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pdfCONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020
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
NHTTAC@icf.com.
CONFERENCE:
SESSION:
DATE(S):
PRESENTER(S):
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)
Please rate how well the session met each of its stated objectives.
OVERALL OBJECTIVES
Poor
Satisfactory
Good
Excellent
Not
Applicable
1.
[Insert objective 1].
1
2
3
4
NA
2.
[Insert objective 2].
1
2
3
4
NA
3.
[Insert objective 3].
1
2
3
4
NA
4.
[Insert objective 4].
1
2
3
4
NA
5.
[Insert objective 5].
1
2
3
4
NA
Please indicate the extent to which you agree or disagree with the following statements.
PRESENTER/FACILITATOR 1:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
6.
The presenter’s knowledge and expertise were appropriate
for this session.
1
2
3
4
NA
7.
The presenter delivered the content of the session clearly
and logically.
1
2
3
4
NA
8.
The presenter responded positively to questions and
comments.
1
2
3
4
NA
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public
reporting burden for this collection of information is estimated to average 0.167 hours per respondent, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any
comments on this collection of information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee
Highway, Fairfax, VA 22031.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020
Form
9.
The presenter created a respectful environment for
participants.
10. The presenter encouraged and initiated helpful
discussions.
1
2
3
4
NA
1
2
3
4
NA
Not
Applicable
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
16. The session addressed the critical issues related to the
topic(s).
1
2
3
4
NA
17. The session was well organized and clear.
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
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2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
PRESENTER/FACILITATOR 2:
11. The presenter’s knowledge and expertise were appropriate
for this session.
12. The presenter delivered the content of the session clearly
and logically.
13. The presenter responded positively to questions and
comments.
14. The presenter created a respectful environment for
participants.
15. The presenter encouraged and initiated helpful
discussions.
CONFERENCE SESSION FEEDBACK
18. The session increased my knowledge related to the
topic(s).
19. The information presented in the session was grounded in
current evidence-based research or promising practices.
20. The information presented in the session was traumainformed.
21. The information presented in the session was survivorinformed.
22. The information presented in the session was grounded in
a multidisciplinary approach to addressing human
trafficking.
23. The information provided in the session reflected a public
health approach to addressing human trafficking.
24. The session improved my ability to serve people who are
currently being trafficked, at risk of trafficking, or have
been trafficked.
25. The meeting space and use of technology provided a good
learning environment.
26. The time allotted was adequate for the scope of material
covered.
27. The education materials provided for this session were
useful.
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public
reporting burden for this collection of information is estimated to average 0.167 hours per respondent, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any
comments on this collection of information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee
Highway, Fairfax, VA 22031.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020
Form
28. I will share the information I learned at the session with
my colleagues.
29. The session increased my practical skills related to the
topic(s).
1
2
3
4
NA
1
2
3
4
NA
30. The session met my professional needs.
1
2
3
4
NA
31. The session met my educational needs.
1
2
3
4
NA
32. I will be able to apply what I learned in my work.
1
2
3
4
NA
Please click the number that best represents your rating for this session for each of the following questions.
33. Please rate the overall quality of this session.
1
2
3
4
Poor
Fair
Good
Excellent
34. How useful was the session information to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
35. As a result of participating in this session, do you plan to do any of the following? (Mark all that apply.)
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□
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
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Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify):
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public
reporting burden for this collection of information is estimated to average 0.167 hours per respondent, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any
comments on this collection of information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee
Highway, Fairfax, VA 22031.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020
Form
36. 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.)
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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
Difficulty in establishing and/or maintaining a
multi-disciplinary team
37. Would you recommend NHTTAC to others for T/TA?
□
□
□
□
□
□ Yes
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):
□ No
38. What aspects of the session were most helpful and why?
39. What could be done differently to improve the session?
40. Do you have any other comments or suggestions?
41. Which of the following best describes the organization in which you work? (Mark all that apply.)
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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
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□
□
□
□
□
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OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify:
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public
reporting burden for this collection of information is estimated to average 0.167 hours per respondent, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any
comments on this collection of information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee
Highway, Fairfax, VA 22031.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020
Form
42. Which of the following best describes your professional capacity or types of services you provide? (Mark all that
apply.)
□
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□
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)
Professional capacity/types of services, continued
Health care (e.g., physician, physician assistant,
nurse practitioner, dentist, nurse, pharmacist)
Housing (e.g., case worker, shelter director,
public housing authority agencies)
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□
□
□
Legal (e.g., immigration, civil and/or rightsbased 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):
43. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
44. 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
45. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Management
□ Other (please specify):
□ Consultant/Trainer
□ Volunteer
□ Administration
□ Peer Educator
46. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of being trafficked, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
All the Time
47. 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
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public
reporting burden for this collection of information is estimated to average 0.167 hours per respondent, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any
comments on this collection of information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee
Highway, Fairfax, VA 22031.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020
Form
48. 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
□
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□
□
□
□
□
□
□
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):
Thank you for taking the time to complete this form and helping to improve NHTTAC activities.
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public
reporting burden for this collection of information is estimated to average 0.167 hours per respondent, including the time for reviewing
instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any
comments on this collection of information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee
Highway, Fairfax, VA 22031.
File Type | application/pdf |
Author | Field, Michael |
File Modified | 2020-03-20 |
File Created | 2020-03-18 |