SIRF_OMB_8_Non-grantee Use of nFORMs Program Operations Survey_clean

Instrument 8 –Non-Grantee Use of nFORM’s Program Operations Survey

SIRF will implement an intervention in one site that is not a federal Responsible Fatherhood grantee. Therefore, we are requesting burden to cover collection of responses to the Program Operations Survey entered into the nFORM, a performance measures data collection system designed for Responsible Fatherhood grantees, by staff in a non-grantee site. This Program Operations Survey is part of the full nFORM information collection request package - Healthy Marriage and Responsible Fatherhood Performance Measures and Additional Data Collection (ICR Ref #202102-0970-014).

A. Mass Marketing, Outreach, and Recruitment

A1. Which of the following types of advertising did you purchase, earn, have donated, or conduct in the current reporting period?

SELECT ALL THAT APPLY

1 □ Newspaper ads or publicity

2 □ TV spots

3 □ Billboards, including those on public transportation or at bus stops (that is, bench ads)

4 □ Radio ads or announcements

5 □ Internet ads

6 □ Social marketing (such as Facebook or Twitter)

7 □ Flyers

8 □ Presentations to external organizations

9 □ Word-of-mouth campaign/outreach by program graduates

10 □ Other

A2. Which recruitment methods did you use in the current reporting period?

SELECT ALL THAT APPLY

1 □ Phone, mail, or email

2 □ Social media (such as Facebook, blogs, or Instagram)

3 □ Street outreach (recruiting people in person in their neighborhoods or places they frequent)

4 □ Referrals from inside your organization

5 □ Referrals from external organizations

6 □ On-site recruitment at external agencies or events

7 □ Other

A3. Which agencies and organizations provided referrals in the current reporting period?

SELECT ALL THAT APPLY

1 □ Hospitals, maternity clinics, or doctors’ offices

2 □ Schools

3 □ Places of worship or faith-based community centers

4 □ Child support agencies (voluntary enrollment)

5 □ Child support agencies (court ordered to enroll in a program like this)

6 □ Employment assistance centers or one-stops

7 □ Temporary Assistance for Needy Families (TANF) offices

8 □ Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies

9 □ Head Start

10 □ Healthy Start

11 □ Child protective services (voluntary enrollment)

12 □ Child protective services (court ordered to enroll in a program like this)

13 □ Other child welfare agencies (voluntary enrollment)

14 □ Other child welfare agencies (court ordered to enroll in a program like this)

15 □ Probation and parole

16 □ Correctional facilities

17 □ External organizations

18 □ Self-referrals

19 □ Other

A4. In the current reporting period, did you conduct on-site recruitment for [PROGRAM] in any of the following?

SELECT ALL THAT APPLY

1 □ Hospitals, maternity clinics, or doctors’ offices

2 □ Schools

3 □ Places of worship or faith-based community centers

4 □ Child support agencies (voluntary enrollment)

5 □ Child support agencies (court ordered to enroll in a program like this)

6 □ Employment assistance centers or one-stops

7 □ Temporary Assistance for Needy Families (TANF) offices

8 □ Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies

9 □ Head Start

10 □ Healthy Start

11 □ Child welfare agencies/child protective services (voluntary enrollment)

12 □ Child welfare agencies/child protective services (court ordered to enroll in a program like this)

13 □ Probation and parole

14 □ Correctional facilities

15 □ External organizations

16 □ Self-referrals

17 □ Other

A5. On average, how many full-time and part-time staff worked for your Healthy Marriage or Responsible Fatherhood grant program (exclusive of their other responsibilities at your organization) on the first day of the current reporting period? (NOTE: please include all staff who are funded in whole or in part by this grant, including primary and partner sites; 35 or more hours per week = full-time; fewer than 35 hours per week = part-time.)

| | | | number of staff funded full-time by grant

| | | | number of staff funded part-time by grant

A6. How many full-time and part-time staff ended their employment for your grant program during the current reporting period? (NOTE: please include staff who are funded in whole or in part by this grant, including primary and partner sites; 35 or more hours per week = full-time; fewer than 35 hours per week = part-time.)

| | | | number of staff funded full-time by grant who left

| | | | number of staff funded part-time by grant who left

A7. How many full-time and part-time people began working for your grant program during the current reporting period? (NOTE: please include staff who are funded in whole or in part by this grant, including primary and partner sites; 35 or more hours per week = full-time; fewer than 35 hours per week = part-time)

| | | | number of staff funded full-time by grant who started

| | | | number of staff funded part-time by grant who started

A8. How many full-time equivalents (FTEs) were dedicated to recruitment in the current reporting period, where each FTE equals 35 or more hours per week in staff time dedicated to recruitment?

SELECT ONE ONLY

1  < 1 FTE

2  1 to 1.9 FTEs

3  2 to 2.9 FTEs

4  3 to 3.9 FTEs

5  4 to 4.9 FTEs

6  5 or more FTEs

B. Staff Characteristics

B1a. What proportion of your facilitators have received, as their highest degree…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. A high school diploma or less?	1 	2 	3 	4 	5 
b. An associate’s degree?	1 	2 	3 	4 	5 
c. A bachelor’s degree?	1 	2 	3 	4 	5 
d. A master’s or doctorate degree?	1 	2 	3 	4 	5 

B1b. What proportion of your case management staff have received, as their highest degree…

na  Do not have case management staff

[SOFT CHECK: IF CASE MANAGER DEGREE = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. A high school diploma or less?	1 	2 	3 	4 	5 
b. An associate’s degree?	1 	2 	3 	4 	5 
c. A bachelor’s degree?	1 	2 	3 	4 	5 
d. A master’s or doctorate degree?	1 	2 	3 	4 	5 

B1c. What proportion of your employment specialists have received, as their highest degree…

na  Do not have employment specialists

[SOFT CHECK: IF EMPLOYMENT SPECIALIST DEGREE = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. A high school diploma or less?	1 	2 	3 	4 	5 
b. An associate’s degree?	1 	2 	3 	4 	5 
c. A bachelor’s degree?	1 	2 	3 	4 	5 
d. A master’s or doctorate degree?	1 	2 	3 	4 	5 

B1d. What proportion of your managerial/supervisory staff have received, as their highest degree…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. A high school diploma or less?	1 	2 	3 	4 	5 
b. An associate’s degree?	1 	2 	3 	4 	5 
c. A bachelor’s degree?	1 	2 	3 	4 	5 
d. A master’s or doctorate degree?	1 	2 	3 	4 	5 

B1e. What proportion of your other staff have received, as their highest degree…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. A high school diploma or less?	1 	2 	3 	4 	5 
b. An associate’s degree?	1 	2 	3 	4 	5 
c. A bachelor’s degree?	1 	2 	3 	4 	5 
d. A master’s or doctorate degree?	1 	2 	3 	4 	5 

B2a. What proportion of your facilitators have…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Less than 2 years in this role?	1 	2 	3 	4 	5 
b. At least 2 years but less than 5 years in this role?	1 	2 	3 	4 	5 
c. At least 5 years but less than 10 years in this role?	1 	2 	3 	4 	5 
d. 10 or more years in this role?	1 	2 	3 	4 	5 

B2b. What proportion of your case management staff have…

na  Do not have case management staff

[SOFT CHECK: IF CASE MANAGER YEARS = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Less than 2 years in this role?	1 	2 	3 	4 	5 
b. At least 2 years but less than 5 years in this role?	1 	2 	3 	4 	5 
c. At least 5 years but less than 10 years in this role?	1 	2 	3 	4 	5 
d. 10 or more years in this role?	1 	2 	3 	4 	5 

B2c. What proportion of your employment specialists have…

na  Do not have employment specialists

[SOFT CHECK: IF EMPLOYMENT SPECIALIST YEARS = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Less than 2 years in this role?	1 	2 	3 	4 	5 
b. At least 2 years but less than 5 years in this role?	1 	2 	3 	4 	5 
c. At least 5 years but less than 10 years in this role?	1 	2 	3 	4 	5 
d. 10 or more years in this role?	1 	2 	3 	4 	5 

B2d. What proportion of your managerial/supervisory staff have…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Less than 2 years in this role?	1 	2 	3 	4 	5 
b. At least 2 years but less than 5 years in this role?	1 	2 	3 	4 	5 
c. At least 5 years but less than 10 years in this role?	1 	2 	3 	4 	5 
d. 10 or more years in this role?	1 	2 	3 	4 	5 

B3a. What proportion of your facilitators are…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Male	1 	2 	3 	4 	5 
b. Female	1 	2 	3 	4 	5 
c. Other gender	1 	2 	3 	4 	5 

B3b. What proportion of your case managers are…

na  Do not have case management staff

[SOFT CHECK: IF CASE MANAGER GENDER = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Male	1 	2 	3 	4 	5 
b. Female	1 	2 	3 	4 	5 
c. Other gender	1 	2 	3 	4 	5 

B3c. What proportion of your employment specialists are…

na  Do not have employment specialists

[SOFT CHECK: IF EMPLOYEMENT SPECIALIST GENDER = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Male	1 	2 	3 	4 	5 
b. Female	1 	2 	3 	4 	5 
c. Other gender	1 	2 	3 	4 	5 

B3d. What proportion of your managerial/supervisory staff are…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Male	1 	2 	3 	4 	5 
b. Female	1 	2 	3 	4 	5 
c. Other gender	1 	2 	3 	4 	5 

B4a. What proportion of your facilitators are…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Hispanic or Latino	1 	2 	3 	4 	5 
b. Not Hispanic or Latino	1 	2 	3 	4 	5 

B4b. What proportion of your case managers are…

na  Do not have case management staff

[SOFT CHECK: IF CASE MANAGER ETHNICITY = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Hispanic or Latino	1 	2 	3 	4 	5 
b. Not Hispanic or Latino	1 	2 	3 	4 	5 

B4c. What proportion of your employment specialists are…

na  Do not have employment specialists

[SOFT CHECK: IF EMPLOYMENT SPECIALIST ETHNICITY = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. Hispanic or Latino	1 	2 	3 	4 	5 
b. Not Hispanic or Latino	1 	2 	3 	4 	5 

B4d. What proportion of your managerial/supervisory staff are…

	SELECT ONE RESPONSE PER ROW
	None	Fewer than half	Half	More than half	All
a. Hispanic or Latino	1 	2 	3 	4 	5 
b. Not Hispanic or Latino	1 	2 	3 	4 	5 

B5a. What proportion of your facilitators are…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. American Indian or Alaska Native	1 	2 	3 	4 	5 
b. Asian	1 	2 	3 	4 	5 
c. Black or African American	1 	2 	3 	4 	5 
d. Native Hawaiian or other Pacific Islander	1 	2 	3 	4 	5 
e. White	1 	2 	3 	4 	5 
f. Other race	1 	2 	3 	4 	5 
g. More than one race	1 	2 	3 	4 	5 

B5b. What proportion of your case managers are…

na  Do not have case management staff

[SOFT CHECK: IF CASE MANAGER RACE = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. American Indian or Alaska Native	1 	2 	3 	4 	5 
b. Asian	1 	2 	3 	4 	5 
c. Black or African American	1 	2 	3 	4 	5 
d. Native Hawaiian or other Pacific Islander	1 	2 	3 	4 	5 
e. White	1 	2 	3 	4 	5 
f. Other race	1 	2 	3 	4 	5 
g. More than one race	1 	2 	3 	4 	5 

B5c. What proportion of your employment specialists are…

na  Do not have employment specialists

[SOFT CHECK: IF EMPLOYMENT SPECIALIST RACE = NA; DISABLE OTHER OPTIONS.]

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. American Indian or Alaska Native	1 	2 	3 	4 	5 
b. Asian	1 	2 	3 	4 	5 
c. Black or African American	1 	2 	3 	4 	5 
d. Native Hawaiian or other Pacific Islander	1 	2 	3 	4 	5 
e. White	1 	2 	3 	4 	5 
f. Other race	1 	2 	3 	4 	5 
g. More than one race	1 	2 	3 	4 	5 

B5d. What proportion of your managerial/supervisory staff are…

	SELECT ONE RESPONSE PER ROW
	None	Less than half	Half	More than half	All
a. American Indian or Alaska Native	1 	2 	3 	4 	5 
b. Asian	1 	2 	3 	4 	5 
c. Black or African American	1 	2 	3 	4 	5 
d. Native Hawaiian or other Pacific Islander	1 	2 	3 	4 	5 
e. White	1 	2 	3 	4 	5 
f. Other race	1 	2 	3 	4 	5 
g. More than one race	1 	2 	3 	4 	5 

C. Quality Assurance and Monitoring

C1. In the current reporting period, did the following staff receive their initial training on the program curriculum(a)?

		SELECT ONE RESPONSE PER ROW
	Yes		No	Do not have this position on staff
a. Facilitators	1 		0 	na 
b. Case managers	1 		0 	na 
c. Employment specialists	1 		0 	na 
d. Supervisors	1 		0 	na 
e. Program managers	1 		0 	na 
f. Other program staff (please specify)	1 		0 	na 

C2. In the current reporting period, did the following staff receive follow-up or refresher training on the program curriculum(a)?

		SELECT ONE RESPONSE PER ROW
	Yes		No	Do not have this position on staff
a. Facilitators	1 		0 	na 
b. Case managers	1 		0 	na 
c. Employment specialists	1 		0 	na 
d. Supervisors	1 		0 	na 
e. Program managers	1 		0 	na 
f. Other program staff (please specify)	1 		0 	na 

C3. In the current reporting period, did the following staff receive training other than on the program curriculum(a)?

		SELECT ONE RESPONSE PER ROW
	Yes		No	Do not have this position on staff
a. Facilitators	1 		0 	na 
b. Case managers	1 		0 	na 
c. Employment specialists	1 		0 	na 
d. Supervisors	1 		0 	na 
e. Program managers	1 		0 	na 
f. Other program staff (please specify)	1 		0 	na 

C4. For the two types of facilitators shown below, were they observed by a supervisor or another experienced facilitator in the current reporting period?

		SELECT ONE RESPONSE PER ROW
	Yes		No
a. Facilitators hired in the reporting period	1 		0 
b. Experienced facilitators	1 		0 

C5. In the current reporting period, on average, how often did the following staff meet with their supervisors one-on-one?

	SELECT ONE RESPONSE PER ROW
	At least weekly	Biweekly	Monthly	Once	Not in reporting period	Do not have this position on staff
a. Facilitators	1 	2 	3 	4 	5 	na 
b. Case managers	1 	2 	3 	4 	5 	na 
c. Employment specialists	1 	2 	3 	4 	5 	na 
d. Supervisors	1 	2 	3 	4 	5 	na 
e. Program managers	1 	2 	3 	4 	5 	na 
f. Other program staff (please specify)	1 	2 	3 	4 	5 	na 

C6. In the current reporting period, how often were staff meetings held (such as discussions about continuous quality improvement and team-building meetings) that included the following staff?

	SELECT ONE RESPONSE PER ROW
	At least weekly	Biweekly	Monthly	Once	Not in reporting period	Do not have this position on staff
a. Facilitators	1 	2 	3 	4 	5 	na 
b. Case managers	1 	2 	3 	4 	5 	na 
c. Employment specialists	1 	2 	3 	4 	5 	na 
d. Supervisors	1 	2 	3 	4 	5 	na 
e. Program managers	1 	2 	3 	4 	5 	na 
f. Other program staff (please specify)	1 	2 	3 	4 	5 	na 

D. Implementation Challenges

D1. Please indicate how much of a problem each of the following has been in the current reporting period.

		SELECT ONE RESPONSE PER ROW
	Not a problem		Somewhat of a problem	A serious problem
a. Obtaining referrals from external organizations	1 		2 	3 
b. Recruiting participants	1 		2 	3 
c. Enrolling the intended target population	1 		2 	3 
d. Getting enrollees to start participating in services	1 		2 	3 
e. Getting enrollees to attend regularly	1 		2 	3 
f. Keeping participants engaged during sessions	1 		2 	3 
g. Getting enrollees to complete the program	1 		2 	3 
h. Recruiting qualified staff	1 		2 	3 
i. Maintaining staff performance	1 		2 	3 
j. Ensuring facilitators understand content	1 		2 	3 
k. Covering all program content in the time allotted	1 		2 	3 
l. Implementing curriculum with fidelity	1 		2 	3 
m. Having adequate program facilities	1 		2 	3 
n. Cooperation of recruitment and referral sources	1 		2 	3 
o. Working with service delivery partners	1 		2 	3 
p. Experiencing extreme weather or natural disasters	1 		2 	3 
q. Getting participants to complete pre-test or post-test	1 		2 	3 
r. Retaining staff	1 		2 	3 
s. Filling open staff positions	1 		2 	3 
t. Providing comprehensive case management services	1 		2 	3 
u. Providing grant-funded participation supports	1 		2 	3 
v. Entering and reporting data	1 		2 	3 

Thank you for completing this survey!