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pdfOMB Control Number: 0970-0519
Expiration Date: 10/31/2021
GENERAL CONFERENCE
FEEDBACK
Form
In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC) better serve the field, we
are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with the Federal Privacy
Act, and we will protect the confidentiality of your responses using procedures we have in place, including reporting all
information in aggregate to avoid identifying information. Only members of the NHTTAC Evaluation Team have access to
information that could identify respondents. If you have any questions about this survey or the evaluation, please contact
NHTTACEval@icf.com.
CONFERENCE TITLE: _______________________________________________________________
DATE(S): __________________________________________________________________________
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
Please indicate how well the conference met each stated objective.
OVERALL OBJECTIVES
Poor
Satisfactory
Good
Excellent
Not
Applicable
1.
[Insert objective 1].
1
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3
4
NA
2.
[Insert objective 2].
1
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4
NA
3.
[Insert objective 3].
1
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4
NA
4.
[Insert objective 4].
1
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4
NA
5.
[Insert objective 5].
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4
NA
Please indicate the extent to which you agree or disagree with the following statements.
CONFERENCE FEEDBACK
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
6.
The conference addressed the critical issues related
to the topic(s).
1
2
3
4
NA
7.
The conference was well organized and clear.
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2
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4
NA
8.
The conference increased my knowledge related to
the topic(s).
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3
4
NA
9.
The information presented in the conference was
grounded in current evidence-based research or
promising practices.
1
2
3
4
NA
10. The information presented in the conference was
trauma-informed.
1
2
3
4
NA
11. The information presented in the conference was
survivor-informed.
1
2
3
4
NA
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
GENERAL CONFERENCE
FEEDBACK
Form
12. The information presented in the conference was
grounded in a multidisciplinary approach to
addressing human trafficking.
1
2
3
4
NA
13. The information provided in the conference
reflected a public health approach to addressing
human trafficking.
1
2
3
4
NA
14. The conference improved my ability to serve people
at risk of or being trafficked.
1
2
3
4
NA
15. The meeting space and use of technology provided
a good learning environment.
1
2
3
4
NA
16. I was satisfied with the overall conference facilities.
1
2
3
4
NA
17. The registration and logistics information were
clear, helpful, and easily accessible.
1
2
3
4
NA
18. The format of the conference provided ample
opportunity and encouragement for participants to
interact meaningfully with each other.
1
2
3
4
NA
19. The conference staff was professional, helpful, and
informative.
1
2
3
4
NA
20. The time allotted was adequate for the scope of
material covered.
1
2
3
4
NA
21. The education materials provided for this
conference were useful.
1
2
3
4
NA
22. I will share the information I learned at the
conference with my colleagues.
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2
3
4
NA
23. The conference increased my practical skills related
to the topic(s).
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2
3
4
NA
24. The conference met my professional needs.
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2
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4
NA
25. The conference met my educational needs.
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2
3
4
NA
26. I will be able to apply what I learned in my work.
1
2
3
4
NA
Please select the number that best represents your rating for this conference for each of the following questions.
27. Please rate the overall quality of this conference.
1
2
3
4
Poor
Fair
Very Good
Excellent
28. How useful was the conference information to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
GENERAL CONFERENCE
FEEDBACK
Form
29. As a result of participating in this conference, do you plan to do any of the following? (Mark all that apply.)
□
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Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
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Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
30. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
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Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multi-disciplinary team
31. Would you recommend NHTTAC to others for T/TA?
□
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□
□
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Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
□ Yes
□ No
32. Please indicate any additional needs that you or your organization have that may be met with future TTA.
______________________________________________________________________________
______________________________________________________________________________
33. Which of the conference sessions were most useful and why?
______________________________________________________________________________
______________________________________________________________________________
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
GENERAL CONFERENCE
FEEDBACK
Form
34. What could be done differently to improve the conference?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
35. Do you have any other comments or suggestions?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
36. Which of the following best describes the organization in which you work? (Mark all that apply.)
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Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
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□
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□
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OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
37. Which of the following best describes your professional capacity or types of services you provide? (Mark all that
apply.)
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□
Behavioral health professional (e.g., psychologist,
psychiatrist, mental health/substance use counselor)
Child welfare (e.g., state agency staff, child welfare
contractor, nonprofit personnel)
Corrections-based services (e.g., parole, probation)
Criminal justice (e.g., law enforcement, prosecutor,
probation, court, forensic interviewer)
Educator (e.g., teacher, professor, school
administrator)
Health care (e.g., physician, physician assistant,
nurse practitioner, dentist, nurse, pharmacist)
Housing (e.g., case worker, shelter director, public
housing authority agencies)
□
□
□
□
□
□
Legal (e.g., immigration, civil and/or rights-based
attorney and/or paralegal, clinic)
Public health (e.g., licensure board, health
department staff, health care executive, community
health workers)
Social worker (e.g., case manager, school
counselor, supervisor, administrator)
Survivor empowerment, mentoring, or peer to peer
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
38. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
39. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
GENERAL CONFERENCE
FEEDBACK
Form
40. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________
□ Administration
□ Peer Educator
41. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of being trafficked, or have been trafficked?
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2
3
4
Never
Occasionally
Frequently
All the Time
42. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
43. Please select any of the following populations you currently work with in a professional capacity (Mark all that apply.)
□
□
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Human trafficking
□ Commercial sexual exploitation of
children
□ Sex trafficking
□
Adults
□
Minors
□ Labor trafficking
□ Adults
□ Minors
Children/youth
□ Out of home/Foster care/Kinship care
□ Juvenile justice
□ Runaway/Homeless youth
People with disabilities
Deaf/Hearing impaired
Elderly
□
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□
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Lesbian, gay, bisexual, transgender, and
questioning
Foreign nationals (migrant workers, undocumented
immigrants, refugees)
People with low incomes
Racial and ethnic minorities
□ American Indian or Alaska Native
□ Asian
□ Black or African American
□ Native Hawaii or other Pacific Islander
□ White
□ Hispanic or Latino ethnicity
History of substance use
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify): __________________
Thank you for taking the time to complete this form and helping to improve NHTTAC activities.
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control number.
The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or additional suggestions,
please write to the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.
File Type | application/pdf |
Author | Field, Michael |
File Modified | 2019-11-01 |
File Created | 2019-11-01 |