Fathers and Continuous Learning in Child Welfare Project

Instrument 13: Implementation Assessment

A Breakthrough Series Collaborative for

The purpose of this survey is to understand the extent to which improvement team members have engaged in BSC activities. The Fathers and Continuous Learning in Child Welfare (FCL) project team will use this information to determine (1) the extent of BSC participation among improvement team members and (2) the spread of BSC practices to others within the participating programs.

It will provide information about BSC participants’ experiences that could be important for full engagement in the BSC. It will be administered twice throughout the BSC.

The average estimated public reporting burden for this collection of information is about 20 minutes per response. Providing this information is voluntary, and all responses that are collected are private to the extent permitted by law.

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 for this information collection is 0970-0531 and the expiration date is 07/31/2022.

Engaging Fathers and Paternal Relatives in Child Welfare

Implementation of Improvement Strategies for Engaging Fathers and Paternal Relatives in Child Welfare

Purpose: The information you provide in this survey will assess your personal experiences with the BSC. Data collected from this survey will provide an understanding of how you and your agency engage with fathers and paternal relatives. The answers will be aggregated to ensure you remain anonymous in any reports. Thank you for taking the time to candidly and thoughtfully share your experience with us.

A. Background information (demographics)

1. Sex

• Male

• Female

2. What is the highest educational level you have completed?

   • High school or GED

   • Some college

   • Associate's degree (A.A.)

   • Bachelor's degree (B.A. or B.S.)

   • Some graduate work

   • Master's degree (M.A. or M.S.)

   • Postgraduate, post-master's work (no doctorate)

   • Doctorate (Ed.D or Ph.D.)

   • Other __________________

3. What is your ethnicity?

• Hispanic or Latino

• Non- Hispanic or Latino

4. What is your race? (Select one or more)

• Black or African American

• White

• Asian

• American Indian or Alaska Native

• Native Hawaiian or other Pacific Islander

5. Do you currently work in a child welfare agency or other system agency that engages with fathers and paternal relatives? (If no, skip questions 6-8)

   • Yes

   • No

6. Select the job title that best describes your current role in the agency or organization.

• Caseworker/case manager

• Case aide

• Supervisor

• Program director

• Agency director

• Staff in a special program (parent support or reunification services)

• Community partner

  1. Description ______________

• Other

  1. Description _________________

7. How long have you worked in your current position?

____ Years _____ Months

8. How long have you been actively promoting the engagement of fathers and other paternal relatives in this or any other professional role?

____ Years _____ Months

B. Individual assessment

The following are statements about your individual experiences with Engaging Fathers and Paternal Relatives in Child Welfare. Please indicate your level of confidence in the following areas.

Please rank your individual level of confidence in the following areas

1 – Not at all confident 10 – Extremely confident

1. My ability to express positive beliefs and attitudes when engaging fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10

2. My ability to engage fathers and paternal relatives from varying backgrounds (e.g. racial, ethnic, socio-economic and other)

1	2	3	4	5	6	7	8	9	10

3. My ability to develop positive working relationships with fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10

4. My ability to create an environment that values and respects fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10

5. My understanding of the importance of cultivating racial equity for men of color in the child welfare system

1	2	3	4	5	6	7	8	9	10

6. My ability to efficiently and effectively identify and locate fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10

7. My ability to assess and highlight the strengths of fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10

8. My ability to assess and address the needs of fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10

9. My ability to assess and address the barriers that fathers and paternal relatives face that could impact their ability to safely care for their children

1	2	3	4	5	6	7	8	9	10

10. My ability to support fathers and paternal relatives involvement with their children

1	2	3	4	5	6	7	8	9	10

11. My ability to use data to effectively improve my engagement of fathers and paternal relatives

1	2	3	4	5	6	7	8	9	10