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pdfNATIONAL ADVISORY
COMMITTEE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
In order to help NHTTAC better serve the National Advisory Committee (NAC), 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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
1.
In the past 12 months, how many NAC meetings have you participated in?
________________________
2.
3.
Please rate the quality of the NAC meeting(s) that you have attended.
1
2
3
4
Poor
Fair
Good
Excellent
Please rate the quality of the NAC webinar(s) that you have attended.
1
2
3
4
Poor
Fair
Good
Excellent
Please indicate how well the NAC has achieved the following objectives.
OVERALL OBJECTIVES
Poor
Fair
Good
Excellent
4.
[Insert objective 1].
1
2
3
4
5.
[Insert objective 2].
1
2
3
4
6.
[Insert objective 3].
1
2
3
4
7.
[Insert objective 4].
1
2
3
4
8.
[Insert objective 5].
1
2
3
4
9.
As a result of my involvement in the NAC, I made meaningful connections with other professionals in the field of human
trafficking identification, prevention, and service provision.
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly Agree
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 5 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.
NATIONAL ADVISORY
COMMITTEE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
10. How would you describe the level of collaboration among NAC members?
1
2
3
4
Very weak
Weak
Strong
Very strong
11. How often would you like to meet in person with NAC members? _____________________
12. How would human trafficking service provision be impacted if the NAC did not exist?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
13. Looking ahead, what additional activities can the NAC undertake to further collaboration and information sharing that would
be useful to members?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements about NHTTAC’s contribution to the
NAC:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
14. NHTTAC has been helpful in orienting new
members to the NAC.
1
2
3
4
NA
15. There has been good communication between
NHTTAC and the NAC.
1
2
3
4
NA
16. The information NHTTAC has shared with the
public reflects a public health approach to
addressing human trafficking.
1
2
3
4
NA
17. NHTTAC has been supportive in meeting
planning.
1
2
3
4
NA
18. NHTTAC has been helpful through their onsite
meeting support.
1
2
3
4
NA
19. Based on your interactions with NHTTAC on the NAC, would you recommend NHTTAC to others to receive T/TA?
□ Yes
□ No
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 5 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.
NATIONAL ADVISORY
COMMITTEE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
20. What do you think are the most important activities that the NAC should prioritize?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
21. Please provide any comments or suggestions on how the NAC can be improved.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
22. Is your agency responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
23. 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?
1
2
3
4
Never
Occasionally
Frequently
All the Time
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 5 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.
CALL CENTER
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
Please indicate the extent to which you agree or disagree with the following statements.
Strongly
Disagree
1
OVERALL ASSISTANCE
3
Strongly
Agree
4
Not
Applicable
NA
Disagree
Agree
2
1.
NHTTAC staff was responsive to my questions and needs.
2.
The information/assistance I received was easy for me to
understand.
1
2
3
4
NA
3.
The information/assistance I received was grounded in
current evidence-based research or promising practices.
1
2
3
4
NA
4.
The information/assistance I received was traumainformed.
1
2
3
4
NA
5.
The information/assistance I received was survivorinformed.
1
2
3
4
NA
6.
The information/assistance I received was grounded in a
multidisciplinary approach to addressing human trafficking.
1
2
3
4
NA
7.
The information/assistance I received reflected a public
health approach to addressing human trafficking.
1
2
3
4
NA
8.
The information/assistance I received will help me in my
work.
1
2
3
4
NA
9.
The information/assistance I received met my professional
needs.
1
2
3
4
NA
10. The information/assistance I received met my educational
needs.
1
2
3
4
NA
11. I am satisfied with the information/assistance I received.
1
2
3
4
NA
12. I will return to NHTTAC staff for my training and technical
assistance needs.
1
2
3
4
NA
13. Please rate the overall quality of the assistance you received.
1
2
3
4
Poor
Fair
Good
Excellent
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 5 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.
CALL CENTER
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
14. How did you first hear about NHTTAC?
□
□
□
□
□
□
The NHTTAC Website
An exhibit or presentation at a conference
A link from another website/Searching the Internet
A colleague or friend
A publication or newsletter
My OTIP program monitor or other OTIP staff
person
□ Other (please specify):
___________________________________
15. How often have you used NHTTAC in the last 12 months?
□
□
1 – 3 times
4 – 6 times
□
□
7 – 9 times
10+ times
16. How did you most recently access NHTTAC? (Mark all that apply.)
□ NHTTAC Website
□ Toll-free number for Call Center
□ OTIP program monitor or other OTIP staff person
__________________________
□
□
□
Email
TTY
Other (please specify):
17. Why did you use/contact NHTTAC? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
Request general information about OTIP or NHTTAC
Obtain a referral for direct services
Access online materials or training
Join the listserv or mailing list
Apply to be a consultant/trainer
Obtain information on services for people who are currently being trafficked, at risk of trafficking, or have been
trafficked.
Acquire help for technical problems on website
Request or apply for assistance:
□ Technical assistance
□ Training
Funding for a conference/event or speaker
Other (please specify): __________________________
18. In general, how promptly was your request(s) acknowledged?
□ Within 24 hours
□ Between 24-48 hours
□ Between 3-5 days
□ Between 6-7 days
□ More than a week
□ My request was not
acknowledged
□ Yes
19. Would you recommend NHTTAC to others to receive T/TA?
□ No
20. Do you have any other comments or suggestions?
______________________________________________________________________________
______________________________________________________________________________
21. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
Academic institution
Anti-trafficking organization
□
□
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
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 5 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.
CALL CENTER
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
□
□
□
□
□
□
□
□
□
□
□
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
22. 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
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
23. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
24. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
25. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________
□ Administration
□ Peer Educator
26. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of trafficking, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
All the Time
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 5 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.
CALL CENTER
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
27. Which of the following best describes your geographic population? (Mark all that apply.)
□ National
□ State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
28. 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
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify): __________________
29. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
30. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
31. What is your gender? (Mark all that apply.)
Male
Female
Transgender
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 5 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.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
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].
CONFERENCE:
SESSION:
DATE(S): _____________________________________________
PRESENTER(S): ________________________________________________________________________________________
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
Please rate how well the session met each of its stated objectives.
OVERALL OBJECTIVES
Poor
Satisfactory
Good
Excellent
Not
Applicable
1.
[Insert objective 1].
1
2
3
4
NA
2.
[Insert objective 2].
1
2
3
4
NA
3.
[Insert objective 3].
1
2
3
4
NA
4.
[Insert objective 4].
1
2
3
4
NA
5.
[Insert objective 5].
1
2
3
4
NA
Please indicate the extent to which you agree or disagree with the following statements.
PRESENTER/FACILITATOR 1: ___________________
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
6.
The presenter’s knowledge and expertise were appropriate
for this session.
1
2
3
4
NA
7.
The presenter delivered the content of the session clearly
and logically.
1
2
3
4
NA
8.
The presenter responded positively to questions and
comments.
1
2
3
4
NA
9.
The presenter created a respectful environment for
participants.
1
2
3
4
NA
1
2
3
4
NA
10. The presenter encouraged and initiated helpful
discussions.
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 10 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.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
16. The session addressed the critical issues related to the
topic(s).
1
2
3
4
NA
17. The session was well organized and clear.
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
30. The session met my professional needs.
1
2
3
4
NA
31. The session met my educational needs.
1
2
3
4
NA
32. I will be able to apply what I learned in my work.
1
2
3
4
NA
PRESENTER/FACILITATOR 2: ___________________
11. The presenter’s knowledge and expertise were appropriate
12.
13.
14.
15.
for this session.
The presenter delivered the content of the session clearly
and logically.
The presenter responded positively to questions and
comments.
The presenter created a respectful environment for
participants.
The presenter encouraged and initiated helpful
discussions.
CONFERENCE SESSION FEEDBACK
18. The session increased my knowledge related to the
topic(s).
19. The information presented in the session was grounded in
current evidence-based research or promising practices.
20. The information presented in the session was traumainformed.
21. The information presented in the session was survivorinformed.
22. The information presented in the session was grounded in
a multidisciplinary approach to addressing human
trafficking.
23. The information provided in the session reflected a public
health approach to addressing human trafficking.
24. The session improved my ability to serve people who are
currently being trafficked, at risk of trafficking, or have
been trafficked.
25. The meeting space and use of technology provided a good
learning environment.
26. The time allotted was adequate for the scope of material
covered.
27. The education materials provided for this session were
useful.
28. I will share the information I learned at the session with
my colleagues.
29. The session increased my practical skills related to the
topic(s).
Not
Applicable
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 10 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.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
Please click the number that best represents your rating for this session for each of the following questions.
33. Please rate the overall quality of this session.
1
2
3
4
Poor
Fair
Good
Excellent
34. How useful was the session information to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
35. As a result of participating in this session, do you plan to do any of the following? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
□
□
□
□
□
□
□
□
□
□
□
□
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
36. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multi-disciplinary team
37. Would you recommend NHTTAC to others for T/TA?
□
□
□
□
□
□
Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
□ Yes
□ No
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 10 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.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
38. What aspects of the session were most helpful and why?
______________________________________________________________________________
______________________________________________________________________________
39. What could be done differently to improve the session?
______________________________________________________________________________
______________________________________________________________________________
40. Do you have any other comments or suggestions?
______________________________________________________________________________
______________________________________________________________________________
41. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
□
□
□
□
□
□
□
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
42. 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)
Professional capacity/types of services, continued
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
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
43. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 10 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.
CONFERENCE SESSION
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
44. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
45. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________
□ Administration
□ Peer Educator
46. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of trafficking, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
All the Time
47. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
48. 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
Domestic and dating 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 10 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.
CONSULTANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
TRAINING/TECHNICAL ASSISTANCE (T/TA):
DATE(S):
NHTTAC COORDINATOR:
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please indicate the number that best represents your rating for each of the following questions.
1.
2.
How satisfied were you with the overall quality of the support you received from NHTTAC staff to complete this T/TA?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
How satisfied were you with your overall experience with NHTTAC staff?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
Please indicate the extent to which you agree or disagree with the following statements:
OVERALL T/TA
3.
4.
5.
6.
7.
8.
NHTTAC was detail oriented and thorough in the planning of the
T/TA.
NHTTAC was responsive to my questions and needs.
Discussions with NHTTAC helped me to identify critical issues
and understand the needs of participants prior to the T/TA.
NHTTAC provided me with the necessary information and
resources to help me adequately prepare for the T/TA.
The information developed or provided in the T/TA was based on
current evidence-based research or promising practices.
The time allotted was adequate for the scope of material covered.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
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number. The estimated average time to complete this form is 5 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.
CONSULTANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
9.
The information [developed for the T/TA] [provided to the
participants] was survivor informed.
10. The T/TA was grounded in a multidisciplinary approach to
addressing human trafficking.
11. The T/TA reflected a public health approach to addressing human
trafficking.
12. The T/TA was trauma informed.
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
13. What obstacles or challenges, if any, did you encounter in the planning or delivery of this T/TA?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
14. In what language was the training delivered?
□ English □ Spanish
15. How prepared did you feel for the delivery of the training?
1
2
3
4
Not At All Prepared
Somewhat Prepared
Mostly Prepared
Very Prepared
Please indicate the extent to which you agree or disagree with the following statements:
PROFESSIONAL DEVELOPMENT AND EXPERTISE
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
16. NHTTAC respected my perspective about
17. This was an appropriate outlet for using my skill sets and
knowledge.
18. Participating in the T/TA as a consultant enhanced my
communication skills.
19. Participating in the T/TA strengthened my confidence to consult in
future T/TA events.
20. As a consultant for NHTTAC, I have improved my leadership
competencies.
21. As a consultant for NHTTAC, I have more opportunities to
collaborate with other professionals in the field.
22. Overall, consulting for the T/TA contributed to my professional
development.
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
23. Would you recommend others to be a consultant for NHTTAC?
□ Yes □ No
24. Would you recommend NHTTAC to others who need T/TA?
□ Yes □ No
25. Do you have any other comments or suggestions about how to improve the NHTTAC’s consultant network and/or NHTTAC
consulting experience??
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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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 5 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.
CONSULTANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
26. What is your NHTTAC consultant category?
□ Survivor Impact □ Training/Technical Assistance (T/TA) Expert
27. Which of the following best describes the organization in which you work? (Mark all that apply.)
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Academic institution
Other (please specify):
______________________________
28. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
□ N/A
29. 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
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
30. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
31. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
3 to 5 years
□
□
6 to 10 years
More than 10 years
32. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/Frontline staff
□ Consultant/Trainer
Management
□ Volunteer
Other (please specify): _______________
□
□
Administration
Peer educator
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number. The estimated average time to complete this form is 5 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.
CONSULTANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
33. Which of the following best describes your geographic population? (Mark all that apply.)
□ National
□ State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________
□
Local
□ Urban
□ Rural
□ Suburban
34. 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): __________________
35. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
_______________________________________
Native Hawaii or other Pacific Islander
White
Other (please specify):
36. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
37. What is your gender? (Mark all that apply.)
Male
Female
Transgender
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 5 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.
T/TA COORDINATION
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
EVENT:
DATE(S):
Please indicate the extent to which you agree or disagree with the following statements:
TRAINING AND TECHNICAL ASSISTANCE (T/TA) FEEDBACK
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1.
It was easy to work with NHTTAC.
1
2
3
4
2.
The T/TA aligned with OTIP’s goals and priorities.
1
2
3
4
3.
Overall, this was an effective way to support the content and purpose of the
meeting.
NHTTAC collaborated with the necessary stakeholders to meet the
objective(s) of the T/TA.
The T/TA was grounded in a multidisciplinary approach to addressing human
trafficking.
1
2
3
4
1
2
3
4
1
2
3
4
4.
5.
6.
The T/TA reflected a public health approach to addressing human trafficking.
1
2
3
4
7.
The T/TA was trauma informed.
1
2
3
4
8.
The T/TA was survivor informed.
1
2
3
4
1
2
3
4
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
11.
1
2
3
4
12.
1
2
3
4
13.
1
2
3
4
14.
1
2
3
4
15.
1
2
3
4
9.
NHTTAC staff effectively responded to any obstacles or challenges
surrounding the planning or implementation of the T/TA.
10. The T/TA was based on current evidence-based research or promising
practices.
Please indicate the extent to which the T/TA met each stated objective:
T/TA OBJECTIVES
16. What could NHTTAC have done differently to better support the objectives of the T/TA?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
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 3 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.
FOCUS GROUP
SUPPLEMENT
OMB CONTROL NUMBER: 0970-XXXX
Date of Expiration: XX/XX/XXXX
Background
Please complete the following information to describe your demographics.
All of the information you share with us today will be kept CONFIDENTIAL. What you say will not
be identified with your name.
This form is OPTIONAL and will only be used to help describe the types of people who participated
in this focus group to help inform NHTTAC’s training and technical assistance services.
If you have any questions about this focus group or the project, please contact [insert point of contact].
1. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task
force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based
organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other (please specify):
_____________________
2. Is your organization responsible for working with people who are currently being trafficked or have been
trafficked? □ Yes
□
No
3. 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
Violence prevention (e.g., child abuse
and neglect, elder abuse, domestic
violence, sexual violence, youth
violence)
Other (please specify):
_______________________________
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 2 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.
FOCUS GROUP
SUPPLEMENT
OMB CONTROL NUMBER: 0970-XXXX
Date of Expiration: XX/XX/XXXX
4. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
5. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
3–5 years
□ 6–10 years
□ More than 10 years
6. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/Frontline staff
□ Consultant/Trainer
Management
□ Volunteer
Other (please specify): _______________
□ Administration
□ Peer educator
7. Which of the following best describes your geographic population? (Mark all that apply.)
□
National
□
State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
8. 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): __________________
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 2 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.
FOCUS GROUP
SUPPLEMENT
OMB CONTROL NUMBER: 0970-XXXX
Date of Expiration: XX/XX/XXXX
9. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
10. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
11. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
Thank you for taking the time to complete this form and helping to improve NHTTAC/SOAR 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 2 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.
FOCUS GROUP GUIDE
OMB Control Number: 0970-XXXX
Date of Expiration: XX/XX/XXXX
[Note: This guide contains a number of questions that might be selected for a typical focus group. It is not
intended that a focus group would include all of these questions. Instead, this serves as a “bank” of focus
group questions from which to choose depending on the nature and purpose of each particular focus group.
Focus groups will last between 60 and 90 minutes.]
[Information for facilitator(s)] The purpose of this focus group is to learn more about how the National
Human Trafficking Training and Technical Assistance Center (NHTTAC) can improve its services to better
meet the training and technical assistance (T/TA) needs of the human trafficking and public health fields in
order improve services and outcomes for individuals at risk of being trafficked and those who have been
trafficked. This focus group can be conducted online or in person, and it can be tailored to specific topics,
tools, resources, processes, or information needs. The information will be used to inform NHTTAC’s T/TA
services.
Preamble/Moderator’s Opening Statements
Thank you very much for agreeing to participate in this focus group discussion. I’m [insert moderator
name], and I will facilitate today’s session. I am joined by [insert support staff and their role].
Each of you has been selected because you [insert specific reason for participation]. The information
gathered in this focus group will be used to inform NHTTAC’s services.
In a group interview like this, it is really important that you express yourself openly. There are no right or
wrong answers. We want to know what you think. We are recording the session to ensure accuracy.
However, your response will not be linked with your name or affiliation in any way. Everything will be
anonymous. Recording will not start until after introductions.
Because we are recording, I may remind you occasionally to speak up and to talk one at a time so that I can
hear you clearly when I review the session tapes. I am your moderator, but I want the interaction to flow
among you.
Each time I ask a question, there is no need for everyone around the table to respond. However, it is
important that a wide range of ideas is expressed. If you would like to add an idea, or if you have an idea that
contrasts with those that have been aired, that’s the time to jump into the conversation. You don’t have to go
in a circle. There is no such thing as “your turn.” It’s always your turn.
Before we get started with introductions, let’s lay some ground rules for how today’s discussion will operate.
[Have standard ground rules for all groups, including restroom, timeframe, talking one at a time, respecting
divergent opinions, having conversations stay in the room, etc., but also include additional ground rules for
focus groups that involve survivors (including safe space)].
Are there any questions before we begin?
1. Introductions and ice breaker
Let’s start with introductions. Please give us your first name only and [insert ice breaker question and
encourage “popcorn style” responses by participants].
FOCUS GROUP GUIDE
OMB Control Number: 0970-XXXX
Date of Expiration: XX/XX/XXXX
[The moderator should select questions from the following list that achieves the goals of the focus group. The
number of questions should account for the number of participants and the amount of time scheduled for the
focus group.]
2. General questions
How satisfied were you with your overall NHTTAC/SOAR experience?
How satisfied were you with the overall quality of support you received from NHTTAC/SOAR staff?
How has working with NHTTAC/SOAR improved your [insert type of skill(s) related to
training/event/tool objectives]?
What were your expectations prior to [insert T/TA]?
o How well were these expectations met?
What types of practical skills did you enhance by attending [insert event/training]?
How well did [insert event/training/tool] meet [insert objectives – ask about one objective at a time]?
3. How did you learn about the tool/resource/T/TA (e.g., SOAR e-guide)
Where did you learn about this tool (training/conference/newsletter/website)? [If they mention
anything specific, ask which one (e.g. which training, which conference, etc.)?]
Where would you usually go to find this type of information, tool, or topic?
Once you heard about it, was this tool easy to find? Is it accessible to everyone who might need it? If
not, what should be changed?
Is there a place to put this tool that users would find easier to locate?
Are there other places you already go to get this information? What do you like about them? What do
you dislike about them?
4. Appropriateness/comprehensiveness of information/content (may ask about tool overall or by
module/component)
How well did the information align with your expectations about what you wanted to see or were
looking for? What was missing?
Was the information too advanced/detailed or too basic?
How is the information applicable to your work?
Are there other topics that need tools similar to this one?
How well did [insert event/training/tool] address culturally and linguistically appropriate services?
o What needs to be improved moving forward?
In what ways has attending [insert type of technical assistance (SOAR for Communities, for
example)] impacted organizational culture related to:
FOCUS GROUP GUIDE
OMB Control Number: 0970-XXXX
Date of Expiration: XX/XX/XXXX
o Trauma-informed approaches
o Survivor-informed practices
o Multi-disciplinary approach
o Prevention efforts
o Identification of (or response to) people at risk of or currently being trafficked
o The utilization of evidence-based or promising practices or research
[Ask the group about each module, as needed—do they have experience with it? Is it appropriate? What
were they expecting or looking for—and find out specific information about how it meets their needs or
can be improved to do so.]
5. Ease of use of tools (such as e-guide, online SOAR trainings, etc.)
How do you feel about the way the information is displayed on [insert tool, e.g., website, MyOTIP,
state/territory profiles, etc.]?
o What do you like about it?
o What do you dislike?
If it was difficult to use, how so?
What would make it easier to use and understand?
What about the layout, length, format, readability of the [web page/MyOTIP page]?
Is the level of interactivity of the tool appropriate?
Is the length of information about right?
What do you think of the content layout (e.g., bullets vs. paragraphs)?
[If this tool is designed to be used to train others] If instructions are provided, are they clear? Are
they needed?
Was the information/tool easy to understand and user friendly? How so? If it was difficult to use,
how so?
What future direction do you think we should take with this tool?
[If there are specific aspects of the tool where feedback is needed, visit those aspects and ask these
questions for each aspect.]
6. Utility
How was this [tool, training, meeting, etc.] helpful?
o How did you, or how would you, use the information/tool?
o If you won’t use it, why not? What do you need that is not here?
How was this [tool, training, meeting, etc.] not helpful?
FOCUS GROUP GUIDE
OMB Control Number: 0970-XXXX
Date of Expiration: XX/XX/XXXX
o How could this be improved? What was missing?
How well does [insert specific objective, session title, etc.] align with the needs of your
organization/community?
[If specific aspects of the tool require feedback, visit those aspects and ask these questions for each
aspect.]
7. Preparedness
What planning occurred prior to the incident(s)/event that made the response more effective?
Which organizations/individuals participated in the planning process? What roles did they play?
Who was missing from the planning process?
What was most beneficial and challenging about the planning process?
What would you recommend to others [doing similar planning for X event/incident]?
Is/was a needs assessment conducted to [XX purpose]?
8. Communications
Do you have any ideas for ways to support more information sharing between
[organizations/groups/XX]?
Do you have a way to reach out to other [organizations/groups/XX] when you have questions or need
resources?
How can communication be improved?
9. Use of technology (e.g., learning management system for SOAR)
What protocols are/were in place and what role does/did technology play in [XX]? Is/was technology
used to [XX]? What other technological strategies were used to aid [XX]?
10. Training and resources
Has your [group, organization, XX] received any [training/resources/XX]? Where they useful? Why
or why not?
What impact has the [XX] had on the [group, organization, XX]?
Can you think of any training you’ve attended that has been particularly useful? Which trainings have
you found most useful to your [group, organization, XX]?
11. Successes and challenges/barriers
Thinking about the integration of SOAR training into your organization’s learning management
system:
o What were some of the successes?
FOCUS GROUP GUIDE
OMB Control Number: 0970-XXXX
Date of Expiration: XX/XX/XXXX
o What were some of the challenges?
When you think of a “success” [XX], what comes to mind?
How would you define success for the [XX]? Any promising strategies you would like to share?
What would you do to make your [group, organization, XX] more “successful” at its work?
What are the most difficult challenges for [XX]?
Were there any gaps in services that impacted [XX]? What were they, and how were they addressed?
What were the challenges to establishing [XX]? [convening the TA, subsequent response afterwards,
timelines, identifying a location, participating agencies and organizations, communication]
12. Lessons learned and best practices
Overall, based on your experience with [XX], what were the greatest lessons learned?
What would you consider as best/promising practices? Why?
What is the most important thing for other [communities, organizations, individuals, etc.] to know in
[XX]?
13. Identified and anticipated technical assistance needs
With a show of hands, how many of you would recommend NHTTAC to others to be a consultant?
o What about working with NHTTAC do you see as beneficial?
o What are some of the challenges in working as a consultant with NHTTAC?
What additional trainings are needed related to [XX]?
o What types of organizations/individuals/entities are best suited to receive this training?
o What would you identify as your top five training needs?
What additional technical assistance needs are related to [XX]?
o What types of organizations/individuals/entities are best suited to receive this technical
assistance?
With a show of hands, how many of you would recommend NHTTAC to others to receive training?
o What about the trainings do you see as beneficial?
With a show of hands, how many of you would recommend NHTTAC to others to receive technical
assistance?
o What about the technical assistance do you see as beneficial?
What could be improved for future activities?
What is important for NHTTAC to know about the field’s needs to address human trafficking?
FOCUS GROUP GUIDE
OMB Control Number: 0970-XXXX
Date of Expiration: XX/XX/XXXX
What additional topics would you like to be covered in future human trafficking trainings? [This
could also be a question you ask to the group; if so, have them write their responses on notecards to
collect.]
Closure
We have about 10 minutes left. As our discussion comes to a close, we would like to thank you for taking the
time to speak with us today. The ideas you have discussed will be helpful for [insert purpose of focus group].
Do you have any additional comments, insights, or questions? If you have questions or concerns after you
leave here today about your participation in this focus group, please contact [insert POC and provide contact
information].
FOLLOW-UP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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 to learn about your experiences since receiving training and technical assistance (T/TA)
[insert time frame] ago. 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].
T/TA
DATE(S):
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please indicate the extent to which you agree or disagree with the following statements:
As a result of [insert T/TA], I have…
1.
2.
3.
4.
5.
6.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
As a result of participating in [insert T/TA], have you done any of the following? (Mark all that apply.)
Changed my management/leadership or
interpersonal communication style
Further developed skills and knowledge about
serving victims of trafficking
Wrote grants/fundraised/identified new funding
resources
Advocated or met with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocated or met with leadership of my
organization to develop/enact policy changes at my
organization
Improved programs/practices
Improved technology/websites/infrastructure
Integrated victim-centered, survivor-informed
strategies
Expanded services or types of services
Began a new project or initiative
Developed/strengthened collaborative or strategic
relationships
Networked with other participants
Shared materials with colleagues
Provided information to clients/families/youth
Trained/educated others in content/skills learned
Raised public awareness/advocacy/outreach
activities offered to victims
Referred colleagues to NHTTAC events/resources
Conducted research
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 8 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
FOLLOW-UP FEEDBACK
7.
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Strengthened evaluation or needs assessment
activities
Improved identification and reporting methods for
trafficking
Took additional training on human trafficking
Other (please specify): __________________
Since [insert T/TA], what barriers have you faced in implementing change? (Mark all that apply.)
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Difficulty in establishing and/or maintaining a
multidisciplinary team
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of training for staff in how to implement
change
Other (please explain): _________________
Please indicate the extent to which you have used the following in your daily work
Never
Occasionally
Frequently
Daily
8.
1
2
3
4
9.
1
2
3
4
10.
1
2
3
4
11.
1
2
3
4
12.
1
2
3
4
13.
1
2
3
4
14.
1
2
3
4
15.
1
2
3
4
16.
1
2
3
4
17. Was there anything not provided during [insert T/TA] that would have been helpful in implementing change?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
18. What aspect(s) of [insert T/TA] were most helpful to you?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
19. Would you recommend [NHTTAC][SOAR] T/TA to others?
□
Yes
□
No
20. Do you have any additional comments or suggestions for future [NHTTAC][SOAR]-related T/TA?
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 8 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.
FOLLOW-UP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
21. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□
□
Yes
No
22. In your professional capacity, how frequently do you come into contact with a person who is being trafficked, at risk of
trafficking, or has been trafficked?
1
2
3
4
Never
Occasionally
Frequently
Daily
Thank you for taking the time to complete this form and helping to improve [NHTTAC][SOAR] 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 8 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.
GENERAL CONFERENCE
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
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].
CONFERENCE TITLE: _______________________________________________________________
DATE(S): __________________________________________________________________________
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
Please indicate how well the conference met each stated objective.
OVERALL OBJECTIVES
Poor
Satisfactory
Good
Excellent
Not
Applicable
1.
[Insert objective 1].
1
2
3
4
NA
2.
[Insert objective 2].
1
2
3
4
NA
3.
[Insert objective 3].
1
2
3
4
NA
4.
[Insert objective 4].
1
2
3
4
NA
5.
[Insert objective 5].
1
2
3
4
NA
Please indicate the extent to which you agree or disagree with the following statements.
CONFERENCE FEEDBACK
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
6.
The conference addressed the critical issues related
to the topic(s).
1
2
3
4
NA
7.
The conference was well organized and clear.
1
2
3
4
NA
8.
The conference increased my knowledge related to
the topic(s).
1
2
3
4
NA
9.
The information presented in the conference was
grounded in current evidence-based research or
promising practices.
1
2
3
4
NA
10. The information presented in the conference was
trauma-informed.
1
2
3
4
NA
11. The information presented in the conference was
survivor-informed.
1
2
3
4
NA
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 10 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.
GENERAL CONFERENCE
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
12. The information presented in the conference was
grounded in a multidisciplinary approach to
addressing human trafficking.
1
2
3
4
NA
13. The information provided in the conference
reflected a public health approach to addressing
human trafficking.
1
2
3
4
NA
14. The conference improved my ability to serve people
at risk of or being trafficked.
1
2
3
4
NA
15. The meeting space and use of technology provided
a good learning environment.
1
2
3
4
NA
16. I was satisfied with the overall conference facilities.
1
2
3
4
NA
17. The registration and logistics information were
clear, helpful, and easily accessible.
1
2
3
4
NA
18. The format of the conference provided ample
opportunity and encouragement for participants to
interact meaningfully with each other.
1
2
3
4
NA
19. The conference staff was professional, helpful, and
informative.
1
2
3
4
NA
20. The time allotted was adequate for the scope of
material covered.
1
2
3
4
NA
21. The education materials provided for this
conference were useful.
1
2
3
4
NA
22. I will share the information I learned at the
conference with my colleagues.
1
2
3
4
NA
23. The conference increased my practical skills related
to the topic(s).
1
2
3
4
NA
24. The conference met my professional needs.
1
2
3
4
NA
25. The conference met my educational needs.
1
2
3
4
NA
26. I will be able to apply what I learned in my work.
1
2
3
4
NA
Please select the number that best represents your rating for this conference for each of the following questions.
27. Please rate the overall quality of this conference.
1
2
3
4
Poor
Fair
Very Good
Excellent
28. How useful was the conference information to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
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 10 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.
GENERAL CONFERENCE
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
29. As a result of participating in this conference, do you plan to do any of the following? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
□
□
□
□
□
□
□
□
□
□
□
□
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
30. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multi-disciplinary team
31. Would you recommend NHTTAC to others for T/TA?
□
□
□
□
□
□
Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
□ Yes
□ No
32. Please indicate any additional needs that you or your organization have that may be met with future TTA.
______________________________________________________________________________
______________________________________________________________________________
33. Which of the conference sessions were most useful and why?
______________________________________________________________________________
______________________________________________________________________________
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 10 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.
GENERAL CONFERENCE
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
34. What could be done differently to improve the conference?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
35. Do you have any other comments or suggestions?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
36. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
□
□
□
□
□
□
□
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
37. 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
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
38. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
39. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
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 10 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.
GENERAL CONFERENCE
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
40. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________
□ Administration
□ Peer Educator
41. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of trafficking, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
All the Time
42. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
43. 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
Domestic and dating 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 10 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.
GENERAL TRAINING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
TRAINING:
DATE(S):
CONSULTANT(S)/FACILITATOR(S):
PRETRAINING EVALUATION
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
for your date of birth:
08 for August)
(example: S for Sara)
(example: M for Maria)
To what extent are you knowledgeable about:
Not At All
Knowledgeable
Somewhat
Knowledgeable
Very
Knowledgeable
1.
1
2
3
2.
1
2
3
3.
1
2
3
4.
1
2
3
5.
1
2
3
How prepared are you to teach others about:
Not At All Prepared
Somewhat Prepared
Well Prepared
6.
1
2
3
7.
1
2
3
8.
1
2
3
9.
1
2
3
10.
1
2
3
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 2 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.
GENERAL TRAINING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
POSTTRAINING EVALUATION
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please click the number that best represents how well this training met its stated objectives:
Did Not Achieve
This Objective
Somewhat Achieved
This Objective
Achieved This
Objective
1.
1
2
3
2.
1
2
3
3.
1
2
3
4.
1
2
3
5.
1
2
3
6.
7.
8.
Overall, how well did this training meet your expectations?
1
2
3
4
Far Below My
Expectations
Did Not Meet My
Expectations
Met My
Expectations
Exceeded My
Expectations
How useful was the training to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
□
Did you receive continuing education credits for completing this training?
Yes
□
No
Please indicate the extent to which you agree or disagree with the following statements:
FACILITATOR 1: ___________________
9.
The knowledge and expertise of the facilitator were
appropriate for the training.
10. The facilitator presented the content clearly and logically.
Strongly
Disagree
Disagree
Agree
Strongly Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
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additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
GENERAL TRAINING
PARTICIPANT FEEDBACK
11. The facilitator responded positively to questions and
comments.
12. The facilitator created a respectful environment for
participants.
13. The facilitator encouraged and initiated helpful discussions.
FACILITATOR 2: ___________________
14. The knowledge and expertise of the facilitator were
appropriate for the training.
15. The facilitator presented the content clearly and logically.
16. The facilitator responded positively to questions and
comments.
17. The facilitator created a respectful environment for the
participants.
18. The facilitator encouraged and initiated helpful discussions.
TRAINING FEEDBACK
19. The format of the training contributed to a positive meeting
environment.
20. The format of the training made it easy to ask questions and
collaborate with other participants.
21. The training addressed the critical issues related to the
topic(s).
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
29. The training was trauma informed.
1
2
3
4
NA
30. I will be able to apply what I learned in my work.
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
33. The training met my educational needs.
1
2
3
4
NA
34. The training met my professional needs.
1
2
3
4
NA
35. I will share the information I learned at the training with my
colleagues.
1
2
3
4
NA
22. The training was organized and clear.
23. The training increased my knowledge related to the
topic(s).
24. The training increased my practical skills related to the
topic(s).
25. The training was survivor informed.
26. The training included current evidence-based or promising
practices related to the topic(s).
27. The training reflected a public health approach to
addressing human trafficking.
28. The training was grounded in a multidisciplinary approach
to addressing human trafficking.
31. The training improved my ability to serve people who are
being trafficked, at risk of trafficking, or have been
trafficked.
32. The meeting space and use of technology provided a good
learning environment.
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number. The estimated average time to complete this form is 6 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.
GENERAL TRAINING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
36. Please rate the overall quality of this training.
1
2
3
4
Poor
Fair
Good
Excellent
To what extent do you feel prepared to apply the following in your daily work:
Not At All Prepared
Somewhat Prepared
Well Prepared
37.
1
2
3
38.
1
2
3
39.
1
2
3
40.
1
2
3
41.
1
2
3
42. If you do not feel prepared to apply one or more of the objectives above, please briefly explain why:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
43. What are the three most important things you learned during the training?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
44. What could be done differently to improve the training?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
45. As a result of participating in this session, do you plan to do any of the following? (Mark all that apply.)
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
victims of trafficking
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to victims
Refer colleagues to NHTTAC events/resources
Conduct research
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number. The estimated average time to complete this form is 6 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.
GENERAL TRAINING
PARTICIPANT FEEDBACK
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Take additional training on human trafficking
Other (please specify): __________________
46. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Lack of time to implement changes
Difficulty in establishing and/or maintaining a
multidisciplinary team
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of training for staff in how to implement
change
Other (please explain): _________________
□
47. Would you recommend NHTTAC/SOAR to others for training?
Yes
□
No
48. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/for-profit organization
Coalition/multidisciplinary team/task force
Federal government
Faith-based organization
State/local government
Nonprofit/community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/worker advocacy organization
Victim service provider
Other (please specify): _____________________
49. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□
Yes
□
No
50. 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
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 6 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.
GENERAL TRAINING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Violence prevention (e.g., child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
51. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
□
3–5 years
6–10 years
□
More than 10 years
□
□
Administration
Peer educator
52. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/frontline staff
Management
Other (please specify): ______
□
□
Consultant/trainer
Volunteer
53. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
54. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
□
State (please specify): ______________
Tribal
International (please specify country): _____________
Local
□ Urban
□ Rural
□ Suburban
55. 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
56. What is your race? (Mark all that apply.)
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): __________________
American Indian or Alaska Native
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number. The estimated average time to complete this form is 6 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.
GENERAL TRAINING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
57. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
58. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
Thank you for taking the time to complete this form and helping to improve NHTTAC activities.
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 6 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
Please provide the information below to create an anonymous ID:
______
______
Birth Month
First letter of first name
(insert just the month
(example: S for Sara)
for your date of birth,
example: 08 for August)
______
First letter of your middle name
(example: M for Maria)
Please rate the extent to which to you agree or disagree that the fellowship program has helped you achieve the following
objectives. This program has increased my…
Strongly
Disagree
OBJECTIVES
Disagree
Agree
Strongly
Agree
Not
Applicable
1. [insert objective here].
1
2
3
4
NA
2. KNOWLEDGE: Grow participant understanding of human
trafficking programs, nonprofits, government, public health
systems, and other processes and services that can help catalyze
positive change.
1
2
3
4
NA
3. TRUST: Increase the level of trust and reciprocity between
survivors and the agencies and institutions committed to their
success.
1
2
3
4
NA
4. NETWORK: Cultivate a thriving leadership network of survivors
and human trafficking professionals that work across
organizational and geographic boundaries.
1
2
3
4
NA
5. CONTRIBUTION: Create relevant and usable resources and
tools that enhance trauma-informed and survivor-centered
OTIP grant programming.
1
2
3
4
NA
6. SKILLS: Empower emerging leaders with leadership skills and
training to lead themselves and their communities forward.
1
2
3
4
NA
Please rate your level of confidence with the following after participating in this program:
SKILL DEVELOPMENT
7. My leadership ability.
Not at All
Confident
1
Not
Confident
2
Confident
3
Very
Confident
4
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number. The estimated average time to complete this form is 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
8. My skills and knowledge about trauma-informed
practices.
1
2
3
4
9. My skills and knowledge about survivor-informed
practices.
1
2
3
4
10. My skills and knowledge about current evidence-based
or promising practices.
1
2
3
4
11. My skills and knowledge about a multidisciplinary
approach to addressing human trafficking.
1
2
3
4
12. My skills and knowledge about a public health
approach to addressing human trafficking.
1
2
3
4
13. My connection to colleagues, professionals, and human
trafficking experts.
1
2
3
4
14. My knowledge of human trafficking programs,
nonprofits, government, and public health systems.
1
2
3
4
15. My ability to collaborate across human trafficking
programs or initiatives.
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
16. The planning support provided by NHTTAC prior to the
beginning of the fellowship program was helpful.
1
2
3
4
NA
17. The onsite support provided by NHTTAC during the inperson trainings was helpful.
1
2
3
4
NA
18. The interim support and check-ins provided by NHTTAC
staff between seminars was helpful.
1
2
3
4
NA
19. I am satisfied with the overall support provided by NHTTAC
staff throughout the fellowship program.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
20. The facilitator’s knowledge and expertise were appropriate
for this program.
1
2
3
4
NA
21. The facilitator responded positively to questions and
comments.
1
2
3
4
NA
22. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
23. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
24. The facilitator’s knowledge and expertise were appropriate
for this program.
1
2
3
4
NA
25. The facilitator responded positively to questions and
comments.
1
2
3
4
NA
NHTTAC STAFF: ________________
FACILITATOR 1: ___________________
FACILITATOR 2: ___________________
Not
Applicable
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number. The estimated average time to complete this form is 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
26. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
27. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
NA
Strongly
Agree
28. Please rate the overall quality of the HTLA.
1
Poor
2
Fair
3
4
Good
29. Would you recommend NHTTAC to others to receive T/TA?
Excellent
□ Yes
□ No
Please indicate the extent to which you agree or disagree with the following statements:
Strongly
Disagree
Disagree
Agree
30. The time allotted was adequate for the scope of the
initiative.
1
2
3
4
NA
31. The program was well organized.
1
2
3
4
NA
32. This program met my professional needs.
1
2
3
4
NA
33. This program met my educational needs.
1
2
3
4
NA
34. The materials provided during this program were useful.
1
2
3
4
NA
35. The format of the program contributed to a positive
learning environment.
1
2
3
4
NA
36. The format of the program provided ample opportunity
and encouragement for participants to interact
meaningfully with each other.
1
2
3
4
NA
37. The content was trauma-informed.
1
2
3
4
NA
38. I am confident the knowledge and skills that I learned
will be useful for my practice and/or for my professional
development.
1
2
3
4
NA
39. I will be able to apply what I learned in my work.
1
2
3
4
NA
40. The program improved my ability to serve people who
are currently being trafficked, at risk of trafficking, or
have been trafficked.
1
2
3
4
NA
41. This program will help me collaborate with various
professionals across the human trafficking field.
1
2
3
4
NA
42. I will share the information I learned at the training with
my colleagues and peers.
1
2
3
4
NA
OVERALL FEEDBACK
Not
Applicable
43. What are the top three ways you improved your effectiveness as a leader?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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number. The estimated average time to complete this form is 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Please rate the overall quality of each session of the Human Trafficking Leadership Academy:
OVERALL QUALITY
44.
45.
46.
47.
HTLA Seminar 1
HTLA Seminar 2
HTLA Seminar 3
HTLA Seminar 4
Poor
Fair
Good
Excellent
Not Applicable
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
NA
NA
NA
NA
48. What insights and experiences did you contribute to the other fellows' learning experiences during the program?
_________________________________________________________________________________
_________________________________________________________________________________
49. What contributions did the other fellows make toward your learning experience?
_________________________________________________________________________________
_________________________________________________________________________________
50. How did working with [grantees/survivors] impact your professional experience?
_________________________________________________________________________________
_________________________________________________________________________________
51. How has your professional network changed through participating in this program? (Mark all that apply.)
□
□
□
□
Increased the number of professionals working to
address human trafficking
Increased the number professionals with similar
professional goals
Met professionals who are in my geographical
area
Met professionals that I could collaborate with in
future endeavors
□
□
□
□
□
Met professionals that I could develop a meaningful
working relationship with
Met professionals that I could develop a close
friendship with
Met professionals who are acquaintances or knows
some of my other colleagues
Met professionals that have skill-sets that are
complementary to mine
Other (please specify): _________________
52. Do you anticipate doing any of the following as a result of participating in this program? (Mark all that apply.)
□
□
□
□
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about
serving people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission,
or strategic plan
□
□
□
□
□
□
□
□
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
Develop/strengthen collaborative or strategic
relationships
Network with other participants
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 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
□
□
□
□
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
□
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
□
□
□
□
□
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
53. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected
in the previous question? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across
organizational collaboration
Improve my own leadership or professional
development skills
□
□
□
□
□
□
□
Difficulty in establishing and/or maintaining a
multi-disciplinary team
Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
54. Please list any other professional goals you have achieved through this program:
______________________________________________________________________________
_______________________________________________________________________________
55. What aspects of the HTLA were most helpful and why?
______________________________________________________________________________
______________________________________________________________________________
56. What else did you hope to achieve through participating in this program?
______________________________________________________________________________
______________________________________________________________________________
57. Overall, what are the program’s strengths?
______________________________________________________________________________
______________________________________________________________________________
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number. The estimated average time to complete this form is 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
58. What could be done differently to improve the program?
______________________________________________________________________________
______________________________________________________________________________
59. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
I am not associated with an organization
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
□
□
□
□
□
□
□
□
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
60. 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
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
______________________________
61. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
62. Which of the following best describes the number of years of experience you have in your current field of work?
Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
63. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Administration
□ Management
□ Volunteer
□ Peer Educator
□ Other (please specify): _______________
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 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
64. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at
risk of trafficking, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
All the Time
65. Which of the following best describes your geographic population? (Mark all that apply.)
□ National
□ Local
□ Not Applicable
□ State (please specify): ______________
□ Urban
□ Tribal
□ Rural
□ International (please specify country):
□ Suburban
_________________________________
66. Please select any of the following populations you currently work with in a professional capacity (Mark all that apply.)
□ Lesbian, gay, bisexual, transgender, and
□ Human trafficking
questioning
□ Commercial sexual exploitation of
□
Foreign nationals (migrant workers, undocumented
children
immigrants, refugees)
□ Sex trafficking
□ People with low incomes
□ Adults
□ Racial and ethnic minorities
□ Minors
□ American Indian or Alaska Native
□ Labor trafficking
□ Asian
□ Adults
□ Black or African American
□ Minors
□ Native Hawaii or other Pacific Islander
□ Children/youth
□ White
□ Out of home/Foster care/Kinship care
□ Hispanic or Latino ethnicity
□ Juvenile justice
□ History of substance use
□ Runaway/Homeless youth
□ Domestic and dating violence
□ People with disabilities
□ Gang-related crime
□ Deaf/Hearing impaired
□ Sexual abuse/Violence
□ Elderly
□ Other (Please specify): __________________
67. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
68. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
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 15 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.
HTLA POST-PROGRAM
FELLOW
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
69. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
70. Do you have any other comments or suggestions?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Thank you for taking the time to complete this form and helping to improve NHTTAC’s 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 15 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.
HTLA FELLOW
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PRE-PROGRAM
Protocol
In order to help NHTTAC better serve the field, we are reaching out to obtain your feedback prior to the start of the fellowship
program. 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. Summary responses will only be shared to enhance the experience and leadership training program in the
future.
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
1.
Have you received prior leadership training?
□ Yes
□ No
If yes, please provide a brief description (e.g., what you learned, when you received training, and the length of that training) :
____________________________________________________________________________________
____________________________________________________________________________________
2.
Please think about someone who you believe is an outstanding leader, and provide 2–3 examples of why. To protect the
privacy of others, please do not list specific names or details.
____________________________________________________________________________________
____________________________________________________________________________________
3.
Describe a recent experience (either big or small) where you exercised leadership. To protect the privacy of others, please do
not list specific names or details.
____________________________________________________________________________________
____________________________________________________________________________________
4.
What do you think is your leadership style (i.e., supportive, organized, action-oriented)?
____________________________________________________________________________________
____________________________________________________________________________________
5.
What are the top three ways you would like to improve your effectiveness as a leader?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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 15 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.
HTLA FELLOW
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PRE-PROGRAM
Protocol
Please rate the importance to you for achieving each of the program’s goals:
PROGRAM OBJECTIVES
Unimportant
Somewhat
Important
Important
Very
Important
Not
Applicable
6.
[insert objective here].
1
2
3
4
NA
7.
KNOWLEDGE: Grow participant understanding of
human trafficking programs, nonprofits, government,
public health systems, and other processes and
services that can help catalyze positive change.
1
2
3
4
NA
TRUST: Increase the level of trust and reciprocity
between survivors and the agencies and institutions
committed to their success.
1
2
3
4
NA
NETWORK: Cultivate a thriving leadership network
of survivors and human trafficking professionals that
work across organizational and geographic
boundaries.
1
2
3
4
NA
10. CONTRIBUTION: Create relevant and usable
resources and tools that enhance trauma-informed
and survivor-centered OTIP grant programming.
1
2
3
4
NA
11. SKILLS: Empower emerging leaders with leadership
skills and training to lead themselves and their
communities forward.
1
2
3
4
NA
8.
9.
12. What insights do you want to contribute to the other fellows' learning experiences during the program?
____________________________________________________________________________________
____________________________________________________________________________________
13. What contributions are you hoping the other fellows will make toward your learning experience?
___________________________________________________________________________________
____________________________________________________________________________________
Please rate your level of confidence with the following:
Not at All
Confident
Somewhat
Confident
Confident
Very
Confident
14. [insert leadership skill here].
1
2
3
4
15. [insert leadership skill here].
1
2
3
4
16. [insert leadership skill here].
1
2
3
4
SKILL DEVELOPMENT
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number. The estimated average time to complete this form is 15 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.
HTLA FELLOW
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PRE-PROGRAM
Protocol
17. [insert leadership skill here].
1
2
3
4
18. [insert leadership skill here].
1
2
3
4
19. My skills and knowledge about trauma-informed
practices.
1
2
3
4
20. My skills and knowledge about survivor-informed
practices.
1
2
3
4
21. My skills and knowledge about current evidencebased or promising practices.
1
2
3
4
22. My skills and knowledge about a multidisciplinary
approach to addressing human trafficking.
1
2
3
4
23. My skills and knowledge about a public health
approach to addressing human trafficking.
1
2
3
4
24. My connection to colleagues, professionals, and
human trafficking experts.
1
2
3
4
25. My knowledge of human trafficking programs,
nonprofits, government, and public health systems.
1
2
3
4
26. My ability to collaborate across human trafficking
programs or initiatives.
1
2
3
4
27. Please list any other professional goals you have for participating in this program:
____________________________________________________________________________________
____________________________________________________________________________________
28. What do you anticipate will be your greatest challenge in the Human Trafficking Leadership Academy (HTLA) fellowship
program?
____________________________________________________________________________________
____________________________________________________________________________________
29. Have you participated in survivor-informed training or curriculum previously?
□ Yes
□ No
If yes, please explain: _________________________________________________
30. Have you participated in anti-trafficking initiatives prior to this program?
□ Yes
□ No
If yes, please explain: _________________________________________________
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 15 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.
HTLA FELLOW
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PRE-PROGRAM
Protocol
31. FOR SURVIVORS: How was your experience engaging with grantees prior to this leadership training? If not applicable,
write “N/A.”
____________________________________________________________________________________
____________________________________________________________________________________
32. FOR GRANTEES: How was your experience engaging with survivors as professionals prior to this leadership training? If not
applicable, write “N/A.”
____________________________________________________________________________________
____________________________________________________________________________________
33. What do you see as the greatest barriers to leadership development for survivors of human trafficking?
____________________________________________________________________________________
____________________________________________________________________________________
34. What opportunities will this leadership training provide you with in the future?
____________________________________________________________________________________
____________________________________________________________________________________
35. How do you think this leadership training will impact the human trafficking field?
____________________________________________________________________________________
____________________________________________________________________________________
Please click the number that best represents your rating for each of the following questions.
36. How satisfied were you with the participation selection process for this program?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
37. How satisfied were you with your preparedness to participate in the program when you were invited by NHTTAC?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
38. What could be done differently in the participant selection process for this program?
____________________________________________________________________________________
___________________________________________________________________________________
39. How many times have you interacted with NHTTAC staff in preparation for this program?
□ 0–1
□ 2–3
□ 4–5
□6 +
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 15 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.
HTLA FELLOW
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PRE-PROGRAM
Protocol
Please indicate the extent to which you agree or disagree with the following statements.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
40. NHTTAC was well organized in the planning of the HTLA.
1
2
3
4
NA
41. NHTTAC was responsive to my questions and needs.
1
2
3
4
NA
42. NHTTAC provided me with the necessary information and
resources to help me prepare for the program.
1
2
3
4
NA
43. NHTTAC helped me adequately prepare for the program.
1
2
3
4
NA
PLANNING OF THE PROGRAM
44. How can NHTTAC [and insert consultants, if applicable] help support you in achieving your goals for this program?
____________________________________________________________________________________
____________________________________________________________________________________
45. What else would have been helpful in preparing for this program?
____________________________________________________________________________________
____________________________________________________________________________________
46. What obstacles or challenges, if any, did you encounter in the planning of the HTLA?
____________________________________________________________________________________
___________________________________________________________________________________
47. What could be done differently to improve NHTTAC’s support in the planning of the HTLA?
____________________________________________________________________________________
____________________________________________________________________________________
48. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
49. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
□ N/A
50. How does your agency currently provide survivor-informed services?
□ N/A
____________________________________________________________________________________
____________________________________________________________________________________
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 15 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.
HTLA FELLOW
PRE-PROGRAM
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
51. Do you have any other comments or suggestions?
____________________________________________________________________________________
____________________________________________________________________________________
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 15 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.
INTERVIEW GUIDE
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
[Note: This protocol lists a number of questions that might be selected for a typical interview. It is not
intended that an interview would include all of these questions. Instead, this serves as a “bank” of questions
from which to choose depending on the nature of each interview. The interview will typically last between
30–60 minutes.]
[Information for the Interviewer(s)] The purpose of this interview is to learn more about how the National
Human Trafficking Training and Technical Assistance Center (NHTTAC) can improve its services to better
meet the needs of training and technical assistance (T/TA) providers and the field and improve services and
outcomes for persons at risk of or who have been trafficked. This interview can be conducted virtually
(online or phone) or in person, and it can be tailored to specific topics, tools, resources, processes, or
information needs. The information will be used to inform NHTTAC’s T/TA services.
T/TA:
DATE(S):
________________________
INTERVIEWER AND NOTE TAKER: ______________________________________________________________________
INTERVIEWEE:
Thank you for agreeing to participate in this interview. I’m [insert name], and I will facilitate the interview
today. I am joined by [insert support staff], and s/he will be taking notes.
In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC)
better serve the field, we would like to obtain your feedback since receiving training and technical assistance
(T/TA). Participating in this interview is voluntary; you may end the interview at any time and choose not
answer questions. 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.
Before we get started, do you have any questions about this interview?
1. How satisfied were you with your overall NHTTAC/SOAR experience?
2. How satisfied were you with the overall quality of support you received from NHTTAC/SOAR staff?
3. How has working with NHTTAC/SOAR improved your [insert type of skill(s) related to
training/event/tool objectives]?
4. What were your expectations prior to [insert T/TA activity]?
5. How well were these expectations met?
6. Identify three things you [plan to do or change] [did] as a result of the [insert T/TA] you received. Please
be as specific as you can (e.g., actions or changes in policy, practice, procedures, or programming).
7. What barriers [do you anticipate facing] [have you experienced] in [insert response from previous
question]?
8. Was there anything not provided by [insert T/TA] that would have been helpful in [insert outcome]?
9. What aspect(s) of the training or technical assistance were most helpful to you, and why?
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 45 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.
INTERVIEW GUIDE
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
10. What aspect(s) of the training or technical assistance were least helpful to you, and why?
11. How could [reference answers from previous question] be improved?
12. At the completion of [insert T/TA], did you have specific action steps or a strategic plan?
13. How well did these action steps align with the needs you identified prior to the training?
14. How confident did you feel in your ability to implement these action steps?
15. How supported did you feel by NHTTAC staff in implementing these action steps?
16. [3, 6, etc.] months later, in what ways have you implemented your action steps/strategic plan?
17. Reflecting back, what would have changed about your action steps/strategic plan?
18. How do you think you will continue to apply what you have learned through this [insert T/TA]?
19. Have you changed any policies at your organization? Any practices?
20. Have you attended any additional trainings or events related to the [T/TA] you attended previously?
21. Would you recommend NHTTAC/SOAR trainings to others?
22. Has your organization proposed or changed policies pertaining to human trafficking since [insert T/TA]?
23. How has your professional networking or peer support changed since [insert T/TA]?
24. How has your access to resources on preventing and identifying human trafficking changed since [insert
T/TA]?
25. Do you have any additional comments or suggestions that you would like to share about [insert T/TA]?
26. Do you have any comments or suggestions for future NHTTAC/SOAR-related trainings?
This concludes our interview. Thank you for taking the time to speak with us and for helping to improve
NHTTAC/SOAR activities.
Do you have any questions or concerns about this interview and how this information will be used? If you
have questions in the future, please contact [email protected].
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 45 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.
PILOT TRAINING
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PARTICIPANT FEEDBACK
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].
TRAINING:
DATE(S):
CONSULTANT(S)/PRESENTER(S):
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please indicate the extent to which you agree or disagree with the following statements:
OVERALL TRAINING
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
The training addressed the learning objectives clearly.
The training addressed the critical issues related to the
topic(s).
The time allotted was adequate for the scope of material
covered.
The training was well organized and clear.
The [material] [strategic planning] was appropriate for my
level of experience and knowledge.
The resource materials (handouts, audiovisuals,
PowerPoints) enhanced the training.
The training increased my knowledge related to the topic(s).
The training increased my practical skills related to the
topic(s).
I will be able to apply what I learned in my work.
The training improved my ability to identify people who are
being trafficked, at-risk of trafficking, or have been
trafficked.
The training was survivor informed.
The training provided sufficient opportunity to network with
others in the field.
The training was trauma informed.
The training content was based on current evidence-based
research or promising practices.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
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 9 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.
PILOT TRAINING
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PARTICIPANT FEEDBACK
15.
16.
17.
18.
19.
The small group activities enhanced my experience.
The training met my professional needs.
The training met my educational needs.
I am satisfied with the overall quality of the training.
The training was grounded in a multidisciplinary approach to
addressing human trafficking.
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
NA
NA
NA
NA
1
2
3
4
NA
Please indicate the extent to which you agree or disagree with the following statements:
MODULE : ____________________________
20.
21.
22.
23.
24.
Disagree
Agree
Strongly
Agree
Not Applicable
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
NA
NA
NA
NA
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
NA
NA
NA
NA
NA
As a result of this module, I can .
As a result of this module, I can .
As a result of this module, I can .
As a result of this module, I can .
The learning objectives for this module were stated clearly.
MODULE : ____________________________
25.
26.
27.
28.
29.
Strongly
Disagree
As a result of this module, I can .
As a result of this module, I can .
As a result of this module, I can .
As a result of this module, I can .
The learning objectives for this module were stated clearly.
30. Please rate the overall quality of this training.
1
2
3
4
Poor
Fair
Good
Excellent
Please indicate the extent to which you agree or disagree with the following statements:
PRESENTER 1:___________________________
31. The presenter demonstrated a comprehensive knowledge of
the subject.
32. The presenter presented the content clearly and logically.
33. The presenter responded positively to questions and
comments.
34. The presenter created a respectful environment for
participants.
PRESENTER 2:___________________________
35. The presenter demonstrated a comprehensive knowledge of
the subject.
36. The presenter presented the content clearly and logically.
37. The presenter responded positively to questions and
comments.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
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 9 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.
PILOT TRAINING
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PARTICIPANT FEEDBACK
38. The presenter created a respectful environment for
participants.
1
2
3
4
NA
39. Did the training provide comprehensive coverage of the topic(s)? Please explain.
____________________________________________________________________________________
____________________________________________________________________________________
40. Was the content current and up-to-date? Please explain.
____________________________________________________________________________________
____________________________________________________________________________________
41. Was there anything you would change about the training content? Please explain.
____________________________________________________________________________________
____________________________________________________________________________________
42. Was there anything you would change about the resource materials (videos, handouts, PowerPoints, etc.)? Please explain.
____________________________________________________________________________________
____________________________________________________________________________________
43. Was there enough time for discussion and questions? Please explain.
____________________________________________________________________________________
____________________________________________________________________________________
44. What aspects of the training were most helpful, and why?
____________________________________________________________________________________
____________________________________________________________________________________
45. Is there any material, content, or activity you would recommend to not include in future trainings?
____________________________________________________________________________________
____________________________________________________________________________________
46. Are there specific resources you would recommend for inclusion in future trainings?
____________________________________________________________________________________
____________________________________________________________________________________
47. Do you have any other comments or suggestions?
____________________________________________________________________________________
____________________________________________________________________________________
48. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other (please specify): _____________________
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 9 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.
PILOT TRAINING
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PARTICIPANT FEEDBACK
49. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
50. 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,
Legal (e.g., immigration, civil and/or rights-based
psychiatrist, mental health/substance use counselor)
attorney and/or paralegal, clinic)
Child welfare (e.g., state agency staff, child welfare
Public health (e.g., licensure board, health
contractor, nonprofit personnel)
department staff, health care executive, community
health workers)
Corrections-based services (e.g., parole, probation)
Social worker (e.g., case manager, school
Criminal justice (e.g., law enforcement, prosecutor,
counselor, supervisor, administrator)
probation, court, forensic interviewer)
Survivor empowerment, mentoring, or peer to peer
Educator (e.g., teacher, professor, school
administrator)
Violence prevention (e.g., child abuse and neglect,
elder abuse, domestic violence, sexual violence,
Health care (e.g., physician, physician assistant,
youth violence)
nurse practitioner, dentist, nurse, pharmacist)
Other (please specify):
Housing (e.g., case worker, shelter director, public
_______________________________
housing authority agencies)
51. In your professional capacity, how frequently do you come into contact with a person who is being trafficked, at risk of
trafficking, or has been trafficked?
1
2
3
4
Never
Occasionally
Frequently
Daily
52. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
□
3–5 years
□
6–10 years
More than 10 years
53. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/Frontline staff
Management
Other (please specify): _______________
□
□
Consultant/Trainer
Volunteer
□
□
Administration
Peer educator
54. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country): _______________
□
□
□
□
Local
Urban
Rural
Suburban
55. 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
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 9 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.
PILOT TRAINING
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
PARTICIPANT FEEDBACK
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): __________________
56. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
57. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
58. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
Thank you for taking the time to complete this form and helping to improve NHTTAC/SOAR 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 9 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.
PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
First letter of first name
(insert just the month
(example: S for Sara)
for your date of birth,
example: 08 for August)
First letter of your middle name
(example: M for Maria)
Part I. NHTTAC Scholarship Program
1.
How did you hear about this Scholarship Program? (Mark all that apply.)
□
□
□
□
□
□
□
□
NHTTAC Website
Exhibit or presentation at a conference
NHTTAC Listserv
OTIP program monitor or other OTIP staff person
Another organization
A colleague or friend
A publication or newsletter
Other (please specify): __________________________
2.
What month and year did you apply? ________________________
3.
Would you recommend the NHTTAC Professional Development Scholarship to others?
□
□ No
Yes
Please indicate the extent to which you agree or disagree with the following statements.
APPLICATION PROCESS
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
4.
NHTTAC was responsive to my questions and needs.
1
2
3
4
NA
5.
The application was easy to complete.
1
2
3
4
NA
6.
The application instructions clearly explained the
eligibility requirements.
1
2
3
4
NA
7.
The application instructions clearly explained the
expenses covered under the program.
1
2
3
4
NA
8.
I am satisfied with the notification process.
1
2
3
4
NA
9.
I am satisfied with the overall application process by
NHTTAC.
1
2
3
4
NA
10. What could be done differently to improve the application process?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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 10 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.
PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
11. Do you have any other comments or suggestions about the application process?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please rate the following registration, pre-meeting service, and logistical arrangements using the following scale:
Poor
Fair
Good
Excellent
Not
Applicable
12. Meeting registration
1
2
3
4
NA
13. Onsite registration check-in process
1
2
3
4
NA
14. Attendee meeting packet
1
2
3
4
NA
15. Meeting direction signs
1
2
3
4
NA
16. Conference meeting room
1
2
3
4
NA
17. Travel information (if applicable)
1
2
3
4
NA
18. Hotel accommodations (if applicable)
1
2
3
4
NA
LOGISTICS
19. Please rate the overall quality of this scholarship program.
1
2
3
4
Poor
Fair
Good
Excellent
20. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
□
□
□
□
□
□
□
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
21. 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,
□ Health care (e.g., physician, physician assistant,
psychiatrist, mental health/substance use counselor)
nurse practitioner, dentist, nurse, pharmacist)
□ Child welfare (e.g., state agency staff, child welfare
□ Housing (e.g., case worker, shelter director, public
contractor, nonprofit personnel)
housing authority agencies)
□ Corrections-based services (e.g., parole, probation)
□ Legal (e.g., immigration, civil and/or rights-based
□ Criminal justice (e.g., law enforcement, prosecutor,
attorney and/or paralegal, clinic)
probation, court, forensic interviewer)
□ Public health (e.g., licensure board, health
□ Educator (e.g., teacher, professor, school
department staff, health care executive, community
administrator)
health workers)
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 10 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.
PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
□
□
Social worker (e.g., case manager, school
counselor, supervisor, administrator)
Survivor empowerment, mentoring, or peer to peer
□
□
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
22. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
23. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
24. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________
□ Administration
□ Peer Educator
25. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of trafficking, or have been trafficked?
1
2
3
4
Never
Rarely
Frequently
All the Time
26. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
27. 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
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify): __________________
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 10 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.
PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
28. What is your race? (Mark all that apply.)
□
□
□
□
□
□
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
29. What is your ethnicity? (Mark all that apply.)
□
□
□
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
30. What is your gender? (Mark all that apply.)
□
□
□
□
Male
Female
Transgender
Other (please specify): ________________________________________
Part II. Event Feedback
31. Please provide the following information about the event you attended with scholarships funds:
Event title: ___________________________________________________________________________________________
Date(s): ______________________________
Location: ____________________________________________________
Please indicate the extent to which you agree or disagree with the following statements.
EVENT FEEDBACK
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
32. The event increased my skills and knowledge related to the
topic(s).
1
2
3
4
NA
33. The event improved my knowledge of current evidencebased research or promising practices.
1
2
3
4
NA
34. The event improved my skills and knowledge about traumainformed practices.
1
2
3
4
NA
35. The event improved my skills and knowledge about
survivor-informed practices.
1
2
3
4
NA
36. The event improved my skills and knowledge about a
multidisciplinary approach to addressing human trafficking.
1
2
3
4
NA
37. The event improved my skills and knowledge about a public
health approach to addressing human trafficking.
1
2
3
4
NA
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 10 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.
PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
38. The event improved my ability to serve people who are
current being trafficked, at risk of trafficking, or have been
trafficked.
1
2
3
4
NA
39. The education materials provided for this event were useful.
1
2
3
4
NA
40. The event increased my practical skills related to the
topic(s).
1
2
3
4
NA
41. The event met my professional needs.
1
2
3
4
NA
42. The event met my educational needs.
1
2
3
4
NA
43. I will be able to apply what I learned in my work.
1
2
3
4
NA
44. At which type of event was the training held?
□ National conference
□ State/regional conference
□ Local conference
□ Other (please specify): __________________________
45. As a result of participating in this scholarship program, do you plan to do any of the following? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
□
□
□
□
□
□
□
□
□
□
□
□
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
46. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
□
□
□
□
□
□
□
□
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
□
□
□
□
□
Difficulty in establishing and/or maintaining a
multi-disciplinary team
Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
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 10 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.
PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
□
Lack of training for staff in how to implement
change
□
Other (please explain): _________________
47. What aspects of the event were most helpful and why?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
48. Do you have any other comments or suggestions about the event?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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 10 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.
REQUESTER FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
REQUESTER NAME/AGENCY:
CONSULTANT(S)/PRESENTER(S):
NHTTAC TRAINING/TECHNICAL ASSISTANCE SPECIALIST: ________________________________________________________
1.
Please select the type of training and technical assistance (T/TA) you requested:
Needs assessment
Review of materials (e.g., protocols, screening
forms, etc.)
Organization audit
SOAR for communities
Remote training
In-person SOAR training
Training of trainers
In-person training
SOAR training for HHS personnel
Peer-to-peer collaboration
Strategic partnerships for SOAR Online
Coaching
Other (please specify): ___________
Mentorship
Please indicate the extent to which you were satisfied or not satisfied with your overall experience working with NHTTAC:
2.
Very
Dissatisfied
Dissatisfied
Satisfied
Very
Satisfied
1
2
3
4
1
2
3
4
3.
The overall quality of the support you received from NHTTAC
staff
Your overall experience with NHTTAC staff
4.
Your interactions with NHTTAC staff
1
2
3
4
5.
Your interactions with the consultants
1
2
3
4
6.
The quality of support you received from NHTTAC staff during the
needs assessment process
The quality of support you received from the consultants in
implementing the T/TA
1
2
3
4
1
2
3
4
7.
Please indicate the extent to which you agree or disagree with the following statements about your interactions with NHTTAC
staff and the planning process:
PLANNING
8.
9.
NHTTAC was responsive to my questions and needs.
NHTTAC was effective in identifying an appropriate
consultant/presenter.
10. NHTTAC staff was detail oriented and thorough in the planning of
this T/TA.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
1
2
3
4
1
2
3
4
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 7 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.
REQUESTER FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
11. NHTTAC was timely throughout the planning process.
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
1
2
3
4
1
2
3
4
15. As a result of the needs assessment, [I][my organization] can….
1
2
3
4
16. As a result of the needs assessment, [I][my organization] can….
1
2
3
4
17. As a result of the needs assessment, [I][my organization] can….
1
2
3
4
NEEDS ASSESSMENT
12. NHTTAC helped me determine the most important needs are for
[me][my organization] to address human trafficking.
13. NHTTAC helped me determine the most important needs are for
[me][my organization] to .
14. NHTTAC helped me determine the most important needs are for
[me][my organization] to .
18. What aspects of the NHTTAC planning process were most helpful, and why?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
19. What aspects of the needs assessment were most helpful, and why?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements about the consultants:
CONSULTANT 1:_____________________
Strongly
Disagree
Disagree
Agree
Strongly
Agree
20. The consultant was easy to communicate with in planning for the T/TA.
1
2
3
4
21. The consultant responded to me in a timely manner.
1
2
3
4
22. The consultant was respectful.
1
2
3
4
23. The consultant’s knowledge and expertise were appropriate for my needs.
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
24. The consultant was easy to communicate with in planning for the T/TA.
1
2
3
4
25. The consultant responded to me in a timely manner.
1
2
3
4
26. The consultant was respectful.
1
2
3
4
27. The consultant’s knowledge and expertise were appropriate for my needs.
1
2
3
4
CONSULTANT 2:_____________________
28. Would you recommend [NHTTAC][SOAR] T/TA to others to receive T/TA?
□ Yes
□ No
29. What suggestions do you have for improving NHTTAC’s support of T/TA planning and/or delivery?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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 7 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.
REQUESTER FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
30. What additional needs do you or your organization have regarding this topic?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
31. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
OTIP grantee
Anti-trafficking organization
Self-employed
Business/For-profit organization
Survivor-led organization
Coalition/Multidisciplinary team/Task force
Tribal government
Federal government
Union/Worker advocacy organization
Faith-based organization
Victim service provider
State and local government
Other (please specify): _____________________
Nonprofit/Community-based organization
32. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
33. 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
Violence prevention (e.g., child abuse and neglect,
elder abuse, domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
34. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
35. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
3–5 years
□
□
6–10 years
More than 10 years
36. Which of the following best describes your primary role in your current position?
□
Direct delivery/Frontline staff
□
Consultant/Trainer
□
Administration
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number. The estimated average time to complete this form is 7 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.
REQUESTER FEEDBACK
□
□
Management
□
Other (please specify): _______________
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
□
Volunteer
Peer Educator
37. Which of the following best describes your geographic population? (Mark all that apply.)
□
National
□
State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________
□
Local
□
□
□
Urban
Rural
Suburban
38. 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): __________________
39. Do you have any other comments or suggestions you would like to share about your [NHTTAC][SOAR] experience?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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 7 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.
RESOURCE TOOL
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
DATE DOWNLOADED/RECEIVED: _______________________
1.
What [NHTTAC][SOAR] resource did you download or receive?
□
□
□
□
□
2.
□
□
□
□
□
Which of the following best describes the reason you obtained ?
3.
SOAR e-guide
State and territory profiles
Screening toolkit
Webinar recordings
Organizational toolkit
Personal use/assist a family member/friend
To better identify people who are at risk or have
been trafficked
To better provide services to a person who is
currently being trafficked, at risk of trafficking, or
has been trafficked
For use in program development/operations
For academic studies
For education/community outreach
To train colleagues
Other (please specify): _____________________
How have you used the ? (Mark all that apply).
To train others
In your work with patients/clients
For protocol development
For outreach efforts
Please indicate the extent to which you agree or disagree with the following statements:
COMPONENT 1: _____________________________
4.
5.
6.
7.
8.
9.
The resource addressed the critical issues related to the topic(s).
I am satisfied with the overall quality of the material.
The material was organized and clear.
The terminology included in the material was used correctly.
The material increased my knowledge about the topic(s).
The material included current evidence-based research or promising
practices.
10. The material reflected a public health approach to addressing
human trafficking.
11. The content of the material was survivor informed.
12. The content of the material was trauma informed.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
NA
NA
NA
NA
NA
1
2
3
4
NA
1
2
3
4
NA
1
1
2
2
3
3
4
4
NA
NA
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 2 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.
SHORT TERM T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
In order to help the National Technical assistance 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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
T/TA: ___________________________________________________________________________________________
DATES(S):_____________________________________________________
FACILITATOR(S): ________________________________________________________________________________
Please indicate how well the technical assistance met each stated objective.
OVERALL OBJECTIVES
Poor
Fair
Good
Excellent
1.
[Insert objective 1].
1
2
3
4
2.
[Insert objective 2].
1
2
3
4
3.
[Insert objective 3].
1
2
3
4
4.
[Insert objective 4].
1
2
3
4
5.
[Insert objective 5].
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements.
FACILITATOR 1: _______________________
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
6.
The facilitator’s knowledge and expertise of this
presenter were appropriate for this technical assistance.
1
2
3
4
NA
7.
The facilitator delivered the content of the technical
assistance effectively.
1
2
3
4
NA
8.
The facilitator responded well to questions and
comments.
1
2
3
4
NA
9.
The facilitator created a respectful environment for
participants.
1
2
3
4
NA
1
2
3
4
NA
10. The facilitator encouraged and initiated helpful
discussions.
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number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SHORT TERM T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
1
2
3
4
NA
12. The facilitator delivered the content of the technical
assistance effectively.
1
2
3
4
NA
13. The facilitator responded well to questions and
comments.
1
2
3
4
NA
14. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
15. The facilitator encouraged and initiated helpful
discussions.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
16. The technical assistance addressed the critical issues
related to the topic(s).
1
2
3
4
NA
17. The time allotted was adequate for the scope of
material.
1
2
3
4
NA
18. The technical assistance was well organized and clear.
1
2
3
4
NA
19. The technical assistance increased my knowledge
related to the topic(s).
1
2
3
4
NA
20. The technical assistance was trauma-informed.
1
2
3
4
NA
21. The technical assistance was survivor-informed.
1
2
3
4
NA
22. The technical assistance was grounded in current
evidence-based or promising practices.
1
2
3
4
NA
23. The technical assistance was grounded in a
multidisciplinary approach to addressing human
trafficking.
1
2
3
4
NA
24. The technical assistance reflected a public health
approach to addressing human trafficking.
1
2
3
4
NA
25. The technical assistance increased my practical skills
related to the topic(s).
1
2
3
4
NA
26. This technical assistance met my educational needs.
1
2
3
4
NA
27. This technical assistance met my professional needs.
1
2
3
4
NA
28. I will be able to apply what I learned in my work.
1
2
3
4
NA
29. The technical assistance improved my ability to serve
people who are currently being trafficked, at risk of
trafficking, or have been trafficked.
1
2
3
4
NA
30. I will share what I learned with my colleagues.
1
2
3
4
NA
FACILITATOR 2: _______________________
11. The facilitator’s knowledge and expertise of this
presenter were appropriate for this technical assistance.
OVERALL FEEDBACK
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number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SHORT TERM T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Please select the number that best represents your rating of this technical assistance for each of the following questions.
31. How satisfied were you with your overall NHTTAC experience?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
32. Please rate the overall quality of this technical assistance.
1
2
3
4
Poor
Fair
Good
Excellent
33. How well did this technical assistance meet your expectations?
1
Far Below My
Expectations
2
Did Not Meet My
Expectations
3
Met My
Expectations
4
Exceeded My
Expectations
34. How useful was the technical assistance information to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
35. How prepared do you feel in implementing what you learned from this technical assistance in your daily work?
1
Not At All Prepared
2
Somewhat
Unprepared
3
4
Somewhat Prepared
Very Prepared
36. As a result of participating in this technical assistance, do you plan to do any of the following? (Mark all that apply.)
□ Change my management/leadership or
□ Develop/strengthen collaborative or strategic
interpersonal communication style
relationships
□ Further develop skills and knowledge about serving
□ Network with other participants
people who are currently being trafficked, at risk of
□ Share materials with colleagues
trafficking, or have been trafficked
□ Provide information to clients/families/youth
□ Write grants/fundraise/identify new funding
□ Train/educate others in content/skills learned
resources
□ Raise public awareness/advocacy/outreach
□ Advocate or meet with leadership of my
activities offered to people who are currently being
organization to develop/enhance vision, mission, or
trafficked, at risk of trafficking, or have been
strategic plan
trafficked
□ Advocate or meet with leadership of my
□ Refer colleagues to NHTTAC events/resources
organization to develop/enact policy changes at my
□ Conduct research
organization
□ Strengthen evaluation or needs assessment
□ Improve programs/practices
activities
□ Improve technology/websites/infrastructure
□ Improve identification and reporting methods for
□ Integrate victim-centered, survivor-informed
trafficking
strategies
□ Take additional training on human trafficking
□ Expand services or types of services
□ Other (please specify): __________________
□ Begin a new project or initiative
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number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SHORT TERM T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
37. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Lack of information sharing among organizations
Lack of time to implement changes
□
□
□
□
□
□
□
38. Would you recommend NHTTAC to others to receive T/TA?
Difficulty in establishing and/or maintaining a
multi-disciplinary team
Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
□ Yes
□ No
39. Please list any professional goals you have achieved through this T/TA.
____________________________________________________________________________________
____________________________________________________________________________________
40. How will this assistance help your agency in responding to human trafficking?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
41. What aspects of the assistance were most helpful and why?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
42. What could NHTTAC do differently to improve similar T/TA requests in the future?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
43. Do you have any other comments or suggestions?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SHORT TERM T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
44. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other (please specify): _____________________
45. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
46. 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
Violence prevention (e.g., child abuse and neglect,
elder abuse, domestic violence, sexual violence,
youth violence)
Other (please specify):
____________________________
47. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
48. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________
□ Administration
□ Peer Educator
49. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
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number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SHORT TERM T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
50. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
51. 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
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (please specify): __________________
52. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
53. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
54. What is your gender? (Mark all that apply.)
Male
Female
Transgender
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 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
PRETRAINING QUESTIONS:
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please rate your level of confidence in your ability to:
Very Low
Low
High
Very High
1.
Identify people who are at risk or have been trafficked
1
2
3
4
2.
Develop or redefine your vision and mission statements
1
2
3
4
3.
Serve individuals [at-risk of human trafficking] [recently out of a
trafficking situation] [who were trafficked in the past]
1
2
3
4
4.
Create a list of objectives for organizational change
1
2
3
4
5.
Identify the elements of an action-planning process
1
2
3
4
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number. The estimated average time to complete this form is 1 minute. 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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
WEEKLY EVALUATION QUESTIONS:
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please indicate the extent to which you agree or disagree with the following statements:
As a result of this week’s training activities, I .
As a result of this week’s training activities, I .
As a result of this week’s training activities, I .
As a result of this week’s training activities, I .
As a result of this week’s training activities, I .
1.
2.
3.
4.
5.
6.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Did the instructor(s) provide feedback on the mastery of the learning objectives?
□
Yes
□
No
Please indicate the extent to which you agree or disagree with the following statements about the self-study materials for this
week:
7.
8.
9.
10.
11.
12.
13.
The materials addressed the learning objectives
clearly.
The materials addressed the critical issues related to
the topic(s).
The time allotted was adequate for the scope of the
self-study materials.
The content of the material was appropriate for my
level of experience and knowledge.
The materials increased my knowledge related to the
topics.
The materials increased my practical skills related to
the topics.
I am satisfied with the overall quality of the
materials.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements about the webinar for this week:
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
14. The webinar addressed the learning objectives
clearly.
15. The webinar addressed the critical issues related to
the topic(s).
16. The time allotted was adequate for the scope of
material covered.
17. The webinar was well organized and clear.
18. The material was appropriate for my level of
experience and knowledge.
19. The webinar increased my knowledge related to the
topics.
20. The webinar increased my practical skills related to
the topics.
21. I am satisfied with the overall quality of the webinar.
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements about each instructor:
Instructor 1:________________________
22. The instructor demonstrated a comprehensive
knowledge of the subject.
23. The instructor presented the content clearly and
logically.
24. The instructor responded positively to questions and
comments.
25. The instructor created a respectful environment for
the participants.
Instructor 2:________________________
26. The instructor demonstrated a comprehensive
knowledge of the subject.
27. The instructor presented the content clearly and
logically.
28. The instructor responded positively to questions and
comments.
29. The instructor created a respectful environment for
the participants.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
WEEK 4 (OR LAST WEEK OF TRAINING) EVALUATION QUESTIONS
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please rate your level of confidence in your ability to:
Very Low
Low
High
Very High
6.
Identify a person who is currently being trafficked, at
risk of trafficking, or has been trafficked.
1
2
3
4
7.
Develop/redefine your vision and mission statements
1
2
3
4
8.
Serve individuals [at risk of human trafficking]
[recently out of a trafficking situation] [who were
trafficked in the past]
1
2
3
4
Create a list of objectives for organizational change
1
2
3
4
1
2
3
4
9.
10. Identify elements of an action-planning process
Please indicate the extent to which you agree or disagree with the following statements:
11. As a result of this week’s training activities, I .
12. As a result of this week’s training activities, I .
13. As a result of this week’s training activities, I .
14. As a result of this week’s training activities, I .
15. As a result of this week’s training activities, I .
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements about each instructor:
Instructor 1:________________________
16. The instructor demonstrated a comprehensive
knowledge of the subject.
17. The instructor presented the content clearly and
logically.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
18. The instructor responded positively to questions and
comments.
19. The instructor created a respectful environment for
the participants.
Instructor 2:________________________
20. The instructor demonstrated a comprehensive
knowledge of the subject.
21. The instructor presented the content clearly and
logically.
22. The instructor responded positively to questions and
comments.
23. The instructor created a respectful environment for
the participants.
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
24. Did the instructor(s) provide feedback on the mastery of the learning objectives?
□
Yes
□
No
Please indicate the extent to which you agree or disagree with the following statements about the self-study materials for this
week:
25. The materials addressed the learning objectives
clearly.
26. The materials addressed the critical issues related to
the topic(s).
27. The time allotted was adequate for the scope of the
self-study materials.
28. The content of the material was appropriate for my
level of experience and knowledge.
29. The materials increased my knowledge related to the
topics.
30. The materials increased my practical skills related to
the topics.
31. I am satisfied with the overall quality of the
materials.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements about the webinar for this week:
32. The webinar addressed the learning objectives
clearly.
33. The webinar addressed the critical issues related to
the topic(s).
34. The time allotted was adequate for the scope of
material covered.
35. The webinar was well organized and clear.
36. The material was appropriate for my level of
experience and knowledge.
37. The webinar increased my knowledge related to the
topics.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Paperwork Reduction Act Notice
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
38. The webinar increased my practical skills related to
the topics.
1
2
3
4
39. I am satisfied with the overall quality of the webinar.
1
2
3
4
OVERALL TRAINING EVALUATION QUESTIONS (FOR LAST WEEK OF TRAINING OR DISSEMINATED 1
WEEK AFTER COMPLETION OF THE COURSE)
Please provide the information below to create an anonymous ID:
____________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
For the next set of questions, please rate your responses based on the overall training:
1.
□
Did you receive continuing education credits for completing the training?
Yes
□
No
Please click the number that best represents your rating for this training for each of the following questions:
2.
3.
4.
5.
Please rate the overall quality of this training.
1
2
3
4
Poor
Fair
Good
Very Good
Please rate the overall quality of the webinar portion of this training.
1
2
3
4
Poor
Fair
Good
Very Good
Please rate the overall quality of readings, videos (excluding webinars), and worksheets used in this training.
1
2
3
4
Poor
Fair
Good
Very Good
Please rate how well the webinars and other weekly learning materials complemented each other.
1
2
3
4
Poor
Fair
Good
Very Good
Paperwork Reduction Act Notice
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Please indicate the extent to which you agree or disagree with the following statements:
Strongly Disagree
Disagree
Agree
Strongly Agree
I am confident that I will be able to use the
knowledge and skills I learned during the SOAR
training when I return to my job.
1
2
3
4
7.
The training met my educational needs.
1
2
3
4
8.
The training met my professional needs.
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
17. The training was survivor informed.
1
2
3
4
18. The training was trauma informed.
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
6.
9.
The educational materials provided during this
training were useful.
10. The activities provided appropriate and effective
opportunities for active learning (case studies,
discussion, Q&A, etc.)
11. The time allotted was adequate for the scope of
material covered.
12. The technology was easy to use.
13. The use of technology provided a good learning
environment.
14. Overall, the instructors were knowledgeable about
the content.
15. As a result of this SOAR training, I can .
16. As a result of this SOAR training, I can .
19. The training was based on current evidence-based
research or promising practices.
20. The training reflects a public health approach to
addressing human trafficking.
21. The training will be useful for my practice or for my
professional development.
22. The training was grounded in a multidisciplinary
approach to addressing human trafficking.
23. The training provided ample opportunity and
encouragement for participants to meaningfully
interact with each other.
24. As a result of participating in this SOAR training, do you plan to do any of the following? (Mark all that apply.)
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
victims of trafficking
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Raise public awareness/advocacy/outreach
activities offered to victims
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
25. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multidisciplinary team
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
□
26. Would you recommend SOAR to others to receiving training?
Yes
□
No
27. What could be done differently to improve the training?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
28. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/for-profit organization
Coalition/multidisciplinary team/task force
Federal government
Faith-based organization
State/local government
Nonprofit/community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/worker advocacy organization
Victim service provider
Other (please specify): _____________________
29. 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)
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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
Violence prevention (e.g., child abuse and neglect,
elder abuse, domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
30. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
31. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
32. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
3–5 years
□
□
6–10 years
More than 10 years
33. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/frontline staff
Management
Other (please specify): ______
□
□
□
□
Consultant/trainer
Volunteer
Administration
Peer educator
34. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□
Local
□
□
□
Urban
Rural
Suburban
35. 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
Paperwork Reduction Act Notice
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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.
SOAR BLENDED LEARNING
PARTICIPANT FEEDBACK
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
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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): __________________
35. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
36. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
37. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
Thank you for taking the time to complete this form and helping to improve SOAR 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
CONFERENCE:
TRAINING:
DATE(S):
PRESENTER(S):
PRE-TRAINING QUESTIONS:
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth:
08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
[Note: Not all objectives listed below will be included in the evaluation form. Specific objectives will be selected from this list
and tailored to each training.]
Please rate your level of confidence in your ability to:
Overall Objectives
Very Low
Low
High
Very High
1.
1
2
3
4
2.
1
2
3
4
3.
1
2
3
4
4.
1
2
3
4
5.
1
2
3
4
Very Low
Low
High
Very High
STOP Objectives
6.
1
2
3
4
7.
1
2
3
4
8.
1
2
3
4
9.
1
2
3
4
10.
1
2
3
4
11.
1
2
3
4
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 2 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
OBSERVE Objectives
Very Low
Low
High
Very High
12.
1
2
3
4
13.
1
2
3
4
14.
1
2
3
4
Very Low
Low
High
Very High
15.
1
2
3
4
16.
1
2
3
4
17.
1
2
3
4
Very Low
Low
High
Very High
18.
1
2
3
4
19.
1
2
3
4
20.
1
2
3
4
21.
1
2
3
4
22.
1
2
3
4
23.
1
2
3
4
ASK Objectives
RESPOND Objectives
24. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
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 2 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
POST-TRAINING QUESTIONS:
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth:
08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
[Note: Objectives selected for the post-training will mirror the objectives selected for the pre-training.]
Please rate your level of confidence in your ability to:
Overall Objectives
Very Low
Low
High
Very High
1.
1
2
3
4
2.
1
2
3
4
3.
1
2
3
4
4.
1
2
3
4
5.
1
2
3
4
Very Low
Low
High
Very High
STOP Objectives
6.
1
2
3
4
7.
1
2
3
4
8.
1
2
3
4
9.
1
2
3
4
10.
1
2
3
4
11.
1
2
3
4
Very Low
Low
High
Very High
12.
1
2
3
4
13.
1
2
3
4
14.
1
2
3
4
Very Low
Low
High
Very High
15.
1
2
3
4
16.
1
2
3
4
17.
1
2
3
4
Very Low
Low
High
Very High
OBSERVE Objectives
ASK Objectives
RESPOND Objectives
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number. The estimated average time to complete this form is 10 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
18.
1
2
3
4
19.
1
2
3
4
20.
1
2
3
4
21.
1
2
3
4
22.
1
2
3
4
23.
1
2
3
4
□
24. Are you applying for continuing education credits for completing this training?
Yes
□
No
If yes, provide your first and last name and email address:
_________________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
33. I am confident that I will be able to use the
knowledge and skills I learned during the SOAR
training when I return to my job.
1
2
3
4
34. The training met my educational needs.
1
2
3
4
35. The training met my professional needs.
1
2
3
4
1
2
3
4
1
2
3
4
Presenter 1:____________________________
25. The presenter’s knowledge and expertise were
appropriate for this session.
26. The presenter delivered the content of the session
effectively.
27. The presenter responded positively to questions and
comments.
28. The presenter created a respectful environment for
participants.
Presenter 1:____________________________
29. The presenter’s knowledge and expertise were
appropriate for this session.
30. The presenter delivered the content of the session
effectively.
31. The presenter responded positively to questions and
comments.
32. The presenter created a respectful environment for
participants.
Conference Session Feedback
36. The educational materials provided during this
training were useful.
37. The activity provided appropriate and effective
opportunities for active learning (case studies,
discussion, Q&A, etc.).
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 10 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
38. The training was grounded in a multidisciplinary
approach to addressing human trafficking.
39. The training reflected a public health approach to
addressing human trafficking.
1
2
3
4
1
2
3
4
40. I learned a great deal as a result of this training.
1
2
3
4
41. The training was survivor informed.
1
2
3
4
42. The training was trauma informed.
1
2
3
4
43. The training was based on current evidence-based
research or promising practices.
1
2
3
4
44. The pace of this workshop was appropriate.
1
2
3
4
45. The workshop was a good way for me to learn the
content.
1
2
3
4
46. Please rate the overall quality of this training.
1
2
3
4
Poor
Fair
Good
Excellent
47. As a result of participating in this training, do you plan to do any of the following? (Mark all that apply.)
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
victims of trafficking
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to victims
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
48. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 10 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multidisciplinary team
Variation in mission and regulatory frameworks
when partnering with other organizations
49. Would you recommend SOAR training to others?
□
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
Yes
□
No
50. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State/Local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other (please specify): _____________________
51. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□
Yes
□
No
52. 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
Violence prevention (e.g., child abuse and neglect,
elder abuse, domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
53. 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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number. The estimated average time to complete this form is 10 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.
SOAR CONFERENCE
TRAINING FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
1
2
3
4
Never
Occasionally
Frequently
Daily
54. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
□
3–5 years
6–10 years
□
More than 10 years
55. Which of the following best describes your primary role in your current position?
□
Direct delivery/Frontline staff
□
Consultant/Trainer
□
Administration
□
Management
□
Volunteer
□
Peer educator
□
Other (please specify): ______
56. Which of the following best describes your geographic population? (Mark all that apply.)
□
National
□
State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________
□
Local
□
□
□
Urban
Rural
Suburban
57. 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): __________________
58. Do you have any comments or suggestions for future SOAR-related trainings?
Thank you for taking the time to complete this form and helping to improve SOAR 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 10 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
PRE-TRAINING EVALUATION QUESTIONS:
Please provide the information below to create an anonymous ID:
______
Birth Month
(insert just the month
for your date of birth:
08 for August)
______
First letter of first name
(example: S for Sara)
______
First letter of your middle name
(example: M for Maria)
[Note: Not all objectives listed below will be included in the evaluation form. Specific objectives will be selected from this list
and tailored to each training.]
Please rate your level of confidence in your ability to:
Overall Objectives
Very Low
Low
High
Very High
1.
1
2
3
4
2.
1
2
3
4
3.
1
2
3
4
4.
1
2
3
4
Very Low
Low
High
Very High
STOP Objectives
5.
1
2
3
4
6.
1
2
3
4
7.
1
2
3
4
8.
1
2
3
4
9.
1
2
3
4
10.
1
2
3
4
Very Low
Low
High
Very High
11.
1
2
3
4
12.
1
2
3
4
13.
1
2
3
4
Very Low
Low
High
Very High
1
2
3
4
OBSERVE Objectives
ASK Objectives
14.
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number. The estimated average time to complete this form is 1 minute. 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
15.
1
2
3
4
16.
1
2
3
4
Very Low
Low
High
Very High
17.
1
2
3
4
18.
1
2
3
4
19.
1
2
3
4
20.
1
2
3
4
21.
1
2
3
4
22.
1
2
3
4
RESPOND Objectives
23. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of trafficking, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
Daily
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 1 minute. 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
POST-TRAINING QUESTIONS:
Please provide the information below to create an anonymous ID:
______
Birth Month
(insert just the month
for your date of birth:
08 for August)
______
First letter of first name
(example: S for Sara)
______
First letter of your middle name
(example: M for Maria)
[Note: Objectives selected for the posttest will mirror the objectives selected for the pretest].
Please rate your level of confidence in your ability to:
Overall Objectives
Very Low
Low
High
Very High
1.
1
2
3
4
2.
1
2
3
4
3.
1
2
3
4
4.
1
2
3
4
5.
1
2
3
4
Very Low
Low
High
Very High
STOP Objectives
6.
1
2
3
4
7.
1
2
3
4
8.
1
2
3
4
9.
1
2
3
4
10.
1
2
3
4
11.
1
2
3
4
Very Low
Low
High
Very High
12.
1
2
3
4
13.
1
2
3
4
14.
1
2
3
4
Very Low
Low
High
Very High
15.
1
2
3
4
16.
1
2
3
4
17.
1
2
3
4
Very Low
Low
High
Very High
1
2
3
4
OBSERVE Objectives
ASK Objectives
RESPOND Objectives
18.
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number. The estimated average time to complete this form is 5 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
19.
1
2
3
4
20.
1
2
3
4
21.
1
2
3
4
22.
1
2
3
4
23.
1
2
3
4
□
24. Are you applying for continuing education credits for completing this training?
□
Yes
No
If yes, please provide your first and last name and email address:
_______________________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements:
Strongly Disagree
Disagree
Agree
Strongly Agree
25. I am confident that I will be able to use the knowledge and skills I
learned during SOAR training when I return to my job.
1
2
3
4
26. The training met my educational needs.
1
2
3
4
27. The training met my professional needs.
1
2
3
4
28. The educational materials provided during this training were useful.
1
2
3
4
29. The use of technology provided a good learning environment.
1
2
3
4
30. The training included current evidence-based research or promising
practices.
1
2
3
4
31. I learned a great deal as a result of this training.
1
2
3
4
32. The training was survivor informed.
1
2
3
4
33. The training was trauma informed.
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
34. The training was based on current evidence-based research or
promising practices.
35. The training was grounded in a multidisciplinary approach to
addressing human trafficking.
36. The training reflected a public health approach to addressing human
trafficking.
37. Please rate the overall quality of this training.
1
2
3
4
Poor
Fair
Good
Excellent
38. As a result of participating in the SOAR training, do you plan to do any of the following? (Mark all that apply.)
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
victims of trafficking
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 5 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Write grants/fundraise/identified new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to victims
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________
39. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multidisciplinary team
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________
40. What suggestions do you have for improving future trainings?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
41. Would you recommend this SOAR training to others?
□
Yes
□
No
42. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/for-profit organization
Coalition/multidisciplinary team/task force
Federal government
Faith-based organization
State/local government
Nonprofit/community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
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 5 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Union/worker advocacy organization
Victim service provider
Other (please specify): _____________________
43. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□
□
Yes
No
44. 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
Violence prevention (e.g., child abuse and neglect,
elder abuse, domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________
45. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
46. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
3–5 years
□
□
6–10 years
More than 10 years
47. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/Frontline staff
□ Consultant/trainer
Management
□ Volunteer
Other (please specify): _________________
□
□
Administration
Peer educator
48. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
National
State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________
□
Local
□
□
□
Urban
Rural
Suburban
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 5 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.
SOAR ONLINE
PARTICIPANT FEEDBACK
OMB Compliance Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
49. 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): __________________
50. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
51. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
52. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________
Thank you for taking the time to complete this form and helping to improve SOAR 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 5 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.
SOAR SPECIALIZED T/TA
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
DATE(S):
CONSULTANT(S)/FACILITATOR(S):
Please provide the information below to create an anonymous ID:
___________
____________
______________
Birth Month
First letter of first name
First letter of your middle name
(insert just the month
(example: S for Sara)
(example: M for Maria)
for your date of birth:
08 for August)
Please rate the extent to which you agree or disagree that the SOAR for Communities training will help your
community achieve the following objectives:
LEARNING OBJECTIVES
Strongly Disagree
Disagree
Agree
Strongly Agree
1.
1
2
3
4
2.
1
2
3
4
3.
1
2
3
4
4.
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements about the overall training:
OVERALL TRAINING
5.
6.
The training reflected a public health approach to addressing human
trafficking.
The training helped me identify potential language and cultural
barriers my community might face in responding to human
trafficking.
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
7.
The training was trauma informed.
1
2
3
4
8.
The training was survivor informed.
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
9.
The training was grounded in a multidisciplinary approach to
addressing human trafficking.
10. The training included evidence-based research or promising
practices.
11. The training will positively impact my community’s response to
human trafficking.
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 9 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.
SOAR SPECIALIZED T/TA
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
12. The training met my educational needs.
1
2
3
4
13. The training met my professional needs.
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
17. This session was trauma informed.
1
2
3
4
18. This session was survivor informed.
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
25. This session helped expand my understanding of all types of human
trafficking.
1
2
3
4
26. This session helped expand my ability to identify at-risk populations.
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
Please indicate the extent to which you agree or disagree with the following statements:
SESSION 1: WHAT IS A PUBLIC HEALTH
APPROACH?
14. This session helped me understand a public health approach to
human trafficking.
15. I feel confident in my ability to apply what I learned about a public
health approach to trafficking in my daily work.
16. Learning about a public health approach to trafficking will positively
impact my community’s ability to serve people who are currently
being trafficked, at risk of trafficking, or have been trafficked.
19. This session helped me define a trauma-informed and survivorinformed response.
20. This session helped me define a cultural and linguistically
appropriate response.
21. This session was grounded in a multidisciplinary approach to
addressing human trafficking.
22. I learned practical ways to apply a trauma-informed framework in
my daily work through this session.
23. This session improved my knowledge in responding to a person who
is currently being trafficked, at risk of trafficking, or has been
trafficked.
24. I will be able to apply what I learned about trauma in my daily work.
SESSION 2: STOP
27. This session helped me identify populations in my community
vulnerable to trafficking.
28. This session helped increase my awareness of instances of
trafficking within my community.
29. I have identified the major challenges my community might face in
understanding human trafficking.
30. I have drafted potential action items and solutions to help my
community mitigate challenges in understanding human trafficking.
31. I will be able to apply what I learned about understanding human
trafficking in my daily work.
SESSION 3: OBSERVE
32. This session helped me recognize warning signs of human
trafficking.
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 9 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.
SOAR SPECIALIZED T/TA
33. This session increased my knowledge about the root causes of
trafficking.
34. This session helped me discover what my community is doing to
identify human trafficking.
35. This session helped me identify the major challenges my community
might face in identifying human trafficking.
36. This session helped me identify potential solutions to help my
community mitigate challenges in identifying human trafficking.
37. I will be able to apply what I learned about identifying human
trafficking to my daily work.
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
52. The facilitator responded positively to questions and comments.
1
2
3
4
53. The facilitator created a respectful environment for participants.
1
2
3
4
54. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
SESSION 4: ASK
38. This session increased my knowledge about identifying all types of
trafficking.
39. This session helped identify existing resources and tools used to
screen for human trafficking.
40. This session helped me identify gaps in how my community
identifies a person who is being trafficked.
41. This session helped me find assets in my community to improve how
a person who is currently being trafficked, at risk of trafficking, or
has been trafficked is identified.
42. I will be able to apply what I learned about screening for human
trafficking to my daily work.
SESSION 5: RESPOND
43. This session will lead to my community to expand into more traumainformed and survivor-led practices.
44. This session helped me identify areas to improve my community’s
response to the intermediate needs of a person who is currently being
trafficked, at risk of trafficking, or has been trafficked.
45. This session helped me identify areas to improve my community’s
response to the long-term needs of a person who is currently being
trafficked, at risk of trafficking, or has been trafficked.
46. This session helped me identify how my organization can help
improve my community’s response to human trafficking.
47. This session helped my community develop and/or strengthen a
comprehensive response to human trafficking.
48. This session helped me identify necessary partners to implement an
improved community response to human trafficking.
49. I will be able to apply what I learned about responding to human
trafficking in my daily work.
Please indicate the extent to which you agree or disagree with the following statements:
FACILITATOR 1:
50. The facilitator’s knowledge and expertise were appropriate for the
training.
51. The facilitator moved through the strategic planning agenda
effectively.
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 9 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.
SOAR SPECIALIZED T/TA
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
FACILITATOR 2:
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
57. The facilitator responded positively to questions and comments.
1
2
3
4
58. The facilitator created a respectful environment for participants.
1
2
3
4
59. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
Strongly Disagree
Disagree
Agree
Strongly Agree
1
2
3
4
1
2
3
4
62. The facilitator responded positively to questions and comments.
1
2
3
4
63. The facilitator created a respectful environment for participants.
1
2
3
4
64. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
55. The facilitator’s knowledge and expertise were appropriate for the
training.
56. The facilitator moved through the strategic planning agenda
effectively.
FACILITATOR 3:
60. The facilitator’s knowledge and expertise were appropriate for the
training.
61. The facilitator moved through the strategic planning agenda
effectively.
LOGISTICS
Strongly Disagree
Disagree
Agree
Strongly Agree
65. Overall, this was an effective way to support the content and purpose
of the strategic planning process.
1
2
3
4
66. The training was well organized.
1
2
3
4
67. The meeting space and use of technology provided a good learning
environment.
1
2
3
4
68. NHTTAC was responsive to my questions and needs.
1
2
3
4
69. Following the training, what three steps will you take to enhance your community’s response to human
trafficking?
a. __________________________________________________________________________________
b. __________________________________________________________________________________
c. __________________________________________________________________________________
70. How do you plan to engage survivors in implementing your strategic plan?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
71. Following the training, how prepared do you feel to take steps toward addressing human trafficking in your community?
1
2
3
4
Not At All Prepared
Somewhat Prepared
Mostly Prepared
Completely Prepared
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 9 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.
SOAR SPECIALIZED T/TA
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
72. Please rate the overall quality of this training.
1
Poor
2
Fair
3
4
Good
Excellent
73. What could NHTTAC do in the future to enhance your level of preparedness during this type of SOAR T/TA?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
74. What could NHTTAC do in the future to enhance your level of preparedness following this type of SOAR
T/TA?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
□
75. Would you recommend NHTTAC to others to receive T/TA?
Yes
□
No
76. Which of the following best describes the organization in which you work? (Mark all that apply.)
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State/Local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other (please specify): _____________________
77. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
78. Which of the following best describes your professional capacity or types of services you provide? (Mark all that
apply.)
Behavioral health professional (e.g.,
Health care (e.g., physician, physician
psychologist, psychiatrist, mental
assistant, nurse practitioner, dentist, nurse,
health/substance use counselor)
pharmacist)
Child welfare (e.g., state agency staff, child
Housing (e.g., case worker, shelter director,
welfare contractor, nonprofit personnel)
public housing authority agencies)
Corrections-based services (e.g., parole,
Legal (e.g., immigration, civil and/or rightsprobation)
based attorney and/or paralegal, clinic)
Criminal justice (e.g., law enforcement,
Public health (e.g., licensure board, health
prosecutor, probation, court, forensic
department staff, health care executive,
interviewer)
community health workers)
Educator (e.g., teacher, professor, school
Social worker (e.g., case manager, school
administrator)
counselor, supervisor, administrator)
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 9 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.
SOAR SPECIALIZED T/TA
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Survivor empowerment, mentoring, or peer to
peer
Violence prevention (e.g., child abuse and
neglect, elder abuse, domestic violence, sexual
violence, youth violence)
Other (please specify):
______________________________
79. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
80. Which of the following best describes the number of years of experience you have in your current field of work?
□
Less than 3 years
□
3–5 years
□
□
6–10 years
More than 10 years
81. Which of the following best describes your primary role in your current position?
□
□
□
Direct delivery/frontline staff
□ Consultant/trainer
Management
□ Volunteer
Other (please specify): ________________
□
□
Administration
Peer educator
82. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
□
State (please specify): ___________________________
Tribal
International (please specify country): _________________
Local
□ Urban
□ Rural
□ Suburban
83. 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 SOAR 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 9 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
T/TA: _______________________________________________________________ DATE(S): _______________________
CONSULTANT FACILITATOR(S): _______________________________________________________________________
NHTTAC COORDINATOR: _____________________________________________________________________________
Please indicate how well the training met each stated objective.
OVERALL OBJECTIVES
Poor
Fair
Good
Excellent
1.
[Insert objective 1].
1
2
3
4
2.
[Insert objective 2].
1
2
3
4
3.
[Insert objective 3].
1
2
3
4
4.
[Insert objective 4].
1
2
3
4
5.
[Insert objective 5].
1
2
3
4
6.
Please list any other professional goals you have achieved through this T/TA.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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 15 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Please indicate the extent to which you agree or disagree with the following statements.
FACILITATOR 1: ___________________
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
7.
The facilitator demonstrated a comprehensive knowledge of
the subject.
1
2
3
4
NA
8.
The facilitator clearly and logically presented the content.
1
2
3
4
NA
9.
The facilitator responded well to questions and comments.
1
2
3
4
NA
10. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
11. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
12. The facilitator demonstrated a comprehensive knowledge of
the subject.
1
2
3
4
NA
13. The facilitator clearly and logically presented the content.
1
2
3
4
NA
14. The facilitator responded well to questions and comments.
1
2
3
4
NA
15. The facilitator created a respectful environment for
participants.
1
2
3
4
NA
16. The facilitator encouraged and initiated helpful discussions.
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
17. The T/TA reflected a public health approach to addressing
human trafficking.
1
2
3
4
NA
18. The T/TA helped me identify potential language and cultural
barriers my organization might face in responding to human
trafficking.
1
2
3
4
NA
19. The T/TA was trauma informed.
1
2
3
4
NA
20. The T/TA was survivor informed.
1
2
3
4
NA
21. The T/TA was grounded in a multidisciplinary approach to
addressing human trafficking.
1
2
3
4
NA
22. The T/TA included evidence-based research or promising
practices.
1
2
3
4
NA
23. The T/TA will positively impact my organization’s response
to human trafficking.
1
2
3
4
NA
24. This T/TA met my educational needs.
1
2
3
4
NA
25. This T/TA met my professional needs.
1
2
3
4
NA
26. This T/TA changed [my/my organization’s] attitudes on
trauma-informed approaches to addressing trafficking
1
2
3
4
NA
27. This T/TA increased my professional networking or peer
support
1
2
3
4
28. This T/TA increased knowledge to inform a human
trafficking public health response.
1
2
3
4
FACILITATOR 2: ___________________
OVERALL FEEDBACK
NA
NA
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 15 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
29. [insert T/TA activity objective].
1
2
3
4
NA
30. [insert T/TA activity objective].
1
2
3
4
NA
31. [insert T/TA activity objective].
1
2
3
4
NA
32. [insert T/TA activity objective].
1
2
3
4
NA
33. [insert T/TA activity objective].
1
2
3
4
NA
34. [insert T/TA activity objective].
1
2
3
4
NA
35. [insert T/TA activity objective].
1
2
3
4
NA
36. [insert T/TA activity objective].
1
2
3
4
NA
37. [insert T/TA activity objective]
1
2
3
4
NA
38. [insert T/TA activity objective].
1
2
3
4
NA
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
39. NHTTAC was responsive to my questions and needs.
1
2
3
4
NA
40. NHTTAC was effective in identifying an appropriate grantee
to help with our request.
1
2
3
4
NA
41. NHTTAC staff was detail-oriented and thorough in the
planning of this T/TA.
1
2
3
4
NA
42. NHTTAC was timely throughout the planning process.
1
2
3
4
NA
43. The planning for this T/TA was well coordinated.
1
2
3
4
NA
T/TA ACTIVITY: ________________________
PLANNING
44. Please rate the overall quality of this T/TA.
1
2
3
4
Poor
Fair
Good
Excellent
45. How satisfied were you with your overall NHTTAC experience?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
3
Met My
Expectations
4
Exceeded My
Expectations
46. How well did this assistance meet your expectations?
1
Far Below My
Expectations
2
Did Not Meet My
Expectations
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 15 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
47. How responsive was NHTTAC to your needs following the T/TA?
1
Completely
Unresponsive
2
3
4
Unresponsive
Responsive
Very Responsive
□ Yes
48. Would you recommend NHTTAC to others to receive T/TA?
□ No
49. What are three things you plan to do as a result of this T/TA?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
50. Following this T/TA, how prepared do you feel to take steps toward addressing human trafficking in your organization?
1
2
3
4
Not At All Prepared
Somewhat Prepared
Mostly Prepared
Completely Prepared
51. What could NHTTAC do in the future to enhance your level of preparedness during this type of T/TA?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
52. What could NHTTAC do in the future to enhance your level of preparedness following this type of T/TA?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
53. What aspects of the T/TA were most helpful and why?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
54. What could NHTTAC do differently to improve similar T/TA requests in the future?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
55. Do you have any other comments or suggestions?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
_____________________________________________________________________________________________________
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 15 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
56. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
Academic Institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
57. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
58. 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,
Legal (e.g., immigration, civil and/or rights-based
psychiatrist, mental health/substance use counselor)
attorney and/or paralegal, clinic)
Child welfare (e.g., state agency staff, child welfare
Public health (e.g., licensure board, health
contractor, nonprofit personnel)
department staff, health care executive, community
health workers)
Corrections-based services (e.g., parole, probation)
Social worker (e.g., case manager, school
Criminal justice (e.g., law enforcement, prosecutor,
counselor, supervisor, administrator)
probation, court, forensic interviewer)
Survivor empowerment, mentoring, or peer to peer
Educator (e.g., teacher, professor, school
administrator)
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
Health care (e.g., physician, physician assistant,
youth violence)
nurse practitioner, dentist, nurse, pharmacist)
Other (please specify):
Housing (e.g., case worker, shelter director, public
_______________________________
housing authority agencies)
59. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
60. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Management
□ Other (please specify): ____________
□ Consultant/Trainer
□ Volunteer
□ Peer Educator
□ Administration
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 15 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
61. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
62. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
63. 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
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify): __________________
64. What is your race? (Mark all that apply.)
□
□
□
□
□
□
American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________
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 15 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.
SPECIALIZED T/TA
FEEDBACK
Protocol
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
65. What is your ethnicity? (Mark all that apply.)
□
□
□
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
66. What is your gender? (Mark all that apply.)
□
□
□
□
Male
Female
Transgender
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 15 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.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
Please rate the extent to which to you agree or disagree that the fellowship has helped your organization achieve the following
objectives.
FELLOWSHIP OBJECTIVES
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
1.
The fellowship increased my leadership skills.
1
2
3
4
NA
2.
The fellowship increased my skills and knowledge
about survivor-informed practices.
1
2
3
4
NA
3.
The fellowship increased my skills and knowledge
about current evidence-based research and promising
practices.
1
2
3
4
NA
The fellowship increased my skills and knowledge
about a multidisciplinary approach to addressing
human trafficking.
1
2
3
4
NA
5.
The fellowship increased my skills and knowledge
on a public health response to human trafficking.
1
2
3
4
NA
6.
The fellowship met my professional needs.
1
2
3
4
NA
7.
The fellowship met my educational needs.
1
2
3
4
NA
8.
I remained engaged with my partner organization in
the fellowship throughout its entirety.
1
2
3
4
NA
9.
[insert objective here].
1
2
3
4
NA
10. [insert objective here].
1
2
3
4
NA
4.
11. Please list any other personal goals you have achieved through this fellowship program:
____________________________________________________________________________________
____________________________________________________________________________________
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additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
12. How were you invited to participate in this fellowship?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
13. Do you think NHTTAC should do anything differently when selecting people to participate in this fellowship?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements about the Fellowship Activities:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
18. [insert objective].
1
2
3
4
19. [insert objective].
1
2
3
4
20. I would recommend keeping the organizational audit as
part of future survivor fellowships organized by
NHTTAC.
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
21. The action plan was developed collaboratively between
me and the partner organization.
1
2
3
4
22. My partner organization and I had the appropriate tools
and resources to develop the action plan.
1
2
3
4
23. The action plan we developed defined clear roles and
responsibilities.
1
2
3
4
24. The action plan we developed accounted for the partner
organization’s culture and structure.
1
2
3
4
25. The action steps we created were grounded in a
multidisciplinary approach to addressing human
trafficking.
1
2
3
4
ORGANIZATIONAL AUDIT
14. The organization was cooperative during the
organizational audit.
15. I had the appropriate tools and resources to conduct the
organizational audit.
16. I had adequate time to collaborate with the organization
I was partnered with in this fellowship on the
organizational audit.
17. The organizational audit helped identify gaps in the
organization’s service provision to people who are
currently being trafficked, at risk of trafficking, or have
been trafficked
ACTION PLAN
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number. The estimated average time to complete this form is 15 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.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
26. The action steps we created were grounded in a public
health approach to addressing human trafficking.
1
2
3
4
27. The action plan accounts for complex and multiple
traumas.
1
2
3
4
28. The action plan we created accounts for all types of
trafficking.
1
2
3
4
29. The action plan we created includes action steps to
address language and cultural barriers to serving at-risk
populations or potential victims of human trafficking.
1
2
3
4
30. I recommend keeping the action plan development as
part of future survivor fellowships.
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
31. NHTTAC supported me with necessary information to
enhance the T/TA I provided to the organization.
1
2
3
4
32. The organization was receptive to the recommendations
and changes provided through the action plan.
1
2
3
4
33. I had the appropriate tools and resources to provide the
organization with customized T/TA.
1
2
3
4
34. I had adequate time to plan for the customized T/TA.
1
2
3
4
35. I had adequate time to provide the customized T/TA.
1
2
3
4
36. The structure of the fellowship was an appropriate way
to incorporate and engage survivors.
1
2
3
4
CUSTOMIZED T/TA
Please indicate the extent to which you agree or disagree with the following statements about your collaboration with
the fellow:
ORGANIZATION: _____________________
Strongly
Disagree
Disagree
Agree
Strongly
Agree
37. The organization was easy to communicate with
throughout fellowship activities.
1
2
3
4
38. The organization responded to me in a timely manner.
1
2
3
4
39. The organization was respectful.
1
2
3
4
40. The organization allotted an appropriate amount of time
for me to help make an actionable change at the
organization.
1
2
3
4
41. The organization responded in a helpful manner to my
questions.
1
2
3
4
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number. The estimated average time to complete this form is 15 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.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
Please indicate the extent to which you agree or disagree with the following statements:
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not Applicable
42. NHTTAC staff clearly articulated my responsibilities in this
fellowship.
1
2
3
4
NA
43. NHTTAC set clear expectations for this fellowship.
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
1
2
3
4
NA
NHTTAC STAFF: __________________
44. NHTTAC provided me with necessary resources and
materials for this fellowship program.
45. NHTTAC staff were detail-oriented and thorough in the
planning of this fellowship.
46. NHTTAC was responsive to my questions and needs.
47. NHTTAC provided me with additional information on a
public health approach to human trafficking upon request.
48. I am satisfied with the overall support provided by
NHTTAC staff throughout the fellowship program.
49. Is there anything additional NHTTAC could have done to support you during this fellowship?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
50. Please rate the overall quality of this fellowship program.
1
2
3
4
Poor
Fair
Good
Excellent
51. Overall, how well did this fellowship meet your expectations?
1
2
Far Below My
Expectations
Did Not Meet My
Expectations
3
4
Met My Expectations
Exceeded My
Expectations
52. How satisfied were you with the overall quality of the support you received from NHTTAC staff to help complete this
fellowship?
1
2
3
4
Very Dissatisfied
Dissatisfied
Satisfied
Very Satisfied
53. Would you recommend NHTTAC to others to receive T/TA?
□ Yes
□ No
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number. The estimated average time to complete this form is 15 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.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
54. What are three things you plan to do as a result of this fellowship?
__________________________________________________________________________________
__________________________________________________________________________________
55. Was the format of this fellowship conducive to improving best practices at the organization you partnered with during this
fellowship? Why or why not?
__________________________________________________________________________________
__________________________________________________________________________________
56. What aspects of the fellowship were most helpful and why?
__________________________________________________________________________________
__________________________________________________________________________________
57. What could NHTTAC do differently to improve similar fellowships in the future?
__________________________________________________________________________________
__________________________________________________________________________________
58. Do you have any other comments or suggestions?
__________________________________________________________________________________
__________________________________________________________________________________
59. As a result of participating in this fellowship program, do you plan to do any of the following? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative
□
□
□
□
□
□
□
□
□
□
□
□
Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): _____________________
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number. The estimated average time to complete this form is 15 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.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
60. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected
in the previous question? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
61.
□
□
□
□
□
□
□
□
62.
□
□
□
□
□
□
Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across
organizational collaboration
Difficulty in establishing and/or maintaining a
multi-disciplinary team
□
Need for partnership building with other
organizations
Variation in mission and regulatory
frameworks when partnering with other
organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): ________________
□
□
□
□
□
Which of the following best describes your organization? (Mark all that apply.)
I do not represent an organization
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
□
□
□
□
□
□
□
□
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
Which of the following best describes the types of services your organization provides? (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
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence, youth
violence)
Other (please specify):
_______________________________
63. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
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number. The estimated average time to complete this form is 15 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.
SURVIVOR FELLOWSHIP
FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Fellow Protocol
64. Which of the following best describes your organization’s geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
65. Please select any of the following populations does your organization 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
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify): __________________
66. In your professional capacity, how frequently does your organization come into contact with a person who is currently
being trafficked, at risk of trafficking, or has been trafficked?
1
2
3
4
Never
Occasionally
Frequently
Daily
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 15 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.
WEBINAR FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
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].
WEBINAR:
_______________________________________________
DATE(S):
_______________________________________________________________
PRESENTER(S):
Please indicate the extent to which you agree or disagree with the following statements:
OVERALL WEBINAR
1.
2.
3.
4.
5.
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
1
2
3
4
1
1
2
2
3
3
4
4
1
2
3
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
1
1
2
2
2
3
3
3
4
4
4
Strongly
Disagree
Disagree
Agree
Strongly
Agree
1
1
1
2
2
2
3
3
3
4
4
4
As a result of this webinar, I
As a result of this webinar, I
As a result of this webinar, I
As a result of this webinar, I
As a result of this webinar, I
6.
7.
8.
9.
The webinar addressed the critical issues related to the topic(s).
The time allotted was adequate for the scope of material covered.
The webinar was organized and clear.
The webinar included information on current evidence-based research or
promising practices.
10. The webinar content was survivor informed.
11. The webinar content was trauma informed.
12. The webinar content reflected a public health approach to addressing human
trafficking.
PRESENTER 1: ___________________
13. The presenter’s knowledge and expertise were appropriate for this webinar.
14. The presenter engaged and interacted with the audience.
15. The presenter created a respectful environment for participants.
PRESENTER 2: ___________________
16. The presenter’s knowledge and expertise were appropriate for this webinar.
17. The presenter engaged and interacted with the audience.
18. The presenter created a respectful environment for participants.
19. Please rate the overall quality of this webinar.
1
2
3
4
Poor
Fair
Good
Excellent
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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.
WEBINAR FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
20. How useful was the webinar information to your work?
1
2
3
4
Not Useful
Somewhat Useful
Useful
Very Useful
21. 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.]
22. There are a total of webinars in the Emerging Issues series. Please check the webinars you attended from the
following list:
23. Please rate the overall quality of the webinars you selected in the previous question.
1
2
3
4
Poor
Fair
Good
Very Good
24. How well did the content in each webinar you selected complement each other?
1
2
3
4
Not At All
Not Well
Well
Very Well
25. Would you recommend NHTTAC to others who need training or technical assistance?
□ Yes
□ No
26. 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):
_______________________________
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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.
WEBINAR FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
27. 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
28. 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?
1
2
3
4
Never
Occasionally
Frequently
Daily
29. 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.
WEBSITE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
Thank you for visiting the National Human Trafficking Training and Technical Assistance Center (NHTTAC) website:
https://www.acf.hhs.gov/otip/training/nhttac. In order to help 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].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
First letter of first name
(example: S for Sara)
First letter of your middle name
(example: M for Maria)
1.
How did you find out about the NHTTAC website? (Mark all that apply.)
□
□
□
□
2.
□
□
□
□
An exhibit or presentation at a conference
A link from another website/Searching the Internet
A professor
My OTIP Program Monitor or other OTIP staff person
What was the goal of your visit today? (Mark all that apply.)
□ Learn about training or technical assistance
opportunities
□ Request/apply for training or technical assistance
□ Learn about SOAR trainings
□ Request/apply for SOAR trainings
□ Learn/apply for Professional Development
Scholarship
□ Learn about/apply for Organization Scholarship
□ Learn about the National Advisory Committee
3.
□ Learn more about survivor fellowship programs
□ Participate in one of the learning communities
□ Learn about NHTTAC
□ Learn more about OTIP grantees
□ Request downloadable resources
□ Obtain contact information
□ Sign up for the listserv
□ Other (please specify):
__________________________
Approximately how many times have you used/visited this site in the past year? (Mark one.)
□ This is my first time
□ Daily
□ Weekly
□ Monthly
4.
Were you familiar with NHTTAC before today’s visit?
□ Yes
□ No
5.
Please rate the overall quality of the NHTTAC website.
6.
The NHTTAC Call Center
A colleague or friend
A publication or newsletter
Other (please specify): __________________________
□ A few times per year
1
2
3
4
Poor
Fair
Good
Excellent
Would you recommend NHTTAC to others for T/TA?
□ Yes
□ No
Paperwork Reduction Act Notice
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number. The estimated average time to complete this form is 5 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.
WEBSITE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
Please indicate the extent to which you agree or disagree with the following statements.
OVERALL ASSISTANCE
Strongly
Disagree
Disagree
Agree
Strongly
Agree
Not
Applicable
7.
It is easy to find the information I need on this site.
1
2
3
4
NA
8.
The website is user-friendly and I am able to
navigate through it with ease.
1
2
3
4
NA
9.
The information on this site met my goals/needs.
1
2
3
4
NA
10. I am satisfied with the content of the site.
1
2
3
4
NA
11. The information on the site is trauma-informed.
1
2
3
4
NA
12. The information on the site is survivor-informed.
1
2
3
4
NA
13. The information on the site is grounded in current
evidence-based research or promising practices.
1
2
3
4
NA
14. The information on the site is grounded in a
multidisciplinary approach to addressing human
trafficking.
1
2
3
4
NA
15. The information on the site reflects a public health
approach to addressing human trafficking.
1
2
3
4
NA
16. I am satisfied with the appearance of the site.
1
2
3
4
NA
17. I will return to this site for my training and
technical assistance needs.
1
2
3
4
NA
18. I will recommend this site to others.
1
2
3
4
NA
19. What aspects of the website were most helpful, and why?
______________________________________________________________________________
______________________________________________________________________________
20. What could be done differently to improve the website?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
21. In your professional capacity, how frequently do you come into contact with people who are currently being
trafficked, at risk of trafficking, or have been trafficked?
1
2
3
4
Never
Occasionally
Frequently
All the Time
22. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
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 5 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.
WEBSITE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
23. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________
24. 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,
□ Legal (e.g., immigration, civil and/or rights-based
psychiatrist, mental health/substance use counselor)
attorney and/or paralegal, clinic)
□ Child welfare (e.g., state agency staff, child welfare
□ Public health (e.g., licensure board, health
contractor, nonprofit personnel)
department staff, health care executive, community
□ Corrections-based services (e.g., parole, probation)
health workers)
□ Criminal justice (e.g., law enforcement, prosecutor,
□ Social worker (e.g., case manager, school
probation, court, forensic interviewer)
counselor, supervisor, administrator)
□ Educator (e.g., teacher, professor, school
□ Survivor empowerment, mentoring, or peer to peer
administrator)
□ Violence prevention (e.g., Child abuse and neglect;
□ Health care (e.g., physician, physician assistant,
elder abuse; domestic violence, sexual violence,
nurse practitioner, dentist, nurse, pharmacist)
youth violence)
□ Housing (e.g., case worker, shelter director, public
□ Other (please specify):
_______________________________
housing authority agencies)
25. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years
□ 3 to 5 years
□ 6 to 10 years
□ More than 10 years
26. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): ______________________
□ Administration
□ Peer Educator
27. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□
National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
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 5 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.
WEBSITE FEEDBACK
OMB Control Number: 0970-XXXX
Expiration Date: XX/XX/XXXX
Protocol
28. 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
Domestic and dating 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 5 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.
| File Type | application/pdf |
| Author | Field, Michael |
| File Modified | 2018-07-06 |
| File Created | 2018-07-06 |