Secondary Stakeholder Survey

Secondary Stakeholder Survey (SSS)

Form Approved

OMB No. 0990-

Exp. Date XX/XX/20XX

Thank you for taking the time to review the Second Decade Project Community Planning Guide (the Guide). The following survey is intended to gather your feedback and recommendations for improving the Guide for the Office of the Assistant Secretary of Health (OASH) and others who work with youth 10-19 years of age. Your thoughtful review is appreciated.

Before you complete this survey, please read the following consent form. The survey will take approximately 30 minutes. By completing and submitting this web survey, you are consenting to participate. Your participation in this survey is completely voluntary; there are no right or wrong answers; and you may contact us with any questions that you have before, during, or after you complete the survey.

Privacy: Your answers to the survey questions will be kept private except as otherwise required by law. Your name will not be linked with the information on your survey. The information that we report to OASH will not contain your name. Your name will not be used in any reports about this evaluation.

Procedures: Secondary stakeholders, specifically adolescent health experts, adolescent health researchers and practitioners, state/local health department officials, and others who have a stake and interest in working with youth will be asked to complete this survey. Therefore, your participation is very important. The survey questions will ask you about your feedback and recommendations for improving the Guide.

Risks: There are few, if any, risks to you by completing this survey. You may stop the survey at any time. You will not be penalized for stopping. If you stop the survey, at your request, we will destroy your survey.

Contact information: If you have any concerns about completing this survey or have any questions about the study, please contact Gingi Pica, Project Manager, at 212-941-5555 or gingi.pica@icfi.com.

Thank you in advance for your willingness to participate.

Your responses are very important to us.

_________________________________________________________________________

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0379. 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 comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

INTRODUCTION

The first set of questions are related to the processes the Guide outlines for developing community plans. Please indicate how effective the Guide is in addressing the following areas:

Item	Response Option
How effective is the Guide in…	Very ineffective	Ineffective	Average	Effective	Very effective
Guide and Community Plan Development
Identifying a process and issues to inform development of comprehensive community plans
Providing guidance to coalitions to set priorities for their community action plan
Providing guidance to coalitions to address more than one specific issue impacting adolescents in their community
Providing guidance to coalitions to develop short-term goals
Providing guidance to coalitions to develop long-term goals
Providing guidance to coalitions to assess their goals
Please share additional comments on processes included in the Guide to develop a community plan
Are there elements of the process to developing a community plan that are missing? If so, please explain?

Please indicate your level of agreement with the following statements regarding the clarity of the directions provided in the Guide.

Item	Response Option
	Strongly disagree	Disagree	No opinion or uncertain	Agree	Strongly agree
Guide Format
The main message of the Guide was clearly communicated
The main message of the Guide was easy to identify
The Guide is an appropriate length
The overall objectives of the Guide are clearly communicated
The Guide clearly explains why the Second Decade is important to communities
The resources provided in the Guide are current
The resources provided in the Guide are relevant to the sections
The resources provided in the Guide are easy to identify
The guidance for identifying a champion in the community is clear
The directions for building a coalition are clear
The guidance for assessing a community’s strengths and gaps are clear
The directions for developing a community action plan are clear
The Guide has an appealing design
The format of the Guide is easy to follow
The chapters in the Guide are well organized and have coherent flow
The Guide has an appropriate level of detail
Please share additional feedback on the directions provided in the Guide overall

Please indicate if the following Guide chapters/sub-chapter is an area of strength or an area that needs improvement and provide feedback in the additional explanations/recommendations section.

It may be helpful to have a copy of the guide available as you review each question.

	Response Option
Chapter/Sub-chapters	Area of Strength	Neutral	Area of Improvement	Additional Explanation/ Recommendations
Chapter: Why the Second Decade? (pg 6-10)
How Do We Ensure Healthy Adolescence? (pg 6)
Why Is the Second Decade Important to Your Community? (pg 7)
What Does a Plan for Promoting Health & Well-Being in the Second Decade Look Like? (pg 8)
Guiding Principles and Practices (pg 9)
Resources (pg 10)
Chapter: Getting Started: Build a Strong Foundation (pg 11-19)
Identify a Champion (pg 11)
Build a Coalition (pg 12)
Establish a Shared Vision (pg 13)
Assess Your Community’s Needs and Gaps (pg 13)
Create an Action Plan (pg 14)
Develop Funding Strategies (pg 17)
Resources (pg 18)
Chapter: Multi-Impact Strategies (pg 22-48)
School-Based Health Centers (pg 26-28)
The Built Environment (pg 29-31)
Health and Safety Zones (pg 32-33)
Parent Engagement (pg 34-36)
Youth Engagement (pg 37-39)
Graduation & Academic Success (pg 40-42)
Social Media & Technology (pg 43-46)
Youth Centers (pg 47-48)
Chapter: Specific Issues (pg 49-85)
Tobacco Prevention (pg 51-53)
Teen Pregnancy Prevention (pg 54-57)
Physical Activity & Active Living (pg 58-60)
Nutrition (pg 61-63)
Youth Violence (pg 64-66)
Alcohol and Substance Abuse (pg 67-69)
Vehicle Safety (pg 70-72)
Healthy Relationships (pg 73-74)
Mental Health (pg 75-78)
Suicide Prevention (pg 79-81)
Youth Homelessness (pg 82-85)

Please share your perspective on the comprehensiveness of the content in the Guide related to youth 10-19. Please respond to the following items:

Item	Response Option
	Strongly disagree	Disagree	No opinion or uncertain	Agree	Strongly agree
Comprehensiveness of Content
The multi-impact strategies included in the Guide are ample for developing a plan for youth 10-19 years of age
The specific issues included in the Guide are ample for developing a plan for youth 10-19
Are there any strategies that are missing from the Guide?	Yes No
If yes, which strategies would you recommend including in the Guide?
Are there any issues are missing from the Guide?	Yes No
If yes, which issues would you recommend including in the Guide?
Are there areas of adolescent health and well-being that are not addressed by the Guide that should be included?	Yes No
If so, please specify
If you were tasked with developing a similar guide for Adolescents what would you differently from the Second Decade Guide?

Please respond to the following questions about your background.

Item	Response Option
Background Information
What is your gender?	Male Female
Which of the following best describes you? Select all that apply.	American Indian or Alaskan Native Asian or Pacific Islander Black or African American White or Caucasian Other
Are you Hispanic or Latino?	Yes No
Which of the following best describes the sector that you or your organization represents?	Education (K-12) Education (College, university level) Health or healthcare State or local government Elected officials (such as mayors, city council members, and school board members) Religion/faith-based Communications or media Social services or a youth-serving organization Non-profit organization Community-based organizations Tribal organization City planner General community member Youth volunteer Other (Please specify)
Do you work directly with youth 10-19?	Yes No

Do you have any other comments or feedback on the Guide? Please specify below.

Thank you for your participation!

ICF International 14

Attachment G - Secondary Stakeholder Survey (SSS)