Tech Girls Job Shadow Host Survey

D17PC00475/140D0420F0308

Evaluation of the TechGirls Program

Job Shadow Host Survey

Page 5

TechGirls Evaluation: Job Shadow Host Survey

[Consent Statement – Online Administration]

Dexis, an independent third-party evaluation firm, has been contracted by the U.S. Department of State to conduct an evaluation of the TechGirls program to assess the effectiveness of program interventions to date and to strengthen future program interventions. As a stakeholder of the program your unique perspectives will assist us in understanding the impact of TechGirls. The evaluation will be used to make informed decisions about future programming efforts. The survey contains 17 questions and should take no more than 10 to 15 minutes to complete.

Please note that your participation in this survey is voluntary, and you are free to end the survey at any time. By clicking the “Consent and enter survey” button below, you are consenting to the following terms: 

• Your participation in this evaluation is voluntary. We do not anticipate that participating in this evaluation will result in any risks or direct benefit to you. However, your inputs may lead to recommendations that benefit the TechGirls program—and, thereby, the general public. You may skip any questions you are not comfortable answering.

• The information that you provide in the survey will be used to write a report. This report will be shared with the U.S. Department of State and other stakeholders for comment and will eventually be made public. Any responses you provide may be reported in the final report as part of the anonymized aggregated quantitative analysis or the de-identified qualitative analysis from open-ended responses. 

• The U.S. government and its contractors will take reasonable measures to protect privacy data, personally identifiable information, and other sensitive data obtained from the survey.

• Data about your post-program connections with TechGirls will be used to generate maps of the linkages within and across countries.

• The data you provide may be reanalyzed at a later date for a follow-up study or other purpose as approved by the U.S. Department of State. The data may be made available to third parties as required by law. 

• You may withdraw your consent at any time by contacting ECAEvaluation@state.gov.

Privacy Act Statement

AUTHORITY: The information on this form is requested under the authority of 22 U.S.C. 2451 et seq (Mutual Educational and Cultural Exchange Act of 1961), P.L. 103-62 (Government Performance and Results Act of 1993), and P.L. 111-352 (Government Performance and Results Modernization Act of 2010). 

PURPOSE: The purpose of gathering this information is to track the networks and relationships built as a result of participation in the TechGirls program.  

ROUTINE USES: The information on this form may be shared with members of Congress, and the Office of Management and Budget (OMB). De-identified data files may be shared (without Personally Identifiable Information such as names or contact information) with ECA implementing partners and external researchers who are assisting ECA in measuring its impact. More information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program Records. 

DISCLOSURE: Responding to this survey is voluntary. The answers you provide on the survey will have no bearing on your participation in future program activities or any future applications you may submit for U.S. State Department programs. 

If you have any questions about this survey or the TechGirls evaluation more broadly, you can contact the Dexis evaluation team at TechGirlsEvaluation@dexisonline.com.  

Please answer the questions to the best of your ability and use the comment boxes to provide fuller answers and more insight on your experiences with TechGirls. Thank you in advance for your time and input!  

CONSENT TO PARTICIPATE

By clicking the button to enter the survey below, you are giving your consent to participate in this evaluation. If you do not wish to participate, please click the exit survey link below.

Consent and Enter Survey ⃝ Refuse and Exit Survey

Thank you for agreeing to complete the survey! The estimated time to complete the survey is 10 to 15 minutes. Please answer each question to the best of your ability.

[Consent Statement – Administered by Phone/Web-based Communication Platform]

[Researcher to read consent statement below]

Thank you for taking time to speak with me today. My name is ____________________, and I am a researcher on the TechGirls evaluation. Dexis, an independent third-party evaluation firm, has been contracted by the U.S. Department of State to conduct an evaluation of the TechGirls program to assess the effectiveness of program interventions to date and to strengthen future program interventions. As a stakeholder of the program your unique perspectives will assist us in understanding the impact of TechGirls. The evaluation will be used to make informed decisions about future programming efforts. The survey contains 17 questions and should take no more than 10 to 15 minutes to complete.

Please note that your participation in this survey is voluntary, and you are free to end the survey at any time. By agreeing to participate in the evaluation, you are consenting to the following terms: 

• Your participation in this evaluation is voluntary. We do not anticipate that participating in this evaluation will result in any risks or direct benefit to you. However, your inputs may lead to recommendations that benefit the TechGirls program—and, thereby, the general public. You may skip any questions you are not comfortable answering.

• The information that you provide in the survey will be used to write a report. This report will be shared with the U.S. Department of State and other stakeholders for comment and will eventually be made public. Any responses you provide may be reported in the final report as part of the anonymized aggregated quantitative analysis or the de-identified qualitative analysis from open-ended responses. 

• The U.S. government and its contractors will take reasonable measures to protect privacy data, personally identifiable information, and other sensitive data obtained from the survey.

• Data about your post-program connections with TechGirls will be used to generate maps of the linkages within and across countries.

• The data you provide may be reanalyzed at a later date for a follow-up study or other purpose as approved by the U.S. Department of State. The data may be made available to third parties as required by law. 

• You may withdraw your consent at any time by contacting ECAEvaluation@state.gov.

If you have any questions about this survey or the TechGirls evaluation more broadly, you can contact the Dexis evaluation team at TechGirlsEvaluation@dexisonline.com.  

Do you have any questions about this survey or the TechGirls evaluation more broadly?

[If the respondent asks questions, answer them.]

[If the respondent asks a question concerning privacy, the voluntary nature of their participation, or use of the data, read the below.]

We have another statement that may help answer your questions. [Read the Privacy Act statement.]

Privacy Act Statement

AUTHORITY: The information on this form is requested under the authority of 22 U.S.C. 2451 et seq (Mutual Educational and Cultural Exchange Act of 1961), P.L. 103-62 (Government Performance and Results Act of 1993), and P.L. 111-352 (Government Performance and Results Modernization Act of 2010). 

PURPOSE: The purpose of gathering this information is to track the networks and relationships built as a result of participation in the TechGirls program.  

ROUTINE USES: The information on this form may be shared with members of Congress, and the Office of Management and Budget (OMB). De-identified data files may be shared (without Personally Identifiable Information such as names or contact information) with ECA implementing partners and external researchers who are assisting ECA in measuring its impact. More information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program Records. 

DISCLOSURE: Responding to this survey is voluntary. The answers you provide on the survey will have no bearing on your participation in future program activities or any future applications you may submit for U.S. State Department programs. 

Do you consent to participate in this evaluation?

[If the respondent says yes, record the consent in the online survey and proceed with question 1. If the respondent says no, thank the respondent and end the call.]

Thank you for agreeing to complete the survey! The estimated time to complete the survey is 10 to 15 minutes. Please answer each question to the best of your ability.

Section 1. Personal Information

1. Name:

2. Company/Organization Name:

3. What year(s) have you hosted TechGirls? (select all that apply) 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019

Section 2. Ongoing Contact

4. Have you maintained contact with the TechGirls you hosted since they returned home? Yes (skip to Q5), no

5. Why not?_____________________________________________ (skip to Q12)

6. Please enter the name of a TechGirls alumna with whom you have had contact.

(Note: If you had contact with more than one TechGirls alumna, please write only one name here. You will be able to add information about additional TechGirls alumnae in the next section.).

For the alumna with whom you have had contact, please answer the following:

7. Home Country (Algeria, Egypt, Jordan, Lebanon, Libya, Morocco, Palestinian Territories, Tunisia, United States, Yemen)

8. Start Date of Contact (month and year)

9. End Date of Contact [if on-going, please leave blank] (month and year)

10. Frequency of Contact? daily, weekly, biweekly, monthly, quarterly, annually

11. Have you had difficulty maintaining contact? no, no difficulty (skip to question 11); yes, moderate difficulty; yes, extreme difficulty

12. Why has maintaining contact been difficult? ______________________________

Section 3. TechGirls Impact

13. Based on your experience, what, if any, has been the impact of the program on the TechGirls? ___________________________________________________________

14. What, if any, has been the impact of the TechGirls program on you/the organization? ____________________________________________________________________

Section 4. Recommendations

15. Would you consider hosting TechGirls again in the future? Yes (skip to Q16) /no

16. If no, why would you not consider hosting again? ______________________________

17. What recommendations would you make to strengthen the program for future cohorts? (If none, leave blank) ______________________________________________________

You have completed the TechGirls Job Shadow Host survey. Thank you for your assistance!

OMB Control Number: 1405-XXXX

Expiration Date: XX-XX-XXXX

Burden Estimate: 5.6 hours / $353.30

Public reporting burden for this collection of information is estimated to average 16 minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection.  You do not have to supply this information unless this collection displays a currently valid OMB control number.  If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to:  ecaevaluation@state.gov.