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Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

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National Human Trafficking Training and Technical Assistance Center Scholarship Application Forms

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W ebinar Feedback OMB#: ####-####

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In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC) better serve the field, we are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with the Federal Privacy Act, and we will protect the confidentiality of your responses using procedures we have in place, including reporting all information in aggregate to avoid identifying information. Only members of the NHTTAC Evaluation Team have access to information that could identify respondents. If you have any questions about this survey or the evaluation, please contact [email protected].

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WEBINAR: _______________________________________________

DATE(S): _______________________________________________________________

PRESENTER(S):



Please indicate the extent to which you agree or disagree with the following statements:

OVERALL WEBINAR

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. As a result of this webinar, I <insert learning objective>

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2

3

4

  1. As a result of this webinar, I <insert learning objective>

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2

3

4

  1. As a result of this webinar, I <insert learning objective>

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2

3

4

  1. As a result of this webinar, I <insert learning objective>

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2

3

4

  1. As a result of this webinar, I <insert learning objective>

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4

  1. The webinar addressed the critical issues related to the topic(s).

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4

  1. The time allotted was adequate for the scope of material covered.

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4

  1. The webinar was organized and clear.

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4

  1. The webinar included information on current evidence-based research or promising practices.

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4

  1. The webinar content was survivor informed.

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4

  1. The webinar content was trauma informed.

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4

  1. The webinar content reflected a public health approach to addressing human trafficking.

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4

PRESENTER 1: ___________________

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. The presenter’s knowledge and expertise were appropriate for this webinar.

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2

3

4

  1. The presenter engaged and interacted with the audience.

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2

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4

  1. The presenter created a respectful environment for participants.

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4

PRESENTER 2: ___________________

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. The presenter’s knowledge and expertise were appropriate for this webinar.

1

2

3

4

  1. The presenter engaged and interacted with the audience.

1

2

3

4

  1. The presenter created a respectful environment for participants.

1

2

3

4


  1. Please rate the overall quality of this webinar.

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2

3

4

Poor

Fair

Good

Excellent





  1. How useful was the webinar information to your work?

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2

3

4

Not Useful

Somewhat Useful

Useful

Very Useful


  1. What additional topics related to human trafficking would you like included in future webinars?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________



[Note: Questions 22–24 are only asked for evaluations of the Emerging Issues webinar series.]

  1. There are a total of <insert number> webinars in the Emerging Issues series. Please check the webinars you attended from the following list:

  • <Insert webinar 1 title>

  • <Insert webinar 2 title>

  • <Insert webinar 3 title>

  • <Insert webinar 4 title>

  • <Insert webinar 5 title>

  • <Insert webinar 6 title>

  • <Insert webinar 7 title>

  • <Insert webinar 8 title>

  • <Insert webinar 9 title>

  • <Insert webinar 10 title>


  1. Please rate the overall quality of the webinars you selected in the previous question.

1

2

3

4

Poor

Fair

Good

Very Good


  1. How well did the content in each webinar you selected complement each other?

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2

3

4

Not At All

Not Well

Well

Very Well

  1. Would you recommend NHTTAC to others who need training or technical assistance? Yes No

  1. Which of the following best describes your professional capacity or types of services you provide? (Mark all that apply.)

  • Behavioral health professional (e.g., psychologist, psychiatrist, mental health/substance use counselor)

  • Child welfare (e.g., state agency staff, child welfare contractor, nonprofit personnel)

  • Corrections-based services (e.g., parole, probation)

  • Criminal justice (e.g., law enforcement, prosecutor, probation, court, forensic interviewer)

  • Educator (e.g., teacher, professor, school administrator)

  • Health care (e.g., physician, physician assistant, nurse practitioner, dentist, nurse, pharmacist)

  • Housing (e.g., case worker, shelter director, public housing authority agencies)

  • Legal (e.g., immigration, civil and/or rights-based attorney and/or paralegal, clinic)

  • Public health (e.g., licensure board, health department staff, health care executive, community health workers)

  • Social worker (e.g., case manager, school counselor, supervisor, administrator)

  • Survivor empowerment, mentoring, or peer to peer

  • Other (please specify): _______________________________



  1. Which of the following best describes your geographic population? (Mark all that apply).

National □ Local

State (please specify): ______________ □ Urban

Tribal □ Rural

International (please specify country): _____________ □ Suburban

  1. In your professional capacity, how frequently do you come into contact with a person who is currently being trafficked, at risk of trafficking, or has been trafficked?

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4

Never

Occasionally

Frequently

Daily

  1. Please select any of the following populations you currently work with in a professional capacity. (Mark all that apply.)

  • Human trafficking

    • Commercial sexual exploitation of children

    • Sex trafficking

      • Adults

      • Minors

    • Labor trafficking

      • Adults

      • Minors

  • Children/youth

    • Out of home/Foster care/Kinship care

    • Juvenile justice

    • Runaway/Homeless youth

  • People with disabilities

  • Deaf/Hearing impaired

  • Elderly

  • Lesbian, gay, bisexual, transgender, and questioning

  • Foreign nationals (migrant workers, undocumented immigrants, refugees)

  • People with low incomes

  • Racial and ethnic minorities

    • American Indian or Alaska Native

    • Asian

    • Black or African American

    • Native Hawaii or other Pacific Islander

    • White

    • Hispanic or Latino ethnicity

  • History of substance use

  • Intimate partner violence (e.g., dating, domestic violence)

  • Gang-related crime

  • Sexual abuse/Violence

  • Other (please specify): __________________




Thank you for taking the time to complete this form and helping to improve NHTTAC activities.

Paperwork Reduction Act Notice

Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control number. The estimated average time to complete this form is 4 minutes. If you have comments regarding the accuracy of this estimate or additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

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AuthorField, Michael
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