Maternal, Infant, and Early Childhood Home Visiting All Grantee & Tribal Regional Meetings Feedback Tools

OMB Control No.: 0970-0401

Expiration Date: 05/31/2021

[insert date and title] Tribal Regional Overall Meeting Feedback Form

Public Burden Statement: 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. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Anne Bergan, Office of Child Care Administration for Children and Families, HHS, Mary E. Switzer Building 330 C Street, SW, Suite 3014F, Washington, DC 2020.

Use of Data: Thank you for providing feedback about the effectiveness of the Tribal MIECHV regional meeting. This form should take less than 6 minutes to complete. Your feedback provides valuable information to Technical Assistance (TA) centers, ACF, and meeting planning committees. We analyze and review the results with rigor and incorporate your suggestions to continuously improve the meeting content and logistics. For example, because of your feedback we now select more interactive sessions and activities that provide more opportunities for deeper discussion with other grantees/awardees. Or, we now incorporate longer, more intensive working sessions that better meet adult learning styles and provide opportunities for applying knowledge and acquiring practical tools and resources.

Please select the role that most closely aligns with your responsibilities related to the MIECHV project.

Grantee Lead/Director/Coordinator Grantee Data/Evaluation Staff Grantee Program Staff

Home Visitor Consultant Other

Meeting Grantee Needs: Please indicate the degree to which the Tribal regional meeting
Was relevant to your work
Provided resources and strategies to support your home visiting efforts
Enhanced your existing knowledge and/or skills
Speakers/presenters demonstrated topic expertise
Future Action: Please indicate to what extent you plan to use what you learned or the resources you obtained.
Share knowledge or skills with various stakeholders and other team members
Make changes in policies, guidelines, procedures, or interagency agreements/contracts
Make changes in the service delivery system for families
Pursue additional technical assistance related to a topic featured during the meeting
Learn more about a topic featured during the meeting
Logistics: Please indicate your overall ratings for the following:
Comfortable and appropriate meeting space
Comfortable and clean sleeping accommodations at the conference hotel
Responsiveness of registration and meeting coordination staff
Ability to participate in individual TA sessions with respective TA providers.

What was the most helpful aspect of the meeting?

What improvements can be made?

What can we improve that would enable you to better apply learning or tools obtained at the meeting to your program?

Other comments:

OMB Control No.: 0970-0401

Expiration Date: 05/31/2021

[insert date and title] Tribal Regional Individual Session Feedback Form

Public Burden Statement: 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. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Anne Bergan, Office of Child Care Administration for Children and Families, HHS, Mary E. Switzer Building 330 C Street, SW, Suite 3014F, Washington, DC 2020.

Use of Data: Thank you for providing feedback about the effectiveness of the Tribal MIECHV regional meeting. This form should take less than 6 minutes to complete. Your feedback provides valuable information to Technical Assistance (TA) centers, ACF, and meeting planning committees. We analyze and review the results with rigor and incorporate your suggestions to continuously improve the meeting content and logistics. For example, because of your feedback we now select more interactive sessions and activities that provide more opportunities for deeper discussion with other grantees/awardees. Or, we now incorporate longer, more intensive working sessions that better meet adult learning styles and provide opportunities for applying knowledge and acquiring practical tools and resources.

Please select the role that most closely aligns with your responsibilities related to the MIECHV project.

Grantee Lead/Director/Coordinator Grantee Data/Evaluation Staff Grantee Program Staff

Home Visitor Consultant Other

Please rate each session using the scale listed below

Strongly Disagree Disagree

Slightly Disagree Slightly Agree

Agree Strongly Agree

Please indicate the degree (enter rating 1, 2, 3, 4, 5 or 6 in the box) to which the Plenary or Breakout session...	Achieved intended objectives	Met your needs	Provided new information	Allotted time for questions and and/or quality discussion	Was well organized, engaging and effectively presented	Speaker(s) demonstrated topic expertise	Provided information you can apply to practice and/or enhanced your professional expertise
Plenary: Date, title and presenter
Breakout Session: Date, title & presenter
Working session: Date, title and presenter

What is one thing that you like best about the session?

What is one thing that you would change?

Other comments: