• DSHS HIV/STD Program
    Post Office Box 149347, MC 1873
    Austin, TX 78714

    Phone: 737-255-4300

    Email the HIV/STD Program

    Email HIV, STD, Hepatitis C, and TB data requests to the Program – Use this email to request Texas HIV, STD, Hepatitis C, and TB data and statistics. Do not use this email to request treatment or infection history for individuals, or to request information on programs or services. Do not email personal, identifying health information such as HIV status, date of birth, or Social Security Number.

    For treatment/testing history, please contact your local health department.

    For information on HIV testing and services available to persons living with HIV, please contact your local HIV services organization.

Outcome Monitoring Toolkit

Introduction to the Outcome Monitoring Toolkit


The Outcome Monitoring Toolkit was produced by the DSHS HIV/STD Program.

The toolkit is a byproduct of the development a system of outcome monitoring that is being used to provide prevention partners with additional information about their programs, thereby increasing the resources they have for reflective practice.


The Outcome Monitoring Toolkit for HIV prevention programs provides a series of tools to assist with program improvement. The toolkit contains the following items for each prevention program it addresses:

  • A one page description of the program, including suggested objectives that can be assessed using the questionnaire;
  • A questionnaire tailored for use with that program
  • A Microsoft Access data entry form
  • A Microsoft Excel data entry form

Questionnaire Development

Questionnaire development involved several steps.

  • Logic models were reviewed or created for each prevention program.
  • Existing questionnaires were matched to the logic models to determine appropriateness.
  • Prevention partner staff members were included in a discussion about the surveys and asked to suggest areas of improvement. Discussions typically addressed questionnaire length, language appropriateness for the target population, and the match between questionnaire items and the prevention program goals.
  • In some cases, pre-existing surveys were used in pilot studies and, in other cases, virtually new surveys were developed.
  • Questionnaires were piloted in the field by prevention partners.
  • Following the pilot studies, the questionnaires were revised based on input from both the program partners and the DSHS staff.

Appropriate Use of Surveys

These questionnaires have been used in the field but have not been subjected to rigorous psychometric analysis. Accordingly, results from responses to questionnaires are appropriate for identifying potential areas for program improvement, as well as program strengths. The results they provide should not be seen as the basis for inferences about the associations among determinants and client behaviors.




One Pager (DOC)

Post Only Questionnaire (DOC)

Data Entry Form (XLS)


One Pager (DOC)

Pre Questionnaire (DOC)

Post Questionnaire (DOC)

Data Entry Form (XLS) | Data Entry Form (Zipped Access file)


One Pager (DOC)

Pre Questionnaire 1 (DOC)

Pre Questionnaire 2 (DOC)

Post Questionnaire (DOC)

Data Entry Form (XLS) | Data Entry Form (Zipped Access file)


One Pager (DOC)

Pre/Post Questionnaire (DOC)

Data Entry Form (XLS) | Data Entry Form (Zipped Access file)


One Pager (DOC)

Pre Questionnaire (DOC)

Post Questionnaire (DOC)

Data Entry Form (XLS) | Data Entry Form (Zipped Access file)



Questionnaire  Determinant/Item#/Source
Questionnaire Item Documentation
  • All
    • All - Source 1
  • Behavioral risk
    • Part 1, #1a-h; Part 2, #1-4 - source 2
  • Perception of risk
    • Part 2, #5 (only item) - adapted from source 3
  • Knowledge about HIV infection and prevention
    • #1-4 - source 2
  • Knowledge about safe sex negotiation
    • #5 (only item) - source 2
  • Intentions
    • #1 & 2 - source 2
  • Knowledge about HIV infection and prevention
    • #1, 2, 7 - 15 - source 3
    • #3, 4, 5, 6 - adapted from source 3
  • Perception of risk
    • Only item - adapted from source 3
  • Intentions
    • #K-T - source 3
  • Knowledge about HIV infection and prevention
    • #1 - source 4
    • #2,3 - source 5
    • #4 - adapted from source 5
    • #5 - source 6
  • Knowledge about safe sex negotiation
    • #6, 7 - source 7
  • Knowledge about HIV infection and prevention
    • #1,2,4,5 - adapted from source 8
    • #3,6 - source 8
    • #7-9 - source 6
    • #10 - source 2
  • Perception of risk for transmitting HIV
    • #1 - source 6
  • Attitudes toward condom use
    • #1 - adapted from Source 9
    • #2 - adapted from source 8
    • #3 - source 8
  • Intention to use condoms
    • #1 - source 9
  • Self-perceptions
    • #1-5 - source 8


Questionnaire Items Sources

1. Developed in discussions with Mpowerment program staff at two prevention programs in Texas.

2. UTSA staff collaborative discussion with UT evaluation expert

3. Austin Outreach SISTA Program Questionnaire

4. Adapted from Project Fate Baseline Survey, Partners in Prevention, The University of Texas Health Sciences Center at San Antonio

5. Advocates for Youth. Training Youth to be Peer Educators. TAP Evaluation Survey: Pretest. advocatesforyouth.org/publications/TAP5.pdf (PDF). Cited in Monitoring Outcomes of HIV Prevention Programs – question Bank.

6. Toolkit authors

7. Valley AIDS Council staff in collaboration with UT staff

8. WILLOW HIV Transmission Reduction Among Women Living with HIV. (1999) Original Evaluation Instruments:

  • Self-Esteem Scale, p. 6.
  • Knowledge Scale, p. 42
  • Condom Attitudes Scale, p. 58

9. SISTA Implementation Manual, p. 291

Last updated May 25, 2021