Organizational
Context
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Mission
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Describe your
organization’s mission.
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History
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Describe the history of
your organization.
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What
led to the development of this organization?
Who
was part of the development team?
How
long has your organization been in existence?
Describe
the target population(s) your organization serves.
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Setting/
infrastructure
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Describe your
organization’s setting and infrastructure.
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Where
does your organization operate?
What
are the key programmatic areas of focus for your organization?
Does
your organization have a board of directors and/or medical
advisory board? If so, what is their role within your
organization?
How
many people does your organization employ?
Describe
the staff expertise at your organization?
What
is the organizational structure?
What is your
organization’s operating budget?
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Role in organization
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How would you describe
your role within your organization?
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Implementation
of the YBCS Intervention
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Intervention
Overview, History and Rationale
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Describe the
background/history of your organization’s YBCS
intervention.
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Describe your
organization’s YBCS intervention.
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What
are the key components of the YBCS intervention?
Who
is the target audience for the YBCS intervention?
How
have the key components of the YBCS intervention been tailored
to meet the unique needs of the target audience?
Was this YBCS
intervention adapted from an already existing program or
intervention?
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Describe your
organization’s goals and objectives for the YBCS
intervention.
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Describe the evidence base
and/or factors that informed (e.g., behavioral/communication
theory, scientific evidence, guidelines, formative research) the
development of the YBCS intervention.
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Describe your role in the
YBCS intervention.
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Intervention execution
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Describe how the YBCS
intervention is implemented.
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How
often is each component of the YBCS intervention implemented?
What
is the duration of the YBCS intervention?
Who
is responsible for delivering key components of the YBCS
intervention?
How
are YBCS intervention participants recruited?
How
has the delivery of the YBCS intervention been tailored to meet
the unique needs of the target audience?
How do you engage
members of the target audience (e.g., YBCS, families/caregivers,
health care providers) in the implementation of the YBCS
intervention?
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What tools, guidelines
and/or protocols are used to direct the implementation of the
YBCS intervention?
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What,
if any, manuals have been created to support implementation of
the YBCS intervention?
Who
created these guidelines?
How are these used
to implement the YBCS intervention?
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What
trainings are offered to staff to implement the YBCS
intervention?
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How
are trainings identified?
Who
delivers these trainings?
What
is the duration of each of these trainings?
How
often are trainings offered to staff?
Are there external
trainings that your organization has participated in to support
implementation of the YBCS intervention?
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Implementation Fidelity
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To what extent has the
YBCS intervention been implemented as planned?
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How does implementation of
the YBCS intervention vary across sites?
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Are there
differences in the way that the YBCS intervention is delivered
across sites (e.g., setting, geographic location, target
population)? If so, how is implementation different?
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Does your organization use
any process improvement strategies to improve the delivery of the
YBCS interventions?
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Resources
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How is the YBCS
intervention funded?
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How
does your organization use funding to implement the YBCS
intervention?
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What other, if any,
non-monetary resources have been provided to your organization to
support the YBCS intervention? If so, please explain.
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Have
you received donated resources, such as materials and/or
supplies, to help support implementation of the YBCS
intervention?
Have
people offered their time and/or expertise to help support
implementation of the YBCS intervention?
Have you received
any in-kind, paid media donations to promote and/or implement
the YBCS intervention?
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Facilitators
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What factors, if any, have
facilitated your organization’s implementation of the YBCS
intervention?
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What
internal organizational factors (e.g., leadership, staff,
resources, expertise) have helped your organization implement
the YBCS intervention?
What
external factors (e.g., training, TA, partnerships) have helped
your organization implement the YBCS intervention?
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Barriers
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What factors, if any, have
challenged your organization’s implementation of the YBCS
intervention?
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What
internal organizational factors (e.g., leadership staff,
resources, expertise) have challenged your organization’s
implementation of the YBCS intervention?
What
external factors (e.g., training, TA, partnerships) have
challenged your organization’s implementation of the YBCS
intervention?
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What
strategies has your organization used to overcome barriers
related to implementation of the YBCS intervention?
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Evaluation
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Knowledge
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Describe your
understanding of program monitoring and/or evaluation.
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Have
you participated in any past evaluation efforts? If so, please
describe.
Do you have
experience creating program logic models?
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Measurement
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For what the YBCS
intervention is trying to accomplish, how would you define
success?
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How is success measured or
documented?
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Do
you have baseline data? Do you intend to collect follow-up data?
At what time?
Do
you collect data at specified points over time (time
series)? What
length of time?
Do
you follow a sample of participants over time (cohort
study)? What
length of time?
Do
you have a comparison group?
What does the
evaluation activity tell you about the success of the YBCS
intervention?
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Describe how your
organization defines and assesses reach for the YBCS
intervention.
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Describe how your
organization measures the implementation of the YBCS
intervention.
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What
data do you collect?
Who
is responsible for measuring/monitoring implementation?
Are
other staff members involved in data collection? How so?
Are
there plans to expand or change how your organization monitors
implementation of the YBCS intervention? If so, please explain?
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What are the available
data sources used to support program monitoring and evaluation
for the YBCS intervention?
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What
data collection tools or instruments does your organization use
in relation to the YBCS intervention? (Request to see or obtain
copies of data, data collection tools, or evaluation reports.)
Describe the data
collection methods used to collect evaluation data for the YBCS
intervention.
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How does your organization
analyze data from the YBCS evaluation in order to collect program
monitoring and evaluation?
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What
analytic techniques does your organization use to conduct
program monitoring and evaluation for the YBCS intervention?
Who within your
organization, who is responsible for conducting analysis for the
YBCS intervention?
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How does your organization
use evaluation findings to inform implementation of the YBCS
intervention?
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Describe how your
organization shares evaluation findings from the YBCS
intervention.
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Facilitators
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What, if any, facilitators
have helped your organization conduct program monitoring and
evaluating for the YBCS intervention?
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Barriers
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What, if any, barriers has
your organization encountered in evaluating the YBCS
intervention?
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What
strategies has your organization used to overcome barriers
related to program monitoring and evaluation of the YBCS
intervention?
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Partnerships
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Development
and Engagement
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Describe
the process your organization has used to identify and develop
partnerships.
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Describe
how new partnerships have been formed to support the
implementation of the YBCS intervention.
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Describe
how you have worked to maintain existing partnerships to support
the implementation of the YBCS intervention.
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Why
were these partners identified (e.g., access to target
population, resources, expertise)?
How
did you continue your engagement with these organizations?
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Contribution
to the intervention
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Describe
how partners participate in the planning or implementation of the
YBCS intervention.
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How
does your organization interact with partners?
How
does your organization communicate with partners?
How
often does your organization communicate with
partners?
How
long has your organization worked partners?
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What partnerships have
been the most beneficial for your organization in the
implementation of the YBCS intervention?
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What additional
partnerships would [insert Nonfunded Organization name] benefit
from to support the implementation of the YBCS intervention?
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Capacity
and Sustainability
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Capacity
to implement intervention
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Describe
your organization’s capacity to implement the YBCS
intervention and how capacity has changed over time.
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Capacity
to evaluate
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Describe your
organization's capacity to plan and implement program monitoring
and evaluation activities, such as creating data collection
tools, collecting data, conducing analysis, and reporting.
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Describe
program staff members who have the expertise/experience to
collect and/or analyze data.
What
additional outside resources does your organization rely on to
help with evaluation (e.g., does your organization use an
external evaluator)?
Describe
the resources your organization reserves to support data
collection (e.g., time, materials, technology) to support
program monitoring and/or evaluation?
What
other resources does your organization designate for program
evaluation/monitoring (e.g., staff, time, technology,
materials)?
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Sustainability
of intervention
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Describe
the sustainability of the YBCS intervention and how
sustainability has changed over time.
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Perceptions
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Awareness
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How has the YBCS
intervention affected awareness for the existence of support
services and/or educational resources among the target audience?
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in increasing awareness for support
services and/or educational resources?
In
your opinion, what communication strategies were the most
effective in promoting and increasing awareness for the YBCS
intervention?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed awareness.)
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Access
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How has the YBCS
intervention affected access to support services and/or
educational resources for the target audience?
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in increasing access to support
services and/or educational resources?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed access.)
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Utilization
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How has the YBCS
intervention affected utilization of support services and/or
educational resources by the target audience?
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in increasing utilization of support
services and/or educational resources?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed utilization.)
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YBCS
knowledge, attitudes, and beliefs (KAB)
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What knowledge, attitudes,
and beliefs does the YBCS intervention aim to affect? How has the
YBCS intervention impacted those specific knowledge, attitudes,
and/or beliefs among the target population? (Examples of KAB
targets include: strategies for reducing
the risk of recurrence and the development of new malignancies,
chronic disease onset, and improving overall health and quality
of life).
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In
your opinion, what aspect of the YBCS intervention has been the
most effective in KAB among the target population?
Does your
organization have data to support the effectiveness of this? If
so, explain how this data is used. (Request to see or obtain
copies of data, data collection tools, or reports pertaining to
how a program has assessed KAB among target audience(s).)
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Value of the YBCS intervention
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What has been the value of
the YBCS intervention?
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In
your opinion, how did the YBCS intervention impact the target
audience?
In your opinion,
how did the YBCS intervention contribute to the evidence base
for promising strategies to reach YCBS, YBCS caregivers, and/or
YBCS health care providers?
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Lessons learned
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What have been some key
lessons learned from your organization’s experience with
the YBCS intervention?
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Recommendations
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What ideas do you have for
improving your organization’s YBCS intervention?
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