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 07/31/2019.

Directions for Research Staff:

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

For chatters: Please provide the chat exit survey link in the chat box.

Please enter all responses into the Advocate Caller Application database.

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

1. We would like to understand why you contacted The Hotline/loveisrespect 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. Did you contact The Hotline/loveisrespect today to:

1. learn about your options and choices?

• Yes, no, or not applicable?

2. talk or chat with someone who understands your situation?

   • Yes, no, or not applicable?

3. understand more about domestic violence and/or dating violence?

   • Yes, no, or not applicable?

4. understand more about healthy relationships?

   • Yes, no, or not applicable?

5. learn about ways to plan for safety?

   • Yes, no, or not applicable?

6. get a referral to services (such as shelter, counseling, legal services, etc.)?

   • Yes, no, or not applicable?

7. be directly connected to a service (such as shelter, counseling, legal services, etc.) by an advocate? [this question is only for callers]

   • Yes, no, or not applicable?

8. get emotional support?

   • Yes, no, or not applicable?

9. learn how family members, friends, or others can get emotional support or how you can provide emotional support to them?

   • Yes, no, or not applicable?

10. Are there any other reasons why you contacted The Hotline/ loveisrespect 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/ loveisrespect?

• 1 - Not at all

• 2

• 3

• 4

• 5 - A lot

3. Please answer yes, no, or not applicable to the following questions about your interaction with The Hotline/loveisrespect. Because of your interaction with The Hotline/loveisrespect,

1. do you know more about your options?

   • Yes, no, or not applicable?

2. do you know more about domestic violence and/or dating violence?

   • Yes, no, or not applicable?

3. do you know more about healthy relationships?

   • Yes, no, or not applicable?

4. do you know more about ways to plan for safety?

   • Yes, no, or not applicable?

5. do you know more about community resources?

   • Yes, no, or not applicable?

6. are you more comfortable asking for help?

   • Yes, no, or not applicable?

7. are you more confident about making decisions related to your situation?

   • Yes, no, or not applicable?

8. are you more hopeful about the future?

   • Yes, no, or not applicable?

4. Please answer yes, no or not applicable to the following questions about how you might use the information you got today. Now that you have contacted The Hotline/loveisrespect, do you plan to:

1. contact the community resource or referral that was provided to you?

   • Yes, no, or not applicable?

2. share the community resource or referral that was provided to you with someone else?

   • Yes, no, or not applicable?

3. go to the shelter yourself?

   • Yes, no, or not applicable?

4. talk to a family member/friend about your situation?

• Yes, no, or not applicable?

5. make plans for your safety?

• Yes, no, or not applicable?

6. contact law enforcement?

• Yes, no, or not applicable?

7. contact legal services?

   • Yes, no, or not applicable?

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

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/loveisrespect 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/loveisrespect 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/loveisrespect, 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, The Hotline/loveisrespect would like you to complete a follow up survey in two weeks.

8. Would you like to contact The Hotline/loveisrespect to complete the survey, or would you like The Hotline/loveisrespect to call you?

• I will contact The Hotline/loveisrespect [go to Question 9]

• Please contact me [go to Question 10]

9. Would you like to get a text message or email reminder to complete the survey? For safety purposes, the text you will receive will only say “Have a nice day” to spark your memory to complete the survey and will not include a phone number, URL, or any mention of The Hotline, loveisrespect, or domestic violence.

• Yes [go to Question 11]

• No [go to Question12]

10. If you would like to receive a call from The Hotline/loveisrespect:

1. What is the best day (Monday through Friday) and time (between 8am and 5pm CST) for you to receive a call from The Hotline/loveisrespect 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 “UNKNOWN”.

3. When we call you, would you like to say that we are calling from someplace other than The Hotline/loveisrespect (for example, a flower shop, restaurant, or drug store) in case someone else answers the phone? [Go to Question 13]

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

4. What is your phone number or email address?

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

• Please write down this toll-free phone number (1-800-799-7233) and this URL [https://goo.gl/TmYGWu] in a safe place. In about two weeks (so, on [DATE]), please call The Hotline/loveisrespect 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 top of main webpages for The Hotline and loveisrespect.

• 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 does not show that you accessed the survey.

  • [Phone Instructions] 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.

  • [Web-based survey instructions] For your safety, we have included information on how to clear your search history. Listed below are the most common internet browsers.  Click the one you are currently using to open a new link on how to erase your 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

13. When we talk [or when you complete the online follow up survey], you will be asked to provide two out of three pieces of information so that The Hotline/loveisrespect can be sure they are talking to the right person [or you are completing the online survey] and not someone else. Please identify the following three pieces of information:

5. Please select a fake name or pseudonym that you can be referred to when completing the follow up survey.

6. 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 a research staff person at The Hotline/loveisrespect 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.

7. Please choose any four-digit number [XXXX]. This number will be used to connect your answers from the survey you took today with the follow up survey.

Please write down the fake name/pseudonym, code word, and four-digit number in a safe place so that you can provide them to us in about two weeks.

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 512-203-9775.

Remember, you can complete the follow-up survey by:

• Calling 1-800-799-7233

• Visiting https://goo.gl/TmYGWu

• Visiting www.thehotline.org or www.loveisrespect.org and clicking on the “Follow-Up Survey” link on the main banner at the top of the page
  
  

Good bye.

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