Form Approved
OMB No. 0920-XXXX
Exp. Date: XX-XX-XXXX
CDC Work@Health™ Wave 2 Trainee Reaction Survey
Public reporting of this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a current valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).
Respondents/Sources |
Method |
Content |
Timing |
Respondents |
Time per Respondent |
Wave 2 trainees participating in the Work@Health™ Hands-on Training Model |
Wave 2 Trainee Reaction Survey (conducted in paper form by PHMC) |
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At the conclusion of Train-the-Trainer graduates Hands-On session with trainees |
150 |
0.25 hrs |
This is a planned paper and pencil survey of Wave 2 employers who participated in the Hands-on training model of the Work@Health™ program. Work@Health™ is a program that trains employers in the design, implementation, and evaluation of worksite health and wellness programs. This survey will be administered immediately after the training has been completed in Winter-Spring 2014 to evaluate the effectiveness of those trained to train others through the Train-the-Trainer model.
Introduction
Thank you for your participation in today’s training for the CDC Work@Health™ program. This survey asks about your thoughts and opinions of the training. Your responses will help us make the Work@Health™ program most useful for employers.
Informed Consent
Before you get started, we’d like to give you some more information to help you decide whether or not you would like to participate.
This project is funded by the Centers for Disease Control and Prevention (CDC). Many parts of this project are being managed by the ASHLIN Management Group (ASHLIN). ASHLIN is a private sector consulting firm with a focus in the area of health and human services based in Greenbelt, MD. They are helping CDC implement the Work@Health™ program. The Public Health Management Corporation (PHMC), a non-profit, public health institute located in Philadelphia, PA and part of the ASHLIN Team designed this survey.
You are being asked to complete the survey because you participated in the Work@Health™ training.
Your participation is voluntary, and you may skip any questions you do not want to answer. You may also choose to end the survey at any time.
The survey is designed to take about 15 minutes.
There are no right or wrong answers or ideas – we want to hear about YOUR experiences and opinions.
All of the comments you provide will be maintained in a secure manner. We will not disclose your responses or anything about you unless we are compelled by law. Your responses will be combined with other information we receive and reported in aggregate as feedback from all respondents. In our project reports, your name and your employer’s name will not be linked to the information or comments you provide.
There are no risks or benefits to you personally for participating in this survey.
CDC is authorized to collect information for this project under the Public Health Services Act.
If you have any questions, you can contact Kristin Minot. Her phone number is 215-985-2519 and her email is Kristin@phmc.org.
Thinking about the Work@Health™ training you just completed, please indicate to what extent you agree or disagree with each of the following statements.
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Strongly Disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Learning Environment |
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Delivery |
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The next set of questions are about the training activities. Please indicate how useful you found each of the following training activities:
How useful were: |
Not at all Useful 1 |
Of little use 2 |
Moderately useful 3 |
Useful
4 |
Extremely Useful 5 |
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The next group of questions is about your perceptions of the individual training modules.
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Strongly Disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
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24A. The learning objectives for the Making the Business Case module were clear. |
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24B. The learning objectives for the Assessing Your Company’s Current Support of Employee Health and Wellness module were clear. |
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24C. The learning objectives for the Planning and Designing a Comprehensive and Effective Program module were clear. |
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24D. The learning objectives for the Building and Sustaining a Total Leadership Approach module were clear. |
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24E. The learning objectives for the Implementing Key Policy, Benefit, and Environmental Supports module were clear. |
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24F. The learning objectives for the Designing an Effective Communications Campaign module were clear. |
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24G. The learning objectives for the Implementing and Sustaining Your Program module were clear. |
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24H. The learning objectives for the Evaluating Your Program module were clear. |
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Strongly Disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
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25A. The level of detail in the Making the Business Case module was appropriate. |
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25B. The level of detail in the Assessing Your Company’s Current Support of Employee Health and Wellness module was appropriate. |
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25C. The level of detail in the Planning and Designing a Comprehensive and Effective Program module was appropriate. |
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25D. The level of detail in the Building and Sustaining a Total Leadership Approach module was appropriate. |
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25E. The level of detail in the Implementing Key Policy, Benefit, and Environmental Supports module was appropriate. |
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25F. The level of detail in the Designing an Effective Communications Campaign module was appropriate. |
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25G. The level of detail in the Implementing and Sustaining Your Program module was appropriate. |
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25H. The level of detail in the Evaluating Your Program module was appropriate. |
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Not at all informative |
Not very informative |
Somewhat informative |
Very Informative |
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26A. How informative was the Making the Business Case module. |
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26B.How informative was the Assessing Your Company’s Current Support of Employee Health and Wellness module. |
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26C. How informative was the Planning and Designing a Comprehensive and Effective Program module. |
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26D. How informative was the Building and Sustaining a Total Leadership Approach module. |
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26E.How informative was the Implementing Key Policy, Benefit, and Environmental Supports module. |
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26F. How informative was the Designing an Effective Communications Campaign module. |
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26G. How informative was the Implementing and Sustaining Your Program module. |
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26H. How informative was the Evaluating Your Program module. |
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Not at all useful |
Not very useful |
Somewhat useful |
Very useful |
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27A. How useful was the Making the Business Case module. |
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27B.How useful was the Assessing Your Company’s Current Support of Employee Health and Wellness module. |
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27C. How useful was the Planning and Designing a Comprehensive and Effective Program module. |
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27D. How useful was the Building and Sustaining a Total Leadership Approach module. |
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27E.How useful was the Implementing Key Policy, Benefit, and Environmental Supports module. |
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27F. How useful was the Designing an Effective Communications Campaign module. |
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27G. How useful was the Implementing and Sustaining Your Program module. |
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27H. How useful was the Evaluating Your Program module. |
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The next group of questions is about your overall impressions of the training. For each question, please indicate the degree to which you agree or disagree with the following statements.
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Strongly Disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
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The next set of questions is about your ability to start or expand a worksite health program at your place of employment.
How confident are you in your ability to start or expand a worksite health program at your employer? (Circle one rating)
Not at all confident
A little confident
Confident
Very Confident
Extremely Confident
If you circled 1 or 2, please answer the following question. Check all that apply.
My confidence is not high because:
I do not have the necessary knowledge and skills.
I do not have a clear picture of what is expected of me.
I have other priorities.
I do not have the necessary resources to do it.
I do not have the support from my employer to do it.
Other (please explain).
Finally we would like to know your thoughts and suggestions for how the Work@Health™ program can be improved.
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Employee Characteristics
What is your business title/role?
CEO/President/Owner
VP
Director, HR
Director, Benefits
Wellness Manager
Environmental Health and Safety Representative
Union/Labor Representative
Other (specify): ________________________
Number of employees at your site or business unit (full and part time)
________________________________
What industry best describes your worksite?
Agriculture, Forestry, Fishing and Hunting
Mining, Quarrying, and Oil and Gas Extraction
Utilities
Construction
Manufacturing
Wholesale Trade
Retail Trade
Transportation and Warehousing
Information
Finance and Insurance
Real Estate and Rental and Leasing
Professional, Scientific, and Technical Services
Management of Companies and Enterprises
Administrative and Support and Waste Management and Remediation Services
Educational Services
Health Care and Social Assistance
Arts, Entertainment, and Recreation
Accommodation and Food Services
Public Administration
Other Services (specify) _________________________
File Type | application/msword |
File Title | DRAFT PILOT TRAINING: HANDS-ON EVALUATION |
Author | schwarz-john |
Last Modified By | CDC User |
File Modified | 2013-11-20 |
File Created | 2013-11-20 |