Youth Serving Organization (YSO) Staff Survey

Performance Monitoring of “Working with Publicly Funded Health Centers to Reduce Teen Pregnancy among Youth from Vulnerable Populations

Att 10 YSO Staff Survey

Youth Serving Organization (YSO) Staff Survey

OMB: 0920-1156

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Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/xxxx















YSO Staff Survey






































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Thank you for agreeing to complete this survey. The purpose of this survey is to assess your job duties, knowledge, attitude, comfort level, and training related to referring youth at risk for teen pregnancy to health care services.


Your responses will be kept private and your completed assessment will be stored on a secure, password protected server. Your responses will be combined with those from others at your organization in order to tailor training and technical assistance. Your individual responses will not be shared. Your participation in this survey is voluntary and you can discontinue participation at any time.



  1. BACKGROUND


    1. Name of Organization




1.2 Current Position

Social Worker Case Worker Program Manager


Youth Program Associate Family Support Specialist


Counselor Health Educator Teacher Nurse


Probation Officer Other ________________



  1. JOB DUTIES


As part of your current job duties, how frequently do you:



Never


Rarely

Sometimes

Often


Very Often


2.1 Provide referrals for any type of social service (e.g., housing, education, food)?

2.2 Provide referrals for any type of health care?


2.3 Provide information on how to prevent pregnancy?

2.4 Provide information on how to prevent STD/HIV?

2.5 Provide a referral guide for adolescent reproductive health services?

2.6 Conduct screenings to determine if a teen is in need of sexual and reproductive health services (e.g., is at risk for unwanted pregnancy or STI)?

2.7 Provide passive referrals for adolescent sexual and reproductive health services?

In a passive referral, a client is provided with information about a service, such as a clinic name and location. It is then up to the client to access the service.

2.8 Provide active referrals for adolescent sexual and reproductive health services?

In an active referral, a client is provided with assistance in getting the referral service, such as getting help setting up an appointment or finding transportation.


3. KNOWLEDGE AND ATTITUDES


How much do you agree or disagree with the following statements?



Strongly Disagree


Disagree

Neither agree nor disagree


Agree

Strongly Agree

3.1 I know enough about sexual and reproductive health to talk to teens.

3.2 I am confident in my ability to discuss preventing STD/HIV and pregnancy prevention with teens in a non-judgmental way.

3.3 I am confident in my ability to conduct a screening to determine if a teen is in need of sexual and reproductive health services (e.g., is at risk for unwanted pregnancy or STI).


3.4 If I talk to teens about sexual activity, STD, HIV and pregnancy this will encourage teens to have sex.

3.5 Teens that are sexually active should get information and referrals about sexual and reproductive health services regularly.

3.6 I am familiar with the different types of birth control, including IUDs and hormonal implants.

3.7 I am comfortable talking about sexual and reproductive health with lesbian, gay, bisexual, transgender, questioning, queer (LGBTQQ) youth.

3.8 It’s difficult for me to talk with teens about sexual and reproductive health because I believe teens should not be sexually active.



4. REFERRALS AND LINKAGES TO SERVICES


Adolescent sexual and reproductive health services includes services such as sexual health assessment, contraceptive services, pregnancy testing and counseling, health exams, STD screening and treatment, and HIV testing.


How much do you agree or disagree with the following statements?



Strongly Disagree


Disagree

Neither agree nor disagree

Agree

Strongly Agree


4.1 It is important to my supervisor that I refer teens to sexual and reproductive health service when needed.

4.2 It is an important part of my job to refer youth to sexual and reproductive health services when needed.

4.3 I know my organization’s policies about how to provide and document a referral.

4.4 I know where to refer teens for youth-friendly, low or no cost, confidential sexual and reproductive health services.

4.5 I am confident in my ability to provide youth information and answer their questions about what to expect during a clinic visit during which sexual and reproductive health would be addressed.

4.6 I am confident in my ability to inform teens about their rights to confidential sexual and reproductive health services.

4.7 I am confident in my ability to provide teens with passive referrals for sexual and reproductive health services.

In a passive referral, a client is provided with information about a service, such as a clinic name and location. It is then up to the client to access the service.

4.8 I am confident in my ability to provide teens with active referrals for sexual and reproductive health services.

In an active referral, a client is provided with assistance in referral services, such as setting up an appointment, providing transportation, reminder call/text or email, or providing an incentive for clinic visit

4.9 I am confident in the quality of sexual and reproductive health services at the local health centers where I can refer youth.


6. TRAINING


Please indicate your training history and additional needs on the following topics.


Topic

Have you attended any workshop/Had training in the past year?


Would you like additional training?



6.1 Providing effective and confidential sexual and reproductive health (SRH) referrals including steps in making a SRH referral.

Yes No

Yes No

6.2 Agency policies and protocols for making and tracking referrals

Yes No

Yes No

6.3 Overview of adolescent sexual and reproductive health needs

Yes No

Yes No

6.4 State laws related to minor’s rights to reproductive health care (including confidentiality)

Yes No

Yes No

6.5 State requirements for reporting suspected child abuse

Yes No

Yes No

6.6 Trauma informed approaches to working with young people (an approach that engages individuals with histories of trauma, recognizes the presence of trauma symptoms, and acknowledges the role that trauma has played in their lives).

Yes No

Yes No

6.7 Needs of LGBTQ youth

Yes No

Yes No


THANK YOU!



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDraft 1/20/2006
AuthorLorrie Gavin
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File Created2021-01-23

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