Human Trafficking Youth Prevention Education (HTYPE) Demonstration Grant Program Implementation Surveys

OMB Control Number: 0970-0531

Expiration Date: 07/31/2022

Pre-and Post-Survey Questions

OTIP designed a survey instrument for grantees to administer to students to collect information for the grantee’s quarterly performance reports. Results from the survey will be reported to OTIP in aggregate; OTIP does not intend to collect raw data from the surveys.

Human Trafficking Prevention Education for Elementary Students

Pre-Survey and Post-Survey

1. I can name one trusted adult who I can talk to if someone I know is being hurt or doing something that is not safe. (Yes / No)

2. I can name a hotline that I can call or text if someone I know is being forced to do something they do not want to do. (Yes / No)

3. If I was afraid that someone might hurt me, I would:

   1. Ask a trusted adult for help.

      1. Likert scale: (1) Strongly disagree; (2) Disagree; (3) Agree; (4) Strongly agree

   2. Call or text a hotline.

      1. Likert scale: (1) Strongly disagree; (2) Disagree; (3) Agree; (4) Strongly agree

   3. Ask a friend for help.

      1. Likert scale: (1) Strongly disagree; (2) Disagree; (3) Agree; (4) Strongly agree

Post-Survey Only

1. I learned something I can do to stay safe. (Disagree / Agree)

2. One thing I learned is: ___________________________. (open text)

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering data on your grant program to understand the extent to which you fulfilled required program activities, the design and effectiveness of the program, and to inform technical assistance needs. Public reporting burden for this collection of information is estimated to average 15 minutes per respondent, including the time for reviewing instructions, answering any questions, and providing the required responses. This collection of information is voluntary. 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 Vera Kiefer, ACF Office on Trafficking in Persons, by email at Vera.Kiefer @acf.hhs.gov.