Form Instrument for Pro Instrument for Pro Instrument for Project Director

Evaluation of Pregnant and Postpartum Women (PPW)

Attachment F - Instrument for Project Director

Project Director

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ATTACHMENT F:

INSTRUMENT FOR PROJECT DIRECTOR

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Biannual Project Director Telephone Interview

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Attachment F-1

Biannual Project Director Telephone Interview

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TI # __________
Biannual Project Director Telephone Interview
2-2-10

[Words in capital letters are notes to the interviewer and not meant to be read aloud.]

Grantee Name:

_____________________________________________

Project Director
Name: ____________________________________________________
Address: ___________________________________________________
Phone #: ___________________________________________________
Email Address: ______________________________________________
Interviewer Name:__________________________________________________
Date of Interview:____/____ /____ Start and End Times: _______ ________

Section 1. Respondent Background
Ask the following questions only on the first telephone interview. These items only need to be
completed on further interviews if the project director changes.
First, I’d like to find out a little about your background and role on the PPW grant.
1.1 How long have you been at [Name of Grantee]?

1.2 What are your current responsibilities?

1.3 Please tell me about your educational background and credentials including any licenses or
certifications.

1.4 About how long have you worked in substance abuse and/or mental health treatment?
_____ Years ______ Months
a. [If greater than 0 months] Please describe your professional experience related to
addictions, mental health, health or other healthcare.

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Position

Facility Type

Duration (In Years)

b. [Has the project director provided direct clinical care?]
Yes
No

Section 2. Clarification of Biannual Report Information
2.1 Clarification of any items from the Biannual Report Coding Form. For example:
a. Your biannual report indicated that in the past six months there were changes in the project
service delivery method. Has the array of services provided by the PPW grant changed (e.g.,
new services added or existing services discontinued)?

If yes, why were these changes made?

b. Your biannual report indicated that the number of clients you plan to serve in this project year
has changed, why was this number changed?

c. Your biannual report indicated that your project goals/objectives have changed, why have
they changed?

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Section 3. Technical Assistance
3.1 You listed the following technical assistance (TA) needs in your biannual report:
[For each technical assistance need listed ask for the following information:]
Identified TA Need

Submitted a TA request through the
online TA system?
Yes
Yes
Yes
Yes

No
No
No
No

DK/Refused
DK/Refused
DK/Refused
DK/Refused

What is the status of that TA
request (e.g., TA scheduled,
consultant identified, TA
completed)

3.2 Have you received any TA during the last six months?
No – [Skip Next Item]
DK/Refused – [Skip Next Item]
Yes
3.3 For those TAs received in the last 6 months, please provide details of each TA (i.e., number of days
of TA received, and type of the TA).
Completed TA

# Days of TA Received

Type of TA
Regular, Ongoing Consultation /Discussion
Customized TA
Training, Webinars, & Other Events
Annual or Semi-Annual Grantee Meeting
Resource Materials
Information or Support Via TA
Provider’s Website
Site Visit
Other (Specify)

Regular, Ongoing Consultation /Discussion
Customized TA
Training, Webinars, & Other Events
Annual or Semi-Annual Grantee Meeting
Resource Materials
Information or Support Via TA
Provider’s Website
Site Visit
Other (Specify)

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3.4 Do you feel that these TAs received will improve/affect the success of the project?
No
DK/Refused
Yes
a. If Yes, please explain.

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Section 4. Training / Professional Development Activities
4.1 You listed _[#]__ of training / professional development activities in your biannual report. Please
clarify how these trainings/activities may improve/affect the success of the project in the following
areas: Probe for examples related to:
a. Decreasing client’s substance use

b. Increasing safe and healthy pregnancies/ improved birth outcomes

c. Improved mental health of clients and their children

d. Improved physical health of clients and their children

e. Improved family functioning

Decreased involvement/exposure to crime, violence, sexual/physical abuse, and child
abuse/neglect

g. Improved economic/housing stability

Section 5. Cross Site Data
5.1 What is your process for ensuring quality control of your data (e.g., system for checking that the data
are entered corrected)?
a. Probe for a formalized process for ensuring quality control of data.

5.2 During the last six months:

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a. How many of your clients consented to participate in the PPW cross-site evaluation data
collection activities (i.e., number of consent forms that clients have completed in the last six
months)? __________
b. How many of your clients refused to participate in the PPW cross-site evaluation data
collection activities (i.e., number of clients who refused to sign consent forms in the last six
months)? __________
1. If greater than 0, what were their reasons for refusal to participate in the PPW crosssite evaluation data collection activities?

Section 6. Program Context and Sustainability
6.1 Have there been any changes in the community that may affect the success of the project?
No
Yes
a. If Yes, please explain.

6.2 Have you developed a sustainability plan to ensure that the project continues after the funding ends?
No
Yes If Yes, please send us a copy
a. If No, have you started a process to begin developing a sustainability plan (i.e.,
strategic planning process)?
1. If Yes, what is the status?

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Section 7. Barriers/Challenges
7.1 Have there been any barriers or challenges during this reporting period that may affect the success of
the project?
No
Yes
a. If Yes, please explain.

Now, I would like to understand some of the challenges that your PPW program has faced in the last six
months. I’m going to read a list of areas that are often challenging for programs. Please tell me how
much of a challenge each has been for your program on a scale of 1 to 5, where 1=Not at all a challenge
and 5=Very much a challenge. Where this has been a challenge, I would like to know what the nature of
the challenge has been and whether you think it was successfully resolved.
How much of a challenge have the following areas been in the past six months?

7.2 Financial matters

Very Much

IF A=2-5:
Much

Somewhat

Little

Program Challenge
Area

Not at all

(A)
Rating

(B) Description/Source of
Challenge
[Don’t Read Categories]
Low Staff Pay
Increased Costs
Budget Cuts
Limited Reimbursement
Other, Specify:

IF A = 2-5:

Ongoing
Resolved
(Specify)

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7.3 Keeping the PPW
program at full capacity
(i.e., beds full)

7.4 Administration or
management of the
program

7.5 Finding and keeping
qualified staff

Very Much

IF A=2-5:
Much

Somewhat

Little

Program Challenge
Area

Not at all

(A)
Rating

(B) Description/Source of
Challenge
[Don’t Read Categories]

IF A = 2-5:

Client Flow
Clients View Program As
Restrictive
Other, Specify:

Ongoing
Resolved
(Specify)

Regulations Imposed By State,
Etc.
Funding
Modernizing Tx Philosophy/
Structure
Other, Specify:

Ongoing
Resolved
(Specify)

Staff Turnover
Limited Staff (Training,
Qualifications)
Not Enough Staff
Finding Qualified Staff
Low Pay
Other, Specify:

Ongoing
Resolved
(Specify)

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7.6 Facilities

7.7 Meeting clients’
needs for services

7.8 Visitation with
children (who are not in
treatment with mother)

Very Much

IF A=2-5:
Much

Somewhat

Little

Program Challenge
Area

Not at all

(A)
Rating

(B) Description/Source of
Challenge
[Don’t Read Categories]
Old Or Run-Down
Insufficient Space
Access To Community /Public
Transport
Neighborhood Iffy (Drugs,
Crime)
Other, Specify:

Meeting Mental Health Needs
Clients Have Too Many Needs
Voc Training/Job Placement
Hard
Not Enough Women’s Beds
Keeping Enough Women In Tx
Safety (Emotional, Physical)
Insufficient Childcare
Medical Issues
Other, Specify:

Children Live Far Away
Cps/Others Won’t Bring Them
Other, Specify:
1

IF A = 2-5:

Ongoing
Resolved
(Specify)

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7.9 Providing services to
children within PPW
program

Very Much

IF A=2-5:
Much

Somewhat

Little

Program Challenge
Area

Not at all

(A)
Rating

(B) Description/Source of
Challenge
[Don’t Read Categories]
Not Enough Child Beds
Accommodating Older Boys
Accommodating Older Girls
Child Behavior Problems
Meeting Children’s Therapeutic
Needs
Other, Specify:

IF A = 2-5:

Ongoing
Resolved
(Specify)

7.10 Having prenatal or
perinatal services
available ONSITE

Expensive W/ Inadequate
Reimbursement
Need Is Variable So Hard To
Keep
Resources/Linkages Fresh
Other, Specify:

Ongoing
Resolved
(Specify)

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7.11 Client satisfaction

Very Much

IF A=2-5:
Much

Somewhat

Little

Program Challenge
Area

Not at all

(A)
Rating

(B) Description/Source of
Challenge
[Don’t Read Categories]
Clients Complain About:
Food
Physical Accommodations
Staff
Prog Rules, Restrictions,
Requirements
Wanting More Services Or Help
Don’t Want To Be Here, Tx
Coerced
Everything - Impossible To
Please
Other, Specify:

IF A = 2-5:

Ongoing
Resolved
(Specify)

Section 8. Respondent Demographic Information
[Ask the following questions only on the first telephone interview. These items only need to be completed
on further interviews if the project director changes.]
Before we finish, I would like to ask you a few questions about your demographic characteristics.
8.1 What is your gender?

8.2 Do you consider yourself to be Hispanic or Latino/a?
No
Yes
DK/Refused
8.3 What race or ethnic backgrounds do you most identify with? You can choose all that apply. Would
you say…
…American Indian or Alaska Native,
…Asian,
…Black or African American,
…Native Hawaiian or other Pacific Islander, and/or
…White?
DK/Refused

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8.4 I am going to list some age categories. Would you say you are…
...18-25
…26-34
…35-44
…45-54
…55-64 or
…65 or older?
Refused
That is all of the questions that I have for you. Do you have any questions for me or would you like to
tell me about any other issues that you think are important to understanding the program or the services
you provide?
Thank you.

File Type	application/pdf
File Title	Attachment F - Instrument for Project Director
Author	Victoria Castleman
File Modified	2010-09-01
File Created	2010-09-01