Form 1 Post Test

Cross-site Evaluation of the Infant Adoption Training Program

DRAFT-IAATPSurvey-FollowUp-OMB

Follow-up Survey

OMB: 0970-0371

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Registrant ID ________









Infant Adoption Awareness Training Program (IAATP)

Trainee Survey


Instrument B: Follow-Up Survey









Dear IAATP Participant:

 

You attended an Infant Adoption Awareness Training session approximately three months ago, and feedback on the training content was requested at that time.  Now that some time has passed, we would again appreciate your feedback on this educational event.  We are particularly interested in whether you have been able to apply the knowledge gained from that course to your daily routine practices that involve providing services to women. 

 

Information gathered from this effort will help to improve the quality of the training.


 Completion of the form will take approximately 10 minutes and is voluntary.  All information gathered from the form is anonymous.   No individual responses are reported. Data will be presented only in aggregate form.


You may decline to participate without penalty.


            Please provide your feedback by completing the form at the following web site: http://_____________.  You may access the site either by pressing ctrl+ enter or by copying the web address and placing it in your browser. If you are unable to complete the survey online, please return a completed copy of this form to James Bell Associates by email, fax, or mail.


Email: iaatp@jbassoc.com

Fax: (703) 243-3017


James Bell Associates

Attn: IAATP

1001 19th Street, North; Suite 1500

Arlington, VA 22209.



 

Once your completed survey is received, a gift certificate or card in the amount of $10 will be sent to you to thank you for your time.


Thank you in advance for your participation.








  1. What is your primary role at work? (Check one)


  • Administrator (non-clinical)

  • Physician Assistant/Nurse Practitioner

  • Social Worker/Case Manager/Counselor/Therapist

  • Certified Nurse Midwife/Midwife/Doula

  • Health Educator/Instructor

  • Office Manager/Administrative Support

  • Physician/MD/DO/Psychiatrist

  • Nurse (RN/PHN/LPN/NA)

  • Other (specify) ___________________________________



  1. Which best describes the services you normally provide to women with unintended pregnancies? (Mark all that apply)


  • I give clients brochures, pamphlets or handouts

  • I discuss community resources with clients

  • I make referrals to community resources

  • I provide options counseling

  • I make assessments of individuals’ needs

  • I have not provided any of these services



  1. Approximately how many clients with unintended pregnancies have you personally encountered in the last month? __________ clients



  1. On average, how much time do you spend per client providing options information or referral services? (If you do not provide these services, enter “N/A”) __________ minutes



  1. When talking to clients with an unintended pregnancy about their options:


  1. How often do you engage in the following activities?

(If you do not provide options counseling, mark “N/A.” )


i. I use open-ended questions

Often Sometimes Rarely Never N/A

ii. I help clients find their own answers

Often Sometimes Rarely Never N/A

iii. I try to make the discussion interactive

Often Sometimes Rarely Never N/A

iv. I let my values guide the discussion

Often Sometimes Rarely Never N/A


  1. How likely are you to talk about adoption as an option with clients who are experiencing an unintended pregnancy?

  • Very likely

  • Likely

  • Somewhat likely

  • Not likely

  • Not likely at all

  • N/A


  1. How often do you engage/involve birth fathers in the discussions?

  • Often

  • Sometimes

  • Rarely

  • Never

  • N/A


  1. Do you provide the following types of referrals, if requested? (Mark all that apply)

  • Prenatal care and delivery

  • Pregnancy termination

  • Infant care

  • Foster care

  • Adoption

  • I don’t make referrals


  1. Do you communicate or collaborate with licensed adoption agencies for clients who are interested in adoption?

      • Yes

      • No

      • N/A


  1. On average, how often do you refer interested clients to adoption agencies/resources for additional information?

  • Never

  • Once a month or less

  • Two to three times a month

  • Once a week

  • Two to four times a week

  • Daily

  • N/A


  1. Have you coached or trained other professionals on presentation of the adoption option?

      • Yes

      • No



  1. How often do you engage in the following activities?

a. Discuss the client’s reaction to the pregnancy

Often Sometimes Rarely Never N/A

b. Discuss the advantages and disadvantages of the various pregnancy options with clients

Often Sometimes Rarely Never N/A

c. Assess the client’s need for other supportive services

Often Sometimes Rarely Never N/A

d. Discuss the possibility of including other family members in future discussions

Often Sometimes Rarely Never N/A

e. Explain the rights of birth mothers, birth fathers, and families according to applicable federal and state laws

Often Sometimes Rarely Never N/A




  1. Mark each item “True” or “False”

  1. Adoptive families receive non-identifying medical and social history on the birth parents, regardless of the type of adoption.

True False

  1. Providing non-directive, non-coercive options counseling includes allowing the client to refuse receiving information.

True False

  1. Pregnant teens often overestimate the challenges of parenting.

True False

  1. In a fully disclosed (“open”) adoption the names and addresses of birth parents and adoptive parents are known to both parties.

True False

  1. A client should only be referred for adoption services when the counselor knows that the client has reached a final decision to pursue adoption.

True False

  1. Culturally responsive helping professionals are prepared to include extended family members in an options discussion if the client wants them included.

True False

  1. Regardless of the client’s interest, all pregnancy options should be discussed.

True False

  1. Adoptive parents are legally bound to allow birth parents’ continued contact with the child when an adoption is “open.”

True False

  1. It is important for staff who provide options counseling to agree with the client’s decision.

True False

  1. Birth parents usually experience some degree of grief and loss, regardless of the type of adoption they choose.

True False

  1. Pregnant teens may need less time than adults to be ready to discuss their options.

True False

  1. A counselor should consider whether or not the client is exposed to domestic violence when discussing pregnancy options.

True False

  1. Birth fathers have the right to be notified of the birth and the adoption plan before their parental rights are terminated and the adoption is finalized.

True False

  1. To increase rapport, counseling staff should share their own opinion about adoption with the client during options counseling.

True False

  1. Under Federal adoption laws, tribes can intervene in court cases regarding the adoption of Native American children.

True False

  1. A birth mother who chooses adoption can change her mind at any time before the judge has made the final decree.

True False

  1. Staff who discuss the adoption option with clients should know enough about adoption law to dispel some of the client’s misunderstandings about adoption.

True False

  1. Counselors should consider allowing pregnant teens to rehearse with them what they will say to a birth father or parent.

True False

  1. Being a culturally responsive counselor includes taking a lead role in the decision making for clients from cultures that view helping professionals as authority figures.

True False

  1. Staff should know the types of services a resource can provide when making a referral for a client.

True False

  1. Whether a client can afford to pay adoption fees should be part of the pregnancy options decision.

True False

  1. When working with pregnant teens who are minors, it is important to know whether your state allows minors to make an adoption plan without the consent of their parents or legal guardians.

True False

  1. Semi-open” adoptions allow contact between birth parents and adoptive parents through an agency or attorney without the identity of the birth parents being revealed.

True False

  1. Federal adoption laws ensure the rights of birth parents to specify the race, color, or national origin of the adoptive parents.

True False

  1. A birth mother cannot make her legal decision about adoption until after the baby is born.

True False

  1. Non-directive, non-coercive options counseling requires staff to be aware of their own values and beliefs.

True False



  1. How would you describe your overall opinion about adoption?

  • Very favorable

  • Somewhat favorable

  • Neither favorable or unfavorable

  • Somewhat unfavorable

  • Very unfavorable



  1. How familiar are you with the adoption process?


Very familiar Somewhat familiar Not at all familiar



  1. Select the response that best reflects your opinion.



I believe that adoption:

Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly Disagree

  1. Is an option that should be presented when a woman is unsure of her decision regarding her pregnancy.






  1. Is an option that I should help the birth parents select if they are unable (e.g., because of age, financial, emotional, or intellectual status) to effectively parent their child.






  1. Is an equally viable option to the other options for an unintended pregnancy.






  1. Is more likely to be successful if the birth parent(s) and adoptive parents share all identifying information and have an open adoption.






  1. Is something that should be presented to diverse cultures (e.g., African-American, Hispanic, Asian Pacific Islander, Native American).







  1. Do you agree or disagree with the following statements?



Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly Disagree

  1. It is a good idea for pregnant teenagers to consider placing the child for adoption.






  1. Adoption is a risky option because it has undesirable emotional and social effects on the pregnant client.






  1. Placing a child for adoption is a kind of abandonment.






  1. Adoption is a solution to an unplanned pregnancy that works well for children who are adopted.






  1. Adoption is always an appropriate solution for an unplanned pregnancy.






  1. If a close female relative or friend of mine were considering adoption for an unplanned pregnancy, I would support her in this decision.








  1. Do you think children adopted as infants are more likely, equally likely, or less likely than other children to:


  1. Have problems at school

More likely Equally likely Less likely

  1. Have behavior problems

More likely Equally likely Less likely

  1. Be well adjusted

More likely Equally likely Less likely

  1. Have problems with drugs and alcohol

More likely Equally likely Less likely

  1. Be happy

More likely Equally likely Less likely

  1. Have medical problems

More likely Equally likely Less likely

  1. Be self-confident

More likely Equally likely Less likely



Instruction: Mark “N/A” for any item that is not applicable to the work that you perform.

  1. Which aspects of the Infant Adoption Awareness Training have you found useful in your work with pregnant clients?


Topic Covered?

Very Useful

Somewhat Useful

Not Useful


N/A

  1. History & Changes in Adoption Practices

Yes No





  1. Understanding Your Own Opinions & Biases

Yes No





  1. Current Adoption Options & Practices

Yes No





  1. Adoption Law

Yes No





  1. Social/Cultural/Personal Influences on Clients

Yes No





  1. Non-directive & Non-coercive Counseling

Yes No





  1. Identifying Resources & Making Referrals

Yes No





  1. Other (specify): _______________________

Yes No







  1. How useful have the following resources from the training been in your work with pregnant clients?


Received?

Very Useful

Somewhat Useful

Not Useful


N/A

  1. Understanding Infant Adoption” Handbook

Yes No





  1. Infant Adoption Training Initiative Website

Yes No





  1. State Referral Resource Guide

Yes No





  1. Brochures

Yes No





  1. Posters

Yes No





  1. Other (specify): _____________________

Yes No







  1. Describe what you have experienced when you use the training in your work?


When I follow the guidelines presented in the Infant Adoption Awareness training program with pregnant clients, I find that…



Strongly Disagree


Disagree


Neither Agree nor Disagree

Agree

Strongly Agree


N/A


  1. I have all the resources I need (e.g., material, information and support) to conduct the discussions according to the training program







  1. I don’t always have enough time to do everything according to the training program







  1. My clients don’t seem to understand all of the information I give them







  1. My clients don’t seem receptive to the messages the training program recommends that I give them







  1. If I do everything according to the training program, the counseling goes very smoothly







  1. I feel knowledgeable enough to present adoption as an option when providing options information or referral services








  1. What, if any, barriers have you encountered to using the Infant Adoption Awareness training in your work? (Mark all that apply)


  • The amount of time I can spend with clients is too short to discuss pregnancy options

  • I don’t know about adoption resources or services in our area to use for referrals

  • I don’t know about other supportive community resources to use for referrals

  • We don’t have adoption resources in our area

  • We don’t have other community resources in our area

  • More staff need the training, but my supervisor/agency won’t allow them the time to attend

  • My supervisor/agency discourages me from using the guidelines in my work with clients

  • Clients with unintended pregnancies are too upset to discuss their options immediately after receiving their pregnancy results

  • Other (specify) _____________________________________________________________

  • No barriers have been encountered



  1. To what extent would you say the Infant Adoption Awareness Training Program was helpful in improving your knowledge and ability to refer clients to the following resources...?



Very Helpful

Somewhat Helpful

Not At All Helpful

  1. Pregnancy counseling services




  1. Adoption agencies




  1. Adoption attorneys




  1. Other supportive community resources (for example, maternal and infant health services, Medicaid, WIC, food stamps, substance abuse, mental health services, or domestic violence services)






  1. Please enter any comments below regarding how you have used or plan to use the Infant Adoption Awareness Training in your work with clients.

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Thank you for your participation in this survey.



IAATP Cross-Site Evaluation Trainee Follow-Up Survey (JBA-E) 8

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