The Hotline/LIR Exit Survey

Instrument 1: Exit Survey

The research staff person will read or type the consent form information (included in Attachment C) to the participant immediately before administering this survey. The consent form includes the following information:

• The purpose of the information collection

• An estimate of the time to complete the instrument (8.5 minutes)

• That the information collection is voluntary

• That the responses will be kept private to the extent permitted by law

• The statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is OMB No.: 0970-0468 and it expires on XX/XX/XXXX.

Directions for Research Staff:

For callers: Please read each exit survey question and each response category aloud as written below.

For chatters: Please type (or cut and paste) each question and each response category into the chat box, as written below.

Please enter all responses into the Advocate Caller Application database.

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Thank you for agreeing to take this survey. Your participation will help us improve the services at The Hotline/LIR and help us understand what we could be doing better.

Please answer the following questions based on your experiences with the National Domestic Violence Hotline (The Hotline) or loveisrespect (LIR) today.

1. We would like to understand why you contacted The Hotline/LIR today. I will read a list of possible reasons. Please indicate yes or no for each one. You may answer yes for more than one.

1. Did you contact The Hotline/LIR today to learn about your options and choices?

• Yes or no?

2. Did you contact The Hotline/LIR today to talk or chat with someone who understands your situation?

• Yes or no?

3. Did you contact The Hotline/LIR today to understand more about domestic violence and/or dating violence?

• Yes or no?

4. Did you contact The Hotline/LIR today to understand more about healthy relationships?

• Yes or no?

5. Did you contact The Hotline/LIR today to learn about ways to plan for safety?

• Yes or no?

6. Did you contact The Hotline/LIR today to get a referral to services (such as shelter, counseling, legal services, etc.)?

• Yes or no

7. Did you contact The Hotline/LIR today to be directly connected to a service (such as shelter, counseling, legal services, etc.) by an advocate? [this question is only for callers]

• Yes or no?

8. Did you contact The Hotline/LIR today to get emotional support?

• Yes or no?

9. Did you contact The Hotline/LIR today to learn how family members, friends, or others can get emotional support or how you can provide emotional support to them?

• Yes or no?

10. Are there any other reasons why you contacted The Hotline/LIR today? If so, please describe. [OPEN TEXT BOX]

2. On a scale from of 1 to 5, with 1 being not at all, and 5 being a lot, how much do you think your needs were met (meaning, you got what you were asking for) today through your interaction with The Hotline/LIR?

• 1 - Not at all

• 2

• 3

• 4

• 5 - A lot

3. Please answer yes or no to the following questions about your interaction with The Hotline/LIR.

1. Because of your interaction with The Hotline/LIR, do you know more about your options?

• Yes or no?

2. Because of your interaction with The Hotline/LIR, do you know more about domestic violence and/or dating violence?

   • Yes or no?

3. Because of your interaction with The Hotline/LIR, do you know more about healthy relationships?

   • Yes or no?

4. Because of your interaction with The Hotline/LIR, do you know more about ways to plan for safety?

   • Yes or no?

5. Because of your interaction with The Hotline/LIR, do you know more about community resources?

   • Yes or no?

6. Because of your interaction with The Hotline/LIR, are you more comfortable asking for help?

   • Yes or no?

7. Because of your interaction with The Hotline/LIR, are you more confident about making decisions related to your situation?

   • Yes or no?

8. Because of your interaction with The Hotline/LIR, are you more hopeful about the future?

   • Yes or no?

4. Please answer yes or no to the following questions about how you might use the information you got today. If the question doesn’t apply to your situation, you can answer “not applicable.”

1. Now that you have contacted The Hotline/LIR, do you plan to contact the community resource or referral that was provided to you?

   • Yes, no, or not applicable?

2. Now that you have contacted The Hotline/LIR, do you plan to share the community resource or referral that was provided to you with someone else?

   • Yes, no, or not applicable

3. Now that you have contacted The Hotline/LIR, do you plan to go to the shelter yourself?

   • Yes, no, or not applicable

4. Now that you have contacted The Hotline/LIR, do you plan to talk to a family member/friend about your situation?

• Yes or no?

5. Now that you have contacted The Hotline/LIR, do you plan to make plans for your safety?

• Yes, no, or not applicable?

6. Now that you have contacted The Hotline/LIR, do you plan to contact law enforcement?

• Yes, no, or not applicable?

7. Now that you contacted The Hotline/LIR, do you plan to contact legal services?

   • Yes, no, or not applicable?

8. Now that you have contacted The Hotline/LIR, are there other ways you plan to use the information that was provided to you today by The Hotline/LIR? If so, please describe.

5. On a scale of 1 to 5, with 1 being not at all, and 5 being a lot, how helpful was the information provided to you by The Hotline/LIR today?

• 1 - Not at all

• 2

• 3

• 4

• 5 - A lot

6. On a scale of 1 to 5, with 1 being not at all, and 5 being a lot, how much do you think the person you contacted at The Hotline/LIR cared about your situation?

• 1 - Not at all

• 2

• 3

• 4

• 5 - A lot

7. On a scale of 1 to 5, with 1 being not at all, and 5 being a lot, overall, how satisfied are you with the services The Hotline/LIR provided to you? If you feel that this is not applicable to your contact today with The Hotline/LIR, you may also select ‘not applicable’ as your response choice.

• 1 - Not at all

• 2

• 3

• 4

• 5 - A lot

• Not applicable

Thank you for your time to complete the survey questions. As I mentioned at the beginning, we would like you to complete a follow up survey in two weeks.

1. Would you like to contact us to complete the survey, or would you like us to call you?

• Participant contacts The Hotline [go to Question B]

• Hotline calls participant [go to Question C]

2. Would you like to get a text message or email reminder to complete the survey? The text or email we send you will only say “Have a nice day” and will not include a phone number, URL, or any mention of The Hotline, loveisrespect, or domestic violence.

• Yes [go to Question D]

• No [go to Question E]

3. [For those who will receive a call from The Hotline]

   1. What is the best day (Monday through Friday) and time (between 8am and 5pm CST) for you to receive a call from us in about two weeks [around DATE]? Please write down this day and time somewhere so that you remember that we will call you.

   2. What is a safe phone number for us to call to reach you? Please only accept the call at the time we agreed on if it is safe to do so. The number you will see when we call you is XXX-XXX-XXXX.

   3. When we call you, would you like us to say that we are calling from someplace other than the Hotline/LIR (for example, a flower shop, restaurant, or drug store) in case someone else answers the phone? [Go to Question F]

4. [For those who choose to receive a reminder text or email]

   1. What is your phone number or email address?

5. You can complete the follow up survey by phone or online.

• Please write down this toll-free phone number (XXX-XXX-XXXX) and this URL [PROVIDE URL] in a safe place. In about two weeks (so, on [DATE]), please call us at that number or go to the URL on any browser. If you want to take the survey online, you can also find a link to the survey at the bottom of main webpages for The Hotline and LIR.

• Please write down the day and time somewhere so that you remember to call or go online to complete the survey.

• If you choose to take the survey online, there are some things you can do to make sure that your computer or web browser do not show that you accessed the survey.

  • Clearing Search History: Which search engine (i.e., Google, Yahoo, Internet Explorer, etc.)? Listed below are the most common internet browsers.  Provide this information to the participant. He/she can click on the appropriate link below to open a page with instructions on how to erase internet history or cache, or how to use the built-in anti-tracking mode.

 

	Internet Explorer --->  erase history  |  clear cache  |  inprivate browsing mode
	Google Chrome --->  erase history  |  clear cache  |  incognito mode
	Mozilla Firefox  --->  erase history  |  clear cache  |  private browsing mode
	Safari  --->  erase history  |  clear cache  |  private browsing mode
	Opera  --->  erase history  |  clear cache  |  private browsing mode

6. When we talk [or when you complete the online follow up survey], we will ask you to give us two out of three pieces of information so that we can be sure we are talking to you [or you are completing the online survey] and not someone else. Let’s go through these three pieces of information now.

   1. Please select a fake name or pseudonym that we can call you when we talk during the follow up survey.

2. Please choose a code word. This can be any word that is easy for you to remember, like a favorite fruit or a place. You can use this word at any time to let us know if you no longer feel safe to complete the survey. You can also always hang up or exit the online survey if you do not feel safe at any time.

3. Please write down this four-digit number [XXXX]. We will use this to connect your answers from the survey you took today with the follow up survey.

If at any time in the next two weeks you decide you do not want to do the follow up survey, you can opt out of any contact with The Hotline/LIR by texting STOP to XXX-XXX-XXXX

Thanks again for your time today, and in advance for completing the follow-up survey in two weeks. Good bye.

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