Form 0920- SurveyMonkey

Welcome to the Coordinated Community Response Team Survey!
This survey has been sent to you as the point of contact on the Coordinated
Community Response Team participating in a program or policy effort as part of
the CDC DELTA Impact program. You may complete the survey with any other CCR
staff that you think would be appropriate. Please submit only ONE survey per CCR.
This survey is an opportunity for CDC to hear feedback from the implementing
agencies. We greatly appreciate your perspective and your input will be used to
inform future initiatives. The results of the CCR surveys will be shared only in
aggregate. Your individual responses will not be shared with the State Coalition
staff or anyone outside of the CDC.
Coalition refers to your State Domestic Violence Coalition (SDVC).
Primary Prevention refers to activities and strategies that keep intimate partner
violence (IPV) or domestic violence (DV) from first occurring.
Community and Societal Level Primary Prevention (CSPP) refers to prevention
strategies that are designed to impact characteristics of the settings (e.g., school,
workplace, and neighborhood) in which social relationships occur, or social and
physical environment factors. This is different from individual level strategies
(usually designed to promote attitudes, beliefs, skills, and behaviors) and
relationship level strategies (focused on relationships that influence an individual
behavior and experience).
Program or Policy Effort (PPE)– refers to the evidence informed program or policy
effort being implemented by your agency or Coordinated Community Response
Team. The PPE will fall in one of the following focus areas: create protective
environments, engage influential adults and peers, or strengthen economic
supports or families.
It should take approximately 30 minutes to complete this survey.
CDC estimates the average public reporting burden for this collection of information as 30 minutes per response, including
the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the
data/information 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 burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D74, Atlanta, Georgia 30333; ATTN: PRA (#).

In what state is your CCR?

Is your CCR implementing more than one DELTA Impact funded PPE?
Yes, we are implementing TWO PPEs.
No, just one PPE.

Program or Policy Effort #1
If your CCR is implementing more than one PPE, please answer the following
questions about one PPE. You will then be asked the same set of questions about
the second PPE.
What is the name of this DELTA Impact funded program or policy effort?

To what extent is the PPE meeting the key milestones as laid out in the
implementation plan?
Not at all
Minimally
Somewhat
To a great extent
N/A

To what extent is the PPE reaching the intended setting(s) and populations?
Not at all
Minimally
Somewhat
To a great extent
N/A

To what extent is the PPE succeeding in addressing the intended risk and
protective factors?
Not at all
Minimally
Somewhat
To a great extent
N/A

To what extent, did your organization develop new partnerships with local
organizations doing IPV related work as a result of DELTA Impact?
Not at all
Minimally
Somewhat
To a great extent
N/A

What is the likelihood that the program or policy effort can continue after the
DELTA Impact project period ends (March 2023)?
Very unlikely
Somewhat unlikely
Somewhat likely
Very Likely
N/A Unable to Assess

What is the likelihood that the CCR could expand or scale up the program or policy
effort (e.g. expand to additional settings or scale up to reach more individuals in
existing settings) beyond what was originally planned?
Very unlikely
Somewhat unlikely
Somewhat likely
Very Likely
N/A Unable to Assess

What were the most challenging aspects of implementing the PPE?

What resources were most helpful to the implementation of the PPE?

Please note the MAIN challenge your CCR may face to sustain the PPE after the
project period.

Please rate the State Domestic Violence Coalition’s involvement in the planning,
implementation, and evaluation of this program or policy effort.
None

Minimal

Moderate

High

Unable to Assess

In the
development of
the PPE
Implementation
plan
In the
development of
the PPE
Evaluation plan
In updating the
PPE
Implementation
plan as needed
In updating the
PPE Evaluation
Plan as needed
In analysis or
interpretation of
the PPE
evaluation
results
In
communication
about the PPE
implementation
and evaluation
to partners

Please share any additional feedback regarding the Coalition’s involvement in the
planning, implementation, and evaluation of the program or policy effort

Are you implementing a second PPE?
Yes
No

Program or Policy Effort #2
What is the name of this DELTA Impact funded program or policy effort?

To what extent is the PPE meeting the key milestones as laid out in the
implementation plan?
Not at all
Minimally
Somewhat
To a great extent
N/A

To what extent is the PPE reaching the intended setting(s) and populations?
Not at all
Minimally
Somewhat
To a great extent
N/A

To what extent is the PPE succeeding in addressing the intended risk and
protective factors?
Not at all
Minimally
Somewhat
To a great extent
N/A

To what extent, did your organization develop new partnerships with local
organizations doing IPV related work as a result of DELTA Impact?
Not at all
Minimally
Somewhat
To a great extent
N/A

What is the likelihood that the program or policy effort can continue after the
DELTA Impact project period ends (March 2023)?
Very unlikely
Somewhat unlikely
Somewhat likely
Very Likely
N/A Unable to Assess

What is the likelihood that the CCR could expand or scale up the program or policy
effort (e.g. expand to additional settings or scale up to reach more individuals in
existing settings) beyond what was originally planned?
Very unlikely
Somewhat unlikely
Somewhat likely
Very Likely
N/A Unable to Assess

What were the most challenging aspects of implementing the PPE?

What resources were most helpful to the implementation of the PPE?

Please note the MAIN challenge your CCR may face to sustain the PPE after the
project period.

Please rate the State Domestic Violence Coalition’s involvement in the planning,
implementation, and evaluation of this program or policy effort.
None

Minimal

Moderate

High

Unable to Assess

In the
development of
the PPE
Implementation
plan
In the
development of
the PPE
Evaluation plan
In updating the
PPE
Implementation
plan as needed
In updating the
PPE Evaluation
Plan as needed
In analysis or
interpretation of
the PPE
evaluation
results
In
communication
about the PPE
implementation
and evaluation
to partners

Please share any additional feedback regarding the Coalition’s involvement in the
planning, implementation, and evaluation of the program or policy effort

CCR Staff Knowledge and Skills Related to Community and Societal
Primary Prevention (CSPP) Efforts
Please consider the CCR staff’s general knowledge and skills related to community
and societal level primary prevention (CSPP) strategies BEFORE the DELTA Impact
(DI) project period began in 2018 and CURRENTLY, in the fourth year of the project
period.
Please rank the following from the 1) lowest level (e.g. no awareness, knowledge,
or capacity) to 4) the highest level (e.g. very knowledgeable, skilled, or capable)
for BEFORE DELTA Impact and CURRENTLY.
Knowledge about community and societal level strategies to prevent IPV
None

Some

Moderate

Proficient

Unsure

Before DELTA
IMPACT
Currently

Capacity to implement community and societal level primary prevention program
or policy efforts.
None

Some

Moderate

Proficient

Unsure

Before DELTA
IMPACT
Currently

Capacity to evaluate community or societal level primary prevention program or
policy efforts.
None

Before DELTA
IMPACT
Currently

Some

Moderate

Proficient

Unsure

Awareness of available data sources related to community or societal level
primary prevention and IPV.
None

Before DELTA
IMPACT
Currently

Some

Moderate

Proficient

Unsure

CCR Support of and Resources Devoted to Community and Societal
Level Primary Prevention Efforts
Please consider the support for community and societal level primary prevention
(CSPP) strategies at your organization BEFORE the DELTA Impact (DI) project
period began in 2018 and CURRENTLY, in the fourth year of the project period.
Please rank the following from the 1) lowest amount (e.g. no support or resources)
to 4) the highest amount (e.g. a lot of support or resources) for BEFORE DELTA
Impact and CURRENTLY
Support for community and societal level primary prevention strategies among
CCR staff.
Not at All

A Little

A Moderate
Amount

A Great Deal

Unsure

Before DELTA
Impact
Currently

Support for community and societal level primary prevention strategies
among CCR leadership.
Not at All

A Little

A Moderate
Amount

A Great Deal

Unsure

Before DELTA
Impact
Currently

Financial resources devoted to community and societal level primary prevention
efforts above and beyond funding dedicated to specific DELTA Impact program or
policy efforts.
Not at All

Before DELTA
Impact
Currently

A Little

A Moderate
Amount

A Great Deal

Unsure

Non-financial resources (training, informational materials, webinars, etc.) devoted
to community and societal level primary prevention efforts.
Not at All

A Little

A Moderate
Amount

A Great Deal

Unsure

Before DELTA
Impact
Currently

Please share any additional comments about how support for community and
societal level prevention efforts at your organization has changed since before
DELTA Impact.

Coalition Support
Please rank your agreement with the following statements about the training,
technical assistance, and support provided by the State Domestic Violence
Coalition to the CCR. Your individual responses will not be shared with the
Coalition.
I am satisfied with the amount of learning opportunities the Coalition facilitated or
shared on implementing community and societal level primary prevention
program or policy efforts.
Strongly Disagree
Somewhat Disagree
Somewhat Agree
Strongly Agree
Unable to Assess

I am satisfied with the amount of training or learning opportunities the Coalition
facilitated or shared on evaluating community and societal level primary
prevention program or policy efforts.
Strongly Disagree
Somewhat Disagree
Somewhat Agree
Strongly Agree
Unable to Assess

I am satisfied with the technical assistance our CCR received from the Coalition.
Strongly Disagree
Somewhat Disagree
Somewhat Agree
Strongly Agree
Unable to Assess

I am satisfied with how the Coalition responded to our questions and concerns
throughout the project period.
Strongly Disagree
Somewhat Disagree
Somewhat Agree
Strongly Agree
Unable to Assess

What types of support from the Coalition was most helpful in implementing and
evaluating the PPE(s)?

What additional type of support from the Coalition would have facilitated
implementation and evaluation of the PPE(s)?

Thank you for your participation!!
Is there anything else you would like to share with us about your participation in
DELTA Impact in general?