Appendix C: Example of a site visit or direct observation protocol
Note: This instrument was approved by OMB (OMB Approval No. 0970-0339).
Site visit protocols under this generic clearance will not be nearly as
comprehensive, detailed or exhaustive.
SUPPORTING HEALTHY MARRIAGE PROJECT
IMPLEMENTATION STUDY PROTOCOL
I. Guide for observations of SHM marriage education group
Instructions: Although the impact of a single module might be limited in scope, it will be important for the observer to assess whether or not the session is likely to move couples toward strengthening their relationships. With this caveat in mind the researcher should document his or her observations immediately after the Marriage Education Group (MEG). When completing your write-up please provide evidence to support your responses. When possible you should also include examples/quotes to further illustrate your explanations.
Learning Space
Describe the workshop neighborhood/location
Describe the workshop learning space please note if there was enough room for people to move about freely, if the space organized, clean, comfortable, and free from outside distractions, if the was temperature reasonable, the seats comfortable, the space in good repair etc.
Did the space appear inviting for men, women, and children?
(decorations were gender neutral and/or appealing men and women)
Did the arrangement of the room allow for participant interaction?
Did the arrangement of the room allow for easy viewing and use of curriculum videos and/or other materials relevant to the session?
Where were the facilitators placed during the session? (sitting, standing, do they separate themselves from the group, sit beside each other, across from each other.)
How suitable was the learning space of the workshop?
Not suitable Somewhat Suitable Very Suitable
O O O O O
Workshop Climate
Did the climate of the session encourage participants to ask questions, generate ideas, and share information?
Did couples appear to feel relaxed and safe?
Did couples interact with one another in respectful ways?
Did the climate of the workshop lend itself to couples feeling comfortable?
Not Comfortable Somewhat Comfortable Very Comfortable
O O O O O
Couple Engagement
Did the workshop include opportunities for participants to interact with each other?
Were there opportunities for couples to listen and learn from each other?
Did the couples seem engaged and responsive to the facilitators?
Did the couples appear disinterested?
(isolated, talked in sub-groups, slept, looked bored, read unrelated material)
To what extent did the group appear bonded during the MEG?
Did the workshop begin or end with a meal or other socializing activity?
If so, did couples interact with each other?
Overall, how engaged were the couples during the workshop?
Disengaged Somewhat Engaged Very Engaged
O O O O O
Couple Learning
What mediums were used to teach the module?
Were there any problems or delays related to setting up the technical equipment and materials? If so, how were these issues resolved?
Did couples have curriculum manuals or other materials as needed? If not how did the facilitators address this need?
Were the materials that were used in the session useful to the couples?
How did facilitators assess whether or not participants understood the key points of the curriculum?
What curriculum connections did couples extrapolate from the curriculum to their lives?
What understandings did couples demonstrate?
Did the couples have any specific questions or challenges in understanding the curriculum material? If so, how did the facilitator respond?
Were there any times during the workshop that participants seemed confused?
Were there any languages spoken during the workshops other than English? If so, please include the frequency of use of any languages spoken in the both the MEG and and/or before or after the group was over. Also include the name of the language and whether or not you notice this causing any challenges with participant learning.
How did the facilitators deal with diverse learning styles?
Overall, how skilled were the workshop leaders in facilitating learning?
Not skilled Somewhat Skilled Very Skilled
O O O O O
Curriculum Content
What did the facilitators identify as the core lesson(s) to be learned? At what point during the workshop did this occur?
Did the pacing of the curriculum content seem appropriate?
Did the facilitators present the curriculum content clearly?
What parts of the session did couples seem to like?
Did individuals exhibit any differences in response to the curriculum based on their cultural background?
Did individuals exhibit any differences in response to the curriculum based on their age?
Did individuals exhibit any differences in response to the curriculum based on their gender?
Facilitation Skills
Did the facilitator(s) appear confident in his/her ability to present the curriculum material?
How did the facilitator(s) challenge couples ideas in order to promote understanding?
Were connections made to other lessons and/or to couples’ real world life contexts? If so how?
Did the facilitators make an effort to find out whether or not the group understood the information presented? How did this occur?
Did facilitators encourage communication and move discussions toward the goals of the session module?
How did the facilitators encourage and/or facilitate couples’ connections with the groups and with each other?
What techniques did the facilitators use to maintain participant engagement?
Describe the interaction between the facilitators (note if they worked as a team, felt camaraderie with each other, if you observed any obvious tensions).
In what ways did facilitators acknowledge cultural differences and/or values?
How effective were the facilitators in covering the curriculum?
Not Effective Somewhat Effective Very Effective
O O O O O
How well did the facilitators work together?
Not Very Well Somewhat Well Very Well
O O O O O
How often did the facilitators engage with the couples?
No Engagement Some Engagement Lots of Engagement
O O O O O
Other Questions to Consider
From your knowledge about the program, do you feel that the workshops are a strength of the program? Please explain?
Do you have any concerns about the workshop you observed? If so, what are they?
If you have observed other workshops, how does this one compare to others? (please list when and where you observed those workshops)
II. Guide for Focus Groups with Married Couples Currently Participating in SHM Programs
The four areas of inquiry below are topics that the research team proposes to use to frame the focus group questions. Do note that the topic areas are flexible and might be changed based on the information that participants provide. Also note that questions will be tailored to suit the contextual circumstances of each site.
Why did you choose to enroll in the program and what kept you participating?
How did the program change your expectations and ideals about marriage, family and parenting?
How did the program affect your marriage, family, and parenting?
What worked and didn’t work well about the services the program provided?
INTRODUCTION
Welcome and thank you for coming today.
My name is ________ and I have with me ________. We are from MDRC, a research company studying programs like ________________. We are not part of any government agency although we are conducting this research for the U.S. Department of Health and Human Services.
We are doing a study on marriage education programs and would like to hear your opinions about them. We like to hear about how this marriage education program affected you and what you liked and didn’t like about the program. The information gathered in these discussions might help us come up with ways to improve these programs and help more married couples participate.
We’re interested in knowing what made you enroll and attend the program, how you feel the program has affected your relationship and family, what has been good about your experience, and what can be improved.
Everything said here is confidential. No one will be quoted by name. We also ask that you keep confidential what others say during this conversation.
Your participation is voluntary, and if you decide not to participate, it won’t affect your participation in this program or any other service or benefit you may be eligible for. The estimated time for this discussion is two hours. At the end, each of you will receive a gift card as a way to thank you for your time.
We will be recording the discussion so that we can remember your comments and opinions. It will help us if you speak one at a time, loudly and clearly. Again, you will never be identified individually and no one outside the research team will have access to the tape.
There are no right or wrong answers. People may disagree, and that’s OK. We welcome the opportunity to hear everyone’s thoughts. We also want to hear both positive and negative comments—whatever you want to share.
To start, please introduce yourself, with just your first name, and tell us a little bit about yourself, like how long you’ve been married, and how many children you have.
1. The following questions ask participants about why they chose to enroll in the program and what kept them participating. We will ask what initially attracted them to the program (e.g. marketing material; incentives; referral partners; program benefits) and what kept them interested once enrolled in the program. The answers to these questions will help us understand how best to reach out to potential couples and what participants think is most valuable about attending.
Why did you come to the program? These questions will ask participants how they heard about the program and what made them come to an intake session and enroll. We will ask about how they found out about the program and what about the marketing material they saw, program recruiter they spoke with, or referral partner who told them about the program peaked their interest. We also want to ask what initial concerns and questions they had about the program and how these were addressed.
Sample questions: How did you hear about the program? Can you remember some of your first thoughts or questions about the program?
What “hook” or message about the program made you want to attend?
Did you know the program would provide support and small “gifts” to your family before enrolling? If so, did this influence your decision to participate?
Why did you keep coming to the program? These questions will ask participants what made them show up for the groups, meetings with family support workers, and other program activities. We will ask which program activities were most helpful, what challenges they had to overcome to attend the program, and what the program could have done to help them attend even more.
Sample questions: What about the program was the most interesting and important to you? (Think about the ME workshops, meetings with your family support coordinator, booster sessions, and social activities) What did you find useful about that kind of activity?
Did you attend the social activities such as date nights or other events offered by the program? Were these events an important part of the program to you?
What challenges did you face in trying to attend the program? (probes: childcare, transportation, job obligations, illness, family responsibilities, other events) How did you overcome these obstacles? What did the program do if anything, to help?
How did the supports the program offered for childcare and transportation contribute to your attendance in the program?
How important were the “gifts”, such as games for your kids in your coming to the program?
2. The following questions ask participants how their expectations, ideals, and standards about marriage, family, and parenting have changed since participating in the program. The answers to these questions will help inform topics for future surveys and help us understand how couples think the program has changed the way they think about marriage and family in general.
Couples will be asked about how their opinions have changed since participating in the program. Topic areas might include: the role of a wife or husband in the household; ideas about commitment to marriage and divorce; how household and parenting decisions are made; what is important in a marriage; and the likelihood of improving problems in a marriage.
Sample questions: How has your opinion on whether or not and how couples can resolve problems in a marriage changed as a result of the program?
Have your expectations for what parenting responsibilities you and your spouse should have changed since participating in the program?
3. The following questions ask participants about how their marriage and family have changed since participating in the programs and how they are using some of the skills the curricula teach. The topics below are examples of areas we may want to cover with couples during focus groups. The answers to these questions will help inform topics for future survey development and help us understand how couples think the program has impacted them.
A. Communication: We will ask participants whether or not the program has changed the way they communicate with their spouse. We also want to know if the program has affected the way they communicate with their children, families, and others in their lives. We will ask how their communication has changed and how the program contributed to this. We will also ask if there is anything else the program could have done to support them on improving their communication.
Sample questions: Has the program helped you listen differently to your spouse? If so, how did the program help?
Are you talking about important things in your life more often with your spouse? If so, what did the program do to help you do this?
B. Disagreement and Conflict Resolution: We will ask participants if there has been any change in how they handle their problems and disagreements since attending the program. We want to know if there has been a change in how often they argue, how they argue, and what they argue about, and how the arguments get resolved. We also want to know if the program has impacted how they handle conflict with their children, families, and others in their lives.
Sample questions: Do you think the program changed the way you and your spouse disagree? Has the program helped your spouse respect your perspective, even with he/she disagrees?
Did the program help you change the way you resolve arguments with your spouse? If so, how did the program help?
C. Fun, Friendship, and Intimacy in Marriage: We will ask participants if the program affected how much time they spend together; how they spend that time; and how much they enjoy the time they have together. We will also ask whether or not there has been a change in how they express appreciation and affection toward their spouse and if they now feel more appreciated or valued by their partner.
Sample questions: Have you been enjoying time spent with your spouse more since participating in the program? In what ways if any did the program change with this?
Did the program affect the ways and how often you express to your spouse that you value him/her? If so, how?
D. Parenting and Family Relationships: This section of questions will ask participants about whether or not the program has affected the way they parent and relate to the rest of their family.
Sample questions: Have there been any changes in the way you parent? Think about:
How much time you spend with your kids.
How you make decisions together about your kids.
Each of your parenting responsibilities.
How else has the program impacted your marriage and family? Are there things we did not ask about that have changed in your life since attending?
4. The following questions ask participants what they think worked well and what did not at the program. We will ask about participants’ experiences with each of the three SHM program components and what they liked or did not like about the way each was offered. We would like to know what qualities in the program activities and program staff are important to participants and what the program could do to improve their services.
Marriage Education Groups
Sample questions: Have you found that the skills that were taught in the workshop have been useful at home? Which ones, and why? How have you been using them? Are there some skill or techniques that have been less useful? Which ones, and why?
Did you feel your workshop facilitator was someone you could relate to? Why or why not?
What workshop topics did you like best or find most useful?
How did you feel about the way topics were presented in workshops? Did you like the videos, handouts, couple workbooks etc that were used?
Family Support Coordination
Sample questions: Did you like meeting with your family support coordinator? Why or why not? How helpful was he/she in working with you on issues you brought up?
Did you usually meet with your family support coordinator with your spouse or alone? How often did you meet with him/her as a couple?
Did you talk about the skills you learned in groups with your family support coordinator?
Did you feel you could relate to your family support coordinator? Did you feel respected and supported?
Extended Activities
Sample questions: Which activities (other than workshops) offered by the program did you like or find useful? What did you like about them? Are there any activities you did not enjoy or did not find valuable? Why not?
What did the program do (group social activities, etc) to encourage you to spend time with other couples in the program?
D. General Comments and Additional Feedback
Sample questions: One of the goals of SHM is to make all participants feel welcome and comfortable. Did you feel that your program did enough to make you feel that way? Did you think that the program environment was comfortable for both men and women, people of different races and ethnicities, people of varying ages? How so? If not, what could the program have done to make you or others comfortable?
Is there anything that we didn’t ask about that you would like to share? Do you have any additional comments about your experience or feedback about the program?
III. Guide for One-on-one Interviews with SHM Site Supervisory Staff
Instructions: Interview should be conducted in private with the Program Director and should take approximately 2 hours to complete.
Site |
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Location/Agency |
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Interviewer name |
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Staff name(s) and title(s) |
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Date of interview |
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Introductory Statement. [Before beginning the interview, please convey the following information to the respondent]: I am conducting this interview as part of a study of the Supporting Healthy Marriages (SHM) Demonstration for the Administration on Children and Families of the United States Department of Health and Human Services. Our goal is to understand how SHM operates and how it has changed since its implementation. Your participation in the study is totally voluntary and all your responses will be kept confidential. Also, if you have any questions about the study, I would be happy to answer them.
1. Background information
How long have you been the Program Director of the SHM Program
What are your overall management responsibilities?
What other programs or services does your agency provide? How does SHM fit into your agency’s overall mission?
2. Program development and start-up
What was the major rationale behind developing a SHM program?
Had your agency operated a similar program before SHM? If so, which program?
Who were the major actors in program development?
Which SHM curriculum did you choose and why?
What were some of the major challenges in program development and implementation? How did you meet those challenges?
Please summarize your program start-up and pilot experiences in the following areas:
Staffing
Training
Curriculum development
MIS issues
Outreach and recruitment
Intake, screening, and eligibility determination
Baseline data collection
Developing extended activities
Developing adjunct services, such as child care or transportation?
Program attendance and retention
3. Program organization and staffing
Do you have an organization chart? If so, may I have a copy?
How many staff are engaged in SHM work, by worker category? For example:
Outreach and recruitment worker
Intake worker
Family support worker
Group facilitator
MIS specialist
Activities coordinator
Other
What is the typical background of your staff, by worker category?
How were workers trained?
How much turnover have you had since SHM operations began? Has worker turnover been a problem?
4. Outreach and recruitment
Please give me an overview your strategies for outreach and marketing as they are currently playing out in the field. How and why have your strategies changed over time?
Which recruitment method has been most successful? Least successful?
Who are your major recruitment/referral sources to date?
Have you developed (or are there pre-existing) special relationships with referral sources? If so, which sources?
What materials are you using to explain the project to applicants? (Note to interviewer: Bring back copies of all current marketing/referral materials).
Are you using SHM program staff for outreach and recruitment? If so, on average, how much time are your outreach/recruitment workers spending out in the field? If not, who has major responsibility for outreach and recruitment? How has this changed over time?
Is your sense that sufficient numbers of potentially eligible couples are learning about SHM to meet your recruitment targets? Are sufficient numbers of potentially eligible couples signing up for the program to make your recruitment targets? If not, why? What do you think can be done to improve the flow of interested couples?
Please summarize your program intake procedures, including, for example:
How interested individuals or couples may contact your program;
What times and days are available for intake;
Which and how many staff conduct intake and eligibility;
How you deal with baseline data collection requirements;
Whether and how intake and eligibility determination have changed since program startup;
How are your staff checking to verify that SHM applicants have not already been randomly assigned?
About how often do individuals or couples fail to make appointments for intake? Has this changed over time? What strategies have you adopted to decrease “no-shows” or to follow-up with couples or individuals that fail to appear for a scheduled intake?
6. Domestic violence screening and protocols
Have all relevant staff been trained in using the program’s screening tool and DV protocol (not the same as the DV 101 that was provided by the local DV partner)?
Have you had either ad hoc or regular meetings with your local DV partner since the program began? If so, what is discussed at these meetings?
Are intake staff regularly administering the Relationship Screener during intake?
Have there been any concerns/problems related to administering the DV screening tool during intake?
How have staff screened women for DV after intake?
Have there been any concerns/problems related to screening for DV after intake? How have these problems normally been handled?
Have any couples been found ineligible for the program because of DV concerns? If so, were the concerns identified during intake or after? What steps were taken? Do you have any concerns about how the situation was handled? If so, what steps have been taken to improve the program’s response to a similar situation in the future?
Do you feel you and your staff have sufficient support to screen for and respond to DV concerns among the couples you serve? If not, what additional services/technical assistance would be helpful to you?
7. Marriage Education Workshops
How many workshops have you conducted since the program started? How many are active now?
Have you had much turnover of workshop facilitators? If so, why?
What changes have you made to the workshop curriculum since the since the program began, if any? If so, why have you made those changes?
What is the typical size of your workshops?
What has been the attendance history for your program? For example, approximately how many couples have completed the workshops? Have any workshops had to close down before completion due to poor attendance?
What steps are you taking to keep couples engaged in SHM from the time they are informed of their research group status and the beginning of marriage education courses?
Have those strategies been effective?
What proportion of treatment group couples have not appeared at their assigned marriage education classes?
What are your procedures for contacting those couples and involving them in the program?
How are make-up sessions being conducted (e.g., one-on-one or small group; at center or in the home)?
What are the main concerns and challenges in implementing the marriage education workshops?
What technical assistance needs, if any, does the program have with regard to marriage education workshops? Are these being met through ongoing TA from the curriculum developers?
Family Support Coordination
Please describe your program’s overall approach to Family Support Coordination, for example:
Do Family Support Workers (FSWs) have assigned caseloads, or do they serve couples and families on an availability basis? If they have caseloads, what size?
How many FSWs do you employ?
Do FSWs have regularly scheduled meetings with couples? If so, how often? For individuals? If so, how often?
If FSWs have regularly schedule meetings, do they address a standard set of issues? If so, what are the issues?
On what schedule are FSWs available to SHM participants?
Do FSWs regularly follow-up on referrals to other programs por services?
What is the professional background of your Family Support Workers?
Do you have a sufficient number of family support workers to meet the needs of the couples in the program?
Is the family support component working out as you had expected? If not, how and why? How could this component be strengthened?
Are there any couple-related events (other than absence at a marriage education workshop) that trigger follow up by the family support worker?
What sort of supervision is provided to the family support workers? How is this working out? Is their work monitored or assessed in any way? If so, how?
How do the family support workers and the marriage education facilitators keep in touch? Are you satisfied with the degree of collaboration that exists now between the family support staff and marriage education facilitators? If not, what steps are you taking to improve collaboration?
What strategies are family support workers using to encourage couples to attend the marriage education workshops regularly? Which strategies are most successful?
What are some of the concerns/challenges family support workers express about their work and/or about the couples with whom they work?
How do you think the role of the FSW can be improved?
Participation Supports
What are the most common types of referrals that family support workers are making?
How are the following participation supports provided:
Child care
Transportation
Emergency assistance
Participation incentives (if used)
Are the supports adequate? What concerns/challenges have come up in administering these supports? Have you changed any administrative processes as a result? Have you changed your approach to supports or changed service providers?
What other supports do you feel might be needed to secure ongoing attendance at workshops and other activities?
If your program includes incentives as participation supports, please provide an overview of the incentives and how they are typically used? Do you feel they have been successful in encouraging participation? If not, why?
Extended activities
Please give me an overview of the sorts of Extended Activities your program includes. How have these changed over time?
What Extended Activities has the program sponsored this past month? What do you plan for next month? May I have a copy of your calendar of Extended Activities? (Please bring back any schedules or calendars of extended activities.)
Is attendance at the Extended Activities what you expected? If attendance is low, what steps will you take in order to increase attendance?
How are couples most often notified of Extended Activities?
Which sorts of Extended Activities seem most popular with the couples?
What are the main challenges in implementing the Extended Activities component of the program? What strategies do you plan to try to address these challenges?
How important do you feel that Extended Activities are to the goals of the SHM Program?
Please give me an overview of the sorts of Extended Activities your program includes. How have these changed over time?
What Extended Activities has the program sponsored this past month? What do you plan for next month? May I have a copy of your calendar of Extended Activities? (Please bring back any schedules or calendars of extended activities.)
Please give me an overview of the Booster Sessions you provide as marriage education course refreshers or to emphasize important lessons. Have these changed over time?
What Booster Sessions has the program sponsored this past month? What do you plan for next month? May I have a copy of your calendar of Booster Sessions? (Please bring back any schedules or calendars of booster sessions.)
Is attendance at the Booster Session what you expected? If attendance is low, what steps will you take in order to increase attendance?
How are couples most often notified of Booster Sessions?
How important do you feel Booster Sessions are to the success of SHM?
Please give me an overview of the sorts of Extended Activities your program includes. How have these changed over time?
Are all relevant staff using the MIS appropriately? If not, in what ways are they not using the MIS as planned?
Have you had any technical problems with the MIS? If so, what were the problems and how were they solved? What problems remain?
Have you and your staff been able to get technical assistance when needed? Has the assistance been adequate?
Which MIS reports do you use on a regular basis? Why? Why not others?
13. Overall assessment
Which aspects of SHM do you feel are most effective in meeting the program’s goals for couples and families?
What have been some of the most successful aspects of your program? Least successful?
How do you feel SHM should be changed to be more effective?
Is there anything else that you would like to share that you think is important for us to know?
SUPPORTING HEALTHY MARRIAGE PROJECT
OMB Control Number: 0970-0299
Expiration Date: 5/31/2009
Research ID: ________________
Agreement to take part in the Supporting Healthy Marriage Study
You are invited to take part in an important project called Supporting Healthy Marriage. This project will study programs to help couples learn how to get along with each other. The programs will also help couples be better parents. They will also help couples get services to improve their employment or health. A research company called MDRC is doing the study. The federal government is paying for the study.
This study is testing ways to help married couples get along.
This study will offer a new program [Local Program] to married couples. [Local program] will not have room for all couples who want to take part. Some couples will get to be part of [Local Program] but some couples will not. We will pick the couples who will get to be part of the [Local program] randomly, like flipping a coin. If we do not pick you, you can still get other services on your own.
If you agree to be in the study, researchers will collect information about you and your children.
The information you share with the study team is important. It could help make these services available to other couples like you. At the start of the study, you and your spouse will be asked to answer some questions in private. These questions will ask you how well you get along with your spouse, how happy or sad you are, and what makes you upset.
If you agree to be in the study, you and your spouse will be interviewed one or more times over the next seven years by a survey company called Abt Associates. Abt Associates is part of the research team for this study. You will be asked about your marriage, how well you are getting along with your spouse, your experiences with [Local program], and your children. You might also be asked to let us do some activities with your children. You do not have to answer any question that you don’t want to answer. You will get [gift amount] for each interview.
If you agree to be in the study, [Local Program] program will share information with the research team about the services you get over the next five years as well. We might also collect data from [State] about things like your wages and benefits. We might also collect data from [State] about services your children get, and your children’s school test scores.
Taking part in the study is your choice. You may stop being in the study at any time. If you stop being in the study, we will use any information that we have collected before then.
Your Answers Will Be Kept Private
Only the study staff will be able to see information you give them. Your name will never appear in any public document. All the study staff is trained to protect privacy. Information gathered from [State] about you or your children will be marked with a code number, not names. We also have a Confidentiality Certificate (CC) from the US government that adds special protection for the research information about you. It says we do not have to identify you, even under a court order or subpoena. Still, if keeping your answers private would put you, someone else or your child in serious danger, then we will have to tell government agencies to protect you or the other person. And, the government may see your information if it audits us.
Consent to Take Part in the Supporting Healthy Marriage Study
I understand that:
[Local Program] will not have room for all couples. A random selection process will decide if I can get [Local Program] services.
If I cannot get [Local Program] services, I will still be part of the study. I can still get other program services in our community.
I will be contacted by the study team later for an interview. Some of the questions will be about personal things and my feelings. I can refuse to answer any question.
The study team might use my name or Social Security number to collect data from government agencies.
All information will be kept confidential, except as required by law or if I request otherwise in writing. However, if a person on the study team or in the program feels that keeping information confidential would result in danger to me or another person, they will have to tell appropriate agencies to protect me or the other person.
I agree to:
Allow a random selection process to decide if I can get [Local Program] services.
Answer some questions now and give the study team information about how to reach me for an interview later.
Let the study team collect information on [Local Program] services that I receive.
Let state and local agencies give information about me to the study team.
Let the study team collect information about my children from me and from sources like state and local agencies.
Allow schools to release my children’s test scores.
I can call [NAME OF PERSON] toll-free at [TELEPHONE NUMBER] at MDRC to ask any questions I may have or to ask about not being part of the study anymore.
Participant
_____________________________
Name of Participant (Printed)
_____________________________ ____________________
Signature of Participant Date
_____________________________
Name of Person Administering this Form (Printed)
_____________________________ ____________________
Signature of Person Administering this Form Date
| File Type | application/msword |
| File Title | SUPPORTING HEALTHY MARRIAGE PROJECT |
| Author | mfucello |
| Last Modified By | Department of Health and Human Services |
| File Modified | 2011-08-31 |
| File Created | 2011-08-31 |