ACF BIAS-NG Project: Generic ICR for Qualitative and Descriptive Quantitative Data Collection for a Child Welfare Site

ACF Behavioral Interventions to Advance Self-Sufficiency Next Generation (BIAS-NG) Project

Appendix A - BIAS NG Survey 2018-06-15.xlsx

ACF BIAS-NG Project: Generic ICR for Qualitative and Descriptive Quantitative Data Collection for a Child Welfare Site

OMB: 0970-0502

Document [xlsx]
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Overview

In-home Cases
Removal


Sheet 1: In-home Cases

Week Survey Questions (Fridays) Notes
0 Hi Jane. This is a research survey for CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers. Reply "decline" to stop receiving questions. Msg&DataRatesMayApply.
Question 1: How confident are you that you know what will happen next in your case? Select one.
A Not at all
B A little
C Somewhat confident
D Confident
E Very confident.
Text highlighted in red is the opt-out (consent) for this survey.
4 Question 2: Hi Jane. This is a research survey for  CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers.
Q: How are you feeling about your home visit, which is coming up? Select one.
A - Not prepared
B - Somewhat prepared
C - Very prepared
  Question 2a: What questions or concerns do you have about the home visit (if any)?
Response: Open ended

6 Question 3:
Hi Jane. This is a research survey for CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers.
Q: How much has your caseworker told you about the conference? Select one.
A - Nothing
B - A little
C - Some
D - A fair amount
E - A lot
Question 3a: Do you have any concerns about the family conference? Please type "Yes" or "No".
[If yes] Question 3b: What is your biggest concern? Please choose one.
1 - Transport
2 - Talking about private topics
3 - My family or friends won't attend
4 - I won't agree with the next steps
5 - Other
[If other] Question 3c: You responded "Other". What is your biggest concern? Please type your response.

9 Question 4:
Hi Jane. This is a research survey for CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers.
Q: How much did the information you received from CYF during your case help prepare you for next steps?
A Not at all
B A little
C Somewhat
D A fair amount
E A lot


Sheet 2: Removal

Week Survey Questions (Fridays) Notes
0 Hi Jane. This is a research survey for CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers. Reply "decline" to stop receiving questions. Msg&DataRatesMayApply.
Question 1: How confident are you that you know what will happen next in your case? Select one.
A Not at all
B A little
C Somewhat confident
D Confident
E Very confident.
Text highlighted in red is the opt-out (consent) for this survey.
4 Question 3:
Hi Jane. This is a research survey for CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers.
Q: How much has your caseworker told you about the conference? Select one.
A - Nothing
B - A little
C - Some
D - A fair amount
E - A lot
Question 3a: Do you have any concerns about the family conference? Please type "Yes" or "No".
[If yes] Question 3b: What is your biggest concern? Please choose one.
1 - Transport
2 - Talking about private topics
3 - My family or friends won't attend
4 - I won't agree with the next steps
5 - Other
[If other] Question 3c: You responded "Other". What is your biggest concern? Please type your response.

6 Question 4:
Hi Jane. This is a research survey for CYF. We'd like you to answer, but you don't have to. Your caseworker and other CYF staff won't see your answers.
Q: How much did the information you received from CYF during your case help prepare you for next steps?
A Not at all
B A little
C Somewhat
D A fair amount
E A lot

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