Form Approved
OMB No. 0920-1006
Exp. Date: 01-31-2016
CDC Work@Health®
Trainee Reaction Survey Train-the-Trainer Model
Public reporting of this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1006).
Respondents/Sources |
Method |
Content |
Timing |
Respondents |
Time per Respondent |
Trainees selected for the Work@Health® Train-the-Trainer model |
Work@Health® T3 Trainee Reaction Survey (collected online by PHMC) |
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At the conclusion of Train-the-Trainer training |
40 |
0.25 hrs |
This is a planned online survey of employers who participated in the Train-the-Trainer training model of the CDC Work@Health® training program. Work@Health® is a program that trains employers in the design, implementation, and evaluation of worksite health and wellness programs. This survey will be administered immediately after the training has been completed to evaluate the effectiveness of the train-the-trainer session.
Introduction
Thank you for your participation in today’s training for the CDC Work@Health® program. This survey asks about your thoughts and opinions of the training. Your responses will help us make the Work@Health® program most useful for trainers. This project is funded by the Centers for Disease Control and Prevention. Many parts of the project are being managed by ASHLIN Management Group (ASHLIN). ASHLIN is a private sector consulting firm with a focus in the area of health and human services based in Greenbelt, MD. They are helping CDC implement the Work@Health® Program. The Public Health Management Corporation (PHMC), a non-profit, public health institute located in Philadelphia, PA and part of the ASHLIN Team designed this survey.
Informed Consent
Before you get started, we’d like to give you some more information to help you decide whether or not you would like to participate.
Your participation is voluntary, and you may skip any questions you do not want to answer. You may also choose to end the survey at any time.
The survey is designed to take about 15 minutes.
There are no right or wrong answers or ideas – we want to hear about YOUR experiences and opinions.
All of the comments you provide will be maintained in a secure manner. We will not disclose your responses or anything about you unless compelled by law. Your responses will be combined with other information we receive and reported in aggregate as feedback from all respondents. In our project reports, your name and your employer’s name will not be linked to the information or comments you provide.
There are no risks or benefits to you personally for participating in this survey.
CDC is authorized to collect information for this project under the Public Health Services Act.
If you have any questions, you can contact Jennifer Lauby. Her phone number is 215-985-2556 and her email is [email protected].
Thinking about the Work@Health® in-person training you just completed, please indicate to what extent you agree or disagree with each of the following statements.
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Strongly Agree |
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The next set of questions are about the training activities. Please indicate how useful you found each of the following training activities:
How Useful Were: |
Not at all Useful 1 |
Of Little Use 2 |
Moderately Useful 3 |
Useful 4 |
Extremely Useful 5 |
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The next group of questions is about your perceptions of the individual training modules.
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The next group of questions is about your overall impressions of the training. For each question, please indicate the degree to which you agree or disagree with the following statements.
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Finally we would like to know your thoughts and suggestions for how this program can be improved.
What changes, if any, would you recommend to the Work@Health® Train-the-Trainer course? For example, would you recommend changes to the objectives, activities, assessments, materials or format of the training?
________________________________________________________________________________________________________________________________________________________________
Topics that were covered in the Work@Health® Train-the-Trainer training included making the case for a healthy worksite, leadership and motivation, data collection methods and tools, health promotion and safety, and program evaluation. What additional topics do you think should be covered in the Train-the-Trainer training?
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How did you learn about the Work@Health® Train-the-Trainer program?
○ Through a business association ○ Website
(e.g., Small Business Association)
○ Letter in the mail ○ Newspaper
○ Radio ○ Word of mouth
○ Colleague ○ CDC
○ ASHLIN Management Group ○ Other (please explain): ________________
What would encourage or motivate other employers/others in your position to attend a Work@Health® Train-the-Trainer training?
________________________________________________________________________________________________________________________________________________________________
What is the best way to reach other businesses like yours and tell them about the Work@Health® Train-the-Trainer program?
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What was the most important lesson or skill that you learned from the Train-the-Trainer Work@Health® training?
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What did you like least about the Train-the-Trainer Work@Health® training?
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What did you like most about the Train-the-Trainer Work@Health® training?
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Participant Characteristics
What is your title/role in your business?
○ Professional Instructor/Trainer ○ CEO/President/Owner
○ VP ○ Director, HR
○ Director, Benefits ○ Wellness Manager
○ Environmental Health and ○ Union/Labor Representative
Safety Representative ○ Other (specify): _____________________
Number of employees at your site or business unit (full and part time): __________________
Which of the following best describes your organization?
○ Health department ○ Professional Organization
○ Private employer ○ Broker
○ Non-profit ○ Business Coalition
○ Chamber of Commerce Hospital/Health Care System
○ Other, please specify:__________________________________________
Created by ASHLIN Management Group specifically and exclusively for the Work@Health Project, funded by the Centers for Disease Control and Prevention.
File Type | application/msword |
File Title | DRAFT PILOT TRAINING: HANDS-ON EVALUATION |
Author | schwarz-john |
Last Modified By | Lang, Jason (CDC/ONDIEH/NCCDPHP) |
File Modified | 2015-12-17 |
File Created | 2015-12-17 |