NIFL K-3 Pilot Program Customer Satisfactory Survey

Master Generic Plan for Customer Surveys and Focus Groups

Revised K-3 Parent Pilot Program Parent Survey

NIFL K-3 Pilot Program Customer Satisfactory Survey

OMB: 1800-0011

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1800-0011 can be found here:

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Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

National Institute for Literacy Parent Interview
Experiences and Satisfaction with Our Reading and Writing Journey
INTRODUCTION: Thank you for coming to talk with me today. I’m from RTI International, a not-forprofit research organization. We have been asked by the National Institute for Literacy to find out about
the Our Reading and Writing Journey program that you participated in last summer. Before beginning,
I’d like to tell you some more about what we will be doing and get your permission for this interview.
ADMINISTER INFORMED CONSENT

Part I. Experiences and Satisfaction with the Program and Staff
A. General Experiences with Our Reading and Writing Journey
First, I’d like to talk with you about your experiences with Our Reading and Writing Journey.
Remember, you can skip anything that you don’t want to answer.

A1. Why did you decide to participate in Our Reading and Writing Journey?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
A2. What are 3 things you hoped to get from participating in the program?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

A3. How well did the Our Reading and Writing Journey sessions meet your expectations? Would you
say they were...
___

better than you expected?

___

exactly what you expected?

___

not what you expected?

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

A3a. Would you explain to me why they were [better than/exactly what/not what you] expected?
PROBE FOR SPECIFICS
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
A4. What did you like about the small group format?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

A5. What didn’t you like about the small group format?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

A6. What did you like about sharing with the group?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

A7. What didn’t you like about sharing with the group?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

A8. What was helpful about seeing the activities modeled?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

A9. How could modeling have been more helpful?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

A10. What was helpful about practicing the activities with the group?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

A11. How could practicing the activities have been more helpful?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

A12. What was helpful about having time for planning the Learning and Using New Words activities that
you would do at home?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

A13. How could it have been more helpful?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

A14. Overall, how many of the group sessions did you attend? Would you say you attended..
_____ all 12 sessions? GO TO ITEM A18
_____ most sessions (i.e., 10 or 11)?
_____ some sessions (10 or fewer)? (Please specify how many ____________)
IF PARTICIPANT DIDN’T ATTEND ALL 12 SESSIONS, CONTINUE. OTHERWISE GOTO A18

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

A15. Please tell me about any issues that made it difficult or impossible for you to attend all group
sessions. [PROBE FOR CONFLICTS WITH WORK, CHILD CARE, TRANSPORTATION,
ILLNESS]
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

A16. Who else in your family attended the program if you were unable to attend sessions? [MARK ALL
THAT APPLY]
_____ CHILD’S MOTHER/FATHER [OTHER PARENT]
_____ SPOUSE/PARTNER [IF NOT CHILD’S PARENT]
_____ SISTER
_____ BROTHER
_____ RESPONDENT’S MOTHER [CHILD’S GRANDMOTHER]
_____ CHILD’S OTHER GRANDMOTHER
_____ RESPONDENT’S FATHER
_____ CHILD’S OTHER GRANDFATHER
_____ FRIEND
_____ OTHER [SPECIFY] _________________________

A17. Did you lose interest in coming to the sessions?
______ YES [GO TO ITEM A17a]
______ NO [GO TO ITEM A18]
A17a. Why did you lose interest in the sessions?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

A18. How satisfied were you with the length of the program? [PROBE FOR NUMBER OF SESSIONS,
LENGTH OF INDIVIDUAL SESSIONS, SPACING OF SESSIONS]
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

B. Perception of Our Reading and Writing Facilitator

Now, I’d like to hear your views about the Facilitator who worked with your group. Remember, none of
the information you share with me today will be given to your Facilitator. And you can skip anything that
you don’t wish to answer.

B1. Describe how knowledgeable you think the Facilitator was about teaching children to read and write.
[PROBE FOR SPECIFIC EXAMPLES]
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

B2. How helpful was the Facilitator’s feedback to you about your skills?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

B3. Describe how well she addressed your questions on topics discussed in group sessions.
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

B4. Did you feel that your Facilitator was able to keep your group working well together?
______ YES [GO TO ITEM B4a]
______ NO [GO TO TIEM B4b]

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

B4a.

Interviewer CR SH

Date ____/____/____

Please tell me why you think your Facilitator was able to keep your group working well
together.

B4b.

Please tell me why you think your Facilitator wasn’t able to keep your group working
well together.

B5.

What did you like the most about the Facilitator of your group?

B6.

What did you like least about the Facilitator of your group?

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

C. Satisfaction with My Reading and Writing Journey
C1. Please describe how satisfied you are with the My Reading and Writing Journey program.
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

C2. If a friend or relative of yours had the chance to be involved with My Reading and Writing Journey
and she wanted your opinion about the benefits of participating, what would you say?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

C3. And what would you say if she then asked for about the drawbacks or disadvantages of participating
in My Reading and Writing Journey?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

C4. What are some ways you think the program could be improved, overall?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
C5. What was your favorite session topic? Why was it your favorite topic? [PROBE FOR INTEREST
IN TOPIC, PREPARATION FOR DOING ACTIVITIES, CHILD’S REACTION TO ACTIVITIES]
IF THEY HAVE THEIR SCRAPBOOK “OUR READING AND WRITING JOURNEY,” HAVE
THEM USE THIS AS A REMINDER. IF NOT, USE THE BLANK COPY.
_____________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

C6. Describe whether and how the program made you more confident about helping your child become
a better reader and writer. [PROBE FOR SPECIFICS – WHAT DID THE PROGRAM DO TO
MAKE THEM FEEL MORE CONFIDENT; IF THE PROGRAM DIDN’T MAKE THE
FACILITATOR MORE CONFIDENT, DESCRIBE]
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

C7.

Have you changed anything in your home environment to support your child’s reading since
completing the program?
______ YES
______ NO [GO TO ITEM C8]
C7a. What have you changed?

C8. How has being a part of this program changed the type of books you select for your child?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

C9. What kind of books do you now read with your child?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

C10. Have you visited the library with your child since completing the program?
______ YES
______ NO

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

C11. Have you continued the activities you learned in My Reading and Writing Journey with your child?
______ YES [GO TO ITEM C11a]
______ NO [GO TO ITEM C11b]
C11a. What is your child’s reaction to continuing to do reading and writing activities?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
AFTER ITEM C11a, GO TO C12

C11b. Why didn’t you continue do the reading and writing activities you learned in My Reading
and Writing Journal?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

C12. What other ways of helping your child learn do you now do differently with your child?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

C13. Since your parent group sessions ended, have you continued to participate in any groups designed
to help you work with your child as s/he learns to read and write?
______ YES
_______NO [GO TO ITEM C14]
C13a. Please tell me about this group. [PROBE FOR WHO AND HOW HELPFUL]
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

C14. Have you received information or guidance from other resources since completing the training such
as the library or school?
______ YES
______ NO [GO TO ITEM C15]
C14a. Please tell me about this information or guidance. [PROBE FOR WHO AND HOW
HELPFUL]
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

C15. In what ways have your personal reading habits changed?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

C16. Are you more involved with your child’s education since participating in the program?
______ YES [GO TO C16a]
______ NO [GO TO C16b]

C16a. In what ways are you more involved? [PROBE FOR SPECIFICS]
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
C16b. Why are you not more involved? [PROBE FOR SPECIFICS]
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
C17. Since you started coming to the “Our Reading and Writing Journey,” have your ideas about being
able to help your child learn to read and write changed?
_______ YES
_______ NO [GO TO ITEM C18]
C17a. In what ways have your ideas about helping your child changed?

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
C18. How much do you think your child has benefited from your participation in My Reading and
Writing Journey? Why?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

C19. Compared with other parent education classes you may have participated in, would you say Our
Reading and Writing Journey provided…..
______ About the same information as most programs
______ More information than other programs
______ Less information than other programs

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

Part II. Participant Background and Demographics
Now we’d like to find out a little about you and your family.
1. What is your current marital status?
______ MARRIED
______ SEPARATED
______ DIVORCED
______ WIDOWED
______ NEVER MARRIED
______ DON’T KNOW
______ REFUSED

2. How many children in your home are less than 5 years of age?
______ [RECORD NUMBER]
______ REFUSED

3. How many children in your home are between 5-8 years of age?
______ [RECORD NUMBER]
______ REFUSED

4. How many children in your home are older than 8 years of age?
______ [RECORD NUMBER]
______ REFUSED

5. How old are you |______|_____|

Parent Interview 3/12/09

YEARS

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

6. Are you of Spanish, Hispanic, or Latino origin?
______ YES
______ NO [GO TO ITEM 8]
______ DON’T KNOW [GO TO ITEM 8]
______ REFUSED [GO TO ITEM 8]

7. Which one of these best describes you...
______ Mexican, Mexican American, Chicano,
______ Puerto Rican,
______ Cuban, or
______ another Spanish/Hispanic/Latino group?
______ DON’T KNOW
______ REFUSED

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

8. What is your race? [MARK ALL THAT ARE MENTIONED]
______ WHITE
______ BLACK, AFRICAN AMERICAN, OR NEGRO
______ AMERICAN INDIAN OR ALASKAN NATIVE
______ ASIAN INDIAN
______ CHINESE
______ FILIPINO
______ JAPANESE
______ KOREAN
______ VIETNAMESE
______ OTHER ASIAN
______ NATIVE HAWAIIAN
______ GUAMANIAN OR CHAMORRO
______ SAMOAN
______ OTHER PACIFIC ISLANDER
______ ANOTHER RACE (SPECIFY)_____________________
______ DON’T KNOW
______ REFUSED

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

9. What is the highest grade or year of school or degree that you completed? (MARK ONE
RESPONSE.)
______ UP TO 8TH GRADE
______ 9TH TO 11TH GRADE
______ 12TH GRADE BUT NO DIPLOMA
______ HIGH SCHOOL DIPLOMA OR EQUIVALENT
______ VOC/TECH PROGRAM AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA
______ VOC/TECH DIPLOMA AFTER HIGH SCHOOL
______ SOME COLLEGE BUT NO DEGREE
______ ASSOCIATE’S DEGREE
______ BACHELOR’S DEGREE
______ GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE
______ MASTER’S DEGREE (MA, MS)
______ DOCTORATE DEGREE (PHD, EDD)
______ PROFESSIONAL DEGREE AFTER BACHELOR’S DEGREE (MEDICINE/MD;
DENTISTRY/DDS; LAW/JD/LLB; ETC.)
______ DON’T KNOW
______ REFUSED

Parent Interview 3/12/09

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

10. Are you currently working full-time, working part-time, looking for work, in school, in a training
program, keeping house or doing something else? (MARK ONLY ONE)
______WORKING FULL-TIME (35 HOURS OR MORE PER WEEK)
______WORKING PART-TIME
______ LOOKING FOR WORK
______ LAID OFF FROM WORK
______ IN SCHOOL/TRAINING
______ IN MILITARY
______ KEEPING HOUSE
______ SOMETHING ELSE (PLEASE SPECIFY)
______ DON’T KNOW

TYPE OF BUSINESS

_______________________

______DON’T KNOW
KIND OF WORK _______________________
IMPORTANT DUTY

Parent Interview 3/12/09

_______________________

Participant ID____ ___ ___ ___

Interviewer CR SH

Date ____/____/____

TO BE CODED BY INTERVIEWER
OCCUPATION CODE

___ ___

OCCUPATION CODE:
Executive, Administrative, and Managerial Occupations..................................................
Engineers, Surveyors, and Architects ................................................................................
Natural Scientists and Mathematicians ..............................................................................
Social Scientists, Social Workers, Religious Workers, and Lawyers ................................
Teachers .............................................................................................................................
Health Diagnosing and Treating Practitioners ...................................................................
Health Assessment and Treating Occupations...................................................................
Writers, Artists, Entertainers, and Athletes........................................................................
Health Technologists and Technicians ..............................................................................
Technologists and Technicians, except Health ..................................................................
Marketing and Sales Occupation .......................................................................................
Administrative Support Occupation, including Clerical....................................................
Service Occupations...........................................................................................................
Agricultural, Forestry, and Fishing Occupations ...............................................................
Mechanics and Repairers ...................................................................................................
Construction and Extractive Occupations..........................................................................
Precision Production Occupations .....................................................................................
Production Working Occupations......................................................................................
Transportation and Materials Moving Occupations...........................................................
Handlers, Equipment Cleaners, Helpers, and Laborers .....................................................
Miscellaneous Occupations ...............................................................................................
NEVER WORKED/HOMEMAKERS ..............................................................................
DON’T KNOW..................................................................................................................
REFUSED..........................................................................................................................

Parent Interview 3/12/09

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Paperwork Burden Statement-Parent Participant Survey Revised
According to the Paperwork reduction Act of 1995, no persons are required to respond to a
collection of information unless such collection displays a valid OMB control number. The
valid OMB control number for this information collection is 1800-0011 V123. The time required
to complete this information collection is estimated to average 30 minutes per response,
including the time to review instructions, search existing data resources, gather the data needed,
and complete and review the information collection. If you have any comments concerning
the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, D.C. 20202-4537. If you have comments or
concerns regarding the status of your individual submission of this form, write directly to:
[insert program sponsor/office], U.S. Department of Education, 400 Maryland Avenue, S.W.,
[insert building/room number], Washington D.C. 20202-4537.

File Type	application/pdf
File Title	SENSITIVE INFORMATION–AUTHORIZED PERSONNEL ONLY
Author	areubens
File Modified	2009-04-08
File Created	2009-04-08