TPP Network grantee technical assistance survey

Form Approved

OMB No. 0990-0379

Exp. Date 08/31/2023

Tier 2 Innovation and Impact Network grantee technical assistance needs assessment survey

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0379. The time required to complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

Tier 2 Innovation and Impact Network grantee technical assistance needs assessment survey

INTRODUCTION AND INSTRUCTIONS

Your input is needed to understand the types of technical assistance you and your team (including network partners) desire. This survey asks questions about your needs related to (1) the Explore and Develop phase, (2) the Test and Refine Phase, (3) the Evaluate phase, (4) Dissemination, and (5) general issues related to study design, data collection and analytic methods. The survey should take about 10 minutes to complete. We would ask that the program lead and evaluation lead each respond separately – therefore, each grantee should have a total of two individuals separately complete the survey. Please submit your completed survey by {DATE}.

PRIVACY

The information you provide will only be seen by your project officer and the evaluation technical assistance team.

Please give your most honest and complete answers so that the evaluation technical assistance team can tailor the technical assistance you will receive to the extent possible.

If you have a comment or a question about the survey or would like to clarify or amend an answer in any way, we have included a space at the end of the survey where you can record your additional thoughts or comments.

Thank you for your participation!

GENERAL INSTRUCTIONS

Please mark all answers within the white boxes provided. Please read each question carefully.

We are interested in providing or facilitating technical assistance on topics of interest related to evaluation activities that you will be engaging in as part of your grant and as you look to the future. For each topic, please let us know the degree to which you are interested or feel you might need evaluation technical assistance. Evaluation technical assistance is intended to encompass measurement, data collection, analysis, and reporting of research findings around a given topic. We’ve organized the TA topics into their potential phases, but we recognize that some of these activities may occur in different phases for different grantees or interventions, or occur in multiple phases.

Name:

Email address:

Grantee Name: [Note: this will be a drop down box with the thirteen grantees]

Role: Program lead ☐ or Evaluation lead ☐

Topic	No interest or need	Limited interest or need	Some interest or need	Strong interest or need
EXPLORE AND DEVELOP
Determining need and demand for a program, component, strategy or policy	☐	☐	☐	☐
Assessing the acceptability and feasibility of implementing a particular program, component, strategy or policy	☐	☐	☐	☐
Creating an initial logic model that links intervention to outcomes	☐	☐	☐	☐
Understanding the role of human-centered design in supporting improvement and refinement	☐	☐	☐	☐
Measuring program costs	☐	☐	☐	☐
Documenting readiness for “test and refine” stage	☐	☐	☐	☐
Disseminating information learned when developing and selecting interventions and strategies	☐	☐	☐	☐
TEST AND REFINE
Performing continuous quality improvement (i.e., identifying problems with implementation, implementing solutions, reviewing progress) using methods such as Learn, Innovate, Improve (LI2)	☐	☐	☐	☐
More in-depth presentation of the Learn, Innovate, Improve (LI2) process	☐	☐	☐	☐
Detailed example of how LI2 was used to develop and refine a curriculum as part of a formative evaluation	☐	☐	☐	☐
Using data to identify a problem with the implementation process (LEARN stage of LI2)	☐	☐	☐	☐
Creating a roadmap for change around the problem identified in the LEARN stage	☐	☐	☐	☐
Innovating and consulting extant literature to identify solutions to problems (INNOVATE stage of LI2)	☐	☐	☐	☐
Creating measures of process, collecting data, and analyzing those data to identify promising innovative solutions (IMPROVE stage of LI2)	☐	☐	☐	☐
Disseminating lessons learned from improvement efforts	☐	☐	☐	☐
Documenting readiness for ”Evaluate” stage	☐	☐	☐	☐
EVALUATE
Planning and implementing a pilot study
Measuring aspects of implementation and outcomes in logic model	☐	☐	☐	☐
Developing and piloting surveys	☐	☐	☐	☐
Developing tracking systems to monitor enrollment and participation	☐	☐	☐	☐
Developing qualitative data collection tools such as observational tools, focus group or interview protocols	☐	☐	☐	☐
Navigating the Institutional Review Board (IRB) approval process	☐	☐	☐	☐
Obtaining parental consent and youth assent for data collection associated with the evaluation	☐	☐	☐	☐
Analyzing program implementation, outputs, and/or outcomes data	☐	☐	☐	☐
Comparing program implementation across settings	☐	☐	☐	☐
Conducting and disseminating findings from pre-post analyses	☐	☐	☐	☐
Planning an impact evaluation
Assessing feasibility of an impact evaluation	☐	☐	☐	☐
Designing an impact evaluation (randomized controlled trial or quasi-experimental design)	☐	☐	☐	☐
Selecting an evaluator for an impact evaluation	☐	☐	☐	☐
Developing clear and realistic research questions for an impact evaluation	☐	☐	☐	☐
Incorporating stakeholder voice in the design of an impact evaluation	☐	☐	☐	☐
ADDITIONAL TOPICS
Developing an ongoing communication and dissemination plan to raise awareness among youth, families, and key stakeholders	☐	☐	☐	☐
Conducting a network analysis	☐	☐	☐	☐
Conducting a systems level evaluation	☐	☐	☐	☐
Conducting a components analysis	☐	☐	☐	☐
Conducting an economic analysis	☐	☐	☐	☐

Other topics of interest

Please let us know of any data or evaluation-related topics of interest not covered above or expand upon the topics above to be more specific about what you would like help with.

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