Form Survey JAN Self-employment Interview

Job Accommodations Network User Follow-Up Interview

Self-Employment Service Form

Interview Structure

SECTION I. INTRODUCTION AND INFORMED CONSENT…………………………………………………….2

SECTION II. OUTREACH………………………………………………………...……………………………………3

SECTION III. SELF-EMPLOYMENT INTERATION OUTCOMES…………………………………………….….5

SECTION V. SELF EMPLOYMENT WEB SITE…………………………………………………………………….6

SECTION VI. GENERAL USER SATISFACTION…………………………………………………………………...7

Section I. Introduction and Informed Consent

Hello. My name is _____________________________. I am calling to invite you to participate in a research study being conducted by West Virginia University on behalf of the Job Accommodation Network or JAN.

On ______________________(date), you contacted JAN, either by phone or electronically to request information about ______________________________. During that consultation you indicated your willingness to participate in a follow-up interview. I have been hired by JAN to do follow-up interviews that will evaluate JAN services.

Have I reached you at an OK time to talk?

If Yes, continue

If No, “What would be a better time?”_______________________________________.

As you may be aware, JAN is a free consulting service that provides information about job accommodations, the Americans with Disabilities Act, and the employability of people with disabilities. The purpose of this follow-up is to evaluate JAN’s service and to identify ways that it could improve services to its clients.

This follow-up will take about 15 minutes of your time. The information that you provide to us will be kept confidential to the extent permitted by law. Any reports or articles about these follow-ups will describe results in a summarized manner so that you cannot be identified.

Your participation in this interview is voluntary. Your decision whether or not to participate will not affect the services you may receive from JAN. You may choose not to take part at all or you may choose to stop participating at any time, and you won’t be penalized or lose the ability to use JAN’s services.

There are no foreseeable risks to participating in this research study. There will be no personal benefit to participating in this study.

Do you have any questions at this point?

Do you wish to take part in the follow-up at this time?

If Yes, continue

If No, “Is there a better time in which you wish to take part in the follow-up?”_______

Section II. Outreach

1. How did you know to contact the Self Employment service?

(ALL THAT APPLY); [Interviewers FIELD CODE into the following categories]

a. Used JAN service before

b. Previous user of JAN service (specify if another employer)

c. JAN Website

d. Other website (not JAN website)

e. Internet search

f. Referral from:

Organization (list) ________________________

Government Agency (list) __________________

Company

DOL Call Center

EARN

JANSelf-employment

g. Friend/co-worker/word of mouth

h. Personal contact with JAN staff member

i. Rehabilitation professional

j. Medical professional

k. Educational institution

l. Union

m. Legal professional

n. Newspaper/magazine/book/professional journal article

o. Television (report or advertisement)

p. Listed in a directory

q. I&R Service

r. Conference

s. JAN Publication or Brochure

t. JAN presentation

u. Used JAN self-employment service before

v. Previous user ofJAN self-employment service

w. Self-employmentWebsite

x. Self-employment Publication or Brochure

y. Other (please specify): _____________________________________________________

2. Before you contacted the Self-employment service, what did you expect the Self-employment service to provide to you?

(Record response verbatim. Query for additional information so that sufficient detail to code into one or more of the following categories.)

a. Information on starting a small business

1. developing a business concept

2. market research

3. writing a business plan

4. obtaining capital

5. loan guarantees

b. Managing a Business

1. technical assistance resources

2. growing a business

3. personnel management

4. financial management

5. developing a marketing plan

c. Disability Issues

1. Social Security

2. PASS plans

3. health care

4. working at home

d. Other. Please specify:________________________________________________

Section III. Self-employment Interaction Outcomes

1. Self-EmploymentInformation:

Where are you now in the process of self-employment?

[Interviewers to read information in parentheses only if asked] SELECT ONLY ONE RESPONSE

a. [Are you] Considering the idea of self-employment

b. Planning stages (Writing the business plan, exploring opportunities and ways agencies and organizations can help with a variety of issues in the planning process)

c. Initial start up stages (Submitting the business plan, organizing work incentive options, approval from VR or other micro enterprise or funding source, licensing, zoning and tax issues in place)

d. Near operation (Funding and operation is in place and business is about to open its doors)

e. Business established

f. Business expansion

5. Hiring other employees

6. DK

7. RF

2. Did the information you received from the Self-employment service help you to get in touch with local resources?

1. Yes (If Yes, Continue to question 3)

2. No (Go to Section IV)

3. DK (Go to Section IV)

4. RF (Go to Section IV)

3. Which of the following resources did you contact based on your consultation with theSelf-employment service (YES/NO to each)

1. Financing, economic development, and/or microenterprise programs Yes No

2. Business planning and technical assistance organizations (includes business incubators, nonprofit organizations, local business development offices, community development offices, women’s business councils etc.) Yes No

3. State vocational rehabilitation (VR) program (includes programs providing small business development assistance within VR) Yes No

4. Small Business Administration (SBA) office (includes Small Business Development Centers, Women’s Business Centers, Service Corps of Retired Executives (SCORE) or other affiliated programs) Yes No

5. Veteran’s Business Development programs (includes SBA Veteran’s programs, Dept. of Veteran’s Affairs) Yes No

6. Social Security Administration and related programs (includes organizations that provide information on work incentive and benefits counseling) Yes No

7. Federal government business resources (includes IRS, Department of Commerce, Dept. of Housing and Urban Development) Yes No

8. Credit or personal financial counseling services Yes No

9. Health Insurance resources Yes No

10. Other __________________________________________________________

Section V. Self-employment Web site

A. User Satisfaction - Ease of Use

1. Have you visited the Self Employment Service website within the last year? [Interviewers may respond that the website is at http://www.jan.wvu.edu/sbses if asked]

1. YES [Go to Q 3]

2. NO [Skip to Section V]

3. DK [Skip to Section V]

4. RF [Skip to Section V]

2. On a scale from 1 to 5 with 1 being difficult and 5 easy, how was the website to navigate?

1 2 3 4 5 8 = DK 9 = RF

(difficult) (easy)

[If response = "1", query "So, the website was difficult to navigate?"]

3. On the same scale, how was it for you to obtain the information that you needed from the website?

1 2 3 4 5 8 = DK 9 = RF

(difficult) (easy)

[If response = "1", query "So, it was difficult for you to get the information that you needed from the website?"]

4. Using the same scale from 1 to 5, how was it for you to find information to contact relevant resources?

1 2 3 4 5 8 = DK 9 = RF

(difficult) (easy)

[If response = "1", query "So, it was difficult for you to find information to contact relevant resources?]

5. What did you hope to find on the website?

__________________________________________________________________________

6. Did you find it? __ Yes __No

If No, Please explain.

Section VI. General User Satisfaction

The last few questions are more general. Please tell me...

[In this section, interviewers will record comments that are provided but will not query for comments.]

1. On a scale from 1 to 5, with 1 being difficult to use and 5 as easy, how easy or difficult was it to contact the Self Employment service?

1 2 3 4 5 8. DK 9. RF

(difficult) (easy)

[If response = "1", query "So, it was difficult for you to contact the Small Business & Self Employment service?"]

Spontaneous Comments: ____________________________________________________________

2. On a scale of 1 to 5 with 1 being “not courteously” and 5 being “courteously,” how were you treated by the receptionist?

1 2 3 4 5 8 = DK 9 = RF

(not courteously) (courteously)

[If response = "1", query "So, the receptionist was not courteous?"

Spontaneous Comments: ____________________________________________________________

3. On that same scale, how were you treated by the consultant?

1 2 3 4 5 8 = DK 9 = RF

(not courteously) (courteously)

[If response = "1", query "So, the consultant was not courteous?"]

Spontaneous Comments: ____________________________________________________________

4. On a scale from 1 to 5 with 1 being "not understand" and 5 being "understood", how well did the consultant understand your needs?

1 2 3 4 5 8 = DK 9 = RF

(not understand) (understood)

[If response = "1", query "So, the consultant did not understand your needs?"]

Spontaneous Comments: ____________________________________________________________

5. On a scale from 1 to 5, with 1 being “did not meet my needs at all” and 5 being “met my needs exceptionally well”, how well did the information that you received meet your needs?

1 2 3 4 5 8. DK 9. RF

(not at all) (exceptionally well)

[If response = "1", query "So, the information you received did not meet your needs at all?"]

6. How could the services you received have better met your needs.

7. Would you use the service again, if you needed information?

a. Yes b. No 8 = DK 9 = RF

8. Where would you get this type of information if the Self Employment service did not exist?

9. Have you referred other people to the Self Employment service?

a. Yes

b. No

10. On a scale from 1 to 5, with 1 being "very unlikely to refer" and 5 being "very likely to refer", how likely would you be to refer other people to the Small Business and Self Employment service?

1 2 3 4 5 8. DK 9. RF

Very unlikely Very likely

11. We would appreciate any comments or suggestions that you may have about the Self Employment service.

Thank you for your participation.

Self Employment 8