27 - SOAR Online Participant Feedback Short Form

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

SOAR ONLINE
PARTICIPANT FEEDBACK

Short 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

5.

1

2

3

4

6.

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 0.0083 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

Short Form
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

6.

7.

Please rate the overall quality of this training.
1

2

3

4

Poor

Fair

Good

Excellent

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

ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

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

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 0.0083 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

Short Form

8.

Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□

□

Yes

No

9. Which of the following best describes your professional capacity or types of services you provide? (Mark all that apply.)

ϒ Behavioral health professional (e.g., psychologist,
ϒ
ϒ
ϒ
ϒ
ϒ
ϒ

ϒ Legal (e.g., immigration, civil and/or rights-based

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)
Health care (e.g., physician, physician assistant,
nurse practitioner, dentist, nurse, pharmacist)
Housing (e.g., case worker, shelter director, public
housing authority agencies)

ϒ
ϒ
ϒ
ϒ
ϒ

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):

10. 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

11. 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

12. 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

13. 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 0.0083 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.

SOAR ONLINE
PARTICIPANT FEEDBACK

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

Short Form

14. Please select any of the following populations you currently work with in a professional capacity. (Mark all that apply.)
ϒ Foreign nationals (migrant workers, undocumented
ϒ Human trafficking
immigrants, refugees)
ϒ Commercial sexual exploitation of children
ϒ People with low incomes
ϒ Sex trafficking
ϒ Racial and ethnic minorities
ϒ Adults
ϒ American Indian or Alaska Native
ϒ Minors
ϒ Asian
ϒ Labor trafficking
ϒ Black or African American
ϒ Adults
ϒ Native Hawaii or other Pacific Islander
ϒ Minors
ϒ White
ϒ Children/youth
ϒ Hispanic or Latino ethnicity
ϒ Out of home/Foster care/Kinship care
ϒ History of substance use
ϒ Juvenile justice
ϒ Intimate partner violence (e.g., dating, domestic
ϒ
Runaway/Homeless youth
violence)
ϒ People with disabilities
ϒ Gang-related crime
ϒ Deaf/Hearing impaired
ϒ Sexual abuse/Violence
ϒ Elderly
ϒ Other (please specify):
ϒ Lesbian, gay, bisexual, transgender, and questioning
15. 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):

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

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

17. 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 0.0083 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.