Form 1 National Responsible Fatherhood Clearinghouse (NRFC)

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the Number of Respondents.

Participation Time: Provide an estimate of the amount of time (in minutes) required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of Respondents and the Participation Time then divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Submit all instruments, instructions, and scripts are submitted with the request.

NOTE: The following are included in the appendix

• Appendix A: Informed Consent

• Appendix B: Fatherhood Conversation Protocol

Appendix A: National Responsible Fatherhood Clearinghouse Conversation

Consent Form

Background

The National Responsible Fatherhood Clearinghouse (NRFC) is a virtual clearinghouse that provides, facilitates, and disseminates current research, proven and innovative strategies that will encourage and strengthen fathers and families. In partnership with CFUF/House of Ruth, NRFC is conducting Fatherhood Conversations to gather fathers’ perceptions about impact of domestic violence and community violence on parenting and on their children. The Fatherhood Conversation will help improve how fatherhood program serve fathers parenting children exposed to domestic violence and community violence and/or living in communities with violence.

Confidentiality and Usage

Today’s conversation will not be audio recorded; rather the facilitator will summarize the conversation using flip charts. Individual answers will not be used in any written results associated with this discussion. The results from this Fatherhood Conversation will be used to make general recommendations about improving fatherhood programs and domestic violence for future participants. All of the information that you provide will be kept confidential.

Participation in this discussion is voluntary. You can decide to not participate at any time. By signing this consent form, you are agreeing to participate in the discussion and to allow the NRFC and CFUF/House of Ruth team to use the information you provide for analysis of your perspectives on parenting children exposed to domestic and community violence.

Thank you for taking the time to participate in this discussion. Your input will help to fatherhood program improve their services.

If you have any other questions, please call Patrick Patterson, NRFC Program Manager, 803.622.0319 or email [email protected]

Signature Date

Printed Name

Appendix B: Fatherhood Conversation Protocol

The Fatherhood Conversation will be conducted on site at CFUF and House of Ruth and will be facilitated by CFUF and House of Ruth program staff. All results of the analysis will be presented as a summary.

Fatherhood Conversation Agenda

• Welcome the participants (5mins)

• Introduce the facilitators (5mins)

• Explain the purpose of the Fatherhood Conversation (10mins)

• Handout and read confidentiality agreement (15mins)

• Conduct Fatherhood Conversation discussion (80mins)

• Thank participants (5mins)

Fatherhood Conversation Guide

Introduction

Welcome and thank you for coming today.

My name is ________ and I have with me ________. We are program staff at Center for Urban Families/House of Ruth. The purpose of this Fatherhood Conversation is to gather fathers’ perceptions about impact of domestic violence and community violence on parenting and on their children. This Fatherhood Conversation will help inform the fatherhood program better serve fathers parenting children exposed to domestic violence and community violence.

As part of our ongoing efforts to advance our understanding of challenges that face low-income fathers, we are conducting these discussions to get your feedback on parenting children exposed to domestic and community violence. An important part of this discussion is to hear your honest opinions about your experiences. Your input will improve our understanding of the challenges fathers face in parenting in community violence.

Everything said here is confidential. No one will be quoted by name. The results from this Fatherhood Conversation will be used to make general recommendations about improving the fatherhood programs for future participants. We also ask that you keep confidential what others say during this conversation.

We will summarize your thoughts using a flip chart. Again, everything you say will be kept confidential.

Before we start, I would like to confirm everyone signed a consent form when they arrived. (If there is anyone who hasn’t signed the consent form, please provide them with a consent form). If you would like to be excused from this discussion, you may leave at this time.

Ground Rules

• As part of your participation in this Fatherhood Conversation, you are asked to respect the privacy of all of the group members and to not repeat any comments outside of the Fatherhood Conversation.

• There are no right or wrong answers. People may disagree, and that’s OK. We want to hear both positive and negative comments—whatever you want to share. Please try not to talk over each other so we can hear all opinions clearly on the recording.

Fatherhood Conversation Questions

1. Background

Let’s start off by talking about your violence in your communities

• Describe your day to day experiences as a parent in your community?

• How does the violence affect the community? Your children?

Probes:

• Describe your school experience.

• What about your children’s peer interaction and social group experience?

2. Personal Experiences

• Have you personally witnessed or experienced violence in your childhood?

• How did you cope with your feelings about witnessing or experiencing violence?

• Does the experience influence how you parent? In what way?

3. Talking about violence with the children

• How have you broached the topic of violence with your child?

Probes:

• Were these conversations before or after your child witnessed or was a victim of violence?

• Have you discussed ways to avoid violence situations?

• After your child witnessed violence, do you encourage them to talk about their feelings regarding what they experienced/saw?

• Other than you, who does your child discuss issues of their feelings about violence? Who does your child communicate with the most regarding the issue of their feelings?

4. Witnessing Violence

Let’s talk about your children and violence…

• What experiences have you had with children who have witnessed violence?

Probes:

• What was the reaction of your child?

• How did you respond?

• What support services are available in your community for child witnesses?

• How often would you say your child has been a witness to any type of violence?

• How have parents, family members, or other community members responded to children who are victims of violence?

5. Behavioral changes

Witnessing violence has negative impacts on children,

• If your child has been a witness of violence, have you seen any changes in your child’s behavior after witnessing these acts of violence?

Probes:

• How is their performance in school?

• How about their friendships?

• How about their relationship with you and their mother

• After witnessing violence, has your children expressed concern or fear for their own safety, or your (or their mother’s) safety, for the safety of other people in your community?

6. Seeking professional help

• Other than family members, have you sought professional help or counseling programs to assist your child in expressing their feelings about violence?

  • If yes, please discuss your experience.

  • If no, please express why you have never sought outside experts.

7. Questions for the Domestic Violence Fatherhood Conversation (ONLY)

• To the best of your knowledge, have your children ever witnessed family violence or “fighting” where one of their parents was the victim? In your household? In any other household?

• If your children have witnessed family violence against one of their parents or “fighting” between the adults in the household, have you noticed any behavioral changes in that child over time?

• Have you noticed any behavioral changes in your child toward you? Toward their mother?

• Have you ever discussed the issue of family violence in your household with your children? If so, how did you broach the topic to your child? To the best of your knowledge, has the children’s mother ever discussed the issue of family violence?

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