Instrument 3_TIES_Reflection from Staff

OMB #: XXXX-XXXX

EXPIRATION: XX/XX/XXXX

Instrument 3 – Fatherhood TIES End of Cohort Reflections for Staff

MDRC will develop an electronic data collection approach using Qualtrics to solicit reflections from the select staff at each site. The Fatherhood TIES team will ask up to 7 staff from each organization to participate for collection time point (once a quarter). The staff could be from a range of positions that were involved in or affected by the intervention implementation, for example, case manager, facilitator, program manager, etc. The Fatherhood TIES team will share an email link to the short electronic survey with each site near the end of each cohort.

Some example questions for staff to respond to are below. With input from each program in the study we will finalize questions based on the what the program wants to get out of the experience and their goals.

Hello! [name the program] is partnering with MDRC, a nonprofit organization, to learn how to better support fathers in their program. The project is called Testing Identified Elements for Success in Fatherhood, or Fatherhood TIES. [Name the program] is one of four fatherhood programs involved in this project.

The Fatherhood TIES team would like to ask you a few questions to learn about your experiences working with [name the program], especially your reflections about program operations and achievements. Your responses will help your team to better service fathers and prepare for the next cohort; any identifying information will be removed before sharing so your responses will remain private. Your responses will also be combined with those from other programs participating in the project to come up with ideas for how fatherhood programs nationwide can be better in the future.

It will take about 15 minutes to give your feedback. We will not ask you any personal information. Providing feedback is your choice. There is no penalty for not answering these questions. If you have questions about this project you can reach out to MDRC by email (TIES@mdrc.org) or call the Fatherhood TIES hotline at (855) 907-6696.

This project is funded by the U.S. Department of Health and Human Services.

PRIVACY STATEMENT: This survey is covered by the Privacy Act. This means that your participation is voluntary, so you can decline to participate. The purpose of this study is to find out which parts of fatherhood programs are the most effective at improving the lives of participating fathers and their children and co-parents. The information you provide may be shared with state and federal agencies and researchers involved in similar work. The legal authority for this project is [insert funding stream for the project]. If you would like more information about this project, please see Systems of Records Notice (SORN) 09-80-0361, OPRE Research and Evaluation Project Records.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to gather preliminary information about the fatherhood field and explore with fatherhood programs the research questions that are of interest and the design options that are feasible. Public reporting burden for this collection of information is estimated to average 15 minutes per response, 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. The answers you give will be kept private. 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. The OMB # is XXXX-XXXX and the expiration date is XX/XX/XXXX. If you have any comments on this collection of information, please contact Dina Israel; Dina.Israel@mdrc.org, and Michelle Manno; Michelle.Manno@mdrc.org ; Attn: OMB-PRA (XXXX-XXXX). 

#	Question	Response Options
consent	Given what you just read about the purpose of this project, please select a response below.	I agree to provide my feedback about [name of program] to help the program and the Fatherhood TIES project to learn how to better support fathers. I understand that no personal information will be collected about me. [move to #1] I do not agree to provide my feedback about [name of program]. I understand that there is no penalty for now answering these questions. [move to Exit_no_consent]

The questions that we’ll ask you will reference the goals for participation in the study laid out in Fatherhood TIES program application and early work with the Fatherhood TIES team. As a reminder, we’ve included it here.

Program Goals (Example): To provide services that meet the needs of the fathers we serve. 

TIES program Element: Program content- parent coaching add-on

Outcome measure: Relationship quality

**contents of this box will be personalized for each site based on the goals they developed, intervention selected, and outcome measures of interest as determined in collaboration with the TIES study team.

The questions you will be asked take three forms: yes or no questions, option to write freely, and rate certain things along a 5-point scale. In all cases, answer in a way that best represents how you feel. There are no wrong answers!

	How well do you think the [TIES program element] was tailored to help meet fathers’ financial, parenting, or co-parenting goals?	Extremely well  Very well   Somewhat well  Not so well   Not well at all
2.	How well do you think the [TIES program element] was delivered as planned?	Extremely well  Very well   Somewhat well  Not so well   Not well at all
3.	Describe the key supports for delivering the [TIES program element] as planned.	Free text response
4.	What challenges, if any, did you have in delivering the [TIES program element] as planned?	Free text response [move to #5]
5.	How much did the [TIES program element] affect the quality of the father’s experience in your program?	A great deal A lot A moderate amount A little Not at all
6.	How much do you think the [TIES program element] improved fathers’ [outcome targeted by intervention]?	A great deal A lot A moderate amount A little Not at all
7.	What some ways that the program has helped fathers increase [target outcomes]	Free text response
8.	What were challenges to fathers’ improving [ targeted outcomes]?	Free text response
9.	What changes to [TIES program element] do you think are needed to better support fathers’ in achieving their financial, parenting, or co-parenting goals?	Free text response
Next, we’d like to ask a few questions about your program’s partnership with the TIES study team. Your feedback is important to ensure we’re providing your team with the best support that we can.
10.	How would you describe your program’s individual meetings with the Fatherhood TIES project team? Choose your response based on a 5-point scale where 1 means you meet too often and 5 means you do not meet enough.	1 We meet too often 2 3 We meet the right amount. 4 5 There is too much time between meetings 9 I haven’t been in any individual meetings cycle
11.	How would you describe the content of your program’s individual meetings with the Fatherhood TIES project team? Choose your response based on a 5-point scale where 1 means the content is not helpful and 5 means the content is very helpful.	1 The meeting content is not helpful to me in implementing the [TIES program element] 2 3 The meeting content is somewhat helpful to me in implementing the [TIES program element] 4 5 The meeting content is very helpful to me in implementing the [TIES program element] 9 I haven’t been in any meetings
12.	How helpful are the Fatherhood TIES Together peer-learning meetings? Choose your response based on a 5-point scale where 1 means the meetings are not very helpful and 5 means they are very helpful.	1 Not very helpful 2 3 Somewhat helpful 4 5 Very helpful 9 I haven’t attended a monthly TIES Together meeting
Exit_responder	Thank you for responding! Your input will help [name the program] to improve!
Exit_no_consent	Thanks for considering.