Short-Term T/TA Feedback Form

NHTTAC Consultant and Evaluation Package

10 - Short Term TTA Feedback

Short-Term T/TA Feedback Form

OMB: 0970-0519

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0970-0519 can be found here:

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SHORT-TERM TRAINING
AND TECHNICAL
ASSISTANCE FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

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.
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)

T/TA: ___________________________________________________________________________________________
DATES(S):_____________________________________________________
FACILITATOR(S): ________________________________________________________________________________

Please indicate how well the technical assistance met each stated objective.

OVERALL OBJECTIVES

Poor

Fair

Good

Excellent

[Insert objective 1].

[Insert objective 2].

[Insert objective 3].

[Insert objective 4].

[Insert objective 5].

Please indicate the extent to which you agree or disagree with the following statements.

FACILITATOR 1: _______________________

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not Applicable

The facilitator’s knowledge and expertise of this
presenter were appropriate for this technical assistance.

The facilitator delivered the content of the technical
assistance effectively.

The facilitator responded well to questions and
comments.

The facilitator created a respectful environment for
participants.

10. The facilitator encouraged and initiated helpful
discussions.

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 NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.

SHORT-TERM TRAINING
AND TECHNICAL
ASSISTANCE FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

Form

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not Applicable

12. The facilitator delivered the content of the technical
assistance effectively.

13. The facilitator responded well to questions and
comments.

14. The facilitator created a respectful environment for
participants.

15. The facilitator encouraged and initiated helpful
discussions.

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not Applicable

16. The technical assistance addressed the critical issues
related to the topic(s).

17. The time allotted was adequate for the scope of
material.

18. The technical assistance was well organized and clear.

19. The technical assistance increased my knowledge
related to the topic(s).

20. The technical assistance was trauma-informed.

21. The technical assistance was survivor-informed.

22. The technical assistance was grounded in current
evidence-based or promising practices.

23. The technical assistance was grounded in a
multidisciplinary approach to addressing human
trafficking.

24. The technical assistance reflected a public health
approach to addressing human trafficking.

25. The technical assistance increased my practical skills
related to the topic(s).

26. This technical assistance met my educational needs.

27. This technical assistance met my professional needs.

28. I will be able to apply what I learned in my work.

29. The technical assistance improved my ability to serve
people who are currently being trafficked, at risk of
trafficking, or have been trafficked.

30. I will share what I learned with my colleagues.

FACILITATOR 2: _______________________
11. The facilitator’s knowledge and expertise of this

presenter were appropriate for this technical assistance.

OVERALL FEEDBACK

SHORT-TERM TRAINING
AND TECHNICAL
ASSISTANCE FEEDBACK
Form

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

Please select the number that best represents your rating of this technical assistance for each of the following questions.
31. How satisfied were you with your overall NHTTAC experience?
1

Very Dissatisfied

Dissatisfied

Satisfied

Very Satisfied

32. Please rate the overall quality of this technical assistance.
1

Poor

Fair

Good

Excellent

33. How well did this technical assistance meet your expectations?
1
Far Below My
Expectations

2
Did Not Meet My
Expectations

3
Met My
Expectations

4
Exceeded My
Expectations

34. How useful was the technical assistance information to your work?
1

Not Useful

Somewhat Useful

Useful

Very Useful

35. How prepared do you feel in implementing what you learned from this technical assistance in your daily work?
1
Not At All Prepared

2
Somewhat
Unprepared

Somewhat Prepared

Very Prepared

36. As a result of participating in this technical assistance, do you plan to do any of the following? (Mark all that apply.)
□ Change my management/leadership or
□ Develop/strengthen collaborative or strategic
interpersonal communication style
relationships
□ Further develop skills and knowledge about serving
□ Network with other participants
□ Share materials with colleagues
people who are currently being trafficked, at risk of
□ Provide information to clients/families/youth
trafficking, or have been trafficked
□ Write grants/fundraise/identify new funding
□ Train/educate others in content/skills learned
□ Raise public awareness/advocacy/outreach
resources
□ Advocate or meet with leadership of my
activities offered to people who are currently being
organization to develop/enhance vision, mission, or
trafficked, at risk of trafficking, or have been
strategic plan
trafficked
□ Advocate or meet with leadership of my
□ Refer colleagues to NHTTAC events/resources
□ Conduct research
organization to develop/enact policy changes at my
□ Strengthen evaluation or needs assessment
organization
□ Improve programs/practices
activities
□ Improve technology/websites/infrastructure
□ Improve identification and reporting methods for
□ Integrate victim-centered, survivor-informed
trafficking
□ Take additional training on human trafficking
strategies
□ Expand services or types of services
□ Other (please specify): __________________
□ Begin a new project or initiative
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 NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.

SHORT-TERM TRAINING
AND TECHNICAL
ASSISTANCE FEEDBACK
Form

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

37. 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
Lack of information sharing among organizations
Lack of time to implement changes

□
□
□
□
□
□
□

38. Would you recommend NHTTAC to others to receive T/TA?

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): _________________
□ Yes

□ No

39. Please list any professional goals you have achieved through this T/TA.

____________________________________________________________________________________
____________________________________________________________________________________
40. How will this assistance help your agency in responding to human trafficking?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
41. What aspects of the assistance were most helpful and why?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
42. What could NHTTAC do differently to improve similar T/TA requests in the future?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
43. Do you have any other comments or suggestions?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

SHORT-TERM TRAINING
AND TECHNICAL
ASSISTANCE FEEDBACK
Form

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

44. Which of the following best describes the organization in which you work? (Mark all that apply.)

□
□
□
□
□
□
□
□

□
□
□
□
□
□
□

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): _____________________

45. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes

□ No

46. 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):
____________________________

47. 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

48. 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

49. In your professional capacity, how frequently do you come into contact with a person who is currently being trafficked, at
risk of being trafficked, or has been trafficked?
1

Never

Occasionally

Frequently

Daily

SHORT-TERM TRAINING
AND TECHNICAL
ASSISTANCE FEEDBACK
Form

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

50. 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

51. Please select any of the following populations you currently work with in a professional capacity (Mark all that apply.)

□

□
□
□
□

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

□
□
□
□

□
□
□
□
□

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): __________________

52. 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): _______________________________________

53. What is your ethnicity? (Mark all that apply.)




Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________

54. What is your gender? (Mark all that apply.)





Male
Female
Transgender
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 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