SIRF_OMB_3_Reflections from Fathers_update_clean

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! [Organization name] 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; no one associated with [Organization name] or SIRF will know how you responded. Providing your feedback is your choice. There is no penalty for not answering these questions. You may skip any question or stop the survey at any time.

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]
The first set of questions will only be asked of the fathers in the outreach cluster. They will be sent about 1 week after program enrollment.
Recruit	How did you hear about [name the program]? Select one.	Family, friend, or associate [move to 4. impression] Social media [move to 4. impression] Flyer or billboard [move to 4. impression] Radio or TV [move to 4. impression] Another organization [move to 4. impression] An event in the community [move to 4. impression] Something else [move to 3. Recruit_other] Don’t know [move to 4. impression]
Recruit_other	How did you hear about [name the program]?	[short form response] [move to 4. Impression]
Impression	What were your first impressions of [name the program] after your first interaction with staff?	[short form response] [move to 5. Enroll_reason]
Enroll_reason	What were your main reasons for enrolling in [name the program]? Select all that apply.	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 Don’t know [move to exit_responder]
The series of questions that come next will be asked of fathers enrolled in all sites; the timing of these questions for the outreach cluster will be a couple weeks after the first set of survey questions. The timing of delivery for the other clusters will be dependent on the length of their workshop period.
participated	Have you attended any services from [name the program] since [timeframe]? Select one.	Yes, in person [skip to 16. attendance] Yes, online [skip to 16. attendance] Yes, both in person and online [skip to 16. attendance] no [move to 7. reason_no_attend] Don’t know [move to exit_responder]
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 8. difficult] No longer interested in services [skip to 12. not_interested] Forgot [skip to exit_responder] Something else [skip to 15. other_reason] Don’t know [skip to exit_responder]
Difficult	What was the main reason it was difficult to attend? Select one.	Not convenient time or location [skip to 9. not_convenient] Issue with computer or internet access [skip to Exit_responder] Personal/family issues [skip to 10. personal_issues] Something else [skip to 11. difficult_text] Don’t know [skip to exit_responder]
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 Don’t know [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 Don’t know [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 13. not_like] I have another reason for not being interested [move to Exit_responder] Don’t know [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] Don’t know [move to exit_responder]
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]? This could include a case worker, facilitator, mentor, or other staff member over the phone, on video, or in person. Select one.	1 or 2 times 3 to 5 times 6 times or more Don’t know [move to 17. mode]
Mode	What was your primary mode of contact with someone from [PROGRAM]?	in-person by phone by video by text message DK Don’t know Move to [18.Challenge_part]
Challenge_part	Do you ever find it challenging to attend services offered by [name the program]? This could include over the phone, on video, or in person.	Yes [move to 19. Main_challenge] No [skip to 23. support_goals] Don’t know [skip to 23. support_goals]
Main_challenge	What are the main challenges you have to attend services offered by [name the program]? Select all that apply.	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 23. support_goals] Don’t know [skip to 23. support_goals] Fathers will be asked follow-up questions, as shown in the brackets, based on the responses they indicate on this screen.
personal_issues2	What type of personal or family issue? Select all that apply.	Lack of childcare Living situation Legal or law enforcement issues Conflict with child’s other parent Something else Don’t know Move to [23. support goals]
not_convenient2	What specifically made it inconvenient? Select all that apply.	Work scheduling conflict Other scheduling conflict Not easy to get to/transportation Something else Don’t know Move to [23. support goals]
Motivation	What could help you be more motivated? Select all that apply.	Different program topics Fewer program hassles Different staff Different program format (such as classes at a different time or classes offered virtually or in-person) Something else Don’t know Move to [23. 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 26. most_useful] No [move to 24. support_needed] Don’t know [move to 25. relationships]
support_needed	What additional support do you need to reach your goals?	[short free-form response] [move to 25. relationships]
relationships	How much do you agree or disagree with the following statement: I have built good and trusting relationships with [PROGRAM] staff.	Strongly disagree Disagree Neither disagree nor agree Agree Strongly agree Don’t know [move to 26. 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 Don’t know [move to Exit_responder]
Exit_responder	Thank you for responding! Please click the right arrow to submit your responses. Your input will help [name the program] to improve! [move to exit_no_consent]
Exit_no_consent	Thanks for your time. We wish you all the best on your fatherhood journey.