connected to the military/veteran community. [CFCE 4]
Feel connected to the civilian community. [CFCE 5]
I am able to take chances in a safe, supportive environment. [CFCE 7]
Learn and improve creative skills. [CFCE 8]
Arts engagement improves my physical health. [CFCE 6]

Frequencies, change scores
Frequencies, change scores
Frequencies, change scores
Frequencies, change scores
Frequencies, change scores
Frequencies, change scores
Frequencies, change scores
Frequencies, change scores
Frequencies, change scores

Creative Expression
Creative Expression
Creative Expression
Creative Expression
Creative Expression
Creative Expression
Creative Expression
Creative Expression
Creative Expression

Arts engagement has a positive effect on my relationships with family or
close friends. [CFCE 9]

Frequencies, change scores

Creative Expression

Creative Expression Subscale (3 – 5)
6.
7.
8.

Total items 1 – 3; mean,
median, mode, range;
change scores

I enjoy getting lost in the process of engaging with the arts. [CFF2]

Frequencies, change scores

Creative Expression - Flow

My concentration improves when I’m fully absorbed in the arts. [CFF3]

Frequencies, change scores

Creative Expression - Flow

Being absorbed in the arts enables me to clarify thoughts or ideas I didn’t
fully understand before. [CFF 1]

Frequencies, change scores

Creative Expression - Flow

Creative Expression – Flow Subscale CFF (6 – 8)

Total items 4 – 6; mean,
median, mode, range;
change scores

9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

I am optimistic and hopeful about the future. [ESPS 13]

Frequencies, change scores

I am grateful for people or opportunities in my life. [ESPS 14]

Frequencies, change scores

I am proud of myself. [ESPS 15]

Frequencies, change scores

I am kind and understanding towards myself when I am going through a hard
time. [ESPS 16]
I am open minded to trying new experiences. [ESPS 17]

Frequencies, change scores

I approach life with excitement and energy. [ESPS 18]

Frequencies, change scores

I have purpose in my life. [ESPS 32]

Frequencies, change scores

I have personal goals that I am working on achieving. [ESPS 33]

Frequencies, change scores

I have a sense of direction in my life. [ESPS 34]

Frequencies, change scores

I am working towards a common goal with other people. [ESPS 35]

Frequencies, change scores

I feel part of something bigger than myself. [ESPS 36]

Frequencies, change scores

My role in my family, work, or community is a positive source of self-worth
and connection to others. [ESPS 37]

Frequencies, change scores

Independence and Successful Adaptation to Civilian Life Sense of Purpose
Subscale (9 – 20)
21.
22.
23.
24.
25.

Frequencies, change scores

Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life

Total items 7 – 18; mean,
median, mode, range;
change scores

I put time and effort into helping others. [EECS 19]

Frequencies, change scores

I feel a sense of belonging to a larger community. [EECS 20]

Frequencies, change scores

I feel connected to my local community. [EECS 29]

Frequencies, change scores

I participate in leadership activities that increase my sense of purpose. [EECS
38]
I participate in community service activities that increase my sense of
purpose. [EECS 39]

Frequencies, change scores
Frequencies, change scores

Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life
Independence and Successful Adaptation to
Civilian Life

26.

I feel like a leader in my community. [EECS 40]

Independence and Successful Adaptation to Civilian Life Engaged
Citizenship Subscale (21 – 26)

Frequencies, change scores

Independence and Successful Adaptation to
Civilian Life

Total items 19 – 24; mean,
median, mode, range,
change scores

I tend to bounce back quickly after hard times. [BRS 1]

Frequencies, change scores

Resilience

I have a hard time making it through stressful events. [BRS 2]

Frequencies, change scores
[reverse]
Frequencies, change scores

Resilience

Frequencies, change scores
[reverse]
Frequencies, change scores

Resilience

Frequencies, change scores
[reverse]
Total items 25 – 30; mean,
median, mode, range,
Resilience Subscale (27 – 32)
change scores
5-point Likert response scale for item 31: Very Poor, Poor, Neither Poor Nor Good, Good, Very good

Resilience

27.
28.
29.
30.
31.
32.

33.

It does not take me long to recover from a stressful event. [BRS 3]
It is hard for me to snap back when something bad happens. [BRS 4]
I usually come through difficult times with little trouble. [BRS 5]
I tend to take a long time to get over set-backs in my life. [BRS 6]

How would you rate your quality of life? [WHOQOL-BREF G1]

Quality of life brief assessment (31)

Frequencies, change scores

Resilience

Resilience

Creative Forces general outcome: Quality of Life

Mean, median, mode,
range, change scores

5-point Likert response scale for item 32: Very Dissatisfied, Dissatisfied, Neither Satisfied Nor Dissatisfied, Satisfied, Very satisfied

34.

How satisfied are you with your health? [WHOQOL-BREF G4]

Well-being brief assessment (34)

Frequencies, change scores

Creative Forces general outcome: Well-being

Mean, median, mode,
range, change scores

7-point Likert response scale for items 35 – 46: Strongly disagree, Disagree, Disagree a little, Neither agree or disagree, Agree a little, Agree, Strongly agree

35.
36.

When I am with other people, I feel included. [GBS 1]

Frequencies, change scores

Social Connectedness

I have close bonds with family and friends. [GBS 2]

Frequencies, change scores

Social Connectedness

37.
38.
39.
40.
41.
42.
43.
44.
45.
46.

I feel like an outsider. [GBS 3]

Frequencies, change scores

Social Connectedness

I feel as if people do not care about me. [GBS 4]

Frequencies, change scores

Social Connectedness

I feel accepted by others. [GBS 5]

Frequencies, change scores

Social Connectedness

Because I do not belong, I feel distant during the holiday season. [GBS 6]

Frequencies, change scores

Social Connectedness

I feel isolated from the rest of the world. [GBS 7]

Frequencies, change scores

Social Connectedness

I have a sense of belonging. [GBS 8]

Frequencies, change scores

Social Connectedness

When I am with other people, I feel like a stranger. [GBS 9]

Frequencies, change scores

Social Connectedness

I have a place at the table with others. [GBS 10]

Frequencies, change scores

Social Connectedness

I feel connected with others. [GBS 11]

Frequencies, change scores

Social Connectedness

Friends and family do not involve me in their plans. [GBS 12]

Frequencies, change scores

Social Connectedness

Total items 35 – 346; mean,
median, mode, range

Subscale GBS

Demographics – used for descriptive statistics and as disaggregation variables
47.

Which best describes you? (check all that apply) [Creative Forces]

o Service Member

o
o

o

▪ Active Duty
▪ National Guard/Reserve
Veteran/Retiree
Spouse/Partner of a Service Member or Veteran
▪ Active Duty Service Member
▪ National Guard/Reserve
▪ Veteran
Other Family Member of a Service Member or Veteran
▪ Active Duty Service Member
▪ National Guard/Reserve

Frequencies for individual and co-endorsements
(categories endorsed by the same individual, such as
“Veteran” plus “Military/veteran caregiver –
clinical”)

Military connection

o

o
o
o
o
48.

▪ Veteran
Caregiver for a
▪ Active Duty Service Member
▪ National Guard/Reserve
▪ Veteran
Health care worker serving military-connected populations
Civilian
Other ________
Prefer not to say

What is your age? [Veterans Administration population data collection]

Frequencies; mean, median, mode, range

Age

Frequencies for individual and co-endorsements
(categories endorsed by the same individual, such as
“Asian” plus “Hispanic or Latino”)

Race/ethnicity

Frequencies

Gender

o
o
o
o

49.

18-24 years
25-44 years
45- 64 years
65 years or older
What is your race and/or ethnicity? Select all that apply.

o
o
o
o
o
o
o
o
50.

American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Prefer not to say

What is your sex?
o
Female
o
Male
o
Prefer not to say