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pdfOMB Control Number: 0970-0519
Expiration Date: 10/31/2021
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
Feedback
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
[insert].
Please provide the information below to create an anonymous ID:
______
______
Birth Month
First letter of first name
(insert just the month
(example: S for Sara)
for your date of birth,
example: 08 for August)
______
First letter of your middle name
(example: M for Maria)
Please rate the extent to which to you agree or disagree that the fellowship program has helped you achieve the following
objectives. This program has increased my…
Strongly
Disagree
OBJECTIVES
Disagree
Agree
Strongly
Agree
Not
Applicable
1. [insert objective here].
1
2
3
4
NA
2. KNOWLEDGE: Grow participant understanding of human
trafficking programs, nonprofits, government, public health
systems, and other processes and services that can help catalyze
positive change.
1
2
3
4
NA
3. TRUST: Increase the level of trust and reciprocity between
survivors and the agencies and institutions committed to their
success.
1
2
3
4
NA
4. NETWORK: Cultivate a thriving leadership network of survivors
and human trafficking professionals that work across
organizational and geographic boundaries.
1
2
3
4
NA
5. CONTRIBUTION: Create relevant and usable resources and
tools that enhance trauma-informed and survivor-centered
OTIP grant programming.
1
2
3
4
NA
6. SKILLS: Empower emerging leaders with leadership skills and
training to lead themselves and their communities forward.
1
2
3
4
NA
Please rate your level of confidence with the following after participating in this program:
SKILL DEVELOPMENT
7. My leadership ability.
Not at All
Confident
1
Not
Confident
2
Confident
3
Very
Confident
4
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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
Feedback
8. My skills and knowledge about trauma-informed
practices.
1
2
3
4
1
2
3
4
1
2
3
4
11. My skills and knowledge about a multidisciplinary
approach to addressing human trafficking.
1
2
3
4
12. My skills and knowledge about a public health
approach to addressing human trafficking.
1
2
3
4
13. My connection to colleagues, professionals, and human
trafficking experts.
1
2
3
4
14. My knowledge of human trafficking programs,
nonprofits, government, and public health systems.
1
2
3
4
15. My ability to collaborate across human trafficking
programs or initiatives.
1
2
3
4
9. My skills and knowledge about survivor-informed
practices.
10. My skills and knowledge about current evidence-based
or promising practices.
Please indicate the extent to which you agree or disagree with the following statements:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
16. The planning support provided by NHTTAC prior to the
beginning of the fellowship program was helpful.
1
2
3
4
NA
17. The onsite support provided by NHTTAC during the inperson trainings was helpful.
1
2
3
4
NA
18. The interim support and check-ins provided by NHTTAC
staff between seminars was helpful.
1
2
3
4
NA
19. I am satisfied with the overall support provided by NHTTAC
staff throughout the fellowship program.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
20. The facilitator’s knowledge and expertise were appropriate
for this program.
1
2
3
4
NA
21. The facilitator responded positively to questions and
comments.
1
2
3
4
NA
22. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
23. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
24. The facilitator’s knowledge and expertise were appropriate
for this program.
1
2
3
4
NA
25. The facilitator responded positively to questions and
comments.
1
2
3
4
NA
NHTTAC STAFF: ________________
FACILITATOR 1: ___________________
FACILITATOR 2: ___________________
Not
Applicable
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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
Feedback
26. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
27. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
NA
Strongly
Agree
28. Please rate the overall quality of the HTLA.
1
Poor
2
Fair
3
4
Good
29. Would you recommend NHTTAC to others to receive T/TA?
Excellent
□ Yes
□ No
Please indicate the extent to which you agree or disagree with the following statements:
Strongly
Disagree
Disagree
Agree
30. The time allotted was adequate for the scope of the
initiative.
1
2
3
4
NA
31. The program was well organized.
1
2
3
4
NA
32. This program met my professional needs.
1
2
3
4
NA
33. This program met my educational needs.
1
2
3
4
NA
34. The materials provided during this program were useful.
1
2
3
4
NA
35. The format of the program contributed to a positive
learning environment.
1
2
3
4
NA
36. The format of the program provided ample opportunity
and encouragement for participants to interact
meaningfully with each other.
1
2
3
4
NA
37. The content was trauma-informed.
1
2
3
4
NA
38. I am confident the knowledge and skills that I learned
will be useful for my practice and/or for my professional
development.
1
2
3
4
NA
39. I will be able to apply what I learned in my work.
1
2
3
4
NA
40. The program improved my ability to serve people who
are currently being trafficked, at risk of trafficking, or
have been trafficked.
1
2
3
4
NA
41. This program will help me collaborate with various
professionals across the human trafficking field.
1
2
3
4
NA
42. I will share the information I learned at the training with
my colleagues and peers.
1
2
3
4
NA
OVERALL FEEDBACK
Not
Applicable
43. What are the top three ways you improved your effectiveness as a leader?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
Feedback
Please rate the overall quality of each session of the Human Trafficking Leadership Academy:
OVERALL QUALITY
44.
45.
46.
47.
HTLA Seminar 1
HTLA Seminar 2
HTLA Seminar 3
HTLA Seminar 4
Poor
Fair
Good
Excellent
Not Applicable
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
NA
NA
NA
NA
48. What insights and experiences did you contribute to the other fellows' learning experiences during the program?
_________________________________________________________________________________
_________________________________________________________________________________
49. What contributions did the other fellows make toward your learning experience?
_________________________________________________________________________________
_________________________________________________________________________________
50. How did working with [grantees/survivors] impact your professional experience?
_________________________________________________________________________________
_________________________________________________________________________________
51. How has your professional network changed through participating in this program? (Mark all that apply.)
□
□
□
□
Increased the number of professionals working to
address human trafficking
Increased the number professionals with similar
professional goals
Met professionals who are in my geographical
area
Met professionals that I could collaborate with in
future endeavors
□
□
□
□
□
Met professionals that I could develop a meaningful
working relationship with
Met professionals that I could develop a close
friendship with
Met professionals who are acquaintances or knows
some of my other colleagues
Met professionals that have skill-sets that are
complementary to mine
Other (please specify): _________________
52. Do you anticipate doing any of the following as a result of participating in this program? (Mark all that apply.)
□
□
□
□
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
Develop/strengthen collaborative or strategic
relationships
Network with other participants
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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
Feedback
□
□
□
□
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): __________________
53. 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.)
□
□
□
□
□
□
□
□
□
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
Improve my own leadership or professional
development skills
□
□
□
□
□
□
□
Difficulty in establishing and/or maintaining a
multi-disciplinary team
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): _________________
54. Please list any other professional goals you have achieved through this program:
______________________________________________________________________________
_______________________________________________________________________________
55. What aspects of the HTLA were most helpful and why?
______________________________________________________________________________
______________________________________________________________________________
56. What else did you hope to achieve through participating in this program?
______________________________________________________________________________
______________________________________________________________________________
57. Overall, what are the program’s strengths?
______________________________________________________________________________
______________________________________________________________________________
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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
Feedback
58. What could be done differently to improve the program?
______________________________________________________________________________
______________________________________________________________________________
59. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
I am not associated with an organization
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
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
60. Which of the following best describes your professional capacity or types of services you provide? (Mark all that
apply.)
□
□
□
□
□
□
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):
______________________________
61. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
62. 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
63. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Administration
□ Management
□ Volunteer
□ Peer Educator
□ Other (please specify): _______________
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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
Feedback
64. 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?
1
2
3
4
Never
Occasionally
Frequently
All the Time
65. Which of the following best describes your geographic population? (Mark all that apply.)
□ National
□ Local
□ Not Applicable
□ Urban
□ State (please specify): ______________
□ Rural
□ Tribal
□ International (please specify country):
□ Suburban
_________________________________
66. Please select any of the following populations you currently work with in a professional capacity (Mark all that apply.)
□ Lesbian, gay, bisexual, transgender, and
□ Human trafficking
questioning
□ Commercial sexual exploitation of
□
Foreign nationals (migrant workers, undocumented
children
immigrants, refugees)
□ Sex trafficking
□ People with low incomes
□ Adults
□ Racial and ethnic minorities
□ Minors
□ American Indian or Alaska Native
□ Labor trafficking
□ Asian
□ Adults
□ Black or African American
□ Minors
□ Native Hawaii or other Pacific Islander
□ Children/youth
□ White
□ Out of home/Foster care/Kinship care
□ Hispanic or Latino ethnicity
□ Juvenile justice
□ History of substance use
□ Runaway/Homeless youth
□ Domestic and dating violence
□ People with disabilities
□ Gang-related crime
□ Deaf/Hearing impaired
□ Sexual abuse/Violence
□ Elderly
□ Other (Please specify): __________________
67. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
68. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
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 15 minutes. If you have comments regarding the accuracy of this estimate or additional
suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
HUMAN TRAFFICKING
LEADERSHIP ACADEMY
FELLOWSHIP POSTPROGRAM
OMB Control Number: 0970-0519
Expiration Date: 10/31/2021
Feedback
69. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
70. Do you have any other comments or suggestions?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Thank you for taking the time to complete this form and helping to improve NHTTAC’s 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 15 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [insert] or 9300 Lee Highway, Fairfax, VA 22031.
File Type | application/pdf |
Author | Field, Michael |
File Modified | 2019-11-01 |
File Created | 2019-11-01 |