5. Network Survey

OMB Number: 0970-0519

Expiration Date: XX/XX/XXXX

NETWORK FEEDBACK

Form

Introduction:

In order to help the Office on Trafficking in Persons’ 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 [insert].

Name: _________________________________________

Position/Title: _________________________________________

Organization: _________________________________________

City/State: _________________________________________

Time at Organization: _________________________________________

How many months have [Insert you/your organization] been participating in the [Insert NHTTAC TTA type or workgroup or CoC]? __________________________________

  I understand the above statements and agree to continue.

  I do not wish to continue.

To complete the survey, please refer to the following definitions of key terms related to [Insert NHTTAC TTA type].

Key Terms

• Workgroup or Continuum of Care (CoC): An umbrella term for the overall collaborative effort within your [Insert organization, community].

• Partners: An umbrella term for all the organizations and individuals participating in the workgroup or CoC. This includes those individuals who participate in the steering committee (if applicable), the organizations (and their representatives) participating in the service delivery network, and those organizations and individuals who participate in both the steering committee and the service delivery network.

Partnership Structure & Activities

LEVEL OF INVOLVEMENT	No Involvement	A Little Involvement	Moderate Involvement	Significant Involvement	Extensive Involvement
Please indicate your organization’s level of involvement in [Insert NHTTAC TTA type #1-4].	☐	☐	☐	☐	☐

For groups where applicable:

Please indicate if the workgroup or CoC:	Yes, Existed Before [Insert T/TA Type]	Yes, Newly Developed After [Insert T/TA Type]	No, Plans to Create/ Adopt this Year	No, Not Part of Current Plans for the Year	Not Applicable
Has workgroups or subcommittees	☐	☐	☐	☐	☐
Has formalized rules and procedures	☐	☐	☐	☐	☐
Has bylaws	☐	☐	☐	☐	☐
Has a vision/mission statement	☐	☐	☐	☐	☐
Has a written strategic plan	☐	☐	☐	☐	☐
Tracks progress on a strategic plan (goals, objectives).	☐	☐	☐	☐	☐
Has regularly scheduled meetings	☐	☐	☐	☐	☐
Has a formal process for decision-making	☐	☐	☐	☐	☐
Has a designated leader(s) or leadership team	☐	☐	☐	☐	☐
Has a non-hierarchical, shared power structure for decision-making	☐	☐	☐	☐	☐
Has a conflict resolution process	☐	☐	☐	☐	☐
Includes persons with lived experience and at risk populations in membership	☐	☐	☐	☐	☐
Has a funded coordinator/leader	☐	☐	☐	☐	☐
Has a process for soliciting insights from the workgroup or CoC members	☐	☐	☐	☐	☐
Has a process for integrating feedback from service population	☐	☐	☐	☐	☐

The following section has questions about your experience participating in the [Insert NHTTAC T/TA type/ initiative]. Thinking about activities within [Insert year T/TA occurred], please rate the extent to which you agree or disagree with the statements below.

WORKGROUP or CoC	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Workgroup or CoC partners are committed to working together to enhance services for individuals who have experienced trafficking or who have increased risk factors for trafficking.	☐	☐	☐	☐	☐
Project partners have adequate time to commit to the workgroup or CoC.	☐	☐	☐	☐	☐
Leaders of participating partner organizations are willing to commit resources, such as financial resources and staff time, to the workgroup or CoC.	☐	☐	☐	☐	☐
My [Insert organization’s, communities’] policies are conducive to developing collaborative relationships with other organizations.	☐	☐	☐	☐	☐
The workgroup or CoC has sufficient staff to carry out its activities.	☐	☐	☐	☐	☐
The workgroup or CoC has sufficient knowledge resources (e.g., in-house expertise, available training resources) to carry out its activities.	☐	☐	☐	☐	☐
My [Insert organization, community] has sufficient financial resources to carry out its activities for the workgroup or CoC.	☐	☐	☐	☐	☐
The workgroup or CoC has the right composition of partners from different key partner groups.	☐	☐	☐	☐	☐
The workgroup’s or CoC’s composition of partners promotes diverse viewpoints.	☐	☐	☐	☐	☐
Individuals with lived experience assume active representation in the workgroup’s or CoC’s efforts.	☐	☐	☐	☐	☐
The roles and responsibilities of partner members are clear.	☐	☐	☐	☐	☐
Project partners can be counted on to meet their obligations to the workgroup or CoC.	☐	☐	☐	☐	☐
The workgroup or CoC has a feeling of cohesiveness and team spirit.	☐	☐	☐	☐	☐
Project partners feel valued and important.	☐	☐	☐	☐	☐
There is a shared vision of what the workgroup or CoC should accomplish.	☐	☐	☐	☐	☐
Conflicts frequently arise among workgroup or CoC partners.	☐	☐	☐	☐	☐
Differences among workgroup or CoC partners are recognized and resolved.	☐	☐	☐	☐	☐
Project partners communicate effectively with each other.	☐	☐	☐	☐	☐
The people in leadership positions for this workgroup or CoC have good skills for working with people and organizations.	☐	☐	☐	☐	☐
The workgroup or CoC has sufficient meetings/conference calls to exchange information among partners.	☐	☐	☐	☐	☐
Critical decisions of the workgroup or CoC are made after discussion and input from all partners.	☐	☐	☐	☐	☐
Project leaders seriously consider partners’ recommendations when making decisions.	☐	☐	☐	☐	☐
Project leaders are integral to achieving workgroup or CoC goals.	☐	☐	☐	☐	☐
Project leaders are responsive to partners’ concerns.	☐	☐	☐	☐	☐
Project leaders provide direction and vision for the workgroup or CoC.	☐	☐	☐	☐	☐
The workgroup or CoC operates efficiently.	☐	☐	☐	☐	☐
The skills and expertise of workgroup or CoC partners are utilized effectively.	☐	☐	☐	☐	☐
[Insert building trust/psychological safety item here]	☐	☐	☐	☐	☐
[Insert building trust/psychological safety item here]	☐	☐	☐	☐	☐
[Insert building trust/psychological safety item here]	☐	☐	☐	☐	☐
[Insert building trust/psychological safety item here]	☐	☐	☐	☐	☐
[Insert collaborative factor here]	☐	☐	☐	☐	☐
[Insert collaborative factor here]	☐	☐	☐	☐	☐
[Insert collaborative factor here]	☐	☐	☐	☐	☐
[Insert collaborative factor here]	☐	☐	☐	☐	☐
[Insert collaborative factor here]	☐	☐	☐	☐	☐

The following section has questions about the future of the workgroup or CoC, including expected sustainability. For the following questions, please rate the extent to which the statements are accurate for [Insert date].

	No Extent	Little Extent	Some Extent	Moderate Extent	Great Extent
Champions—internal and/or external leaders—actively advocated for the workgroup or CoC.	☐	☐	☐	☐	☐
The workgroup or CoC was supported by policies designed to help ensure sustained funding.	☐	☐	☐	☐	☐
The workgroup or CoC contributed/reviewed adoption of [Insert outcome] at my organization.	☐	☐	☐	☐	☐
The workgroup or CoC contributed/reviewed adoption of [Insert outcome] at partner organizations.	☐	☐	☐	☐	☐
The workgroup or CoC contributed/reviewed adoption of [insert outcome] withing the community/non-partner organizations.	☐	☐	☐	☐	☐
Project partners were invested in the development and sustainability of the workgroup or CoC.	☐	☐	☐	☐	☐
The workgroup or CoC was well integrated into the operations of the workgroup or CoC partners.	☐	☐	☐	☐	☐
The workgroup or CoC uses data to inform the strategic plan and priority areas.	☐	☐	☐	☐	☐
The workgroup or CoC review helped to adapt and adopt new strategies as appropriate.	☐	☐	☐	☐	☐
The workgroup or CoC review provided decision-making about which components are ineffective and how to discontinue them.	☐	☐	☐	☐	☐
The workgroup or CoC integrated communication strategies to secure and maintain external awareness and support.	☐	☐	☐	☐	☐
The workgroup or CoC included plans for future resource needs.	☐	☐	☐	☐	☐
The workgroup or CoC has a sustainability plan in place.	☐	☐	☐	☐	☐

2. Connection to Partners

For closed networks:

How frequently do(es) [Insert you/your organization] work with this [Insert individual/organization] on issues related to [Insert focal area or action plan goal]?	INDIVIDUAL/ORGANIZATION A	INDIVIDUAL/ORGANIZATION B	INDIVIDUAL/ORGANIZATION C	INDIVIDUAL/ORGANIZATION D	INDIVIDUAL/ORGANIZATION E	INDIVIDUAL/ORGANIZATION F	INDIVIDUAL/ORGANIZATION G	INDIVIDUAL/ORGANIZATION H	INDIVIDUAL/ORGANIZATION I
Not once in the last 6 months	☐	☐	☐	☐	☐	☐	☐	☐	☐
Once in the last 6 months	☐	☐	☐	☐	☐	☐	☐	☐	☐
Multiple times in the last 6 months	☐	☐	☐	☐	☐	☐	☐	☐	☐
Multiple times in the last month	☐	☐	☐	☐	☐	☐	☐	☐	☐
Weekly	☐	☐	☐	☐	☐	☐	☐	☐	☐
Multiple times a week	☐	☐	☐	☐	☐	☐	☐	☐	☐
I don’t know this [Insert individual/organization].	☐	☐	☐	☐	☐	☐	☐	☐	☐
Mark which organization is yours on this line.	☐	☐	☐	☐	☐	☐	☐	☐	☐

For open network this is asked individually:

How frequently do(es) [Insert you/your organization] work with this [Insert individual/organization] on issues related to [Insert focal area or action plan goal]?

1	2	3	4	5	6
Never	Once a year or less	About once a quarter	About once a month	Every week	Every day

Who do you rely on for learning about the topics listed below? (Check all that apply.)	INDIVIDUAL/ORGANIZATION A	INDIVIDUAL/ORGANIZATION B	INDIVIDUAL/ORGANIZATION C	INDIVIDUAL/ORGANIZATION D	INDIVIDUAL/ORGANIZATION E	INDIVIDUAL/ORGANIZATION F	INDIVIDUAL/ORGANIZATION G	INDIVIDUAL/ORGANIZATION H	INDIVIDUAL/ORGANIZATION I
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐
[Insert topic associated with T/TA]	☐	☐	☐	☐	☐	☐	☐	☐	☐

2. Services Coordination Activities

For the following questions, please rate the extent of coordination between [Insert yourself, your organization] and each workgroup or CoC partner on a 5-point scale from 1=Not at all to 5=Very Much. Skip the column with [Insert your, your own organization’s] name in the heading. If the activity listed in any of the questions below does not apply to your organization, please select 1 (“Not at all/Not Applicable”).

1 Not at all/Not Applicable

2 A Little

3 Somewhat

4 Considerable

5 Very Much

Pleaserate the extent to which your organization does the following with each workgroup or CoC partner:	INDIVIDUAL/ORGANIZATION A	INDIVIDUAL/ORGANIZATION B	INDIVIDUAL/ORGANIZATION C	INDIVIDUAL/ORGANIZATION D	INDIVIDUAL/ORGANIZATION E	INDIVIDUAL/ORGANIZATION F	INDIVIDUAL/ORGANIZATION G	INDIVIDUAL/ORGANIZATION H	INDIVIDUAL/ORGANIZATION I
Has formal written agreements, contracts, or memorandum of understanding	☐	☐	☐	☐	☐	☐	☐	☐	☐
Shares materials, tools, or other resources (e.g., pamphlets, procedure manuals, centralized databases)	☐	☐	☐	☐	☐	☐	☐	☐	☐
Provides/receives training with this organization	☐	☐	☐	☐	☐	☐	☐	☐	☐
Provides/receives referrals with this organization	☐	☐	☐	☐	☐	☐	☐	☐	☐
Uses common intake forms	☐	☐	☐	☐	☐	☐	☐	☐	☐
Shares client information as appropriate	☐	☐	☐	☐	☐	☐	☐	☐	☐
Shares record keeping and management information systems data	☐	☐	☐	☐	☐	☐	☐	☐	☐
Develops client service plans together	☐	☐	☐	☐	☐	☐	☐	☐	☐
Participates in joint case conferences or case reviews	☐	☐	☐	☐	☐	☐	☐	☐	☐
Collaborates with workgroup or CoC partners on changes to policies and procedures at their organization	☐	☐	☐	☐	☐	☐	☐	☐	☐
Collaborate on policy level work with this organization	☐	☐	☐	☐	☐	☐	☐	☐	☐
Works together on fundraising	☐	☐	☐	☐	☐	☐	☐	☐	☐
Works together on other collaborations or committees (does not have to be related to trafficking)	☐	☐	☐	☐	☐	☐	☐	☐	☐

Individual Network Functioning Beyond NHTTAC Established Networks

CLOSED NETWORK Only: From the list, select the [Insert up to 10 individuals/organizations] with which you have an established relationship (either formal or informal). In subsequent questions you will be asked about your relationship with these organizations in the context of [Insert NHTTAC T/TA type] peer network.

• Note: A list of [Insert individuals/organizations] in the [Insert NHTTAC T/TA type] peer network will be provided in the survey.

OPEN NETWORK Only: Please identify [Insert up to 10 individuals/organizations] [that were not included in the list above] with which you have an established relationship (either formal or informal) for [Insert focal area or action plan goal]. In subsequent questions you will be asked about your relationship with these individuals/organizations in the context of [Insert focal area or action plan goal].

In this section, you will answer questions for each partner/individual/organization you selected or identified in the prior question.

Select the appropriate response for each [Insert individual/organization] with whom you are interacting.

How valuable is [Insert individual’s/organization's] POWER AND INFLUENCE in achieving the overall vision of the [Insert NHTTAC TTA peer network, focal area or action plan goal]?

*Power/Influence: The [Insert individual/organization] holds a prominent position in the [Insert network/community/cohort] being powerful, having influence, success as a change agent, and showing leadership.

1			8
Not at all			A great deal

How valuable is [Insert individual’s/organization's] LEVEL OF INVOLVEMENT in achieving the overall vision of the [Insert NHTTAC TTA peer network, focal area or action plan goal]?

*Level of Involvement: The [Insert individual/organization] is strongly committed and active in the partnership and gets things done.

1			8
Not at all			A great deal

How valuable is [Insert individual’s/organization's] RESOURCE CONTRIBUTION to achieving the overall vision of the [Insert NHTTAC TTA peer network, focal area or action plan goal]?

*Contributing Resources: The [Insert individual/organization] brings resources to the partnership like funding, information, or other resources.

1			8
Not at all			A great deal

How RELIABLE is [Insert individual/organization]?

*Reliable: This [Insert individual/organization] is reliable in terms of following through on commitments.

1			8
Not at all			A great deal

To what extent does [Insert individual/organization] SHARE A VISION with the [Insert NHTTAC TTA peer network’s/cohort’s] vision and goals?

*Vision Congruence: This [Insert individual/organization] shares a common vision of the end goal of what working together should accomplish.

1			8
Not at all			A great deal

How OPEN TO DISCUSSION is [Insert individual/organization]?

*Open to Discussion: This [Insert individual/organization] is willing to engage in frank, open, and civil discussion (especially when disagreement exists). The [Insert individual/organization] is willing to consider a variety of viewpoints and talk together (rather than at each other). You are able to communicate with this [Insert individual/organization] in an open, trusting manner.

1			8
Not at all			A great deal

How TRUST AND PSYCHOLOGICAL SAFETY was achieved with [Insert individual/organization]?

*Trust and Psychological Safety: This [Insert individual/organization] is [Insert definition and example for how trust and psychological safety was built for a specific T/TA type].

1			8
Not at all			A great deal

Do you rely on [Insert individual/organization] to learn about the topics listed below? (check all that apply).

• [Insert topic]

• [Insert topic]

• [Insert topic]

• [Insert topic]

• [Insert topic]

• [Insert topic]

Which of the following NHTTAC roles is important for the success of [Insert NHTTAC TTA peer network, focal area or action plan goal]? (Choose all that apply)

• Convening and connecting everyone in the [Insert NHTTAC TTA peer network/cohort]

• Communication tools

• Data resources and evidence based practices

• [Insert specific type of technical assistance]

• Evaluation

• Trust building and group dynamics

Which of the following [Insert NHTTAC TTA type] peer network results are critical to improving [Insert goal(s) or intended outcomes]? (Choose all that apply)

• Improved resource sharing

• Increased knowledge sharing

• Coordinated communication

• Networking with organizations that do similar things

• Networking with organizations that do different things

• Data and information available through the NHTTAC website

• Coordinated assessments

• Increased access to services

• Improved client outcomes

• Reduction of health disparities

• Public awareness

• Creating healthier environments (e.g., schools, worksites, community)

• Policy, law, and/or regulation

How successful has [Insert entity] been at implementing a coordinated effort to impact the [Insert cohort, goal(s), or intended outcome(s)]?

1				8
Not successful				Very Successful

What aspects of [Insert NHTTAC TTA type] contribute to this success? (Choose all that apply)

• Bringing together diverse stakeholders

• Meeting regularly

• Exchanging information/knowledge

• Coordinated communication

• Sharing resources

• Informal relationships created

• Collective decision-making

• Having a shared vision and goals

• Collective synergy

• Creation of trust

• Establishing psychological safety

• Not sure

Networking and Community Building

Please rate your level of agreement with the following items related to your beliefs about networking and community building.

Through engagement in [Insert NHTTAC TTA peer network, focal area or action plan goal], I…	Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree
Made connections with colleagues around shared goals.	☐	☐	☐	☐	☐
Enhanced psychological safety across the network.	☐	☐	☐	☐	☐
Gained access to professional relationships that changed my perspective or understanding.	☐	☐	☐	☐	☐
Engaged regularly with [Insert NHTTAC TTA type recipients].	☐	☐	☐	☐	☐
Participated in [Insert NHTTAC TTA type] activities that were meaningful.	☐	☐	☐	☐	☐

Please describe a meaningful activity or connection you experienced (e.g., a conversation, a working session, a project, etc.) as a result of [Insert NHTTAC TTA peer network, focal area or action plan goal]. _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Gaining Knowledge

Please rate your level of agreement with the following items related to your beliefs about gaining new knowledge outside of the NHTTAC TTA. This section captures new knowledge within your [Insert NHTTAC TTA peer network, focal area or action plan goal].

Through engagement in the [Insert NHTTAC TTA peer network, focal area or action plan goal], I…	Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree
Acquired a new skill or new knowledge.	☐	☐	☐	☐	☐
Gained insight about a person or group I can turn to for information or support.	☐	☐	☐	☐	☐
Gained access to new tools, information, or processes I would not otherwise have access to.	☐	☐	☐	☐	☐
Saw opportunities for learning that I did not see before.	☐	☐	☐	☐	☐
Received peer support.	☐	☐	☐	☐	☐
Provided peer support.	☐	☐	☐	☐	☐
Received peer coaching.	☐	☐	☐	☐	☐
Provided peer coaching.	☐	☐	☐	☐	☐
Shared resources.	☐	☐	☐	☐	☐
Received resources.	☐	☐	☐	☐	☐
Received job assistance.	☐	☐	☐	☐	☐
Provided job assistance.	☐	☐	☐	☐	☐
Received introduction to others within or outside this network.	☐	☐	☐	☐	☐
Provided an introduction to others within or outside this network.	☐	☐	☐	☐	☐
Collaborated around shared issues and common problems.	☐	☐	☐	☐	☐

Applied Learning and Practices

Please rate your level of agreement with the following items related to areas where you further applied learning and practices.

As a result of the [Insert NHTTAC TTA type network], I …	Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree
[Insert applied skill or practice] learned from a [Insert NHTTAC TTA type] peer to accomplish a goal	☐	☐	☐	☐	☐
[Insert applied skill or practice] learned from a [Insert NHTTAC TTA type] peer to accomplish a goal	☐	☐	☐	☐	☐
[Insert applied skill or practice] learned from a [Insert NHTTAC TTA type] peer to accomplish a goal	☐	☐	☐	☐	☐
[Insert applied skill or practice] learned from a [Insert NHTTAC TTA type] peer to accomplish a goal	☐	☐	☐	☐	☐
Leveraged a [Insert NHTTAC TTA type] peer connection to accomplish [insert a task]	☐	☐	☐	☐	☐
Leveraged a [Insert NHTTAC TTA type] peer connection to accomplish [Insert a task]	☐	☐	☐	☐	☐

As a result of the [Insert NHTTAC TTA type network], my organization/network/community …	Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree
[Insert applied skill, practice, policy, etc.]	☐	☐	☐	☐	☐
[Insert applied skill, practice, policy, etc.]	☐	☐	☐	☐	☐
[Insert applied skill, practice, policy, etc.]	☐	☐	☐	☐	☐
[Insert applied skill, practice, policy, etc.]	☐	☐	☐	☐	☐
Leveraged a [Insert NHTTAC TTA type] peer connection/policy/procedure to accomplish [Insert a task]	☐	☐	☐	☐	☐
Leveraged a [Insert NHTTAC TTA type] peer connection/policy/procedure to accomplish [Insert a task]	☐	☐	☐	☐	☐

Sometimes participation in a collaborative effort changes your perspective, direction, strategy, or understanding of what success is. If this has taken place through your connection to a [Insert NHTTAC TTA type] peer, please describe it.

________________________________________________________________________________________________________

Do you have any additional comments regarding this survey or partnerships related to [Insert NHTTAC TTA type] initiative?

________________________________________________________________________________________________________

Thank you for taking the time to complete this form and helping to improve NHTTAC activities.

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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 service delivery. The public reporting burden for this collection of information is estimated to average 1 hour 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.