26 - SOAR Online Participant Feedback Long Form

NHTTAC Consultant and Evaluation Package

26 - SOAR Online Participant Feedback Long Form

OMB: 0970-0519

Document [pdf]
Download: pdf | pdf
OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long 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
NHTTACEval@icf.com.
PRE-TRAINING EVALUATION QUESTIONS:
Please provide the information below to create an anonymous ID:
Birth Month
(insert just the month
for your date of birth:
08 for August)

First letter of first name
(example: S for Sara)

First letter of your middle name
(example: M for Maria)

[Note: Not all objectives listed below will be included in the evaluation form. Specific objectives will be selected from this list
and tailored to each training.]
Please rate your level of confidence in your ability to:

Overall Objectives

Very Low

Low

High

Very High

1.



1

2

3

4

2.



1

2

3

4

3.



1

2

3

4

4.



1

2

3

4

Very Low

Low

High

Very High

STOP Objectives
5.



1

2

3

4

6.



1

2

3

4

7.



1

2

3

4

8.



1

2

3

4

9.



1

2

3

4

1

2

3

4

Very Low

Low

High

Very High

11. 

1

2

3

4

12. 

1

2

3

4

13. 

1

2

3

4

10. 

OBSERVE Objectives

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 0.10 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.

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long Form
ASK Objectives

Very Low

Low

High

Very High

14. 

1

2

3

4

15. 

1

2

3

4

16. 

1

2

3

4

Very Low

Low

High

Very High

17. 

1

2

3

4

18. 

1

2

3

4

19. 

1

2

3

4

20. 

1

2

3

4

21. 

1

2

3

4

22. 

1

2

3

4

RESPOND Objectives

23. 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

Daily

POST-TRAINING QUESTIONS:
Please provide the information below to create an anonymous ID:
Birth Month
(insert just the month
for your date of birth:
08 for August)

First letter of first name
(example: S for Sara)

First letter of your middle name
(example: M for Maria)

[Note: Objectives selected for the posttest will mirror the objectives selected for the pretest].
Please rate your level of confidence in your ability to:

Overall Objectives

Very Low

Low

High

Very High

1.



1

2

3

4

2.



1

2

3

4

3.



1

2

3

4

4.



1

2

3

4

5.



1

2

3

4

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 0.10 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.

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long Form
STOP Objectives

Very Low

Low

High

Very High

6.



1

2

3

4

7.



1

2

3

4

8.



1

2

3

4

9.



1

2

3

4

10. 

1

2

3

4

11. 

1

2

3

4

Very Low

Low

High

Very High

12. 

1

2

3

4

13. 

1

2

3

4

14. 

1

2

3

4

Very Low

Low

High

Very High

15. 

1

2

3

4

16. 

1

2

3

4

17. 

1

2

3

4

Very Low

Low

High

Very High

18. 

1

2

3

4

19. 

1

2

3

4

20. 

1

2

3

4

21. 

1

2

3

4

22. 

1

2

3

4

23. 

1

2

3

4

OBSERVE Objectives

ASK Objectives

RESPOND Objectives

□

24. Are you applying for continuing education credits for completing this training?

□ No

Yes

If yes, please provide your first and last name and email address:

Please indicate the extent to which you agree or disagree with the following statements:

25. I am confident that I will be able to use the knowledge and skills I
learned during SOAR training when I return to my job.

Strongly Disagree

Disagree

Agree

Strongly Agree

1

2

3

4

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 0.10 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.

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long Form
26. The training met my educational needs.

1

2

3

4

27. The training met my professional needs.

1

2

3

4

28. The educational materials provided during this training were useful.

1

2

3

4

29. The use of technology provided a good learning environment.

1

2

3

4

30. The training included current evidence-based research or promising
practices.

1

2

3

4

31. I learned a great deal as a result of this training.

1

2

3

4

32. The training was survivor informed.

1

2

3

4

33. The training was trauma informed.

1

2

3

4

1

2

3

4

1

2

3

4

1

2

3

4

34. The training was based on current evidence-based research or
promising practices.
35. The training was grounded in a multidisciplinary approach to
addressing human trafficking.
36. The training reflected a public health approach to addressing human
trafficking.

37. Please rate the overall quality of this training.
1

2

3

4

Poor

Fair

Good

Excellent

38. As a result of participating in the SOAR training, do you plan to do any of the following? (Mark all that apply.)

ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

Change my management/leadership or interpersonal
communication style
Further develop skills and knowledge about
serving victims of trafficking
Write grants/fundraise/identified 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

ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

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 victims
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 0.10 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.

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long Form

39. 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.)
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

ϒ

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 multidisciplinary team

ϒ
ϒ
ϒ
ϒ

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):

40. What suggestions do you have for improving future trainings?

41. Would you recommend this SOAR training to others?

□

Yes

□

No

42. Which of the following best describes the organization in which you work? (Mark all that apply.)

ϒ Academic institution
ϒ Anti-trafficking organization
ϒ Business/for-profit organization
ϒ Coalition/multidisciplinary team/task force
ϒ Federal government
ϒ Faith-based organization
ϒ State/local government
ϒ Nonprofit/community-based organization

ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/worker advocacy organization
Victim service provider
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 your professional capacity or types of services you provide? (Mark all that apply.)
ϒ Educator (e.g., teacher, professor,
ϒ Behavioral health professional (e.g., psychologist,
school administrator)
psychiatrist, mental health/substance use counselor)
Health care (e.g., physician, physician
ϒ
ϒ Child welfare (e.g., state agency staff, child
assistant, nurse practitioner, dentist, nurse,
welfare contractor, nonprofit personnel)
pharmacist)
ϒ Corrections-based services (e.g., parole, probation)
□ Housing (e.g., case worker, shelter director,
ϒ Criminal justice (e.g., law enforcement,
public housing authority agencies)
prosecutor, probation, court, forensic interviewer)
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 0.10 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.

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long Form
ϒ
ϒ
ϒ

ϒ Survivor empowerment, mentoring, or peer to peer
ϒ Violence prevention (e.g., child abuse and

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)

ϒ

neglect, elder abuse, domestic violence, sexual
violence, youth violence)
Other (please specify):

45. In your professional capacity, how frequently do you come into contact with a person who is currently being trafficked, at risk
of being trafficked, or has been trafficked?
1

2

3

4

Never

Occasionally

Frequently

Daily

46. Which of the following best describes the number of years of experience you have in your current field of work?
□

Less than 3 years

□

3–5 years

□

□

6–10 years

More than 10 years

47. 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

48. 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

49. Please select any of the following populations you currently work with in a professional capacity. (Mark all that apply.)

ϒ

ϒ

Human trafficking
ϒ Commercial sexual exploitation of
children
ϒ Sex trafficking
ϒ Adults
ϒ Minors
ϒ Labor trafficking
ϒ Adults
ϒ Minors
Children/youth
ϒ Out of home/Foster care/Kinship care
ϒ Juvenile justice

ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

ϒ

Runaway/Homeless youth
People with disabilities
Deaf/Hearing impaired
Elderly
Lesbian, gay, bisexual, transgender, and questioning
Foreign nationals (migrant workers,
undocumented immigrants, refugees)
People with low incomes
Racial and ethnic minorities
ϒ American Indian or Alaska Native
ϒ Asian
ϒ Black or African American

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 0.10 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.

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

SOAR ONLINE
PARTICIPANT FEEDBACK

Long Form
ϒ

ϒ
ϒ

Native Hawaii or other Pacific Islander
ϒ White
ϒ Hispanic or Latino ethnicity
History of substance use
Intimate partner violence (e.g., dating,
domestic violence)

ϒ
ϒ
ϒ

Gang-related crime
Sexual abuse/Violence
Other (please specify):

50. What is your race? (Mark all that apply.)
□
□
□
□
□
□

American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify):

51. What is your ethnicity? (Mark all that apply.)
□
□
□

Hispanic or Latino
Middle Eastern or North African
Other (please specify):

52. What is your gender? (Mark all that apply.)
□
□
□
□

Male
Female
Transgender
Other (please specify):

Thank you for taking the time to complete this form and helping to improve SOAR 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 0.10 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 Typeapplication/pdf
File Title26 - SOAR Online Participant Feedback Long Form.docx
AuthorField, Michael
File Modified2020-03-20
File Created2020-03-20

© 2024 OMB.report | Privacy Policy