Organizational Context
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Mission
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Describe your
organization’s mission.
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History
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Describe the history of
your organization.
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What
led to the development of this organization?
Who
was part of the development team?
How
long has your organization been in existence?
Describe
the target population(s) your organization serves.
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Setting/ Infrastructure
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Describe your
organization’s setting and infrastructure.
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Where
does your organization operate?
What
are the key programmatic areas of focus for your organization?
Does
your organization have a board of directors and/or medical
advisory board? If so, what is their role within your
organization?
How
many people does your organization employ?
Describe
the staff expertise at your organization?
What
is the organizational structure?
What is your
organization’s operating budget?
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Role in organization
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How would you describe
your role within your organization?
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Implementation of the
Cooperative Agreement (CA)
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Core Components of the
DP11-1111 Cooperative Agreement
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Describe
your participation in the DP11-1111 cooperative agreement (CA).
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Training/Technical
Assistance
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What
types of trainings has your organization participated in to help
with the management of the CA?
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How
were these trainings delivered?
How
often did your organization participate in these trainings?
Who
delivered the trainings?
How were you able
to apply the training you received to help with program
implementation and/or evaluation?
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What kinds of technical
assistance (TA) has your organization received as a part of the
CA?
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Resources
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Describe
the resources that your organization has used to implement the
CA.
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What
are each staff member’s key tasks for the CA?
Describe
technology that supports your organization’s participation
in the CA?
Describe
other materials that support your organization’s
participation in the CA.
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Facilitators
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What factors, if any, have
facilitated your organization’s participation in the
CA?
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What
internal organizational factors (e.g., staff, resources,
expertise) have helped your organization participate in the CA?
What
external factors (e.g., training, TA, partnerships) have helped
your organization participate in the CA?
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Barriers
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What factors, if any, have
challenged your organization’s participation in the
CA?
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What
internal organizational factors (e.g., staff, resources,
expertise) have challenged your organization’s
participation in the CA?
What
external factors (e.g., training, TA, partnerships) have
challenged your organization’s participation in the CA?
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What
strategies has your organization used to overcome
barriers/challenges related to the CA?
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Implementation of the YBCS
Intervention
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Intervention Overview,
History and Rationale
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Describe your
organization’s YBCS intervention that is funded through the
CA.
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What
are the key components of the YBCS intervention?
Who
is the target audience for the YBCS intervention?
How have the key
components of the YBCS intervention been tailored to meet the
unique needs of the target audience?
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Describe your
organization’s goals and objectives for the YBCS
intervention.
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How did activities
conducted as a part of the CA
guide the development of the YBCS intervention?
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Describe the evidence base
and/or factors that informed (e.g., behavioral/communication
theory, scientific evidence, guidelines, formative research) the
development of the YBCS intervention.
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What intervention
components are new as a result of the CA?
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What intervention
components were enhanced/expanded as a result of the CA?
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Describe your role in the
YBCS intervention.
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Intervention execution
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Describe how the YBCS
intervention is implemented.
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How
often is each component of the YBCS intervention implemented?
What
is the duration of the YBCS intervention?
Who
is responsible for delivering key components of the YBCS
intervention?
How
are YBCS intervention participants recruited?
How
has the delivery of the YBCS intervention been tailored to meet
the unique needs of the target audience?
How do you engage
members of the target audience (e.g., YBCS, families/caregivers,
health care providers) in the implementation of the YBCS
intervention?
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What tools, guidelines
and/or protocols are used to direct the implementation of the
YBCS intervention?
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What,
if any, manuals have been created to support implementation of
the YBCS intervention?
Who
created these guidelines?
How are these used
to implement the YBCS intervention?
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What
trainings are offered to staff to implement the YBCS
intervention?
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How
are trainings identified?
Who
delivers these trainings?
What
is the duration of each of these trainings?
How
often are trainings offered to staff?
Are there external
trainings that your organization has participated in to support
implementation of the YBCS intervention?
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Implementation Fidelity
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To what extent has the
YBCS intervention been implemented as planned?
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How does implementation of
the YBCS intervention vary across sites?
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Are there
differences in the way that the YBCS intervention is delivered
across sites (e.g., setting, geographic location, target
population)? If so, how is implementation different?
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Does your organization use
any process improvement strategies to improve the delivery of the
YBCS interventions?
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Resources
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How
does your organization use funding received through the CA to
implement the YBCS intervention?
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What other, if any,
monetary(leveraged) or non-monetary(in-kind) resources have been
provided to your organization to support the YBCS intervention?
If any, please explain.
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Have
you received additional funding from other organizations to help
support implementation of the YBCS intervention?
Have
you received donated resources, such as materials and/or
supplies, to help support implementation of the YBCS
intervention?
Have
people offered their time and/or expertise to help support
implementation of the YBCS intervention?
Have you received
any in-kind, earned media donations to promote and/or implement
the YBCS intervention?
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Facilitators
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What factors, if any, have
facilitated your organization’s implementation of the YBCS
intervention?
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What
internal organizational factors (e.g., leadership, staff,
resources, expertise) have helped your organization implement
the YBCS intervention?
What
external factors (e.g., training, TA, partnerships) have helped
your organization implement the YBCS intervention?
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Barriers
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What factors, if any, have
challenged your organization’s implementation of the YBCS
intervention?
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What
internal organizational factors (e.g., leadership staff,
resources, expertise) have challenged your organization’s
implementation of the YBCS intervention?
What
external factors (e.g., training, TA, partnerships) have
challenged your organization’s implementation of the YBCS
intervention?
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What
strategies have your organization used to overcome barriers
related to implementation of the YBCS intervention?
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Evaluation
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Knowledge
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Describe your
understanding of program monitoring and/or evaluation.
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Have
you participated in any past evaluation efforts? If so, please
describe.
Do you have
experience creating program logic models?
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Measurement
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For what the YBCS
intervention is trying to accomplish, how would you define
success?
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How is success measured or
documented?
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Do
you have baseline data? Do you intend to collect follow-up data?
At what time?
Do
you collect data at specified points over time (time
series)? What
length of time?
Do
you follow a sample of participants over time (cohort
study)? What
length of time?
Do
you have a comparison group?
What does the
evaluation activity tell you about the success of the YBCS
intervention?
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Describe how your
organization defines and assesses reach for the YBCS
intervention.
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Describe how your
organization measures the implementation of the YBCS
intervention.
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What
data do you collect?
Who
is responsible for measuring/monitoring implementation?
Are
other staff members involved in data collection? How so?
Are
there plans to expand or change how your organization monitors
implementation of the YBCS intervention? If so, please explain?
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What are the available
data sources used to support program monitoring and evaluation
for the YBCS intervention?
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What
data collection tools or instruments does your organization use
in relation to the YBCS intervention? (Request to see or obtain
copies of data, data collection tools, or evaluation reports.)
Describe the data
collection methods used to collect evaluation data for the YBCS
intervention.
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How does your organization
analyze data from the YBCS evaluation in order to collect program
monitoring and evaluation information?
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What
analytic techniques does your organization use to conduct
program monitoring and evaluation for the YBCS intervention?
Who within your
organization, who is responsible for conducting analysis for the
YBCS intervention?
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How does your organization
use evaluation findings to inform implementation of the YBCS
intervention?
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Describe how your
organization shares evaluation findings from the YBCS
intervention.
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Facilitators
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What, if any, facilitators
have helped your organization conduct program monitoring and
evaluating for the YBCS intervention?
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Barriers
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What, if any, barriers has
your organization encountered in evaluating the YBCS
intervention?
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What
strategies has your organization used to overcome barriers
related to program monitoring and evaluation of the YBCS
intervention?
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Partnerships
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Development and Engagement
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Describe
the process your organization has used to identify and develop
partnerships.
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Describe
how new partnerships have been formed to support the
implementation of the YBCS intervention.
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Describe
how you have worked to maintain existing partnerships to support
the implementation of the YBCS intervention.
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Why
were these partners identified (e.g., access to target
population, resources, expertise)?
How
did you continue your engagement with these organizations?
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How
has your organization’s involvement in the CA helped you to
develop and maintain partnerships?
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Have
you collaborated with other grantees as a part of the CA?
Has
access to other programs serving YBCS helped your organization
develop new partnerships? If so, please explain.
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How
would you describe partners’ engagement in the YBCS
intervention?
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Contribution to the
intervention
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Describe
how partners participate in the planning or implementation of the
YBCS intervention.
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How
does your organization interact with partners?
How
does your organization communicate with partners?
How
often does your organization communicate with
partners?
How
long has your organization worked partners?
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What partnerships have
been the most beneficial for your organization in the
implementation of the YBCS intervention?
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What additional
partnerships would [insert Grantee Organization name] benefit
from to support the implementation of the YBCS intervention?
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Capacity
and Sustainability
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Capacity to meet the
requirement of the CA
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Describe
your organization’s capacity to meet the requirements of
the CA and how capacity has changed over time.
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Describe
how support received from CDC through the CA has affected your
organization’s ability to meet the requirements of the CA.
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Capacity to implement
intervention
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Describe
your organization’s capacity to implement the YBCS
intervention and how capacity has changed over time.
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Describe
how the CA has enabled your organization to implement the YBCS
intervention.
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To
what extent was your organization able to utilize CDC’s TA
to improve the implementation of the YBCS intervention?
To what extent was
your organization able to utilize CDC training opportunities to
improve the implementation of the YBCS intervention?
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Capacity to evaluate
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Describe your
organization's capacity to plan and implement program monitoring
and evaluation activities, such as creating data collection
tools, collecting data, conducing analysis, and reporting.
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Describe
program staff members who have the expertise/experience to
collect and/or analyze data.
What
additional outside resources does your organization rely on to
help with evaluation (e.g., does your organization use an
external evaluator)?
Describe
the resources your organization reserves to support data
collection (e.g., time, materials, technology) to support
program monitoring and/or evaluation?
What
other resources does your organization designate for program
evaluation/monitoring (e.g., staff, time, technology,
materials)?
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Describe how the CA has
enabled your organization to plan and implement program
monitoring and evaluation activities for the YBCS intervention.
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To
what extent was your organization able to utilize CDC’s TA
to improve the program monitoring and evaluation for the YBCS
intervention?
To what extent was
your organization able to utilize CDC training opportunities to
improve the program monitoring and evaluation for the YBCS
intervention?
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Sustainability of
intervention
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Describe
the sustainability of the YBCS intervention and how
sustainability has changed over time.
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Describe how the CA has
enabled your organization to plan for and ensure the
sustainability of the YBCS intervention.
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To
what extent has your organization able to utilize CDC’s TA
to improve the sustainability of your YBCS intervention?
To what extent has
your organization been able to utilize CDC’s training
opportunities to improve the sustainability of the YBCS
intervention?
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Perceptions
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Awareness
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How has the YBCS
intervention affected awareness for the existence of support
services and/or educational resources among the target audience?
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in increasing awareness for support
services and/or educational resources?
In
your opinion, what communication strategies were the most
effective in promoting and increasing awareness for the YBCS
intervention?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed awareness.)
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Access
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How has the YBCS
intervention affected access to support services and/or
educational resources for the target audience?
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in increasing access to support
services and/or educational resources?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed access.)
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Utilization
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How has the YBCS
intervention affected utilization of support services and/or
educational resources by the target audience?
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in increasing utilization of support
services and/or educational resources?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed utilization.)
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YBCS knowledge, attitudes,
and beliefs (KAB)
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What knowledge, attitudes,
and beliefs does the YBCS intervention aim to affect? How has the
YBCS intervention impacted those specific knowledge, attitudes,
and/or beliefs among the target population? (Examples of KAB
targets include: strategies for reducing
the risk of recurrence and the development of new malignancies,
chronic disease onset, and improving overall health and quality
of life).
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in KAB among the target population?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed KAB among target audience(s).)
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Value of the CA
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What has been the value
for your organization to participate in the CA?
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Value of the YBCS
intervention
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What has been the value of
the YBCS intervention?
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In
your opinion, how did the YBCS intervention impact the target
audience?
In your opinion,
how did the YBCS intervention contribute to the evidence base
for promising strategies to reach YCBS, YBCS caregivers, and/or
YBCS health care providers?
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Lessons learned
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What have been some key
lessons learned from your organization’s experience with
the CA?
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In
your opinion, what aspects of your CA worked well?
In your opinion,
what aspects of your CA did not work well?
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What have been some key
lessons learned from your organization’s experience with
the YBCS intervention?
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Recommendations
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What ideas do you have for
improving your organization’s YBCS intervention?
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