Follow-up Feedback Form

FOLLOW-UP
FEEDBACK
Form

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

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 to learn about your experiences since receiving training and technical assistance (T/TA)
[insert time frame] ago. 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.
T/TA
DATE(S):

Please provide the information below to create an anonymous ID:

____________

____________

______________

Birth Month

First letter of first name

First letter of your middle name

(insert just the month

(example: S for Sara)

(example: M for Maria)

for your date of birth:
08 for August)
Please indicate the extent to which you agree or disagree with the following statements:

As a result of [insert T/TA], I have…
1.
2.
3.
4.
5.
6.

Strongly Disagree

Disagree

Agree

Strongly Agree

1
1
1
1
1

2
2
2
2
2

3
3
3
3
3

4
4
4
4
4

As a result of participating in [insert T/TA], have you done any of the following? (Mark all that apply.)
Changed my management/leadership or
interpersonal communication style
Further developed skills and knowledge about
serving victims of trafficking
Wrote grants/fundraised/identified new funding
resources
Advocated or met with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocated or met with leadership of my
organization to develop/enact policy changes at my
organization
Improved programs/practices
Improved technology/websites/infrastructure

Integrated victim-centered, survivor-informed
strategies
Expanded services or types of services
Began a new project or initiative
Developed/strengthened collaborative or strategic
relationships
Networked with other participants
Shared materials with colleagues
Provided information to clients/families/youth
Trained/educated others in content/skills learned
Raised public awareness/advocacy/outreach
activities offered to victims
Referred colleagues to NHTTAC events/resources
Conducted research

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 8 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

FOLLOW-UP
FEEDBACK

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

Form

Strengthened evaluation or needs assessment
activities
Improved identification and reporting methods for
trafficking
7.

Took additional training on human trafficking
Other (please specify): __________________

Since [insert T/TA], what barriers have you faced in implementing change? (Mark all that apply.)
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Difficulty in establishing and/or maintaining a
multidisciplinary team
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of training for staff in how to implement
change
Other (please explain): _________________

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

Please indicate the extent to which you have used the following in your daily work
Never

Occasionally

Frequently

Daily

8.

1

2

3

4

9.

1

2

3

4

10.

1

2

3

4

11.

1

2

3

4

12.

1

2

3

4

13.

1

2

3

4

14.

1

2

3

4

15.

1

2

3

4

16.

1

2

3

4

17. Was there anything not provided during [insert T/TA] that would have been helpful in implementing change?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________

18. What aspect(s) of [insert T/TA] were most helpful to you?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________

19. Would you recommend [NHTTAC][SOAR] T/TA to others?

□

Yes

□ No

20. Do you have any additional comments or suggestions for future [NHTTAC][SOAR]-related T/TA?
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 8 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.

FOLLOW-UP
FEEDBACK

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

Form

_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
21. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
22. In your professional capacity, how frequently do you come into contact with a person who is being trafficked, at risk
of being trafficked, or has been trafficked?

1

2

3

4

Never

Occasionally

Frequently

Daily

Thank you for taking the time to complete this form and helping to improve [NHTTAC][SOAR] 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 8 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.