1
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Which
of the following best describes your role within [PREP PROGRAM]?
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Developed
for PREP
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2
|
What
is your age?
|
Developed
for PREP
|
3
|
Are
you male or female?
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OMB
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4
|
Are
you Hispanic/Latino?
If so, are you Mexican/Mexican
American/Chicano/a? Puerto Rican? Cuban?
|
OMB
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5
|
Another
Hispanic, Latino/a, or Spanish origin?
|
OMB
|
6
|
What
is your race?
|
OMB
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7
|
What
is the highest level of education you have completed?
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Developed
for PREP
|
8
|
What
is your profession or area of work?
|
TCU
Survey of Organizational Functioning
|
9
|
How
many years of experience do you have working in programs for
youth ages 10 to 14 (either working directly with youth or in
youth program administration)?
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TCU
Survey of Organizational Functioning
|
10
|
How
much experience do you have working in programs for youth ages 15
to 19 (either working directly with youth or in youth program
administration)?
|
TCU
Survey of Organizational Functioning
|
11
|
How
long have you worked for your current employer?
|
TCU
Survey of Organizational Functioning
|
12
|
How
long have you worked in teen pregnancy prevention programs?
|
TCU
Survey of Organizational Functioning
|
13
|
How
long have you worked in a job that requires collaborating with
community partners?
|
TCU
Survey of Organizational Functioning
|
14
|
When
you FIRST started working with PREP PROGRAM, what kind of formal
training did you receive in how to implement the program?
|
GOI
- Using General Organizational Index for Evidence-Based Practices
|
15
|
What
kind of ongoing training to support implementation of PREP
PROGRAM do you receive?
|
New
|
16
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I
need more training on…
a. Increasing youth participation
b. Monitoring youth
participant progress
c. Improving the quality of
communication among youth participants and between youth
participants and adults
d. Engaging youth participants in
program topics and materials
e. Decreasing youth
participants’ risk behaviors and improving their
decision-making skills
f. Improving and managing youth
participant behaviors
|
TCU
Survey of Organizational Functioning
|
17
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
a.
I have the skills I need to implement all PREP PROGRAM topics
b.
I am satisfied with the training I have received on PREP PROGRAM
topics
c. I need more training on some PREP PROGRAM
topics
d. I have the skills I need to conduct effective
youth health risk prevention and youth development programs
e.
I need more training to conduct effective youth health risk
prevention and development programs
|
TCU
Survey of Organizational Functioning
|
18
|
After
you began implementing [PREP PROGRAM], did you change the
sequence of program sessions or activities from the order that
was initially planned?
|
Developed
for PREP
|
19
|
After
you began implementing [PREP PROGRAM], did you change the number,
frequency, or duration of the sessions or activities from what
was initially planned?
|
Developed
for PREP
|
20
|
After
you began implementing [PREP PROGRAM], did you drop some sessions
or activities from those initially planned?
|
Developed
for PREP
|
21
|
After
you began implementing [PREP PROGRAM], did you add some sessions
or activities to those initially planned?
|
Developed
for PREP
|
22
|
After
you began implementing [PREP PROGRAM], did you change the content
of a session or activity from what was initially planned?
|
Developed
for PREP
|
23
|
Please
rate how much you agree or disagree with the following
statements:
- There are internal agency or school
policies in place that conflict with PREP PROGRAM
-Agency and school policies support PREP PROGRAM implementation
Policies and regulations at my agency or the schools we work in
prevent staff from fully implementing PREP PROGRAM
-My
agency or the schools we work in have policies that limit program
staff access to resources needed to implement PREP PROGRAM
-There are internal agency or school policies in place that
conflict with PREP PROGRAM
|
EBP-SI
Sustainability Index;
State
Health Authority Yardstick
|
24
|
Please
rate how much you agree or disagree with the following statements
about your organization: (1=strongly disagree to 5=strongly
agree)
-The workload and pressures here decrease
my motivation to implement new programs like PREP PROGRAM
-Training activities take too much time away from delivery of
program services
-Training helps facilitate PREP
PROGRAM implementation
- It is too difficult to adapt
information learned in trainings so they will work in PREP
PROGRAM
- The resources that are available help
facilitate PREP PROGRAM implementation
-The background
and training of program staff limits the kind of improvements to
PREP PROGRAM implementation that are possible
-There
are too few rewards for trying to improve PREP PROGRAM
|
TCU-PTN
Survey of Program Training Needs
|
25
|
A
program champion is an organization leader or other person with
influence who advocates for a program within the larger
organization and in the community. Does PREP PROGRAM have a
program champion? If so, please describe this person’s
role and relationship to PREP PROGRAM
|
State
Health Authority Yardstick
|
26
|
The
next questions are about the PREP PROGRAM leader that has overall
responsibility for implementing PREP PROGRAM. Please rate how
much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
The PREP
PROGRAM leader (or coordinating team) ...
- Has
adequate dedicated time for PREP PROGRAM implementation, and that
time is protected from distractions, conflicting priorities, and
crises
- Has the necessary authority to run PREP
PROGRAM
- Has good relationships with community
programs
- Is highly knowledgeable about PREP
PROGRAM
- Is viewed as an effective leader (influence,
authority, persistence, knows how to get things done) for PREP
PROGRAM,
- Accepts responsibility for the success of
this program
- Is someone who speaks out about PREP
PROGRAM and is sought out for advice about the program
- Works will with the intervention team and partners
|
State
Health Authority Yardstick; Organizational Readiness to Change
Assessment
|
27
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
a. My
program managers provide effective management for continuous
improvement of implementation of PREP PROGRAM
b. My program
managers clearly define areas of responsibility and authority for
supervisors and frontline staff involved in PREP PROGRAM
c.
My program managers promote team building to solve problems with
implementing PREP PROGRAM
d. My program managers do not
promote effective communication among program staff, partners,
the state and other stakeholders working on PREP PROGRAM
|
Organizational
Readiness to Change Assessment
|
28
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
-Management here trusts my professional judgment
- I do
not feel appreciated for the job that I do
- Ideas and
suggestions related to -implementing PREP PROGRAM get adequate
and fair consideration from program management
-
Director, facilitators, and support staff collaborate to make
sure PREP PROGRAM runs effectively
– Staff working on
PREP PROGRAM work well together as a team
|
TCU
Survey of Organizational Functioning
|
29
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
a.
My agency has communication protocols or pathways that make it
clear who to communicate with about challenges or issues related
to PREP PROGRAM.
b. I have regularly scheduled check-in
meetings with my supervisor about PREP PROGRAM
c. My
supervisor and I rarely discuss PREP PROGRAM
d. I am never
sure whom I should talk to about issues related to PREP PROGRAM
|
Developed
for PREP
|
30
|
Please
rate how much you agree or disagree with the following statements
(1=not true, 2=slightly true, 3=somewhat true, 4=mostly true,
5=true):
a. PREP PROGRAM is a top priority of this
agency/school.
b. People do not put a lot of effort into
making PREP PROGRAM a success.
c. At this agency/school,
PREP PROGRAM takes a back seat to other projects.
d. People
at this agency/school think that implementation of PREP PROGRAM
is important.
e. One of this agency/school's main goals is
to implement PREP PROGRAM effectively.
f. People here really
do not care about the success of PREP PROGRAM.
g. In this
agency/school, there is a big push for people to make the most of
PREP PROGRAM.
|
NIRN
- Stage-Based Measures of Implementation Components
|
31
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
In my
agency/school, for the implementation of PREP PROGRAM...
a.
We have adequate resources to ensure that PREP PROGRAM can be
implemented in the way it was designed to be implemented
b.
We have the necessary budget or financial resources we need to
implement PREP PROGRAM
c. We have the necessary staffing to
implement PREP PROGRAM
d. We have the necessary staff
training we need to implement PREP PROGRAM
e. We have the
necessary time to support continuous improvement of PREP PROGRAM
implementation
f. We need additional guidance or coaching to
support improvement of PREP PROGRAM implementation
|
Organizational
Readiness to Change Assessment
|
32
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
-My
office and equipment are adequate to support PREP PROGRAM
implementation
-Most programmatic record keeping for
PREP PROGRAM is computerized
-Facilities where PREP
PROGRAM sessions and activities are conducted are adequate for
delivering the program
-Computer equipment at this
agency/school is mostly old and outdated
|
TCU
Survey of Organizational Functioning
|
33
|
Please
rate how much you agree or disagree with the following statements
(1=strongly disagree to 5=strongly agree):
a.
I feel like PREP PROGRAM can make a difference for youth
b.
The general attitude at my agency is to adopt new youth risk
prevention programs and practices for working with youth when
possible, as we are in PREP PROGRAM
c. PREP PROGRAM does not
fit well with the values and priorities of our community
d.
I adopt new ideas like those in PREP PROGRAM quickly
e. I do
not feel effective and confident in implementing PREP PROGRAM
f.
PREP PROGRAM addresses many of the risks youth in our community
face
g. I give high value to the work you do with youth here
h. PREP PROGRAM fits well with the values and philosophy of
our organization
|
TCU
Survey of Organizational Functioning
|
34
|
Please
rate how much you agree or disagree with the following
statements. In my community …
a.
There are other programs that address topics that are the same as
or similar to our PROGRAM
b. There is broad support for
programs that help prepare youth for adulthood
c. Many
groups and/or individuals do not support teaching comprehensive
approaches to pregnancy and STD prevention
d. We have a
number of programs that address different types of youth risk
behavior, such as alcohol, tobacco, or drug use, delinquency,
bullying or harassment, etc.
e. We lack programs designed to
prepare youth for adulthood.
f. There is broad support for
programs that address reducing teen sexual risk behaviors.
|
Developed
for PREP
|