Strengthening the Implementation of Responsible Fatherhood Programs (SIRF)

OMB #: 0970-0531

EXPIRATION: 07/31/2022

Instrument 3 - SIRF Reflections from Fathers

MDRC will develop an electronic data collection approach using Qualtrics that the Learning Cycle Manager and staff at each site can use to solicit reflections from fathers to be used in each site’s learning cycle reflection process. All possible questions are noted below but the exact deployment of them will depend on the interventions being tested with each site.

Hello! [name the program] is partnering with MDRC, a nonprofit organization, to learn how to better support fathers in their program. The project is called Strengthening the Implementation of Responsible Fatherhood Programs, or SIRF. [Name the program] is one of 10 fatherhood programs involved in this project.

As part of this project, we’d like to hear about your experiences with [name the program] by asking you a few questions. Your responses will help the program to better engage fathers in their services. Your responses will also be combined with those from the other programs participating in the project to come up with ideas for how fatherhood programs nationwide can be better in the future.

It will take about 15 minutes to give your feedback. We will not ask you to provide any personal information. Your responses will be kept private. Providing your feedback is your choice. There is no penalty for not answering these questions.

If you have questions about this project you can reach out to MDRC by email ([email protected]) or call the SIRF hotline at (877) 375-9340.

This project is funded by the U.S. Department of Health and Human Services.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to gather preliminary information about the fatherhood field and explore with fatherhood programs the research questions that are of interest and the design options that are feasible. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. The answers you give will be kept private. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0531 and the expiration date is 07/31/2022. If you have any comments on this collection of information, please contact; [email protected], and Dina Israel; [email protected]; Attn: OMB-PRA (0970-0531).  

Consent	Given what you just read about the purpose of this project, please select a response below. I agree to provide my feedback about [name of program] to help the program and the SIRF project to learn how to better support fathers. I understand that no personal information will be collected about me. [move to 2. Recruit or 7. Participated, depending on site and timing in cycle] I do not agree to provide my feedback about [name of program]. I understand that there is no penalty for now answering these questions. [move to Exit_no_consent]
Recruit	How did you hear about [name the program]? Select one.	Family, friend, or associate [move to 4. Wait_time] Social media [move to 4. Wait_time] Flyer or billboard [move to 4. Wait_time] Radio or TV [move to 4. Wait_time] Another organization [move to 4. Wait_time] An event in the community [move to 4. Wait_time] Something else [move to 3. Recruit_other]
Recruit_other	How did you hear about [name the program]?	[short form response] [move to 4. Wait_time]
Wait_time	How long did you wait before reaching out to [name the program]? Select one.	Less than a week 2 to 3 weeks Less than a month More than a month [move to 5. Impression]
Impression	What were your first impressions of [name the program]?	[short form response] [move to 6. Enroll_reason]
Enroll_reason	What was your main reason for enrolling in [name the program]? Select one.	To get help with employment To get help with parenting issues To get help to strengthen my relationships with others To get help with child support To get help with court or criminal justice issue I was encouraged by someone else to enroll Another reason [move to 7. Participated or exit_responder, depending on site and timing in cycle]
participated	Have you attended any services from [name the program] in [timeframe]? Select one.	Yes, in person [skip to 17. attendance] Yes, online [skip to 17. attendance] Yes, both in person and online [skip to 17. attendance] no [move to 8. reason_no_attend]
Question series for fathers who did not attend any services during timeframe in question.
Reason_no_attend	What was the main reason you did not attend? Select one.	Not supposed to attend (didn’t sign up or sessions weren’t scheduled) [skip to exit_responder] Difficult to attend [skip to 9. difficult] No longer interested in services [skip to 13. not_interested] Forgot [skip to exit_responder] Something else [skip to 16. other_reason]
Difficult	What was the main reason it was difficult to attend? Select one.	Not convenient time or location [skip to 10. not_convenient] Issue with computer or internet access [skip to Exit_responder] Personal/family issues [skip to 11. personal_issues] Something else [skip to 12. difficult_text]
not_convenient	Why was the time or location inconvenient? Select one.	Lack of childcare Work scheduling conflict Other scheduling conflict Not easy to get to/transportation Something else [move to Exit_responder]
personal_issues	What type of personal or family issue? Select one.	Lack of childcare Living situation Legal or law enforcement issues Conflict with child’s other parent Something else [move to Exit_responder]
Difficult_text	What made it difficult to attend?	[short form response] [move to Exit_responder]
Not_interested	Why are you no longer interested in services? Select one.	Achieved my goals [move to Exit_responder] My goals changed [move to Exit_responder] Found a different program to attend [move to Exit_responder] Did not like the program [skip to 14. not_like] I have another reason for not being interested [move to Exit_responder]
Not_like	What did you not like about the program? Select one.	Do not like the way it was delivered [move to Exit_responder] Topics were not helpful to me [move to Exit_responder] Too many program hassles [move to Exit_responder] Something else [move to 15. Other_not_like]
Other_not_like	What did you not like about the program?	[short form response] [move to Exit_responder]
Other_reason	What was the reason you did not attend?	[short form response] [move to Exit_responder]
Question series for fathers who did attend during the timeframe in question.
Attendance	About how many times have you met with someone from [name the program] since [timeframe]? Select one.	1 or 2 times 3 to 5 times 6 times or more [move to 18. challenge_part]
Challenge_part	Do you ever find it challenging to attend services offered by [name the program]?	Yes [move to 19. Main_challenge] No [skip to 27. support_goals]
Main_challenge	What is the main challenge you have to attend services offered by [name the program]? Select one.	Personal/family issues [skip to 20. personal_issues2] Not convenient time or location [skip to 21. not_convenient2] Need more motivation [skip to 22. motivation] Issue with computer or internet access [skip to Exit_responder] Something else [skip to 27. support_goals]
personal_issues2	What type of personal or family issue? Select one.	Lack of childcare Living situation Legal or law enforcement issues Conflict with child’s other parent Something else Move to [27. support goals]
not_convenient2	What specifically made it inconvenient? Select one.	Work scheduling conflict Other scheduling conflict Not easy to get to/transportation Something else Move to [27. support goals]
Motivation	What could help you be more motivated? Select one.	Different program topics Fewer program hassles Different staff Different program format Something else Move to [23. support goals]
Other_challenge	What is the another challenge you have to attend services offered by [name the program]?	Personal/family issues [skip to 24. personal_issues3] Not convenient time or location [skip to 25. not_convenient3] Need more motivation [skip to 26. motivation] Issue with computer or internet access [skip to Exit_responder] Something else [skip to 27. support_goals]
Personal_issues3	What type of personal or family issue? Select one.	Lack of childcare Living situation Legal or law enforcement issues Conflict with child’s other parent Something else Move to [27. support goals]
Not_convenient3	What specifically made it inconvenient? Select one.	Work scheduling conflict Other scheduling conflict Not easy to get to/transportation Something else Move to [27. support goals]
Motivation3	What could help you be more motivated? Select one.	Different program topics Fewer program hassles Different staff Different program format Something else Move to [27. support goals]
Question series for fathers who did attend during the timeframe in question.
support_goals	Do you feel that [name the program]’s support is helping you to reach your goals?	Yes [skip to 29. most_useful] No [move to 28. support_needed]
support_needed	What additional support do you need to reach your goals?	[short free-form response] [move to 29. most_useful]
most_useful	What aspect of [name the program] do you think is most useful for you to meet your goals? Select one.	The program topics Help with employment Help with parenting issues Help to strengthen my relationships with others Help with child support Help with court or criminal justice issue Other services The staff Other fathers Nothing [move to Exit_responder]
Exit_responder	Thank you for responding! Your input will help [name the program] to improve! We wish you success in reaching your goals.
Exit_no_consent	Thanks for considering. We wish you all the best on your fatherhood journey.