Participant Implementation Questionnaire

Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD)

Appendix_G_Participant Implementation Questionnaire 10-3-12

Participant Implementation Questionnaire

OMB: 0970-0413

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Appendix G

Participant Questionnaire

Appendix G

Participant Questionnaire

Updated 10.3.12

The U.S. Department of Health and Human Services and the U.S. Department of Labor have contracted with MDRC to evaluate innovative subsidized and transitional employment models targeting TANF recipients, noncustodial parents, former prisoners, and other low-income parents. The goal is to better understand what kinds of employment programs are most effective at helping people with these kinds of disadvantages gain and hold regular employment.


As part of our research, we are speaking with program participants to learn about their experiences with the program and what kinds of services they are receiving from the program and/or their subsidized job. This document is a short questionnaire. It should take about 10 minutes to complete. All of your responses on this questionnaire will be kept private; the research staff has been trained in protecting private information and your name will not appear in any written reports we produce. Your responses to these questions are also completely voluntary; you are not required to answer any questions you do not wish to answer. All of the study results will be reported for groups of individuals; no results will be analyzed or reported for individuals. Also, your responses to these questions will in no way affect your participation in the STED/ETJD program or affect your receipt of any kinds of public benefits or services.

According to the Paperwork Reduction Act (PRA), an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 0970-XXXX and it expires XX/XX/XXXX.

Thanks in advance for your time helping us with this valuable research. If you have any questions or would like any more information about the project, please contact Dan Bloom, the project director, at 212-340-8611 or at [email protected]

Participant Questionnaire

Subsidized and Transitional Employment Demonstration (STED)/Enhanced Transitional Jobs Demonstration (ETJD)



  1. What is the name of the organization or company you work for?


__________________________________________________


  1. Have long have you worked with this organization or company?

1 Less than one month

2 1-3 months

3 More than 3 months


  1. Briefly describe some of the tasks that you work on in an average day:


__________________________________________________________________________________________________________________________________________________________________

This section includes questions about who you work with on the job and how much contact you have with them on an average day at work. Please select the answer that best describes your experience on the job.


  1. On an average day at work, do you mostly work with:

1 Other people from <PROGRAM NAME>

2 Employees who are not part of the <PROGRAM NAME> program

3 A mix of <PROGRAM NAME> participants and other employees

4 No one else (mostly work alone)

5 Other: ­­­­


  1. On average, how often do you talk or email with your supervisor about work?

1 Several times each day

2 Once a day

3 A few times a week

4 Once a week

5 Less than once a week

6 Hardly ever


This section includes statements about how you feel about the work you are doing in your current job.


  1. I am doing work that is very important to the agency or company where I work.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I understand what is expected of me on the job.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I know who at work to ask for help when I need it.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot

  1. My supervisor provides advice about how to handle situations at work.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. My supervisor will help me if personal issues come up that get in the way of working.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. My supervisor treats me the same as employees who aren’t from <PROGRAM NAME>.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot

6 Doesn’t apply (only work with other <PROGRAM NAME> participants)


  1. I am doing the same kind of work as employees who aren’t from <PROGRAM NAME>.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot

6 Doesn’t apply (only work with other <PROGRAM NAME> participants)


  1. My responsibilities have increased since I began working in this job.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot

  1. I have opportunities to grow and take on new responsibilities in this job.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I am satisfied in this job.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. Overall, I feel better about myself since beginning this job.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


This section includes statements about how this job has helped you so far and how it might help you in the future.


  1. The kind of work I am doing will help me get a decent-paying job later.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I am learning specific job skills that I will use in the future.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I have met people through this job who may help me find a job in the future.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I am learning how to work better with others in a team.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I am learning how to cooperate better with my supervisors.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. I am late to work less often than when I began this job.

1 Agree

2 Disagree

3 Does not apply (did not need to improve in this area)


  1. I am more likely to call my supervisor if I’m going to be late or miss work than when I began this job.

1 Agree

2 Disagree

3 Does not apply (did not need to improve in this area)







  1. This job has helped me learn to present myself better at work.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


Finally, this section includes several questions about services you’ve received through this job and/or <PROGRAM NAME>.


  1. What types of supports or preparations did you receive from <PROGRAM NAME> or through your job? (Check all that apply.)

1 Help arranging child care

2 Transportation assistance

3 Help addressing housing problems

4 Anger management classes

5 Alcohol or substance abuse treatment

6 Counseling/parenting classes

7 Help with work-appropriate clothing

8 Computer training

9 Career planning/resume writing/job interview preparation/job search assistance

10 General money management assistance

11 Help setting up a bank account

12 Access to benefits (e.g., Social Security, food stamps, disability insurance, etc.)

13 Help understanding or changing child support payments

14 Other (please describe):



______________________________________________________

15 None










  1. As a result of the <PROGRAM NAME> program: (check all that apply)

1 I have better job skills.

2 I am better at working with others.

3 I feel more in control of my finances.

4 I have a greater sense of well-being.

5 I feel better able to handle responsibilities and challenges in my personal life so that they don’t get in the way of my job.

6 My relationships with my family members are better.

7 I feel better prepared to find work in the future.

8 I feel better able to meet my basic needs (e.g. food, clothing, shelter, transportation).

9 My self-esteem has improved.

10 Other (please specify): ____________________________________________________

11 Did not receive services


  1. What types of supports or preparations did you need but did not receive from <PROGRAM NAME> or through your job? (Check all that apply.)

1 Help arranging child care

2 Transportation assistance

3 Help addressing housing problems

4 Anger management classes

5 Alcohol or substance abuse treatment

6 Counseling/parenting classes

7 Help with work-appropriate clothing

8 Computer training

9 Career planning/resume writing/job interview preparation/job search assistance

10 General money management assistance

11 Help setting up a bank account

12 Access to benefits (e.g., Social Security, food stamps, disability insurance, etc.)

13 Help understanding or changing child support payments

14 Other (please describe):


__________________________________

15 None (received all services I needed)

  1. Without <PROGRAM NAME>, I would likely still be unemployed.

1 Agree a lot

2 Agree a little

3 Neither agree nor disagree

4 Disagree a little

5 Disagree a lot


  1. Please list the 2 or 3 most helpful skills or lessons that you received in this job or through <PROGRAM NAME>.


a. _____


b.


c. _________________


Thank you for completing this questionnaire!



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleParticipant Implementation Questionnaire
AuthorDepartment of Health and Human Services
File Modified0000-00-00
File Created2021-01-29

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