C Attachment C - Newsletter Issue Brief Groupsite Customer

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

Attachment C - Newsletter Issue Brief Groupsite Customer Satisfaction Survey

Maternal, Infant, and Early Childhood Home Visiting Program HV-ImpACT Technical Assistance Program Feedback and Satisfaction Surveys

OMB: 0915-0212

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OMB Control Number: 0915-0212

Expiration Date: 05/31/2018


Newsletter/Issue Brief/MIECHV Groupsite Customer Satisfaction Survey

Please fill out this brief survey and tell us about the HV-ImpACT Home Visiting Home Run newsletters, Home Visiting Issues and Insights issue briefs, and the MIECHV Groupsite.


Public Burden Statement: 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 project is 0915-0212. Public reporting burden for this collection of information is estimated to average 0.12 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-29, Rockville, MD, 20857.


Section 1

  1. Listed below are three technical assistance resources that the HV-ImpACT provides. Please select all of the resources you have accessed in the past 3 months. (Check all that apply.) Note: Respondents will be directed to complete Section 2 for each of the responses checked.

    1. Home Visiting Home Run newsletters

    2. Home Visiting Issues and Insights issue briefs

    3. MIECHV Groupsite

    4. None of the above


Section 2

  1. (Matrix) Please tell us the extent to which you agree or disagree with the following statements.

  1. The (newsletter/issue brief/MIECHV Groupsite) helped support our program mission to deliver evidence-based home visiting services.

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree

  1. The (newsletter/issue brief/MIECHV Groupsite) provided my organization with opportunities to engage in learning about a topic in which we need support.

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree

  1. The topics covered enhanced my organization’s ability to support LIAs in addressing an identified need.

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree

  1. The (newsletter/issue brief/MIECHV Groupsite) connected me with resources that are useful for my organization’s home visiting needs.

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree



  1. (Matrix) Overall, how satisfied are you with the quality of the following items?

  1. The quality of the (newsletter/issue brief/MIECHV Groupsite) content

Extremely satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Extremely dissatisfied

  1. The readability of the (newsletter/issue brief/MIECHV Groupsite)

Extremely satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Extremely dissatisfied

  1. The timeliness of the (newsletter/issue brief/MIECHV Groupsite) content

Extremely satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Extremely dissatisfied



  1. (Matrix) Please indicate the extent to which you agree or disagree with the following statements.

  1. The (newsletter/issue brief/MIECHV Groupsite) improved our ability to reach our performance measures.

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree

  1. The (newsletter/issue brief/MIECHV Groupsite) increased our capacity to engage families.

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree

  1. The (newsletter/issue brief/MIECHV Groupsite) increased the knowledge and skills of our workforce

Strongly agree

Somewhat agree


Neither agree nor disagree

Somewhat disagree

Strongly disagree


  1. (Open-ended) What can we do to improve (future newsletters/future issue briefs/the MIECHV Groupsite)?


Section 3 (All respondents who indicated they have accessed the newsletter, issue brief, and/or MIECHV Groupsite in the past 3 months.)


  1. (Open-ended) What topics or subjects would you like us to address in future newsletters and issue briefs?



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AuthorMcAuley, Emma
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