Violence Prevention Technical Assistance Center: Needs Assess

Needs Assessment Survey for PPTB Recipients

OMB Control No. 0920-1050

Exp. Date 05/31/2022

The public reporting burden of this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to - CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333 ATTN: PRA (0920-1050)

The Violence Prevention Technical Assistance Center (VPTAC) invites you to complete the following survey. Your participation in this survey is completely voluntary; you may choose to skip any question. The survey will take approximately 20 minutes to complete.

VPTAC will use the findings from this survey to develop training and technical assistance (TTA) events and products for you and other recipients of funding from the Prevention, Practice, and Translation Branch (PPTB) of the Centers for Disease Control and Prevention’s (CDC) Division of Violence Prevention.

This survey should be completed by you, the primary point of contact for your PPTB award. When you answer questions about the type or amount of TTA that your health department or state domestic violence coalition needs from VPTAC, please answer on behalf of your entire team. VPTAC is interested in your collective capacity, not just the capacity level of the individual survey respondent.

If you have any questions about VPTAC or this survey, please send an email to [email protected].

Planning

1. Please indicate how much TTA your organization currently needs or will need to engage in the following activities involved in planning:

How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
Developing a shared vision
Collecting or identifying data on incidence and prevalence of violent behavior, violence-related hospitalizations, etc.
Collecting or identifying data on risk and protective factors
Developing goals
Developing SMARTIE objectives (specific, measurable, assignable, realistic, time bound, inclusive, and equitable)
Considering factors shared across multiple types of violence and multiple levels of the social-ecological model
Examining preventable differences in the burden of violence associated with inequities
Ensuring that systems are in place to support implementation of violence prevention plans (e.g., systems related to financial management, contracts, and personnel management, including diversity, inclusion, and equity)
Prioritizing risk and protective factors
Writing the plan
Other: please specify activity (activities) and level(s) of TTA need:

2. To the best of your knowledge, what are the biggest barriers faced by your organization with respect to planning?

Partnerships

3. Please indicate how much TTA your organization currently needs or will need to engage in the following activities involved in partnerships:

How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
Identifying partners and their roles
Developing partnerships with a broad range of sectors and stakeholders
Developing partnership agreements
Including culturally diverse youth and families
Ensuring that partners understand the public health approach
Sustaining partnerships
Other: please specify activity (activities) and level(s) of TTA need:

4. To the best of your knowledge, what are the biggest barriers faced by your organization with respect to partnerships?

   
   
   

   
   

5. Please indicate how much TTA your organization currently needs or will need to engage in the following activities involved in policy efforts.

   How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
   Identifying a role for your agency in engaging and educating stakeholders about evaluating efforts
   Engaging in the following process: identify the problem; review and analyze existing procedures; develop an strategy for executing procedures; implement procedures
   Other: please specify activity (activities) and level(s) of TTA need:

6. To the best of your knowledge, what are the biggest barriers faced by your State Domestic Violence Coalition with respect to procedures efforts?

Selection of Strategies

7. Please indicate how much TTA your health department or state domestic violence coalition currently needs or will need to engage in the following activities involved in selecting strategies.

   How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
   Using a data-driven approach (e.g., aligning strategies with needs assessment data)
   Selecting a mix of strategies (i.e., general preventive directions or actions)
   Identifying a set of approaches (i.e., specific ways to advance the strategies)
   Selecting community-level strategies based on the best available evidence
   Aligning new strategies with existing sexual violence prevention initiatives
   Prioritizing policies, practices, and programs that address the needs most affected by violence
   Educating local and/or state decision makers about violence prevention strategies
   Other: please specify activity (activities) and level(s) of TTA need:

8. To the best of your knowledge, what are the biggest barriers faced by your health department or state domestic violence coalition with respect to selecting strategies?

Adaptation

9. Please indicate how much TTA your agency currently needs or will need to engage in the following activities involved in adapting approaches.

   How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
   Identifying the essential elements of your approaches
   Adapting the approach to increase fit while keeping essential elements of the approach
   Tracking and evaluating adaptations to improve delivery of the approach
   Other: please specify activity (activities) and level(s) of TTA need:

10. To the best of your knowledge, what are the biggest barriers faced by your state domestic violence coalition with respect to adaptation?

Implementation

11. Please indicate how much TTA your state domestic violence coalition currently needs or will need to engage in the following activities involved in implementation:

    How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
    Forming an implementation team to include community members most affected by violence
    Developing an action plan for each selected strategy
    Maintaining fidelity to essential program elements
    Integrating lessons learned along the way
    Ensuring sustained engagement of all members of the implementation team
    Other: please specify activity (activities) and level(s) of TTA need:

12. To the best of your knowledge, what are the biggest barriers faced by your state domestic violence coalition with respect to implementation?

Evaluation

1. Please indicate how much TTA your state domestic violence coalition currently needs or will need to engage in the following activities involved in evaluation:

How much TTA is needed?	None	Some	A Moderate Amount	Quite a Bit	An Extensive Amount	Don’t Know or N/A
Building an evaluation team
Developing an evaluation plan
Selecting process indicators for implementation evaluation
Identifying data sources for process indicators
Selecting outcome indicators to measure changes in desired outcomes
Collecting data from existing sources, such as publicly available data, to inform evaluation
Conducting new data collection activities, such as surveys, focus groups, or interviews to inform evaluation
Sharing results with community to emphasize the participatory nature of violence prevention work and build investment for sustainability
Other: please specify activity (activities) and level(s) of TTA need:

14. To the best of your knowledge, what are the biggest barriers faced by your state domestic violence coalition with respect to evaluation?

Wrap-up

15. Do you have any questions about VPTAC? If so, please write them below.

16. Is there anything else you would like to ask or share with VPTAC or do you have TTA needs that were not addressed in this survey? If so, please enter your questions or comments below.

17. If you would like a direct response to question(s) and/or request(s) you shared through this survey, please provide the following information in the space below:

• Your state or territory

• Your PPTB program (i.e., Rape Prevention and Education, DELTA Impact, Essentials for Childhood, or Preventing Teen Dating and Youth Violence [“1605”])

Thanks for taking time to complete this survey!

AMERICAN INSTITUTES FOR RESEARCH | AIR.ORG

0

Copyright © 2020 American Institutes for Research. All Rights Reserved.