National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form

O MB #: 0970-0401

Expiration Date: 5/31/2021

NCECHW INFOLINE EVALUATION

You sent an inquiry that was responded to by the National Center on Early Childhood Health and Wellness. We are always striving to improve our programs and services. Please take a moment to tell us how we did by completing the survey below.

1. Your organization (please check all that apply):

 Child Care

 Head Start

 Community Partner

 Other (specify)

2. Your role (please check all that apply):

 Parent/Caregiver/Guardian

 Family Child Care Specialist/ Provider

 Home Visitor

 Teacher/ Teacher's Aide/Assistant/ Educator / EHS Caregiver

 Health Manager/ Coordinator/ Specialist

 Child Care Health Consultant

 Mental Health Content Manager/Coordinator

 Mental Health Consultant

 Nutrition/Food Services Content Manager/Coordinator

 Disabilities Manager/ Coordinator/ Specialist

 Education Content Manager/Coordinator

 Family Services Manager / Coordinator/ Advocate

 Center Director/ Supervisor/ Manager/ Coordinator

 Governing Body/Board Member/Policy Council

 Technical Assistance Staff

 Federal Staff

 Child Care Partner

 Community Partner

 Dental Hygienist Liaison

 Head Start Collaboration Office

 Licenser

 Health Care Provider

 Other (specify)

3. Years in your current role

4. What type of information were you requesting in your Infoline inquiry? (please check all that apply)

 Webinar

 Training

 Materials/Resources

 Other (specify)

The response to my inquiry met or exceeded my expectations.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

I was satisfied with the quality of the response.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

I was satisfied with the timeliness of the response.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

The responder was knowledgeable in the content area.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

The responder was responsive to my questions and need for information.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

The content of the response was relevant to my work.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

Please let us know whether you found the content in the response to be too simple, too advanced, or just about right.

1 Far too advanced

2 A bit too advanced

3 About right

4 A bit too simple

5 Far too simple

The response deepened my knowledge of the topic presented.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

I plan to use information I learned from the response to…

Create practice or policy changes in my organization.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

5 N/A

Build collaborations with others.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

5 N/A

Make changes to improve my practice.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

5 N/A

I learned something from the response that I plan to use in my work.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

I plan to share the information from the response with others.

1 Strongly Disagree

2 Disagree

3 Agree

4 Strongly Agree

How likely would you be to use the Infoline again?

1 Extremely Likely

2 Likely

3 Unlikely

4 Extremely Unlikely

5 N/A

19. Please provide an example of how the Infoline response made a difference for your program.

20. Which type(s) of information could the Infoline provide that would help you improve your practice?

Thank you for your participation and feedback.

Paperwork Reduction Act Burden Statement: This collection of information is voluntary. Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, 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.