Survey Instrument crosswalk

Work@Health Survey Instrument Cross Walk

Respondent Type:

A. Interested Employers. Includes employers who wish to be considered for inclusion in the Work@Health® Program as Program Participants; these data represent organizational entities (employers), not individuals. A senior leader from each employer who has indicated that their organization meets the program eligibility requirements will be asked to complete an online Employer Application Form (Attachment E-1). This form will collect information from interested employers related to the eligibility criteria, employer characteristics (e.g., number of employees, type of industry), and status of their worksite health program.

Instrument	Method	Respondents	Time of Data Collection	Program Objective	Data Collected
Employer Application Form	Online	Interested employers	Prior to training	- Describe aggregate employee population at each participating employer	Employer contact info Employer characteristics (number of employees, type of industry) Status of workplace health program (have one, how many years in existence) Employer’s readiness for change in workplace health program

B. Selected Employers. Over three years, CDC will select 480 employers to participate in Work@Health® trainings. Information to be collected from the selected employers includes the CDC Worksite Health Scorecard (Attachment E-2), Organizational Assessment (Attachment E-3), Case Studies (Attachment E-5 and E-6), and the Employer Follow-up Survey (Attachment E-4). Each of these instruments is described in more detail below.

Instrument	Method	Respondents	Time of Data Collection	Program Objective	Data Collected
CDC Worksite Health Scorecard The CDC Worksite Health Scorecard (Attachment E-2) will collect information from the 480 employers selected to participate in Work@Health® to assess the extent to which employers have implemented evidenced-based health promotion interventions in their worksites and identify gaps in their health promotion activities.	Online	Employers participating in Work@Health®	Two times: 1 month prior to training and 12-15 months after first administration	- Assess elements of workplace structure, practices, and policies related to health and safety such as health benefits, health promotion programs, occupational health programs, work organization, and leadership and management support (CEO/C-Suite) for workplace health and safety initiatives	Employer characteristics and elements of worksite health promotion offered at your org. health ed, links to services, supportive environment, integration of health promotion into company’s culture, and employee screening Organizational supports (e.g., employee needs assessment, HRA, org commitment, use of incentives, competitions, health promotion committee, annual budget) Description of health and wellness programs (policies, activities, environment) related to tobacco control, Nutrition, Physical activity, Weight management, Stress management, Depression, High blood pressure, High cholesterol, Diabetes, Signs and Symptoms of Heart attack and stroke, and Emergency response to heart attack and stroke Supplement area (lactation, occupational health and safety, community resources)
Organizational Assessment The Organizational Assessment (Attachment E-3) will collect information from the 480 employers selected to participate in Work@Health® to assess changes in environmental elements of the physical worksite such as facilities and settings where employees work, as well as access to opportunities and resources for health promotion in the surrounding community.	Online	Employers participating in Work@Health	Two times: 1 month prior to training and 12-15 months after first administration	- Assess environmental elements of the physical workplace such as facilities and settings where employees work as well as access, opportunities, and resources for health promotion provided by the surrounding community where employees live - Assess aggregate employee participation in programs and community partnership activities - Indicators of culture	Elements of workplace structure (leadership support, health promotion committee) Motivators and barriers to implementations, importance of workplace health topics, Employee participation rates in workplace health programs Use and access to community resources for workplace health programs
Employer Follow-up Survey The Employer Follow-up Survey (Attachment E-4) will be used to collect information from the 480 employers who participated in the Work@Health® Program to assess maintenance and sustainability of worksite health and wellness programs, policies, and environmental changes.	Online	Employers participating in Work@Health	11-14 months after training	- Assess maintenance of workplace health and wellness programs, policies, and environmental changes	New workplace health programs, policies, or environmental supports as a result of training Other types of training that might be helpful in expanding programs
Case Study Interviews with Senior Leadership The Evaluation Team will conduct a series of interviews with senior leaders to develop Case Studies. The interviews will take place during site visits and by telephone. From the worksites selected for the employer level case studies, a senior leader will be invited to discuss his or her experience with the program, using the Case Study Interviews with Senior Leadership discussion guide (Attachment E-5). These discussions will focus on the extent to which the program met their expectations, challenges to and strategies for successful program implementation, and plans for sustainability.	Paper form	Employer leadership at participating employers	10-12 months after training	- A senior leader will be invited to discuss his or her experience with the program	Extent to which the program met their expectations Challenges to and strategies for successful program implementation Plans for sustainability
Case Study Interviews with Employees The Evaluation Team will conduct a series of interviews with employees, to develop Case Studies. The interviews will take place during site visits and by telephone. The evaluation team will conduct interviews with one to two employees (who were not trainees of the Work@Health® Program) from case study sites who participated in worksite-based health promotion activities developed as a result of the applied knowledge gained through the training, using the Case Study Interviews with Employees discussion guide (Attachment ). These discussions will focus on the employees’ expectations for healthy changes, perceptions of changes in the worksite’s physical and social environment, their own experiences with healthy options, and plans for continued healthy behaviors.	Paper form	1-2 employees at participating employers	10-12 months after training	- An employee who participated in workplace-based health promotion programs will be invited to discuss his or her experience with the program	Expectations for healthy changes Perceptions of changes in the workplace physical and social environment Their own experiences with healthy options and plans for continued healthy behaviors

C. Trainee Participants. Each of the 480 employers selected to participate in Work@Health® will assign a maximum of two employees to participate in the Work@Health® training. These 960 trainee participants will participate in either the Hands-On, Online, or Blended Training Model. The instruments used to collect data from the trainees include a Trainee KAB Survey (Attachment F-1), Trainee Reaction Survey (Attachment F-2-4), Trainee Technical Assistance Survey (Attachment F-5), a Trainee Focus Group guide (Attachment F-7), and Case Study Interview guides for selected trainees (Attachment F-6). Each of these instruments is described in more detail below.

Instrument	Method	Respondents	Time of Data Collection	Program Objective	Data Collected
Trainee KAB Survey The Trainee KAB Survey (Attachment F-1) will collect information from the 960 Work@Health® trainee participants to assess changes in trainees’ knowledge, awareness, skill, and behavior related to implementing worksite health programs.	Online	Trainees participating in training	Two times: 1 month prior to training and 5-8 months post-training	- Assess knowledge, awareness, and behavior related to implementing workplace health programs	Changes in knowledge, awareness, and behaviors based on each module of the Work@Health training curriculum
Trainee Reaction Survey: Hands-on Model The Reaction Surveys will assess trainees’ reactions to the Work@Health® training including their satisfaction with the training they received, whether the training was engaging, whether the facilitator, materials, and activities supported the goals of the training, whether the training met their needs, and their confidence in implementing or enhancing a health and wellness program at their place of employment	Paper form Trainees will be asked to seal their completed surveys in an envelope provided for the purpose to assure them that the facilitators will not see their answers.	Trainees participating in the Hands-on training model	At the conclusion of each Hands-on Training	- Evaluate trainees’ reaction to the Work@Health Program. - Evaluate outcomes and the ways in which participating trainees increased their knowledge and perceived ability to implement programs, policies, and environmental support changes that will improve workplace health.	Trainees’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met trainees’ needs and trainees’ confidence in implementing or extending a health and wellness program at their place of employment.
Trainee Reaction Survey: Online Model The Reaction Surveys will assess trainees’ reactions to the Work@Health® training including their satisfaction with the training they received, whether the training was engaging, whether the facilitator, materials, and activities supported the goals of the training, whether the training met their needs, and their confidence in implementing or enhancing a health and wellness program at their place of employment	Online	Trainees participating in the Online training model	At the conclusion of each Online Training	- Evaluate trainees’ reaction to the Work@Health Program. - Evaluate outcomes and the ways in which participating trainees increased their knowledge and perceived ability to implement programs, policies, and environmental support changes that will improve workplace health.	Trainees’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met trainees’ needs and trainees’ confidence in implementing or extending a health and wellness program at their place of employment.
Trainee Reaction Survey: Blended Model The Reaction Surveys will assess trainees’ reactions to the Work@Health® training including their satisfaction with the training they received, whether the training was engaging, whether the facilitator, materials, and activities supported the goals of the training, whether the training met their needs, and their confidence in implementing or enhancing a health and wellness program at their place of employment	Paper form Trainees will be asked to seal their completed surveys in an envelope provided for the purpose to assure them that the facilitators will not see their answers.	Trainees participating in the Blended training model	At the conclusion of each Blended Training	- Evaluate trainees’ reaction to the Work@Health Program. - Evaluate outcomes and the ways in which participating trainees increased their knowledge and perceived ability to implement programs, policies, and environmental support changes that will improve workplace health.	Trainees’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met trainees’ needs and trainees’ confidence in implementing or extending a health and wellness program at their place of employment.
Trainee Technical Assistance Survey The Trainee Technical Assistance Survey (Attachment F-5) will be conducted to capture how much trainees have used the technical assistance and their perceptions about the utility of the technical assistance they received through the course of the program. Trainees will be asked to assess how useful different aspects of the technical assistance (e.g., topical Webinars, interactive discussions with peers and facilitators) were to their ability to transfer what they learned to their worksites.	Online	Trainees participating in all models of Work@Health	Two times: 4-7 months after training and 12-15 months post-training	- Assess the use and effectiveness of post-training technical assistance and peer learning networks		Utility of different aspects of the technical assistance (e.g., topical webinars, interactive discussions with peers and facilitators) Ability to transfer what was learned to workplaces and others
Case Study Interviews with Trainees From the worksites selected for the case studies, the individuals who participated in the training program will be invited to discuss their experiences, using the Case Study Interviews with Selected Trainees discussion guide (Attachment F-6). These discussions will focus on trainees’ expectations for the program, their experiences in the training and trying to implement what they learned, their perceptions of the outcomes, and sustainability of the changes.	Paper form	Trainees participating in the Hands-on, Online, or Blended Model	10-12 months after training	- An employee who participated in the Work@Health Program will be invited to discuss their experiences		Motivation for attending the Work@Health Program Expectations for the Work@Health Program Experiences in implementing what they learned at their workplace Perceptions of outcomes and sustainability of the changes implemented at their workplace
Trainee Focus Group Discussion Guides Evaluators will convene a focus group of trainees immediately following two hands-on and blended trainings. The discussion will be guided by the questions in the Trainee Focus Group Discussion Guide (Attachment F-7).The purpose of the focus group will be to gather in-depth information from trainees about their perceptions of the training; content they expect to be useful; effectiveness of the instructor; the pace of the session; areas for additional technical assistance; and plans for participating in future technical assistance activities.	Paper form	Trainees participating in Work@Health	At the conclusion of Hands-on training sessions	- Assess trainees’ reactions to the Work@Health training.		Comparison of expectations to reality of Work@Health training and expectations for implementation Opinions on training curriculum and aspects of delivery Expectations for participation in technical assistance Suggestions for improvement Satisfaction with communication materials

D. Interested Train-the-Trainer Participants. Individuals interested in participating in the Train-the-Trainer model of the Work@Health® Program will be asked to complete a Train-the-Trainer Application Form (Attachment G-1). The online form will be used to assess applicants’ background experience in worksite health programs and training facilitation.

Instrument	Method	Respondents	Time of Data Collection	Program Objective	Data Collected
Train-the-Trainer Application Form	Online	Interested employers, trainers, and/or facilitators	Prior to training	- Select participants for the Train-the-Trainer model of the Work@Health Program	Applicants’ contact information Experience in training facilitation, leadership in an organization implementing a workplace health program Referral from a health department, community-based health organization, employer membership organization, or private/non-profit organization

E. Selected Train-the-Trainer Participants. CDC will select 120 qualified employers, trainers, and facilitators to participate in the Train-the-Trainer model of the Work@Health® Program. Information to be collected from the selected Train-the-Trainer participants includes a Train-the-Trainer Participant Survey (Attachment G-2), Train-the-Trainer Reaction Survey (Attachment G-3), and Train-the-Trainer Technical Assistance Survey (Attachment G-4). Each of these instruments is described in more detail below.

Train-the-Trainer Participant Survey The Train-the-Trainer Participant Survey (Attachment G-2) will collect information from the 120 Train-the-Trainer participants to assess changes in trainees’ facilitation skills and ability to train others using the Work@Health® curriculum.	Online	Trainees participating in Train-the-Trainer model	Two times: 1 month prior to training and 5-8 months post-training	- Assess facilitation skills and the ability to train others	Self-rate strength of facilitation skills Attitudes about what makes an efficient trainer Preparation and confidence in training others in workplace health programs
Trainee Reaction Survey: Train-the-Trainer Model The Trainee Reaction Survey – Train-the-Train Model (Attachment G-3) will assess trainees’ reaction to the Work@Health® training including their satisfaction with the training they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training, whether the training met their needs, and their confidence in training others in the Work@Health® Program	Paper form	Trainee/employees participating in the Train-the-Trainer Training	At the conclusion of each Train-the-Trainer Training	- Evaluate participants’ reaction to the Work@Health Program. - Evaluate outcomes and the ways in which participants increased their knowledge and perceived ability to train employers in the Work@Health Program.	Participants’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met participants’ needs and participants’ confidence in training others in the Work@Health Program.
Train-the-Trainer Technical Assistance Survey Train-the-Trainer participants will complete the Trainee Technical Assistance Survey (Attachment G-4) to capture how much trainees have used the technical assistance and their perceptions about the utility of the technical assistance they received through the course of the program. Trainees will be asked to assess how useful different aspects of the technical assistance (e.g., topical Webinars, interactive discussions with peers and facilitators) were to their ability to transfer what they learned to their worksites. .	Online	Trainees participating in Train-the-Trainer model	Two times: 4-7 months after training and 12-15 months after training	Capture how much trainees used the technical assistance and their perceptions about the utility of the technical assistance they received through the course of the program	Utility of different aspects of the technical assistance (e.g., topical webinars, interactive discussions with peers and facilitators) Ability to transfer what was learned to workplaces and others

F. Trainee Participants Wave 2. Each participant who completes the Train-the-Trainer curriculum (i.e., certified trainers) will be required to conduct the Work@Health® training with five employer representatives known as Wave 2 Trainee participants. CDC will collect information from these 600 employer representatives (120 Train-the-Trainer participants * 5 employers per Train-the-Trainer participant) through the Wave 2 Trainee Reaction Survey (Attachment H-1) to assess their satisfaction with the training they received, whether the training was engaging, whether the facilitator, materials, and activities supported the goals of the training, whether the training met their needs, and their confidence in implementing or enhancing a health and wellness program at their place of employment.

Wave 2 Trainee Reaction Survey: Hands-on Model	Paper form	Trainees participating in Hands-on training sessions conducted by Train-the-Trainer graduates	At the conclusion of each Train-the-Trainer’s Wave 2 Hands-on session with trainees	- Evaluate Train-the-Trainer graduates’ ability to train others in the Work@Health curriculum.	Trainees’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met trainees’ needs and trainees’ confidence in implementing or extending a health and wellness program at their place of employment.
Wave 2 Trainee Reaction Survey: Online Model	Online	Trainees participating in Online training sessions conducted by Train-the-Trainer graduates	At the conclusion of each Train-the-Trainer’s Wave 2 Online session with trainees	- Evaluate Train-the-Trainer graduates’ ability to train others in the Work@Health curriculum.	Trainees’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met trainees’ needs and trainees’ confidence in implementing or extending a health and wellness program at their place of employment.
Wave 2 Trainee Reaction Survey: Blended Model	Paper form	Trainees participating in Blended training sessions conducted by Train-the-Trainer graduates	At the conclusion of each Train-the-Trainer’s Wave 2 Blended session with trainees	- Evaluate Train-the-Trainer graduates’ ability to train others in the Work@Health curriculum.	Trainees’ satisfaction with the trainings they received, whether the training was engaging and whether the facilitator, materials, and activities supported the goals of the training. Whether the training met trainees’ needs and trainees’ confidence in implementing or extending a health and wellness program at their place of employment.

G. Training Instructor and Coach Group Discussions (Attachment I) The Evaluation Team will gather information from training instructors and online coaches about their perceptions of the training, challenges trainees experienced, areas of high and low participation, and suggested improvements. The focus group discussions will take place by telephone.

Instructor Group Discussion Guides

Paper form

Instructors/online coaches facilitating Work@Health training and technical assistance

Two times: Shortly after formal training ends and 5-8 months post-training

- Evaluate experience as an instructor in the Work@Health Program

Comparison of expectations to reality of Work@Health Opinions on training curriculum and aspects of delivery Suggestions for improvement Satisfaction with support Opinions on technical assistance aspects (Time 2 only)

17