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pdfOMB No.: 0970-0354
Expiration Date: 10/31/2021
Staff Survey – Home Visitor
Draft for OMB
February 2020
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. 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 number
and expiration date for this collection are OMB #: 0970-0354, Exp: 10/31/2021.
INTRODUCTION
Thank you for taking the time to let us speak with you today. This survey is part of the Baby
FACES study. We obtained permission from the director of your program to talk with you about
your experiences in Early Head Start. We appreciate your time and effort in completing this
survey.
This collection of information will be used to describe the characteristics of children and families
served by Early Head Start, and the characteristics and features of programs and staff that serve
them. Your participation in the study is voluntary. Please be assured that all information you
provide will be kept private to the extent permitted by law. The questions I will be asking today
have been approved by the Federal Office of Management and Budget, also known as OMB. We
are only allowed to ask you these questions and you can only answer them if there is a valid OMB
control number. For the questions asked as part of today’s discussion, the OMB control number
is 0970-0354 and it expires on 10/31/2021.
The survey will take about 30 minutes to complete.
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1
OMB DRAFT
SECTION B. STAFF DEVELOPMENT AND SUPERVISION
The first questions are about the supervision, coaching, and training provided by your program.
First, I’d like to ask you a few questions about your supervisor.
Source: Adapted from Baby FACES 2009
B1.
Does your supervisor use an individual career or professional development plan to
provide you with professional development and training?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T HAVE A PROFESSIONAL DEVELOPMENT PLAN ................................. 2
DON’T KNOW/REFUSED ..................................................................................... d
Source: Adapted from Baby FACES 2009
B3.
Do you have one-on-one supervision meetings, group supervision meetings, or both?
CODE ONE ONLY
ONE-ON-ONE SUPERVISION ............................................................................. 1
GROUP SUPERVISION ....................................................................................... 2 GO TO B5
BOTH .................................................................................................................... 3
NONE .................................................................................................................... 0 GO TO B6
DON’T KNOW/REFUSED ..................................................................................... d GO TO B6
IF ONE-ON-ONE SUPERVISION OR BOTH (B3=1 OR B3=3), ASK:
Source: Adapted from Baby FACES 2018
B4.
How many times a year do you typically have one-on-one supervision meetings?
|
|
|
| TIMES PER YEAR
DON’T KNOW/REFUSED .................................................................................. d
IF GROUP SUPERVISION OR BOTH (B3=2 OR B3=3), ASK:
Source: Adapted from Baby FACES 2018
B5.
How many times a year do you typically have group supervision meetings?
|
|
|
| TIMES PER YEAR
DON’T KNOW/REFUSED .......................................................................................... d
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OMB DRAFT
IF ANY SUPERVISION OR BOTH (B3=1,2 OR B3=3), ASK:
Source: New Item
B5c.
Does your supervisor conduct formal performance reviews with you?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
IF B5C=1, ASK:
Source: New Item
B5d.
How many times a year does your supervisor conduct a formal performance review with
you?
|
|
|
| TIMES PER YEAR
DON’T KNOW/REFUSED ............................................................................. d
Source: Adapted from Baby FACES 2018
B6.
These next questions are about coaching. Some people may think of this as mentoring. A
coach is a person, usually someone other than your supervisor, who has expertise in
specific areas and provides ongoing professional development, performance feedback,
and works with staff to improve practice.
Please tell me which of the following statements is the most applicable to you.
CODE ONE ONLY
I have a coach who is different from my supervisor ............................................. 1
My coach is also my supervisor ............................................................................ 2 GO TO B9.1
I don’t have a coach .............................................................................................. 0 GO TO B9.1
DON’T KNOW/REFUSED ..................................................................................... d GO TO B9.1
IF RESPONDENT HAS COACH (B6=1), ASK:
Source: Adapted from Baby FACES 2018
B6a.
Is your coach a person whose sole job is coaching (that is, not consultants or staff whose
primary role is as a home visitor, manager, or director)?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW/REFUSED ..................................................................................... d
IF RESPONDENT HAS COACH (B6=1), ASK:
Source: Adapted from Baby FACES 2018
B7.
How many times a year do you typically meet with your coach?
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|
|
|
TIMES PER YEAR
DON’T KNOW/REFUSED .................................................................................. d
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OMB DRAFT
ASK BASED ON RESPONSES TO B6 (IF NO COACH, IF COACH AND SUPERVISOR ARE SAME, OR
DON’T KNOW/REFUSED)
Source: Adapted from Baby FACES 2018
B9.1
Supervisors have different approaches or ways of supporting home visitors in improving
their practice. Please tell me whether your supervisor uses each of the following methods
when working with you.
DON’T KNOW/
YES
NO
REFUSED
1
0
d
1
0
d
1
0
d
d. Have you observe another home
visitor (live or video)?
1
0
d
e. Model good home visiting
practices?
1
0
d
1
0
d
g. Provide trainings to you?
1
0
d
h. Review child assessment data
with you?
1
0
d
Provide materials or resources to
you?
1
0
d
Help you set goals or make plans
to improve your practice?
1
0
d
Make themselves available or
check in with you?
1
0
d
Assist you with specific needs or
challenges?
1
0
d
1
0
d
a. Discuss what they observe during
home visits?
b. Provide written feedback on what
they observe during home visits?
c.
f.
i.
j.
k.
l.
Have you watch a video tape of
yourself conducting a home visit?
Suggest trainings for you to attend
or certifications for you to obtain?
m. Help you think about your own
practice and problem-solve to
address challenges?
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OMB DRAFT
ASK BASED ON RESPONSES TO B6 (IF THEY HAVE A COACH WHO IS DIFFERENT FROM THEIR
SUPERVISOR)
Source: Adapted from Baby FACES 2018
B9.2
Coaches and supervisors have different approaches or ways of supporting home visitors
in improving their practice. For each method used, please tell me who uses the approach:
your coach, your supervisor, both, or neither. Does your coach or supervisor…
PROBE: THE FIRST TIME RESPONDENT SAYS NO, PLEASE CONFIRM THAT NEITHER
COACH NOR SUPERVISOR DO THIS.
CODE ONE PER ROW
DON’T KNOW/
COACH
SUPERVISOR
BOTH
NEITHER
REFUSED
a. Discuss what they observe
during home visits?
1
2
3
0
d
b. Provide written feedback on
what they observe during
home visits?
1
2
3
0
d
1
2
3
0
d
d. Have you observe another
home visitor (live or video)?
1
2
3
0
d
e. Model good home visiting
practices?
1
2
3
0
d
1
2
3
0
d
g. Provide trainings to you?
1
2
3
0
d
h. Review child assessment
data with you?
1
2
3
0
d
Provide materials or
resources to you?
1
2
3
0
d
Help you set goals or make
plans to improve your
practice?
1
2
3
0
d
Make themselves available
or check in with you?
1
2
3
0
d
Assist you with specific
needs or challenges?
1
2
3
0
d
1
2
3
0
d
c.
f.
i.
j.
k.
l.
Have you watch a video
tape of yourself conducting a
home visit?
Suggest trainings for you to
attend or certifications for
you to obtain?
m. Help you reflect on your own
practice and problem-solve
to address challenges?
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5
OMB DRAFT
INSTRUCT RESPONDENT TO CONSULT SHOW CARD (purple)
Source: Adapted from Baby FACES 2018
B13.
Next, I’d like to ask you about trainings that you may have received from this program
since September.
This can include one-on-one training, training received through workshops, or training
you may have completed online. This can also include on-site or off-site training. For each
topic, please tell me whether or not you received the training since September. Then,
please indicate the usefulness of the training received. Since September, did you receive
training aimed at…
CODE ONE PER ROW
A
Since
September,
did you
receive
training
aimed at…
B
[Ask only if A= YES] How useful was this training? Was it…
YES
NO
VERY
USEFUL
SOMEWHAT
USEFUL
NOT TOO
USEFUL
NOT AT ALL
USEFUL
1
0
4
3
2
1
Supporting positive home visitor-family
interactions?
1
0
4
3
2
1
e. Engaging parents and families in program
activities and in children’s learning?
1
0
4
3
2
1
General communication skills and strategies
(for example, showing empathy, interest,
and responsiveness)?
1
0
4
3
2
1
Supporting children who are dual language
learners and their families?
1
0
4
3
2
1
m. Culturally responsive strategies and working
with diverse families?
1
0
4
3
2
1
h. Understanding the ways in which parents
learn (for example, learning through handson experiences and feedback)?
1
0
4
3
2
1
q. Helping parents use available materials and
resources to support children’s learning and
development?
1
0
4
3
2
1
b. Supporting positive parent-child
relationships?
c.
l.
f.
Turning next to curricula and assessments...
Source: Adapted from Baby FACES 2009
B15.
Do you use any specific curriculum for your home visiting services?
YES, SPECIFIC CURRICULUM ........................................................................... 1
YES, COMBINATION ............................................................................................ 2
NO ......................................................................................................................... 0 GO TO B18a
DON’T KNOW/REFUSED ..................................................................................... d GO TO B18a
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OMB DRAFT
INTERVIEWER: INSTRUCT RESPONDENT TO CONSULT SHOW CARD (white)
IF HOME VISITOR USES SPECIFIC CURRICULUM OR A COMBINATION OF CURRICULA (B15=1
OR 2), HAND SHOW CARD AND ASK:
Source: Adapted from Baby FACES 2018
B16.
What curricula or curriculum do you use in your home visiting services? Please just tell
me the name or names. CODE ALL THAT APPLY IN COLUMN A
IF MORE THAN ONE MENTIONED, ASK: Which of these that you mentioned do you
consider the main curriculum? CODE ONE ONLY IN COLUMN B
CODE ALL THAT
APPLY
CODE ONE
ONLY
A.
CURRICULA
USED
B.
MAIN
CURRICULUM
a. AGENCY-CREATED CURRICULUM
1
1
c.
33
33
d. BEAUTIFUL BEGINNINGS
3
3
e. CONSCIOUS DISCIPLINE (BABY DOLL CIRCLE TIME)
30
30
4
4
h. GROWING GREAT KIDS
9
9
i.
HAWAII EARLY LEARNING PROFILE (HELP)
10
10
k.
LEARNING ACTIVITIES FOR INFANTS (MAGDA GERBER,
RIE)
14
14
l.
ONES AND TWOS (Parenting: The First Three Years
curriculum)
15
15
m. PARENTS AS TEACHERS (PAT)
16
16
n. PARTNERS FOR A HEALTHY BABY
21
21
o. PARTNERS IN PARENTING EDUCATION (PIPE)
23
23
s.
28
28
f.
BABY TALK
CREATIVE CURRICULUM LEARNING GAMES/TEACHING
STRATEGIES
OTHER (SPECIFY)
NO MAIN
CURRICULUM
t.
DON’T
KNOW/REFUSED
u.
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DON’T
KNOW/REFUSED
OMB DRAFT
IF HOME VISITOR USES SPECIFIC CURRICULUM OR A COMBINATION OF CURRICULA (B15=1
OR 2), ASK
Source: Adapted from FACES 2014 teacher survey
B16a. In the past year, have you or anyone else used a tool or checklist to assess how you use
the curriculum? Which of the following describes how you have used the tool or
checklist? Using a tool or checklist to assess how you use the curriculum is sometimes
called fidelity of implementation.
INTERVIEWER: OPTION 3 CAN NEVER BE USED IN CONJUNCTION WITH ANY OTHER
OPTION
CODE ALL THAT APPLY
I completed a tool or checklist about how I use the curriculum ............................ 1
Someone else completed a tool or checklist about how I use the curriculum ...... 2
Neither me nor anyone else used a tool or checklist to assess how I use the
curriculum .............................................................................................................. 3
DON’T KNOW/REFUSED ..................................................................................... d
IF HOME VISITOR USES SPECIFIC CURRICULUM OR A COMBINATION OF CURRICULA (B15=1
OR 2), ASK
Source: FACES 2014 teacher survey
B16b. Which types of support have you received to help you use the main curriculum? Have you
received…
CODE ONE PER ROW
YES
NO
DON’T
KNOW/
REFUSED
a. Help understanding the curriculum?
1
0
d
b. Opportunities to observe someone implementing the curriculum?
1
0
d
c.
1
0
d
d. Help implementing the curriculum?
1
0
d
e. Help planning curriculum-based activities?
1
0
d
f.
1
0
d
h. Help identifying and/or receiving additional resources to expand the
scope of the curriculum and activities?
1
0
d
i.
Help implementing the curriculum for children with special needs?
1
0
d
j.
Feedback on implementing the curriculum?
1
0
d
k.
Feedback about the results of a checklist about how you use the
curriculum?
1
0
d
Refresher training on the curriculum?
Help individualizing or tailoring the curriculum for families?
IF HOME VISITOR USES SPECIFIC CURRICULUM OR A COMBINATION OF CURRICULA (B15=1
OR 2), ASK
Source: New Item
B17a. Do you individualize the main curriculum for families that you work with?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
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OMB DRAFT
DON’T KNOW/REFUSED ..................................................................................... d
ASK IF B17A=1
Source: New Item
B17b. What are the tools or resources that you use to individualize the main curriculum for
families that you work with?
CODE ONE PER ROW
YES
NO
DON’T
KNOW/
REFUSED
a. Child assessment data
1
0
d
b. Data related to family needs
1
0
d
c.
Classroom observation data
1
0
d
d.
Parent input
1
0
d
1
0
d
e. Curriculum developer’s guidance on individualizing the curriculum
Source: New Item
B18a. How do you involve parents when planning home visits? Do you…
CODE ONE PER ROW
YES
NO
DON’T
KNOW/
REFUSED
a. Review what happened during the last visit?
1
0
d
b. Ask for parental input during the home visit?
1
0
d
1
0
d
d. Discuss what parents will work on prior to the next visit?
1
0
d
e. Leave a copy of the home visit plan with parents?
1
0
d
c.
Discuss what topics and activities they would like to cover in the next
visit?
My next questions are about child assessments.
Source: Adapted from Baby FACES 2009 Program Director Survey
B19.
Since September, have you used any assessments to gather information on children’s
development or progress?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
NOT APPLICABLE- HV ONLY SEES PREGNANT WOMEN .............................. n
DON’T KNOW/REFUSED ..................................................................................... d
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9
OMB DRAFT
INTERVIEWER: INSTRUCT RESPONDENT TO CONSULT SHOW CARD (yellow)
IF CHILD ASSESSMENT TOOLS USED (B19=1), HAND SHOW CARD AND ASK:
Source: Adapted from Baby FACES 2009 Program Director Survey
B21.
What child assessments and/or screeners have you used since September this year?
INTERVIEWER PROBE: Any others?
CHILD SCREENERS AND ASSESSMENTS:
CODE ALL THAT
APPLY
SCREENERS
ASSESSMENT USED
a. AGENCY-CREATED SCREENING ASSESSMENT
1
b. AGES AND STAGES QUESTIONNAIRE (ASQ)
2
y.
25
ASQ: SOCIAL-EMOTIONAL
aa. BRIEF INFANT TODDLER SOCIAL EMOTIONAL ASSESSMENT
(BITSEA)
26
bb. BRIGANCE SCREENER
24
h. DENVER DEVELOPMENTAL SCREENING TEST
8
ASSESSMENTS
cc. BRIGANCE ASSESSMENT
f
29
CREATIVE CURRICULUM TOOLS (MAY ALSO BE KNOWN AS
TEACHING STRATEGIES GOLD)
6
g. DESIRED RESULTS DEVELOPMENTAL PROFILES-R (DRDP)
7
i.
DEVEREUX EARLY CHILDHOOD ASSESSMENT (DECA)
9
j.
EARLY LEARNING ACCOMPLISHMENT PROFILE
10
m. HIGH SCOPE CHILD OBSERVATION RECORD (COR)
13
n. INFANT-TODDLER DEVELOPMENTAL ASSESSMENT (IDA)
14
o. INFANT TODDLER SOCIAL EMOTIONAL ASSESSMENT (ITSEA)
15
p. OTHER (SPECIFY)
22
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OMB DRAFT
IF CHILD ASSESSMENT TOOLS USED (B19=1), ASK:
Source: Baby FACES 2018
B26.
Please tell me whether you feel each of the following are challenges to using child
assessment data or data used to understand family needs to plan and provide services for
individual families.
[READ ITEM]… Would you say this is a challenge or not a challenge?
CODE ONE PER ROW
YES, THIS IS
A
CHALLENGE
NO, THIS IS
NOT A
CHALLENGE
DON’T
KNOW/REFUSED
a. Not having the technology I need to collect and work
with data?
1
2
d
b. Not having enough time to collect the data I need?
1
2
d
1
2
d
d. Not knowing how I can use data to individualize or
improve the strategies I use with families?
1
2
d
e. Lack of understanding of what the data mean?
1
2
d
1
2
d
c.
f.
Not knowing how to accurately collect child
assessment data or data to understand family needs?
Not having child assessment tools that are well
adapted for home visiting settings?
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OMB DRAFT
SECTION C: ORGANIZATIONAL CLIMATE
This next section is about your work environment and the people you work with.
Source: Adapted from TCU- Survey of Organizational Functioning
C1.
INTERVIEWER: INSTRUCT RESPONDENT TO CONSULT SHOW CARD (green)
Please tell me the extent to which you disagree or agree with the following statements
about your Early Head Start program. For each statement, please tell me whether you
strongly disagree, disagree, neither disagree nor agree, agree, or strongly agree.[READ
FIRST ITEM] How strongly do you disagree or agree with this statement? What
about…[CONTINUE WITH REST OF LIST]?
CODE ONE PER ROW
DISAGREE
NEITHER
DISAGREE
NOR AGREE
AGREE
STRONGLY
AGREE
DON’T
KNOW/
REFUSED
1
2
3
4
5
d
1
2
3
4
5
d
The staff in this program always work
together as a team.
1
2
3
4
5
d
d. Staff in this program are always quick to
help one another when needed.
1
2
3
4
5
d
e. Mutual trust and cooperation among
staff in this program are strong.
1
2
3
4
5
d
Everybody in this program does their
fair share of work.
1
2
3
4
5
d
g. Ideas and suggestions from staff get fair
consideration by program management.
1
2
3
4
5
d
h. The formal and informal communication
channels in this program work very well.
1
2
3
4
5
d
STRONGLY
DISAGREE
a. Staff in this program get along very well.
b. There is too much friction among staff
members.
c.
f.
i.
Program staff are always kept well
informed.
1
2
3
4
5
d
i.
More open discussions about program
issues are needed in this program.
1
2
3
4
5
d
k.
Staff members always feel free to ask
questions and express concerns in this
program.
1
2
3
4
5
d
You are under too many pressures to
do your job effectively.
1
2
3
4
5
d
m. Staff members often show signs of
stress and strain.
1
2
3
4
5
d
n. The heavy workload in this program
reduces program effectiveness.
1
2
3
4
5
d
o. Staff frustration is common in this
program.
1
2
3
4
5
d
p.
1
2
3
4
5
d
l.
You are satisfied with your present job.
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12
OMB DRAFT
CODE ONE PER ROW
DISAGREE
NEITHER
DISAGREE
NOR AGREE
AGREE
STRONGLY
AGREE
DON’T
KNOW/
REFUSED
1
2
3
4
5
d
You like the people you work with.
1
2
3
4
5
d
s.
You give high value to the work you do
in this program.
1
2
3
4
5
d
t.
You are proud to tell others where you
work.
1
2
3
4
5
d
1
2
3
4
5
d
STRONGLY
DISAGREE
q. You feel appreciated for the job you do.
r.
u. You would like to find a job somewhere
else.
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13
OMB DRAFT
Source: Adapted from Organizational Climate Description for Elementary Schools (OCDQ-RE)
C2.
INTERVIEWER: INSTRUCT RESPONDENT TO CONSULT SHOW CARD (pink)
Next, I would like to ask your opinion about your program director and how often he or she
interacts with you and other home visitors at this program. Please tell me how often the
following occurs in your program. For each statement, please tell me whether this occurs
rarely, sometimes, often, or very frequently. [READ FIRST ITEM]. How frequently does this
occur? What about…[CONTINUE WITH THE REST OF THE LIST]?
CODE ONE PER ROW
DON’T
KNOW/
REFUSED
RARELY
SOMETIMES
OFTEN
VERY
FREQUENTLY
a. The program director goes out of his/her
way to help home visitors.
1
2
3
4
d
b. The program director uses constructive
criticism.
1
2
3
4
d
c.
1
2
3
4
d
d. The program director listens to and
accepts home visitors’ suggestions.
1
2
3
4
d
e. The program director looks out for the
personal welfare of home visitors.
1
2
3
4
d
f.
The program director treats home visitors
as equals.
1
2
3
4
d
g. The program director compliments home
visitors.
1
2
3
4
d
h. The program director is easy to
understand.
1
2
3
4
d
i.
1
2
3
4
d
The program director explains his/her
reasons for criticism to home visitors.
The program director goes out of his/her
way to show appreciation to home visitors.
Source: Baby FACES 2018
C3.
Thinking about your safety when going into the homes of your clients, how often do you
feel unsafe when conducting home visits? Would you say…
CODE ONE ONLY
All or almost all of the time, ................................................................................... 1
Most of the time, .................................................................................................... 2
Some of the time, .................................................................................................. 3
Hardly ever, or ....................................................................................................... 4
Never? ................................................................................................................... 5
DON’T KNOW/REFUSED ..................................................................................... d
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OMB DRAFT
SECTION D: LANGUAGE
Next, we are going to talk about the languages you speak.
Source: Baby FACES 2018
D1.
What is your primary language? This is the language that you feel most comfortable
communicating in.
CODE ONE ONLY
ENGLISH .............................................................................................................. 1
SPANISH .............................................................................................................. 2
OTHER (SPECIFY) .............................................................................................. 3
____________________________________________________________
DON’T KNOW/REFUSED ..................................................................................... d
Source: Adapted from Baby FACES 2009
D2.
Do you speak any language other than [PRIMARY LANGUAGE FROM D1]?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0 GO TO F1
DON’T KNOW/REFUSED ..................................................................................... d GO TO F1
D2=1
Source: Adapted from Baby FACES 2009
D3.
What languages?
PROBE: Any other languages?
CIRCLE ALL THAT APPLY
SPANISH .............................................................................................................. 1
ENGLISH .............................................................................................................. 2
OTHER (SPECIFY) ............................................................................................... 3
____________________________________________________________
OTHER (SPECIFY) ............................................................................................... 4
____________________________________________________________
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OMB DRAFT
SECTION F. DEMOGRAPHICS
These last questions are about your background.
Source: OMB Guidance
F1.
Are you of Hispanic, Latino/a, or Spanish origin? You may choose one or more.
IF THEY SAY ‘YES’ WITHOUT ELABORATING, ASK: Are you… READ ALL YES CHOICES
BELOW (THEY MAY SAY MORE THAN ONE)
CODE ALL THAT APPLY
NO, NOT OF HISPANIC, LATINA/O OR SPANISH ORIGIN ............................... 1
(YES) Mexican, Mexican American, Chicano/a .................................................... 2
(YES), Puerto Rican .............................................................................................. 3
(YES), Cuban ........................................................................................................ 4
(YES), Another Hispanic, Latino/a, or Spanish origin ........................................... 5
DON’T KNOW/REFUSED ..................................................................................... d
Source: OMB Guidance
F2.
What is your race? You may choose one or more. Is it…
CODE ALL THAT APPLY
White ..................................................................................................................... 1
Black or African American ..................................................................................... 2
American Indian or Alaska Native ......................................................................... 3
Asian ..................................................................................................................... 4
Native Hawaiian or Other Pacific Islander ............................................................ 5
DON’T KNOW/REFUSED ..................................................................................... d
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Source: Adapted from Baby FACES 2009
F3.
What is the highest level of school you have completed?
If you are still in school or no longer in school, please tell us about the last year of
schooling you finished.
CODE ONE ONLY
LESS THAN A HIGH SCHOOL DIPLOMA ........................................................... 1
GO TO F4
HIGH SCHOOL DIPLOMA OR EQUIVALENT ..................................................... 2
GO TO F4
SOME VOCATIONAL/TECHNICAL SCHOOL, BUT NO DIPLOMA .................... 3
GO TO F4
VOCATIONAL/TECHNICAL DIPLOMA ................................................................ 4
GO TO F4
SOME COLLEGE COURSES, BUT NO DEGREE ............................................... 5
GO TO F4
ASSOCIATE’S DEGREE ...................................................................................... 6
GO TO F4B
BACHELOR’S DEGREE ....................................................................................... 7
GO TO F4B
GRADUATE OR PROFESSIONAL SCHOOL, BUT NO DEGREE ...................... 8
GO TO F4B
MASTER’S DEGREE (M.A., M.S.) ....................................................................... 9
GO TO F4B
DOCTORATE DEGREE (PH.D., ED.D.) ............................................................... 10
GO TO F4B
PROFESSIONAL DEGREE AFTER BACHELOR’S DEGREE
(MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.) ................................... 11
GO TO F4B
DON’T KNOW/REFUSED ..................................................................................... d
ASK FOR RESPONDENTS WHO REPORTED HAVING LESS THAN AN ASSOCIATE’S DEGREE IN
F3
Source: Adapted from Baby FACES 2009
F4.
Do you have either of the following credentials or certificates?
CODE ONE PER ROW
YES, I
HAVE IT
NO, I
DON’T
HAVE IT
DON’T
KNOW/
REFUSED
a. An Infant/Toddler Child Development Associate (CDA)
credential
1
0
d
h. Some other kind of CDA credential or state awarded
certificate/license
1
0
d
ASK FOR RESPONDENTS WHO REPORTED HAVING LESS THAN AN ASSOCIATE’S DEGREE IN
F3
Source: Adapted from Baby FACES 2018
F4.1.
Are you currently working toward an associate’s or a bachelor’s degree?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW/REFUSED ..................................................................................... d
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ASK FOR RESPONDENTS WHO REPORTED HAVING AN ASSOCIATE’S DEGREE OR HIGHER IN
F3
Source: Adapted from Baby FACES 2018
F4.2.
Is your degree in Early Childhood Education or a related field?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW/REFUSED ..................................................................................... d
ASK FOR RESPONDENTS WHO REPORTED HAVING AN ASSOCIATE’S DEGREE OR HIGHER IN
F3
Source: Adapted from Baby FACES 2018
F4a.
Did your degree or graduate work include the study of or a focus on prenatal or
infant/toddler development?
YES ....................................................................................................................... 1
NO ......................................................................................................................... 0
DON’T KNOW/REFUSED ..................................................................................... d
Source: Adapted from Baby FACES 2018
F5.
How many years have you worked as a home visitor serving families with infants and
toddlers?
IF LESS THAN ONE YEAR, WRITE 0. ROUND TO WHOLE NUMBERS
|
|
| NUMBER OF YEARS
DON’T KNOW/REFUSED ..................................................................................... d
Source: Adapted from Baby FACES 2009
F6.
In total, how many years have you been working in Early Head Start?
IF LESS THAN ONE YEAR, WRITE 0. ROUND TO WHOLE NUMBERS
|
|
| NUMBER OF YEARS
DON’T KNOW/REFUSED ..................................................................................... d
Source: Adapted from Baby FACES 2018 Center Director survey
F6b.
How many years have you been working with this program?
IF LESS THAN ONE YEAR, WRITE 0. ROUND TO WHOLE NUMBERS
|
|
| NUMBER OF YEARS
DON’T KNOW/REFUSED ..................................................................................... d
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Source: Adapted from Baby FACES 2009
F7.
Are you male or female?
CODE ONE ONLY
MALE..................................................................................................................... 1
FEMALE ................................................................................................................ 2
OTHER .................................................................................................................. 3
DON’T KNOW/REFUSED ..................................................................................... d
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SECTION E: HEALTH
We are almost done. Now I am going to hand you a page of questions for you to complete on your
own. Once you have completed it, please place the survey in this envelope and seal it before
returning it to me. Please be assured that your responses to these questions will be kept private.
HAND RESPONDENT PAGE OF QUESTIONS AND ENVELOPE.
Thank you very much for your participation and cooperation in this
important study.
INTERVIEWER, PLEASE INDICATE TODAY’S DATE:
|
|
MONTH
|/|
|
DAY
Prepared by Mathematica Policy Research
|/|
|
|
|
|
YEAR
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Source: The Center for Epidemiologic Studies Depression Scale Revised (CESD-R)
E1.
For each statement below, please indicate how often you have felt this way in the past
week or so by circling your response. Please circle only one response for each statement.
CIRCLE ONE PER ROW
LAST WEEK
5-7
DAYS
NEARLY
EVERY
DAY FOR
2 WEEKS
DON’T
KNOW
2
3
4
d
1
2
3
4
d
0
1
2
3
4
d
d. I felt depressed ...........................................................
0
1
2
3
4
d
e. My sleep was restless ................................................
0
1
2
3
4
d
f.
I felt sad ......................................................................
0
1
2
3
4
d
g. I could not get going ...................................................
0
1
2
3
4
d
h. Nothing made me happy ............................................
0
1
2
3
4
d
i.
I felt like a bad person ................................................
0
1
2
3
4
d
j.
I lost interest in my usual activities .............................
0
1
2
3
4
d
k.
I slept much more than usual .....................................
0
1
2
3
4
d
l.
I felt like I was moving too slowly ...............................
0
1
2
3
4
d
m. I felt fidgety .................................................................
0
1
2
3
4
d
n. I wished I were dead...................................................
0
1
2
3
4
d
o. I wanted to hurt myself ...............................................
0
1
2
3
4
d
p. I was tired all the time .................................................
0
1
2
3
4
d
q. I did not like myself .....................................................
0
1
2
3
4
d
r.
I lost a lot of weight without trying to ..........................
0
1
2
3
4
d
s.
I had a lot of trouble getting to sleep ..........................
0
1
2
3
4
d
t.
I could not focus on important things ..........................
0
1
2
3
4
d
NOT AT ALL
OR LESS
THAN 1 DAY
1-2
DAYS
3-4
DAYS
a. My appetite was poor .................................................
0
1
b. I could not shake off the blues ....................................
0
c.
I had trouble keeping my mind on what I was doing ..
PLEASE PLACE THIS IN ENVELOPE AND RETURN TO INTERVIEWER.
INSERT LABEL HERE
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| File Type | application/pdf |
| File Title | Baby FACES Home Visitor Interview |
| Subject | CATI - client-friendly |
| Author | MATHEMATICA |
| File Modified | 2020-02-21 |
| File Created | 2020-02-21 |